HomeMy WebLinkAbout15-03531lND II Al:
CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Isar, CA 91765
(909) 839-7420 Fax: (909) 861-3117 Bwtding Inspection Hotline (909) 839-7027
BUILDING PERMIT APPLICATION
JOB SITE ADDRESS a e=
APN LOT TRACT
OWNER —4117- .4444
ADDRESS e-Z
CITY . l&.rE-f ZIP TEL
APPLICANT . CAAJ"'t'r TEL
CONTRACTOR __ w dsarlAll
ADDRESS
CITY !" 6frr ZIP TEL
ARCFWENGfDESIGNER
ADDRESS
CITY ZIP TEL
Ilffi NEtAAMIRUN
S Pantry efirm odor wmaRy of osqury M I am menipt hears thw Conaaclees State tomse Law err the reason(s)
hilikow below by this c I have admid maid In ft applIcabis deaw I 313st rh &UMM ad
Will Any city at es nit OW nequillrais a pert to canslinact, aim imp, ftwfhdh, or IW Ir. an
dnixitm, prtar'ta ft leampon, fro rmlL* s to appikard Aviv the permit to IN a sip W S&IsertoM Md he or As
to flie. of this state ilcamaLaw {t isr9$ wihpeefkmr
M of DNiaien l of the 1101aw AM pitaftakins radial at Csat he or stie Is emnpt fner, kem. avid ft bagds for
Via aw"on AM vlooicenof M1 5 by my applimotoagnatsuo*fieeppltcanGSacWFe`odily
of WX rnae ftA Nil murwW On X W!
L}i aaCow *fZtnC ' o`nrje"laymwim wages astheir w%cDmipensatft,will doU9OfOf{jpatNana
oT ft warn, and Machin is M irrtenlad or atfared tar Asia (Socgon A94, &Lsness and Professions Code The
0%Vac1&3' Stara tlCm bare don not Ap* as an owrr orpropanty who tfaouo employees or persenat anon builds
or Imitroya the property Awded that "Improvenents are d nthnded or offered for sale it however the Walling or
k Veiia er» w SW " tun one year of omplaocin the Owrm Uhler will have n burden of proving drat n wad net hulk
of Improved hat Cis purpose of Sale )
U L as be W of the Woo wfty, AM Whlshioly =ntrac" with Ikensed Cnntrnctar9 i4 eonetruel the prajpel (Secrilan
7D44, &zine a and Prntualons Coda The Cnnbttctoro Stath ueer±ae Law does rot apply fo an owner at property who
bu'fdsrrknlslrwesdletern ars1whatioritrut Wthopugemwith aNcensedCmlrworounwamlathe CrxrtracAtre State
License Law)
(-) 1 Am meript Mn linnsure under Me fAlydrachr'e Stato License law lot dire following reason(s).
By my signature below I aelonawkidge that, excepttor my personal residence in which I must have resided brat least one
year prior to compladen of me Impmwmens novorad by this permit I cannot legally sell a slruclure that I have bum as or.
owner builder H R has not been constructed in IbenbrAty by Ikxensed coeiVaelas l understand drat a copy of the applicable
law Sectlon 7D44 of the Nuslnece end PnofaReterrs Carla is available upon request when tins application Issubmdtad or at
the follumng' b $IV IgplMo ca gov,
DATE !' SIGN+w—
LICfitL5ED CONTRACTI)IR'S ORATION
I hereby a ffenn under parmily, of perjury that 1 am licensed under 7cntp q of Chapter 9 iwmmendrp with Ssctlon 7M
of DAstnn 3 Al the g.uuelness and Protesslom and my Pie is h hlt Jame
,AAnndd elm
LCE1SEC AS e, �.... 'O '& �!1 zz'n
DATE. ��� pOHiRAt TINL 4-jr:*f{6
'S DifLapiykTadtTgNl F�QAHATiGfI
I tiFdM AFFIRM tiNIDER PEM,TY ill 90UURY DNE OF'K F0110`d S
t h;Ln and wd nwnlea s a Cortificeis of Canvd at W Ineure for WAiM li Corepansallon, as Wooded by
Sedon 37W of this L pr Oode Nr tow gociammme at ft work for wItM ties wrist th issued
Ilthverivenwi0rnabrPa;nllt kerYt rip ksurarvae araga! �r5i€yi hxi xxrlbde for
iiw polermance 01 €ire wwk hr wriiictt dds pww N haiveil mirworkAw's Ca umnsramon Imeance Carrier am
P014 Number am
CARit€Hi
r`
9MUC9NaNEDNDTBEMWMM 'IF TNE POW 15 FOR ONE RINIM DDLIARSISIM0111:ESS,
Icerefy dig in dim pnfm lance tbww«kla wl'rcAr fhN pmrriAb hued I s rrstaroby wrypmsot m ant manner mar m
hermme subject to the Owtar's OetiveKatior Laws d ColIb,a And KnVo drat If I snood barge s4lect to the Watkera
r m err w7kJons m Sedan 3700 d the 1 with thoso pre+ rs
DATE -z--1,� A(-1K—APPIdCANP
WAHNOG FW& m to saaxe Worker s Camperrsadan WMW is vdawM and SW subject an employer to criminal
ptnartim And cka fines up to Ana hundred tt wind dDgn M0001P in eddrdw b the ens at the earnipensabon
damages as pmvbed far in saam 37(* of the labor code, Intrest and aftmity 6 Ines
CONS1111=01I LMOIND AGISKY
I heeq' affirm under penalty at perjury that them W a Conoueibn Landing Agency tar the pertomwtco of the worts tot
which this pannit is issued (Sac 3097, Clv C )
LENDER 3 NAME.
