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HomeMy WebLinkAbout15152 (13) _�y� CITY OF DIAMOND BAR - DEPARTMENT OF COMMiJNITY 8c DEVELOPMENT 5ERVICES � 21660 E.Coplcy Drive Suite 190 ,� (909)8603195 Fax(909)861-3117 � . PRE$S : '%�'''� °BUQ.DING PERMTT APPLICATION � -' FIRMLY d DDflESS 5y2 �r�rn��dl tS/f� ����� OA�CATION 3 NUMB R ✓ �/_ R� c � APN LOT T CT ISSUE TYPE � OCC DATE CONST. GROUP p OWNER k[,�jf#-.�{�v � C 3 f.k'C ADDRESS ' ZONING SEfBACKS w CfTY ZIP TEL R�R RW � APPLICANT TEL. SI�E/SIDESTREET RW O CONTRACT R 1� SIDE ❑ � ADDRES u CITY ZIPg/�,f.�._ TEL PROPOSED USE � aac Nc� PJ. � � _ DESIGNER � NO.DWEL NO. NO. ADDRESS F3.���J L:c��[�P A (�L UNITS STORIES BEDROOMS y C1TY ,��N'�h��- ZIP9'�ij� TEL,^Ls'f,�tR_2�)i3`l y DESCRIPTION SQ:FT. `FACTOR�PSF ADJ.AREANALUATION Q OWNER-BU�LOER DECLARATION � SFRlADD/REM O p I NEREBYAFFtlW INDER VENAL7Y OF iERAli1Y 7HAT I AM E%EY7T iROM TIE GOHTRACTORS LF (`,arape/Carport � � l,f,l CEI6EUWfOHiT1FfOLLOWINOREASON(SEC.10�1.68USNESSMAPROFESSIONSCOOE:AN'ICT'OR (n C.� COUNiYW/AQ/REOURESAGERIARTOCONSTRUCT,AITERIIAPHOYEDEM0l13KORREPAIRANYS7RUG W PatiaJOeck � TXiE,►Rp11 i0 RS SSUANCE.AL'SO REW WE81ME APPIICMR fOR SUp1 PENMIT TO FlLE A SIGNED w STA7E4ENT TMAT NE OR SNE IS LiCENSED�U0.5UMlT TO THE PROVISIONS OF THE CONTMCTOR9 LL CENSE lAW(p1APTER�(COA1MENpNO WTI8ECTION 7oo0)OF DN510N]OF THB BUSINESSAND PRO- V" POOUSpB fE5SI0N5COO�d1TMA7MEORSHEISEXEMPTTHEfiEFf10M1WDTNEBA5�5FOR'�MEALLEOEDEXEMP• (ry TqH.AMlVIOLAT�OHOFSECf10N7o�1.68VANYAP7LICAHTFORAPEfU11TSUBJECTS7HEAPPLICAN7T0 Z Re-Raot � ACMLiENALTYOFNOTIAORE7NANFNEHUNOHE00011J1RSfi5oDI.1: � � OI.A40NMEROFTHEPRDPERTY,ORMYEMPLOYEESWITHWA6ESASTHEIRSOIECOYPENSATION, 0 �mmerciat . - YM.L DO THE WORK,AHO THE STRUCTl1RE IS NDT Ml7ENDE0 OH OFFERED fOR S�LE(SEC.70N.BU54 J Iff53 AND VROFESSION3 CODE:TNE CONTMCTOR9 UCEN9E lAW DOES NOT APPLY TO IUI OWNER OF N iqOPEHfYMkqBUIDSdiW01pVE3THEREON.ADD�NI0DOE55Uf7iWOfU(MINSELFONHERSELFOR = (� T/Yi011[iMM50NMEROWNEMPLOYEES,iROVDEOiNAT8UpIWPROVEMEMSMENOTMTENDE00R m OOFFEpEUfOqS�IEtF,FqWEYEi�ME8UL01IbORWC1iOVEYENTlS50lDWfTMNONEYEANOFCOMPLE � -TpN.THE OWNEII-0U4DER MALL!N'�E iNE BUNOEN OF FROVINCi THAT NE OR SHE