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HomeMy WebLinkAbout10637 (5) --. _.. ---.._. . __ . ,.. . ._ .. .__... _. .. . . .. _ . . .._ . ...._..... ._ .. � . CITY OF DIAMOND BAR / COMMUNITY DEVELOPMENT DEPARTMENT ,,.c z�66o�.cop��y n���so�c�i90 PRESS (909)8643193 Fax(909)861•311� '°''� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION PERMIT P/C A ADDRESS 1�'IU vh�-�'� 1�15T�t DR �-�5!? DATE NUMBER/O�� 1t � ISSUE lYPE pCC � � APN LOT TRACT DATE CONST. GRDUP � OWNER M��► /CK � ADDRESS SQa0) 5. TEI� A'JE �F LD� 20NING SET9ACKS CffY �OL�l1AE.�-C.�� ZIP L' �D TEL.�?i�Zd-1-?-44� FRONT RW ❑ APPUCANT W f�1F=TL I�llE3�E]-1 TEL.?� "1 iA_77 r t„ REAR ❑ Z SIDFJSIDE STREET RW ❑ � CONTRACTOR SIpE ❑ ADDpESS - ` � PROPOSEDUSE_ C�kK4..�G'-(A'L D C.� � �(gSjQ-'S.�• Q R H/ENGIMA'1`�tu�,v� ZIP aU� TEL.S����3 -7�t33 �i. 4t��.lt±� P.z� n�-'l�.. .t± t"k-�MISi�.t4 ustt 1 �— � DESIGNER �?Of�_/kA-�-'� S��lLCk3 � � j R`���' ADDRESS D 2 14�P.fi'-I.I�A /c�� Z-l(r ro0.DWEL NO. NO. � CITY��y�"L P�L�f�_� _ ZIP � �I, TEL��(Q,��(� UNlTS STOR�ES BE�ROOMS �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BI:ILDER DECLARATION SFRlA00?iEM p 1 IffREBY AFFIRM UJDER PENAl7'/OF PFRJURV THAT I AM EXEMPT FROM iHE CONTMC7WIS LI- G8f909K'.91pOf1 - LIl CENSEUWFORTHEFOLLOWW�NEA50N(SEC.7n31.iWSINES3ANDPROFESSION9CODE:ANYCITYDR (J� � COUNTVN4tlpIREOUIRESAPERMiTTOCONSTHUCT.ALTE7i,1MPROVE,DB.WLISH,ORREP/.IRM1YSTqUC- W p�NOJDYd( V 7UqE,PRIDR TO RS ISSVANCE,ALSO REW�RES THE APPIICAN7 FOR SUqI PEAMIT TO FlLE 11 SIGNED w STATEAIEM THAT MG OR SHE I6 UCENSED PURSUANT TO TNE DROVISIONS OF TME CONTqACTQii4 LI- � GENSE LAW(ChUPTER�(COMMENCINO WITHlEGTION 7000)OF�IVISqN 7 0F TNE 0U31NE5S 1WD PR0- u' POOVSp� FESSIONS OODE)di Tf1�7 HE OR SNE IS EXEAIDT7HEREFpOM AND TNE BASIS FON TFIE ALlEOED FXENP• TION.ANYVqLAT10NOF8ECTIOH7W1.6BVANYMPLICANTFORAVERMITSU8JEL76THEMPLICMITTO Z Re-Roo1 r A CML OENAITY OF NOT RWRE TW W FlVE HUNDNED DOLLMS(!5W 1.7: � ❑4�4�'NNEROFTNEPROPERTV,ORMYEMPLOVEESWITNWAOES�STNEIRSOLECOMPEf�44ATI0N, � Commucial WILL 00 TNE WOqK.MIO THE STRUGTUAE IS NOT IMEPOED OR OFFERED FOR SILLE(BEC.7W1.lU51• J NE55 ANO PROFESSION6 CODE:THE CONTMCTDRS LICENSE UW OOES NOT APPLY i0 HJ ONMER OF � PiIOPERTYYYIiOBUILO30RM/PROVE5IHEREON,ANDWHODOESEUCNWOHKNIMSEIFORHERSELFOR = � iMqOupNMSORNEiiOWNFMVLOYEES,PpOVIDEDTMA78l1CF11M�ROVEMEMBARENOTWTENDEDOR m � OFFEREDPoRBALEIF,MqWEYER7MEDURDINfJORWIPROVEMENfISSOLLWITWNONEYEAROFCOMPIE- � TIdJ,1ME OWNENSUIIDER WILL N�VE TNE BURDEN OF PROVNO THA7 ME OR SHE pID NOT BU40 OR IMPROVE FOH iNE PUPPOSE OF SAI.E). ❑I,AS ONMER OF THE PROPERTY,/JI E%CIUSIVELY O�N7MCTM0 WITFI LIGENSE�CONTNAGTORS �/� � i0 CONSTRl1C7 THE PROJEC7(6EC.70/�,BUSINESS M1D PqOFESSIONS CODE:THE OONTMCTOi18 LI• VHIUBI V{/Y• O�U ApJ.AREA CENSE UlW OOES NOT APPLY TD AN OWNEN OF A PROPERTY MMO BUILDS OR IMPROVES THEREON.AND Z WFqCONTRACT6iOR9tIG1PROJECT6NnTHACONTRACTOR(B)IICENSEDPl1R6UIMTOTHECONTMC- OUANTITY DESCRIPTION FEE � TqiSIIGENSE UW.