LENDER S ADDRESS .................
1 csrbty thal f have read thbr appbcabsrr And A= that the OM h VTra%n is correct I agree b Comedy wrth all Pty and
county ordinances and state laws rela!Mg to burtding cwwcucWn and hereby adtrnl;a reprauntathms of thle co+xty to
enter upon the
above mentioned properly let Bn s purp*M
Afy,;6 ii�/ • P ........ «........
PmwtrEE NAME (PRINT;
e w ✓%
S16WL19E DF PEWMff DATE
PRESS
FIRMLY
APPLICATION DATE �-' P/C#
ISSUE DATE 1 1 S PERMIT# P12, %%—
TYPE CONST /E "���f OCC GROUP
ZONING SETBACKS
FRONT
REAR
SIDE/SIDESTREET
SIDE
(I
RW ........ 1
C1.... 111
RW D ,,,,,,,,,,,,,,, ,
PROPOSED USE
# DWEL UNITS # STORIES
N BEDROOMS �
DESCRIPTION
SQ FT
FACTOR PSF
AI3J AREA/VALUATION
S WA=R !
i
aara�arcar�ott
�
t/,t
ua
U'
Pa[iWE�ck
z
Ae-fbof
Conn nercta
Valuation — Adl.
Area
QUANTITY
DESCRIPTION
FEE
i
r
r
i
r
�
I
CONSTRUCTION
PLAN REVIEW
1 C3 1
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
S S
I
ENERGY PJC
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
SSAF
C= I
I
TOTAL FEES
COMMENTS
4" 1
RECEIPT # 4 t PAID OY
VALIDATION .—
6ETBACKI =H
FOOTINGS FORMS
SLAB
UG PLUMBING
UG ELECTRICAL
UFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLIOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTEFUOR
FRAMINGA ENTIN G
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C ( )
ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
DRYWALL
LATH ,PRE)
LATH EXTERIOR
LATH INTERIOR
GAS TEST
SCRATCH MOAT
ELECTRIC METER RELEASE
GAS METER RELEASE:
SPECIAL INSPECTION
FINAL BUILDING
FINAL MECHANICAL
FINAL ELECTRICAL
FINAL PLUMBING
T C of OCCUPANCY
CENT. of O PAlf Y
COMMENTS
.M...................................
CITY OF DIAMOND BAR
INSPECTION RECORD
i .& 0
TRACT AND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T-BAR
INTERCEPTER
HOT MOPISHOWERPAN
SEPTIUCESSPOOL
11 HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOUSPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
GAS TEST
PRE GUNITE
POOL PRE DECK BONDING
P-TRAP
FENCE i GATE/ ALARM
FINAL POOL
WALLS
WALL FOOTING/STEEL
WALL STEEL l9( ) 2-( )LIFT
WALL BONO BEAM
WALL DRAIN! SEAL
WALL FLNAL
RD FRAME PLAWM APPROVAL
ROUGH FIRE APPROVAL
FINIAL FIRE DEPARTMENT
FINIAL PLANNING
FINAL ENGINEERING/ PW
FINIAL. COMMUNITY SMICES
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE