HomeMy WebLinkAbout10915 (5)CITY OF DIAMOND BAR ' • `
COti1M17UN[TY DEVELOPMENT DEPARTMENT '
21660 E.Copley Drive Suite 190
909)860 3195 Fax(909)861 3117 ' " ' • PR ESS
BUILDING PER1111TAPPLICATION j FIRMLY
JOBSITE . if APPLICATION.p PERMIT PIC
ADDRESS K N J " DATE-_ NUMBER„#
c ISSUE TYPE OCC,
APN LOT TRACT DATE CONST GROUP. '
p OWNER ,j O o
p ADDRESS S ZONING SETBACKS
z CITY ZIP ELi
FFONT RW 0 ' .
APPLI -, TEL. REAR p
SIDE/SI E STREET RW O
CONTRACTOR t SIpE p
ADDRESS /!z
PROPOSED USE_Fc
MsV( (j.i ao p S H F<<'C— -
cirv T° IP a l r TEL. t. V O a p.w ARC t-t
1
w DESIGNER NO.DWEL.
a ADDflESS UNITS -- STORIES BEDROOMS
CITY ZIP TEL.
u OESCRIPTION SQ.FT. FACTOR PSF " ADJ.AREANALUATION
p OWN[R•6CILDER DECLARATION . .. . . ._
SFR/ADD/REM
O
p 1 HENEBY AFFIAM UNDER PENALTY OF PERNRY iNAT 1 AM E%EMVT FROM iHE CONTMC70R5 LI Ga12gpJC3fppA -
W CENSEUWFORTMEFOILOWINGREA50N(SEC.7oI1.68U51NES5ANDPROFE5510NSCODEANYCIT'Oq (n
U COUN YWNIp1RE0UIRE5 PERM 7TOCANSTRUC7,ALTER PROVE,DEMOLISH,ORREPARiAYYSTAUG W 'Pyt10/DOCkNRE.PRIOR TO RS ISSUANCE.ILLSO RECUIFES THE APPLIGWT FOA SUCN PEPMR TO FILE A SICNEDw
STATEMFM TMA7 ME OR SME IS 110EN5ED VVflSUMli TO THE PflOV1510N5 OF TNE LONTMCTOFS LI•
W
S, CENSE UN(CNAOTER Y(COMMENCING N'ITN 5[CTION 7000)OF UINSiON 70F THE Bt151NE55 AND PqO l" PoaUSpa
FESSIONSCOOE)OR7HATHEORSH[ISEXENP7T1/EREFROMAIiO7NEBA515FORTNEAILEGEDEXEA P• (
V TION.ANYNOI,ATIONOFSECTION7071.SBYANVAPPLICANTFORAPEHMIiSUBJECfSTMEAPPLIGWTTp '• Z Re Roof
r A CML OENALTV OF 1qT MORE THAN ME HUNDRfD DttURS(f5o0).:
Z
4ASOWNEROFTHEPROPERT/.ONMYEMPLOYEESWfTMWAGESASiMEIH50LECOMPEN5 ITION, Commercial
WtLL DO TME WORK,AND THE S7RUCIURE IS NOT IMENOED OH OFFERED FOR SALE(SEC.7ou,BU51- J
NESSAND VROFESSIONS COOE:TME CANTfiALTORS LIGENSE LAW OES NOT APPLY TO AN OWNER OF ? . '
PHOPERiYVrFiO8UM1D30RIMPROVESTHEHEON,MIDriHODOESSUCHWORKHIMSEIFORHERSELFOR
7HRWGHMISORHEROWNE4 GLOYEE5,7ROVIpEDTNATSUCNINDqOVE lENTS RENOTWTENOEDOR m
OOFFEREDFORSALEIF,FIOWEYEiL1MEBUILD NGORIMVROVEMENTI550lDWITMINONEYEAROFCOMPIE-
Z TION.THE OwNER-BURDER MALL FIAVE THE BUIiDFN OF VROViN THAT NE OR SHE DtD NOT BUIID ORIMPROVEFORTXEPURPOSEOFSIE.
