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HomeMy WebLinkAbout16613 _ .--- � !---_ .. . . -- _ _ .- -- ... . _ . . �� CITY OF DIAMOND BAR -1 DEPARTMENT OF COMMiJNITY 8c DEVELOPMENT SERVICES 21660 E.Copley Drivc Suiu 190 PRESS � (909)860-3195 Faz(909)861-3117 ����� BUQ.DING PERMIT APPLICATION FIRMLY JOBSffE � APPLICATION) _ I PERMR P/C o ADDRESS �6J ��� �' DATE v� `��U ( NUMBER 1 4�� M � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER ��Q�+✓ R-ruGKw,� p ADDRESS • ZONING SETBACKS "' CITYD/��eM�/Qd? ZIP 9`7K� TE 9 FRONT RW ❑ � APPLICANT TEL. REAR ❑ SIDFJSIDE STREEf RW ❑ � CONTAACTOR N F•P .tTr ' SIDE 0 � ADDRESS • PROPOSED USE � CfTY ZIP�j�_ T . � ARCFVENG/ • DESIGNER NO.DWEL NO. NO. ADDRESS UNITS .`�iTOR1ES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SO.FT. 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O I AM E%EA1PT UIDER SEG B.{P.G fOR THIS REASON U Q LL DATE OMMER V .. .Tr W F z UCENSED CONTRACTORS DECLARATION -' � W IMEREBYAfFIRNUNOERPENA:T10FfERAIfi'7M�T�NALICENSEDUNOERPROVISiON50FG1AMEFi Ur � i(COANIENdNO NTTH SECTION 700010F DNISqN 70F TME BUSiNE55 M1�FHOiES5KKi5 COOE,AND Z W LICENSE IS N FULL FOHCEAND EFFECL m � UCENSECUSS 'J�C�'� LIC.NO.�T J // j � �ATE�:'T.���A�CONTRACTOR � 6• "' f�,/�� •1�'�-- � WORKERS'COMP[NSATION DECLARATIY`iN U U�Q��' � N INEREBYAFFIfWUNDERPENALTVOFPERNRYONEOFTHEFOILOWINCDECLARA7lON5: N a d � _IWIVEANDWILLMAMTNHACERTIFIGTEOFCONSENfT06ElF•iNSUREFORN"ORKEfiS' S � � Q COuvENSnTqu.A4VROv�DE0BV5EC7iON77ooOFTHEU�ORCOOE.FORTHEPERf-0NAANCE w OFTIE W01iK FORNTIIdI iH15 PERMIT IS ISSVED. � � _I HAVE AND W'lL MAINUN WORNERS C0�.�7ENS�TpN INSUIW�CE.AS FC WIRED BV SEGTqN Q �7po pF M UBOR O00E.FOA TME FERFORMANCE Or THE WORK iOR WNICH 7H15 GERMR 15 0 ISSUFD.WIMORKER4' PE ATIONIN.^,UiUNCEGRRIER4N�VOULYNUNOERAflE: CONSTAUCTION � ��Eq �'�� F/1N• PLAN FEVIEW � POLIGYlNMBCR��=�. . ELECTRIC �n+ssEcnorarsmr,areemr.�t�nocnev[ar.ir�s�una��unr�ooau�sR��la+�ssl PLUMBING _ W MECHANICAL ��` � Z ICER71FY7W�TNTHEPERFONMIwCEOFTMEN'ORKFORWHICHiHiSPERM171565UED,1 ('� SWLLLNOTEMPLOYIINYYEILSONNIWYMANNERSOFS708ECOAIESUBIECTTOTHE � N WOPI(ERSCOMVEHSATIONUNISDFCA:.IFORNI�,AN�AGRLETNATIFISHOIADBECOME INSPECTIONFEE >` S SUBJEGTTOTHEWORKERS'COMPENSATIONPRONSIONSOfSECTqN77000FTHElA90R �SSUANCE b U�7 COOE.1 S14LL1 FOR7HVJfTH CdA�LV WI:H TMOSE PIiOVI510N5. O SMIP