HomeMy WebLinkAbout1_6_03 - 3101 CRPPLED CREEL DR �� C1TY OF DIAMOND BAR - � ' DEPAR'TMENT OF COMMUNfiY 8c DEVELOPMENT SERVICES J� ;,, 21825 E.Copley Drive � PRESS (909)860-3195 Fax(909)861-3117 "''"`• BUILDINGPERMITAPPLICATION . FIRMLY N JOBSITE 3 0 00 Ct D ' L APPLIC T N PERMIT P!C o ADDRESS Dl/C�Rl�V (3/�VL� � � �7�r DATE I O NUMBER ( M c� ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER M�f��avzo "-' ADDRESS D I G DL' R ' ZONING SETBACKS � CITYD—I/�-� �ND ZIP TEL 7 , FRONT RW ❑ APPLICANT.AI/`�U�� TEL L • h�' S� REAR O � SIDE/SIDE STREEf RW O CONTRACTOR SIDE O � ADDRESS CITY ZIP TEL PROPOSED USE o ARCFUENG/ � DESIGNER NO.DWEL 1 NO. NO. ADDRESS UNITS � STORIES � BEDROOMS�_ � CITY ZIP TEL. � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER OECLAFiATION SFR/ADD/REM O p 1 HEREBY AFFIMA UNDER PE/ULTY OF PE0.AIRV THAT 1 N.1 EriEUFT iROM 1HE CONTRACTOqS ll• G8t8�B/CBIpOK W CENSEUWFORTHEFOLLOWNNiREA50N(SEC.70.71.6BUSMESSMAPROFESSIDNSCODE:ANYqTYOH (n C� COUNTYWMdIREOUIRESAiERMRiOCONSTRUC'i,ALTER�MPROYE,DEMOUSH.ORREPNRAHY571WG W P8f10ID6Ck S 7lRiE,PRIOR TO RS t55UMKE,AL50 REOUIRES T1E MPLICANi FOR SUGI PERMRTO FlLE A SIGNED .� SUTEMENT i}UT HE OR SHE IS LICENSED RIRSUM7T i0 THE PROVISIONS OF 1ME CONTMCTOHS Ll• � CENSE UW(CHAPTER Y(COMMENpNO WITH SECTION)000)OF DMSION 7OF THE BUSiNE55 AND PRP � P��Pe FE551DNS COOE)OR h1AT HE OFI SHE IS EXEMPT iHEHEFAOM AND 7ME BASIS FOR THE IILEOED E%EAIP• TION.ANYViOLAT10NOF5ECTION70�1.lBYANYAPPIICANTFOHAGEHYITSUOJELTSTHEAPPLIGWTTO Z qe.poof F ACMLPENALTYOFNOTMOREl1WJiNEMJNOREDDOLLARS(t6001�1' � OI��EROFTHEPR07ERiV.OR4VEAIPLOVEESWITHWAGESASTHEIR50lECOlAPENSATpN, � CpmmBfCl81 WILL00 TME YIOWC,N�D hIE STRUCTURE 5 NOT IMEN�ED OR OFFERED FOR SALE ISEC.)ON,BU54 J y NE53 AND VROFE590N3 CODE THE CONTMGTORS UCENSE UW DOES NOTAiPLYTO AN OWNER OF j iROPEfin'WMO BUlD3OR IMVROVES TMEREON.�NO YMO DOES SUp/WqiK NIMSELF OR HERSEIF OR Q THROUGIiHISOftHERONMEW�LOYEE3,FRWiDEOTINTSUCNMVROVEMEMSAREHOTINiENDmON m �1 OFFEREO iOH SALE IF,lIOM�EVER 11�E BULDINOOR IMPROVEMINT IS SIXD WRHNONE YEAR OF COMRE- ZTION.T1/E OWNER-BU0.DEH YALL HAVE iME BURDEN OF VROVINU iHAT ME Ofi SHE DD NOT BUIID OR , = MV F�iTNEPURPOSEOFSAIEI W ASONMENOFTIIEVROPERTY,MIE%CLUSIVELYCOMMCTIlIaWRHLICENSEDCd/TMCTORS � TO UCT THE PRWECT(SEG 70U,BUSMESSAND VROFESSIONS COOE:TIE CONTRACTORS L6 V81U8t1011 AQJ.AREJI CENSE UW DOES NOTMPLY TO FN OWNER OFA PROPERTY W110 BVILDS OR MPROVE4 7HEREON,AND T�- YAqCONTMCT5FOH5UptOROJECTSYATMACONiMCTORIS)LICENSEDPURSUANTTOTHECONTMC- OUANTITY DESCRIPTION FEE � � TORS LIGENSE UW.�. � p1AME7�MPTUNDERSEG B. P.C.FORTMISPEASON � 3 c' LL" OATE OwNE � U � UCENSED CONTRACTORS DE -� ¢ W OC IMEREBYAFflRMVNOERPENILLTYOfGEM1tt1RYTHATIMILICEN PROYISIONSOFCIUVTER Vr d •�COMYENCWOWfTHSECTION7o0o]OFDIVISqN70FTHE8U51NE55ANDFROFE5310N5CO0E,M1� Z � IAY IICENSE IS W FUL.L FORCE AND EFFECT. m � LICENSE CtASS LIC.NO. � F�- �j DATE CONTRACTOR - .. . W � WORKERS'COMPENSATION DECLARATION � , � U � I HERFBV AFFlRAI UN�ER VENALTY OF PERAIR`/ONE OF 1HE FMIAWINfi DEClAMT10NS q