w - OIASOYMEAOFTHE0R07ERN,AMEXCLUSNELYCOMMCTINON7THLICENSEDCONiMCTOflS
Q TO CONSTRUCT THE PRQIECT(SEG 70t0.BUSINE55 MO ROFESSIONS LODE:TME CONiMCTOfiS L4 VdAldliOf7 A0.1.AREA -
W CENSEUWDOCSNOTAPPLYTOANOWNEflOFAPR07ERTYWFqBUILD50RIMPROVESTHEREON.,WD
VMOCONTMCTSFOFSUCHGRQIECTSW THACONT0.4CTOR(5)UCENSEOPURSUMrtTOTHGCOMMG QUANTITY DESCRIPTIO.V ' - FEE
Y TORSUCENSEUri.).
OIAMEXEMPTUNDERSEC. 8.8P.C.FOFTHISIiLA50N Q
U
DATE OWNER
O W
F LICENSED CONTRACTORS DECLARATION W
IHEREBYAFflHMVNDERPENA TYOfPEFWRYTHATIAMLICENSEDUNDERPROVISIONSOF HACTER• .
d Y(C06 A1[NCWGWRNSECTION7000)OFDM510N OFTHEBUSINESSANf)7ROFESSIONSCODE,AN z
X MY UCENSE IS W FULL FOflCE AND FFFELT.
Q
IICENSE CUSS LIC.N0. __A_I
Z
V OATE ^_CONTMCTORV h1L1 k a6 p,
W TTl
WORKEFiS'COMPENSATION OECLARATION a
IMEREBVAFFIRMUNDERPENALTYOFDEiWRVONEOFTHEfOLLOW:NCOECURA710N5: Z
IHAYEANDYALLMAPiTAINACERTIFICATEOFCONSENTTOSELFdNSUflEFOflMRMKERS'
COMPENSATIpN,ASPROMOEDBY5EC710NJ7ooOF1HEUBORC00E,FORTHEPEHFORMANCE WOFTNEWMKFORWHICHTHISPERMITISISSUEO.
Q
INAVEANDWILLMAMTAINWORKERS'COMPENSATIONINSUWWCE.ASPEOVIREDBYSEGT ON
Q 7000FTHELIBORCODE.FORIHEPERFORMANCEOFTNEWORKFORNM1IICHTHISPEPoNITIS
ISSUED.4YWOtU(ENS'CONPENSAT 45U,RANCECARR:ERAN POLICVNUM ERIWE: CONSTRUCTION I Q
fT TCAFRIER N PLAN REVIEW
POLICY NUMDER_L!n 7_Q_3 ELECTRIC
zd T 7
0 (M1iS5EC110NNCm+OTBECCYnPLETmOFT1EPER.if6iOR0'EHfDAEDOLYIARS(i OC10RLE5S1 PLUMBING ...
