HomeMy WebLinkAbout17902 _�
J� C1TY OF DIAMOND BAR �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
��� 21825 E.Copley Drivo
_ (909)860-3195 Fax(909)861-3117 PR ESS
���-�'� BUILDINGPERMITAPPLICATION FIRMLY
o DDRESS���8� DATEfCATION �b'i 0 Z NUMB R.�7 fo Z M��
� issue TYPE occ
APN OT TflACT DATE CONST. GROUP
p OWNEF
"" ADDRESS � 20NING SETBACKS
gCITY�.•.,.A� ZIP TEL.�Q��Y R�RT RW O
APPUCANf TEI. SIDE/SIOESTREET RW p
� CONTRACTO SIDE p
� ADDRESS PR P S�US L
� CITY • ZIP TEL� � � Q�7 .Fr,� !
o ARCWENG/
zw DESIGNEFi NO.DWEL. NO. NO.
n. ADDRESS UNITS STOFIES BEDROOMS
� CITY ZIP TEL.
N D�SCRIPTION SO.Ff. FACTOR PSF ADJ.AREANALUATION
� OWNER-BUILDER DECLARATION SFWADD/REM
O I HEREBY AFFlRM LMDER PENFITY OF PEiWFY TIUT I M1 EXEMPT FPOM THE CONTRACTORS LI• G0f890IC8�OR
W CENSEUWFORTMEFOLLWANOREASON(SEC.70.77.6BUSINESS�NDFHOFESS�ONSCOOE:ANYdTYOR (n
C.) COUHTYWHICHREOUIRESAPERMITTOCONS7RUC'f,llLTE0.�MPROVE,DE�OIISH,ORREPAIRANVSiRUC- W patio/Dack
� TURE,VRIOR TO ITS ISSUANCE.ALSO REOUIqES TNE A�PLICANT FOH SUCN GERMIT TO FILE A SICNED
.� STATEMEM THAT ME OR SNE IS UCENSED iURSU�NT TO 7HE PROYISiONS OF THE CON7RACTORS U•
� CENSEUW(dUP7ERY(COMMENCMON7THSECTION70Da)OFO�VISION70FiNEBUSINE5SAN7PF0- � POOVSpO
FESSbN5CO0E)OqTHA7HEOR5HEI5E%E�PTTHEREFROMANDTHE6AS�SFORTMEALlE0E0E%EMP• ('
V TION.ANYVIOUTIONOFSECTION7W1.6BYANYAVPLICANTFORAiEWAITSU&lECT57MEAPPUCANTiO Z Re�Roof
r ACMIFENALTYOFN�TMOHETHANFNEMINOFEODOlURS(fsW).1:
� ❑LASMVNEROFTHEPPOPERTY.ORMYEMCLOYEESWITHWAGESASiHEIR50LECOMPENSATION. � CDITR1BfG18I
z WILL DO TME W�RK.AND TME STRUCTURE�NOT IMENOEO OR OFFERED FOR SALE(SEC.70N,BU56 J
NESS AND PROFESSIONS COOE:TNE CONTMCT01iS LICENSE Uw DOfS NOT APVLv 70 AN OWNER OF
� iROPEi7TYVlHOBUILDSORIMVROVESTHEPEON,AN�WF1000ES5UCJIWORKNIMSELFOqNERSELFOR �
[[ TIIFlOUGHHISORHEHOWNEMVLOYEES,PPO'ADEDTHATSUCHIMPROVEMENTSMENOTNTENDEOOR m
W OFFEREOWRSALEIF,110WE�EFl1HEBU0.DINCOitWPqOVEMENT�SSOlDW17MINONEYEMOFCOu�LE-
� T�ON.THE OWNER�BUIIDER W1LL MAVE TNE BURDEN OF VflOVING 7HAi HE OR 6ME 010 NOT BVIID OR
z �AIPROVE FORTHE PURPoSE Of SALE}
� ❑�ASOWNEROFTXEPROVEHIY,AME%CLUS�VELYCOMRACTIN�WITHLICENSEDCONTRACTORS
Q TO CONSTRIKT TNE PROJECT(SEC 7W�.BUSMESS AN�PROFESSIONS COOE:TME GON7MLTORS U� V81UeIlOf1 A0.1.AqEA
W CENSEIAWDOESNOTAPKYiOANOVRIEHOFAPROPERTYNTI0BUM50RIMPROVfSTHEREON,AND
� NM1IOCON7MMSFORSUp/VRO.IECTSN7TMACOHiMCTOR(5)L�CENSED7URSU,WTTOiNECONiMC� ounrmTv DESCR�PTION FEE
Y 1DRS IICENSE UW.�.