n� [A Z 4 G �IHAVE/�NOWILLMAiMANACERTiFlGTEOFCONSENTTOSELF-INSUREFOFWORNERS' _ � CpAPENSATqN,AS PROVIDED BY SECTION 1TOOOF iHE L/BOit COOE,FOi11HE PERFONAANCE �U OF 1HE VVORK FOR NA/IR17M15 PENbiIT IS ISSUED. � O Q _I NAVE AND WILL WIMTA�N WORKERS'Cd1PEN5ATION MSURANCE,AS REOUIRED BY SECTqN 770o OF THE UBOR COOE,FOR ME VER W RMANCE OF THE WOR1f FOR WHICH THIS DERMIT 15 � ISSUED.IAYYrVRKER3'COMPEHSATIONINSUiUNCECMNERINDPOLICYMIMBERME CONSTRUCTION � CAARIER PLAN REVIEW C� POUCYNUMBER EIECTRIC � �nusEcnor+uEmr�oreeoas«nocn�v[rx�tsr•ata�r+.m�Dml.t.�sK+�laRtEssl PLUMBING w Z 1 CERTIFV TMAT W iHE PERFORMANCE OF iHE WONK FOR WNlpi iHIS PEfWIT IS ISSUED,1 MECHANICAL '� (,'J SHALLNOTEUPLOYANYVER50NWAN'lMANNERSOASTOBECOME9UBJECTTOTME � WOPoCERS'C0IAPENSATIONUWSOFGLIFORNIA,ANDAOREETIIAiIFISMWlDBECOME INSPECTIONFEE S SU&IECTTOTHEWORKERS'COMPEHSATIONiROVI510N50F5ECiIDN770oOFTMEUeOR �SSUANCE � �' CODE,1 SHALL fOitilM'17H COIA7LY N1TH THOSE VROVISIONS. � SMIP p DATE: APPLICAN7: . ►L ENERGY P!C WARNiNO:iALURETO SECURE WORKERS WMPENSATqN COVEMGE IS UNLAwFUI.AND SWLLL BE � SU&IECTANEMPLOYERTOCRIMMALPEWLLTIESANDCMLiWESUPTOONEHUNORED7M0U5AN� ENERGYPERMIT DOLIARS(5100.000I.N I�DOfT10N TO THE GOST OF COMVENSATqN.DAMA6E5 AS PNDVqEO FOR RI � SECTIONf7oeOFTMELAeORCODE.MEREST,ANDATTORNEY'SFEES. � RETENTIONFEE: pw_, CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � INEREBYAFFIPAIUNDERVENALTfOFPERRIHYTMAT7MEREISACONSTRUCTIONLENOw0A0ENCY z FOR TME VEHFORMANCE OF TME WORK iOR WHICH TMIS PENMIT IS ISSUED�SEC.1oo7,GY.C.� W � LENOER'SNAME � � lEN0EH3IDDRE53 W ICERT1FYiMATIHAVEREADTM15MPLICATqNMlDS7ATETUTTMEABOVENFOiIAAATqNISCORRECf. TOTAL FEES � p, IAGFEETOCOMPLYWITHALLGTYANDCOUNTYORDPIANCFSANDSTATEUWSREUT1NfiTOBVIlDIN6 fANSTRUCTION.AND HEREBY AUI1/OWZE RE7RESENTATNES OF THIS COVNTY TO ENTER UPON 7ME � ABOVEJAEHTIONEO P FOR INSVECTION VURPOSES. COMMENTS �� � Z��J � m iERA1ITiEE NAUE � � Q � � y SIONANREOF ERMI E DA ' � RECPT.NO. � VAID BY VAIIDATION WHITE—Oepartment Copy,YELLOW--Finance Copy,PtNK—Aasesaor Copy,GOLDENR D—Fils Copy,OREEN Appicant's Copy :4:�.:� ,. .. � , .�..-.,i.. , .,1.�.t..'�''."a%.. . ` . ... '�'. wwt;.i , ?1 "� �y,. :� ` �1 ;�y. ..� 'r i. ..P�v� � . - �.. --�._.._.. _ .. , , ..... ' �.,_�i�;. _ - . - ... , . CITY OF DIAMOND BAR It�lSPECTION RECORD f�'��a�:��X��� i�'r�'�i� �1�'.f.�a��;����� il`�-����'�I��� ��'���, �(`.�-�_��:�I�oa'il�; � SET BACK • j � FLOOR JOIST� FTGS/FORMS/STEEL �� FHA REQMTS . ELECTRIC GROUND - UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CO�IDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT.BOND BEAM FRAMINGNENTILIATI�N FINAL B�ND BEAM ROOF COVER ! PRE-GRADING ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWEF�/TUB TEST POOL ELECTRIC EXT:LATH/SIDING PDOL FENCING WALI INSUtATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. �/ _ 3 � FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING EN RGY `c"=�,�+rt����0�..�._., �.� . .�.Y_:fa=`._. COMMENTS i � . , SEPTIC TANK SIZE SEEP PIT/U SIZE I�� � � � . ,: , . ,,���� ,ii � . i � , . \