Z 1 CERTIFYTHRT N THE VERFOPM0.4CE OF iNE N'ORK FOIi WMIOI THIS ERMIT 6155I1E,I MECHANICAL
LJ' . SWLLLNOTEMPLOYANYPERSONINANY MANNERSOASTOBECOIJESUBJEGTiOTHE
y WORKERS'LOAIPENSATpNL1W50FCALIFORNIA,ANDAGFEETMATIFISMOULDBFCOME INSPEGTIONFEE ' ' '- '- '
SU&IEGT TO i}IE WOfiKERS'CAMPENSATqN PRONSIONS OF SECTION 700 OF TME UBOR
CODE,1 HALLFORiM41THCONP VW11HiHOSEPROVI5lON5. SSUANCE I
O rlf
1p
DATE: 0 Q APPLICANT: SMIP . .. . . J'
WAFNING:FAI f'f SECURESMDRNERS'COMPENSATIONCAVERAGEISUNUWFULANDSHALLBE ENERGYP/C -
SUB.7EGTAN 4PlOYERTOCRIMINALPENALTIESIWOqVILFWE5l17TOONEMUN RED7FICU5AND ENERGYPERMI7DOLURS(Si00,000,WAD01T10NTOTMECOSTOFfAMPENSATION,DAMAGESASOROYiDEDFORIN
SECT ON 770t OF iHE LABOH CODE,WTFREST,NO ATTU{UIEY'$FEES. "
RETENTION FEE:
OCONSTRUCTION LENDING AGENCY PRE•ALT FEE: _ji)y.py
IMEFEBYAiFIqMUN ERPENAL7YOFPERNHYTH/.TiMEREISACONSTRUCTIIXJLENDINCACENCY
u
l/J• '
fOqTHE VERFORMAHGE OF THE WOF7K FOR WHICH THIS VERMIT IS ISSUED(SEG 7097,CN.C.).
ZW LENDER'SNAME
LENDEKSl OHE55
W TOTAL FEES 7'd.S-ICERTIFYiHATINAYERE147THI5APVLMATIONANOSTATETM TTXE BOVEWFORM TqNISCARR[CT.
I CFEE TO COMPLY WITH ALLCfTV AND COUNTY ORDINANCES I ND STATE UwS PELATING iO BUILDWC
CONSTRIICTION,ANDNERE6YAl7T qRIZEflEPRESENTATNE50FTNI5CIXINT'/TOENTEflUPONTME
Z
ABOVE MENtIONEDPROPERTYFORINSPEC'ONPUAPOSES.
COMA7ENTS i
0J
m FERM E j
rt 9//
n SIGN TU L7 T1M E . I ./
RECPT.N0. 2 PAID 8Y VALIOATION
WHITE-0epartment Copy.YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD--Filo Copy.GREEN—Applicant's Copy . . .
4.. - . . .... :. ..
CITY.OF DIAMOND BAR. . . ' `
INSPECTION RECORD ,' , .
SET BACK FLOOR JOIST
FTGS/FORMS/STEEL _ __ _ FHA REQMTS
ELECTRIC GROUND UNDER FLOOR QUCrti::":r' r• `
GROUND PLUMBING UNDER FL A`CCJNDU{Tt i
SLAB GRADE - FIREPLACE FOUNDATION . ' , ' '
TEMP POWER _ ,--... _FIREPLACE BOND BEAM` `-' : '• <., )•.4:!
WATERSERVI E - MIDHT.BOND;BEAM. •-: ..•,,-:'' `' '
ROOF SHEATNING ` 8 FT. BOND BEAM
FRAMINGNENTILIATION ; FINAL BOND BEAM
ROOF COVER - / ?PRE-GRADING .
ROUGH HEATING BENCHING
FiOUGH ELECTRIC- ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWERlf"UB TEST POOL ELECTRIC
EXT.LATH/SIDING 7.;, - POOL FENCING
WALL INSULATION POOL FINAL
CEI ING INSULATION OFF SITE IMPS.
ORYWALL NAILING DEDICATIONS
SEWER.... _.. FINAL ENG.
SEPTICTANK LANDSCAPE/1RRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST - - FINAL ZONING
FINAL CONST. - FIRE DEPT.FINAL
FINAL HEATWG -H ALTH DEPT.FINAL
FINAL ELECTRIC DEV.FEES PAID
FINAL PLUMBING EhlERGV
1 i c
c- ` t`•,. . .
GOMMENTS -- _ . __ .
r
t; ; ;ti
1 ; o .S:, •`.,,
i
1 ' .
l , y;,
SEPTIC TANK SIZE - "
SEEP PIT/U SIZE ' f1 : .'r•
t'..
1 ' 1 L• .;s..
t;- . j 77 7,- .. '