� p ❑I NA EXEMFT UNDER BEC. B.�P.G fOR TNIS NEASON U 3 ¢ u' DATE 01^MER f' . Z W � UCENSED CONTRACTORS OECLAAATION W � �HEREBY AFFIRM UNDEN PENAL7Y OF PERlUHY 7HAT 1 AM LICEN6E0 UNDER PROVISIONS Of CHAPTER � , d �(OOMMENCINO NATM$EGTION 70W�OF OIVISqN 9 OF THE BUSINESS MI�PqOFES$qN3 DODE,11ND Z X MY LICENSE IS MI FULL FORC6 M1D EFFECT. m � UCENSE CU�,S)S �Y, IIC.NO. ` v���� � V OATE ��r�"l CONiMCTOR �MIdJILSO7t�SCN � LG • a� WORICERS'COMPENSA710N DECLARATION � � IMEREBYAFFIRMUNDEHPEWLLTYOF►EfiM1RYONEOFTHEPoLLOWINODECLAMilONB: Z � _111�VE ANO MIILL MNN7AIN A CEHTIFIGI7E OF CONSENT TO SELFINSURE FOq M/ORKER6' '�S COMVENSATION,AB P(�VIDED 8V SECTION 97o00F THE UBOR ODDE FOR TIIE PEHFORNANCE � Q OF TFIE WOPoC GOR MMCN TM9 PERMIT IS ISSUEO. . , �FJ �M�VE ANO WILL MAINTAW WOflKERS'COMPENSATION INSURANCE.AS qE0U1RED 8V 9ECT�ON Q8700 OF TFIE UIBOR CODE.FOR 7HE PENFORMANCE OF 7NE WOPo(POA WMlpi TM19 PERMfT IS ��/��� � I6SUEO,MYWORKFRS'C041PENSATIONI/NS�U�WJCECARRIERANDPOLICYlAlU18ERARE: TRUCTION � �. GIRRIER T� LIIJ/J P�AN REVIEW � POLICYNUMOER ELECTRIC Q o mussEcriorrr�wreeaou0.�an,Faeanrr�swaa�ti�moauasa+�a+�ss1 PLUMBING Z 1 CER7IFY TFMi MI TME PENFOFlMMICE OF TIIE W1DRK POq WNlpl iM19 iFRMIT IS ISSUfD,1 MECHANICAL �� ('f SHAIL NOT EMPLOV ANY PERSON N ANV MMINEH 90 AS TO BECOME SU&IECT 70 iHE �.�� � WORKERS'C011PEN9AilONLAWSOFCALIFORMAANDA(iREE7MATIi15HOUlABECOYE INSPECTIONFE S BUBJECTTOTHEVYORKER3'COMPEN9ATqNPiiOVI510NSO,5ECT10N17000FTNELNlON CdOE,1 BHALL FORTXVATM CddPW WITH T 5 PRpV S 5. ISSUANCE o ,P �.� . s-. y p OA7E: C��� APPLICANT: L� , . . � ENER6Y P/C � � WARNINO:FARURE TO SECUHE WtMNERS'COMPEHSATION RAfiE IS UNIAWFUL.ANO SHALL BE � SUBJELTINEMPIAYERTOCRIMINALVENAL7lESMNCNILFWESUPTOONEMUNOREDSNOUSAND NERGVP T � • � OOlLAR9(1100.000�.W ACDITION TO TME CAST OF COMPBA9ATION,GAMAGES Il4 PROVIDED FOR IN /J A ' J DECTIDN�7oeOFTMELABOROODE.NITEREST,ANDA7TOHNEY'SFEES. M'IONF . _ L�•`�r Q OCONSTRUCTION LENDING AGENCV pRE-ALT FEE: � �� � 1 NEREBV AFFIqM UNOfN PENAL1Y OF PERJURV THAT THERE IS A CO�LSiRUCTqN LENDINO MiENCV PoR TNE►ERFORMiWCE OF iHE WOWC F00.YVFIIGI THIS PEqM1T IS ISSUEO(SEC.i00a7.CIY.C.�. � I LENDER'S NMIE � lEN0EN7ADORE33 ' � �� , /� /' � 1 CERTIFY TMAT I NM/E READ TMIS APPLICATqN ANp STATE h1AT iFiE AfiOVE NFOIiMAT10N IS OONRECT. T(�TAL FEES � ��� 1 S�9' S✓ � IAfiREETOCOMRYWRHALLCT'ANCCOUN7YOAC�NANCESMlOSTATEUWSREUTIN4T06UILDINO , �,� � CONSTRUCiION. ONER Y EREVRESENTA7IVESOFTNISCWN�'/TOENiERUPONTNE � C � �aove-ME non tv i vEcrae�wnPoses. COMMENTS 9 t`'..r`" („� � oEwainEE roa ,_ .+ /� % � y r"v'�.� �• lIONl�TJp PERM 'EE� _;, , •� D TE j�ECPT.NO.�1/ PAID BYl�� � VALJDATION � WHITE-0epartment Capy.YELLOW—FManca Copy,PINK—Msessor Copy,dO1.DENROD--FIIa Copy.6REEN—Appllant'e Copy .. .. .. , . ,. . . .;,., _ . � .,... . .... .. , . . . . ,. ,.. .. . . . � . , . , . . .,.. . � .,, . _ � ; � .