DD NOT BUIID Oii R1PIqVE iOR TTIE VURPOSE OF BALE� ' W 04�SOYMEHOFiMEiROVEiir1:ANEXCLU�NELYCONRUCTRK7YNiHlICEN5E0C01RMCTOR3 [� ��MSTNUC�THE iRO.1ECT(SEG 7WA.BUSINE35 AND VHOfE3S10N3 CODE TNE CONTRAC70R5 L4 V9�u9�iIX1 ADJ.AREA iti CENSEUWOOElNOTMPLYTOANOYMEHOFIIYROGERiYYAqBURD50RIA1PqOVESiHEREON,MlD � WNOCONTMCTSfORSUCN7R0.1ECTSNITHAWNTMCTOR(5)LICENSEOpURSUANTTOTHEWNTMG pUANTITY DESCRIPTION FEE � � TpiSUGEHSEUW.} .,J � OIMIEXEMPTUNDERSEG B.lP.C.FORiHISREA50N Q {� OV� I Q ' �� �� � u" DATE OwNER F � W / �/ `' , �� UCENSED CONTRACTORS DECURATION W � INEREBYAiFIRMUNOEqPENALTTOFPEIWRYTUITI�ML�CENSEDUNDERPROV1510N50FGHAiTER � s •(COMM[NCNOWRHSECTION7000)OFDMSION]OFiHEBUS�NESSMIOPROFES510NSC00E,IWD Z X W LCENSE 6 N FULL FOflCE MA EFFECT. m lL /' �' � � UCENSE nCUSS `'IO �LIC.NO. loC,`6! �j DATE [l�3��ZBCIO CONTRACTOA � T C C � � � .._ .. � WORKERS'COMPENSATION DECLAAATI � C��� � I HEREBY 11FFIflY UNDER PENALTY DF VERRIRY ONE OF THE FOLIDYlNC ^X `n�( N (/ / � �INAVEANOVnLIMARlTAIHACEiRIFICATEOFCUNSEHTT05 FaNSU NUHKERS' ✓ _ � CpAPENSA710N.ASPROVI0m8YSEGTON7J0oOFTNE RCOOE,FORTMEiERFORMANG U OF T1E V/ORK FOi1NM1ilq1 TMIS PERM�T IB tSSUEO. � �INAYEAHDWILLIMN�AINWOPoCERSCOMPENSATIDNINSURAHC, AEWIRED Q770o OF THE LABOA COOE.LOFt IME CERPDRMM'CE OF 7HE WORK FOR WMICM iFuS iEAM1T IS � ISSUm.WWOIiKER3'COMPENSATIONWSUfUNCE RIEHANDPOLICYNUA9ER/JiE: CONSTRUCT�ON y CANIUER__.��� �'�PLAN REVI � vaicrMnmen - �— EIF RIC � � � �-__, �0 (i1i38[C7ICHIE�6ATBEOOr.iLE7IDCf7}EiE�f6FORbNEHUti1ED � �LU B�fi77 /%1/ ' � ICERi1FVhUTINTHEVEHFORMANCEOFTHEWORKFORWHlpf1HISPERMI 15ISSUE H?dVIQAL 6HALLHOTEMPLOYANYVEFSON�NINYYJIMIERSDASTOBECOAAESU&IE O7HE � • WOPo(ERYCdAPEN3ATIONUWSOFCALIfOiWIAANDAOREETMA7IFISHOIID �COME IN PECTIONF - � 6UBJECTTOiHEW0f7KERS'CdAC[NSATIONPRO 50 ON]IOOOf �E R cao�,i suu.Fomxrvmi caattr vnni na �s �. E T � p OA7E:� APPL�cAM: ' SMIP �����',��+ � ENERGY P!C WARNINO:iA1LURE TO SECUPE WOi1KER5 CO�.�PENSAiqN COVERA6E IS UNUWFLI,AND SW�LI BE �y 6UBJECTANEMiLOTERiOCNIMPIALPENALTIES/WDLMLFNESUPTOONEFRINDNEDTIOUS�ND ENERGYPERMIT DOIIA/t4(i10o,000�,N ADOITION TO THE COST OF�pAPEN5AT10N.DAAU�ES AS►HONDED FOfi IN 1 � SECTpN770lOFiHELABORCOOE.�NTEHESiANDATfORNEY5FEE4. (j�NT�ONFEE: 1 •) W CONSTRUCTION LENDING AGENCY ppE•ALT FEE: , ^ � G.. -- -� .� ..... O C � V L+/ll.a • - . � IHEREB�AFFIpMUNOERPENKTVOFPEiLtt1RVTHATTHEREISACONSTR�MIONLENDIN�A6ENCY -_-. . _�, .. .�-... " � FORiHEiERFORIAMICEOFh1EWO�KFORWHip1M�SPEWAITI5155UEDf5EC.i0G7,pV.G1. s��J 1V�IlfS�LJ/ � � � � LENOERS WWE � C LENDER'SADOPF53 � ILERTIFYTHATIN�VEflEADM15AVPl�CA710NINOSTATETIATTHEABOVENFOfiMAiIONISCOMECT. TOTAL FEES . � � � IAQREETOCOM7LVN7n1ALLCrtYANDCOUNiYd10WANCESANDSTATEIAwSNELATM70TOBUlDINfi CONSTNUCTION,AND MEREBY AUINORIZE REOqE5EN7ATNE5 OF iHIS COUNTV TO EMER UPON iME S� /BOVE-MEMIONEDVROPERTYFORWSVECTIONpIIRPOSES. COMMENTS O � h � / / � . 4 PERA.1rtTEE (WIlT) �Y � Z. y SIG VE EE , DATE � � RECPi.NO. � PAID BY VAUDATION Vh11TE—Department Copy,YELLOW—Finence Copy.PINK—Aeseuor Gopy.GOLDENROO—F(le Copy.GREEN—Apdicanl'a Copy ,,. ..., . . .., , ,. . . , :• . , . . , , � . ,, , .. .. . . .. _. _ �. .. , � . � .. : .. �. • . _� . '�. ... .. :"' - �11•'� . CITY OF DIAMOND,BAR �,��:�. � , �,e,�.��ti;�•.•���, ��,-. �r,�;. .:��,-��INSPECTION�RECORD ..,�:� .��::,�.. �.•.: ���;. �- r��tcf., ...� _..:C. ,is � ;, '.�• . �-`'l���rX������1�� �' a����� y���.a�.��� �.� �.�.!.�-��.!�A_e,���i�...�::. 1�'� �� `'�R��� el�+°.�i � "p' .:...r.....,...:..,:.........�. ...:...,:,..........��:......�.....�......�:.....tt .�.. w. �SETBACK �'�', ! �� -:� _ `,� . . M I� 1. _.,?r.l, 'FL'O.ORJOIST�7.�� e r . �: •'�... !'{ �'15:: :;,�-._,�, t^.� .,, „ ., � �TCS/FOR��ASlSTEEL`-- -- ,,, ;, - ,` � '�� .; i 'FHd REQMTS. _. �_� _ __ ,.,� � , ,� . ' _+ '.__ _ .. : � �;. �EL�CTRIC GROUNQ---- ----'? � ..-__.� . _`_ _ ;_: �,, _ 'l7NDER FLO�R D,UCT- r: .,�' . � ` _ __- -- � __ __ — --- - -- --- -- _ _ . -- (GP,DUND FLUMBING ., ,: . ::, - UNDER FLOOR CU�I��IT '-'� �';�" . _,`; " S "`�'' ', :': ; � `:; ----- _ _ . , .., iSl.AB GRADE----- __ ,� , , , -------- ---- FIREPLAC�FOUNDATION , , I � i- -- ; T�h1P POWER ,- ----- - -� - . -,.- � FIREPLACE BOND BEAM' _ _ - - -- - - : _ -;: � �; � bVi�TEfl SERVICE -- __ . .-_-- . _. _ _ ' ' __I MID HT. BOi�1D'�EAti1,�•,_'.�f r•!-' t{-N=��• �.�y+4.:!