p DATE: APPIICANT: � � ENERGY P/C � WAANINQ:FAM1URE TO 5[CURE W ONKERS'QOAIVENSATION COVEMGE IS UNUWFU�ANO SHAlLOE � SUB.IECTANEMPLAYERTOCRIMW�LVENALTIESANDCMLFMESl1PTOON[HUNDREOh10U5AN0 ENERGYPERMIT OOLURS(t100.000).N ADDITION TO TME COST OF COMPENSATION,DAAUGES AS PNOVmED FOii IN J SEGi�DN77oeOFT1EU80RWOGwTEREST,ANDATfDRNEY5FEE5. RETENTIONFEE: Q W CONSTRUCTION LENDING AGENCY PRE•ALT FEE: n. 0 � IMEREBYAFFlRMUNDENVENALTYOFPE0.R1RYiHA71NERE5ACONSTRUCTqNLENDW6AGENCY Z FOR TME PERiORYANCE OF iME WORK FOR WMICH THIS PEiWR IS ISSVED(SEC.�oY�.CIV.C.). W � LEMDER3IUME � LENDER'SADORE55 � WICERTIFYTIIATIlUYEPFJ1DR95APiLILA710NAND3TATE7MATTHE�flOVERiFOfiMATIONISODMECT. TOTAL FEES •S� � IAGREETOCOIAPLYWITHALLCT'/�NOCOlMT1'ORDINANCES/�NOSTA'EUWSREUTWOTOBUIDINd CONSTRUCTION.AND HEREBY Al1fIqRIZE PEPISESENTA71VE5 OF THIS GOUNTY TO ENTEN UPON iME S� ABOVE-uEM10r�EDCROPEnTYfORWSPECTIONWRPO5E5. COMMENTS ' � 1 .c �e.ar�• � � QPE EENAME(PW �„ �v � D y SIGNATUp[OF OATE RECPT.NO. PAID BY VALiDATION � WHITE—DODo�.ment COpy,YELLOW—Finence Gopy.PINK—Asaessa Copy,GOLOENROD—File Copy,GREEN—Applicant's Copy ,... , , . . .. . . . . ,. . .. . ..,,_ . . . . . .- . . ,�. . . . , , .� . . . .. .. ..... , . . .. . CITY OF DIAM�P�D BAR , _... ..:. • , . 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" � -- , , IROOF.SHEATHING - � 8 F7.BOND BEqhtl = ` . _ . •..-., -' = ''-�.•. - . , � _. .. _.. . . . -. .._ i FRA�AIPdG/1,'ENTILIATI�N -- - -- FINAL°BO�1D BEAM � � � � ' -�' . --. .._ . . -• I ,.... _ .._ . • : ... :ROOF COVFR :. • :� PRF-GRADING . • _: I '.� _. - - !ROUGH H�ATING - ' �-� -- - - - BENCHING ,: , � � .:. . �ROUGH.ELECTAIC _.._ �. .. �' � ROUGH GRADING_. ... .. .. .. . _ . _. _. . ---.---.----.- ;ROJGH PLUti181NG - '- - -� -- - - . --. ' . . :: FINISH GRADING � '- ;SHOY.��R;TUBTEST--: - - -- - � -= - ' POOL ELECTRIC ! :: ;EX7.i�ATHlSIDlNG --..:_.. _. --- - ... _ _. ..-- - POOL�FEP�CI�1G � . .• ' .: ..' � ;.. :�"JALL tNSUU1TION-- -- -- --- -- ---- ---. _.._. _. POOL FINAL , .. : i :: ;'CE1L1N^u il'•�SULATION. -- " "� -�- ' --- - - - OFF SITE IMPS. i ::.. IDFYI,":AL.LUAI::IPdG- � - - _. DEDICATIrJNS . � . .', ' =. �SE6"v'�R -._. ._ _... . ...- -- . -- - FINAL ENG. . . �.. .. - = � � �SEPTICTANK � LANDSCAPE/IRRIG. `ISCCp.P:T,'L.L._ . • , . . � . 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