�. - ar�r aF oi��or�a BA� , IN�PECTIOh! P.EC�RI� ' ' f E ` ► ' ' ' t � , • � . .,. SET BACK ' FLpOR JOIST ' FTGS/FORMS/STEEL -- - ------ ^� FNA REQMTS , � . , , , f , ., - ELECTRIC GROUND _� UNDER FLOC?R p: :, � �• r •,.. ;. � , • , , GROUND PLUMBING UNDER FLOOR'CC1nIbUlT ' F •'��' - •: I+'�;� � SLAB GRADE � — -�------ � -, , _ :__�I FIREP��FbL1NDA1'ION TEMP POWER ' FIREPLACE BOND BEAM � i WATEFi SERVICE �-` ' ' ' ` ' ` �` ° � I. MID HT.BUND BEAM . ROOF SHEATHING ' �� ,"• '� ' � ' `8 FT. BOND BEAM • .. FRAMINGNENTILIATION S ZG�7 _T.0__ ^--- _ ` FINAL BUND BEAM ,_, '.. ..' :,' � , � � ,• '� � ,~, ! i ;. .`-- � . ROOF COVER ' PRE- RADING� � :1 i' r ' . �.�,�i' ROUGH HEATING - -- -�---------�`` - - ---�- � � BENCHiNG --.�. l ' ROUGH ELECTRIC � !�'-2/-�7 i�g���,_ ; ROUGN GRAQING ` � I --- -___.. ----,--------- ROUGH PLUM8ING _; _ T _ � � � -----T- �-` - _„__.�_____ � FINISH ^uRADING SHOWERiI"UB TEST = __ `. P(70L ELECTRIC � ^ ;� EXT.LATH/SIDING - -j- -- -:-POOL FENCING i--- - -- ~ - �---- ? WALL INSULATION _�_� POOL FINAL CEII.ING INSULATION `i � Oi�F 51TE lMPS. `` � DRYWALL NAILING F�i•LYst7 DEDICATIONS ` � ---�-- ------- - -��-r --��- ' � SEWER^ � , FINAL ENG. ------------- .�____:_i_.__ _��_�_1___. I SEPTIC TANK 4^ �—'�T '� __�_ ` _ � LANDSCAPE/IRRiG. i + SEEP PIT/L.L. _ I! � OA�SITE IMPS. �' "-`� GAS AlR TEST �`i _:� �__ FINAI.ZONING �--- --_.----�----------i------------.__ I � FIRE DEPT, FINAL �-�-- � FINAL CONST. s fT _ _ i � — - --�---------------- ;- FINAL HEATING _ HEALTH DEPT. FINAL i � FINAL ELECTRIC ! B � DEV. FEES PAID �I �`--- � ---------- - ----------- ------- -- ----�---- ---------------------- ------f 1`� - --- =- -----�_-.___.-___ ; , •- -}- _�`, ENERGY I � FINALPLUMBING --+-- --------------------- ---------------- -- - - �-- �-- ------ � -,- -, - ------ --�--� �--------- � --- - - ----- ------------..._ ._ ..__._ .__ ,.,._..�. . �---------! I� • • � ----__�_.�_ __._____. _ ---- .-----L--� - --- COMMENTS — -�----- -�--- -�- -- --- —� �'��_�-r-_�telil'��---��'----�1�-�.�----�OorZ_—�t� '. - ------------ —� ------- � --- ---- ---- ---•----. ..-- ----- I : ---- ---------------- - ----------------- --�---- � , r4� -- --�------------- --------•--•-- ----- ----- } ,. . ,� �• ' - --. - ---- ---- __._ ------------ - ----------•-------- ----------- ---Y-- 'C.i.---- � -- SEPTIC TANK SIZE ` .� -----------�----- -- S E E P PIT/U S IZE __ --- -----------�----- ------�--------- -- - - - ----------------- -- - .._�_.. _.............._.._.. ___..._ ...,.., ._. � a �b � j . �--- -----....-------------- ---------�---------- -- --- � �- "r� - - - � t-✓"�""'� 7�.i"'���- � �— - � �����g� _ �c�--- r, - � �; �� S��d- s�� �:,,o ��J� �W�y� 1 G. �2 .—..—_^---------- ----__-- ----��-- ----..._--�- ' . , : . � --- .. , . ����—��—��z'� _ ` . � ='���: ' t6 .:/-,�'. _ .,*'c+ 1 -yr ,�,,�,y ti„ � �. .. . .. . _. . � � ---