� ,. �:'� �,�:_ ? ; - , FaC�FSHEATHING , .,; 8 FT.BOND-BEAM , : _.' �;._�� -+�`-;;� _�:►• �a�_ � . � ., i _ ; �-HAFAING!L�ENTILIAT(ON�'------ - --__ _ - " FINAL 801�1D BEAM. , ' ` . �' ,,,�.' , . . j •� �F�C:,UFCOVFR .:i -_ ._ _ _ , _ � r PRE-GRADING-� ._.,1 ca:� - -7 ..,ti.1,�1�',.� )_ ` .- ' i !..: � � I'RC:tJGti HEi,71NG `--� �---��/ �' I"` - - ' 6ENCHWG s'f� ti '.�'� � C 5 ,` . :�,` �`T� �, , � ; _ � ._ if30�1GN'p�ECTHIC- � 6 �/� -�" `` �:; „- ROUGH �AADIN6 . _ _ .._., ; ., _. � ` _ `. ' '�;'`' IUMBING -.--- 1-'7�- - -- - - - FINISH GRADING ; _r.� ' SF;CL'VERl�UBTEST : _ ------ _- --------- -- . ,. - POOLELECTRIC : : , ,. :,, „ � ,:.. , : ,---- ,,; , ' _ . : .' � , .� , ;; � E�T.L,4TH!SIOING-- _- ---.----- . __. ___.___ .___ ._ ...- POOL FENCING , : ,: i VJALI lNSULATfON_ _ .__ _- - ------- _. .__ .- -___ _.._ _ � POOL FINAL•' ; ; ; ;� � . „ � CEILING-INSUt_ATION�- �---- _ _ - --___---__ _.._..---� I OFF SIT.E IMPS. , , , DRYWI.LL"NA1LiNG _.._.1.---_._ _-- --.--.--- _-- -- - DEDICA710NS , ,. _ . � __. - - SE�'VER-----._ __ . ._ --- -- FINAL ENG., , ,; . , ; SEPTIC TANt; i, LANDSCAPE/IRRIG. ! ! SEEP_P1TlLL._._ - -� .� ��•,� � .; _ _.. _ _ ___ � ONSITEIMPS._ . � , . � rGAS AiFi TES'i ', ' ' FINAL ZONING I ;-r �---__— _ ._ , . — � .rR`�AL,C�NST,_; t_'�.�Z'r► � , -;��.1�:,.:>tl:�'t 1 t� :_ 1r� .FIRE DEPT.FINAL.., ,, _ ; ,, . , _... _ _ __ _.,_ , F;PJALHEATING __ _1 ?_ `� _�tiQ� __; '� _ __t,; _HEALTH DEPT.FtNAt j - _ ; -- _ �.------ ^, J�'_ _ .i _._ 1 l DEV.FEES PAID -__ __ . _. _ _._ _ _ _ FI,JA'•_E�EGTRlC�-. _-- �i/G� I ,_�.r ,'=iiV,AL-Pi.UMBIt�lG ___ . --{--/- - _ . _ ___ .---.._ .-�-I EfdERGY ' ' �� - - -- - f -- -�--_ _ _.. _ i _ �. � ' _ .--- --- -._ __- ---- - -- i ' �- �S� t���.��,i-� � ;;\—� �-_ ___- - - _ ___ .. .___ � ___ ___ ._ . __ _ y.., �i y", " , .., ., ,.� -, -� � �_ _ ._ _ - -- - . . _;._ . . - . -_ _ _. _._ . _, . ,.-, _ _ ' ri. , ,. _ _ _.. . . . .. _ i - ---- - . _ _ _ '� � � .� . �' i�, , c�r;��E�Ts=.__. ._ �.., �� ,. . _ , �. . � �- __ _ - --- - ---_ _ -__ ___ � , , , . , , . _... �. , . -_ __ _ _- - � �. , - -- -- - ___� _ ----- - - - _ _ ___ . - - - - _, ; _ , � , . ,- . �. � . ___ . _ , . . � , �,_ . - _ _.. .._ r . 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