� OIAAIEXf4PTUNDERSEC. B.IVQFORTHiSREA50N U
� �
�=" OATE OWNER V
�c� LICENSED CONTRACTORS DEGLARA710N W
LC INEREBYAFFIRMUN�ERPENR7YOFPE0.M1IFYTNATIAMUCENSEDUNOENPROVISiONSOFCNAPTER �
� Y(COMMENC�NO VATH SECTqN 1000)OF DMS10N 70F THE BUSINE55 AN�VROFE5510NS COOE,ANO Z
�� W LKENSE IS N LUIL FORCE AND EFFELT.
� UCENSE CUlSS L�C.NO_��„7�.(` m
�
�j�,/ �
, . .V OATE � CONTRACTOR��/���/II�J�,/J(,}_�J a
W
� WORKERS'COMPENSATION OECLARATION �
N V
N 1 MEREBV AFFIRM UNDER OENi1LTV OF 7ERIURY ONE aFTNE FOLLOWING DECURATIONS. Z
Q
O _IIUVEANDWILIMAINTAINACEflTIFICATEOFCpNSEMTOSELF•INSUR6LORWORNERS' _
� COMPENSATION,ASPROVIOEOBVSECTION]70aOFTHEL�BORCODE.LORTHEPERFOR/AANCE �U
OF iHE WORK FOR WHlpl THIS PERMIT IS ISSUEO. �
�
W �IlUVEMlOYnLLM111FRAINYVORKERS'COMPENSATIONINSUFWiCE,ASRE0UIREDBYSECTION
O �70o OF TME LABOR CODE,FON TME PERFORMANCE OF THE WORK FOR WHldi TNIS PEWliT IS �O 9• �O
ISSUEO.MYWOR q5'COMFENSATIONJy,�UfU�NC/ECA�RqiERRJOPOIICYNUFIBERARE: CONSTRUCTION �
� CARRIER TT�IYl�� PLANREVIEW
Q POLICYNVIABER Z-�!� -- —� ELEC7RIC
� (II�SSECIb11NE�NJTBEOd.RFTEDOFhEPERAR5FOR01+ElUrUREDDOLLAilSM0olqiLESSl PLUMBING �--• �-;. ,_ --
I� � .i-� . I i I i J 1
Z ICERTIFYTHATRliHEPERFO�ANCEOFTIIE\MDRKFORWHICHTHISPEPMITISISSUED.I MECHANICAL -
(,�} SWLLLNOTEMVLOVANYPERSONNANYMANNERSOASTOBECOMESVBJECiTO7ME I
� WORKERS'COM7ENSATpNU�OFCALIFOPNItiµDACREETNATIFISI/DULDBECOME INSPECTIONFEE
S SUBJECTTOTNEWORKERS'LOMPENSATqNVRON510N50F5ECTION77000FTMEUBOR �SSUANCE
LOOE,I SHALL FOflT1WITH CAMPLV WITH 7TIOSE�bNS.
� � SMiP • 7
p OATED_��,�nPPLICANL � - ,
J j�_,)� -
WARNIN6:FAILURETOSECUf1EWOfiNERS'COMPENSATpNCOVEMGE15UNUWFU4AN�5MALLBE ENERGYP/C
� SUBJECfANEMPLOYERTOCRiMIW�,PENALTIESANDGVILiWESUPTOONEMUNDPEDTlqUSAND ENERGYPERMIT
DOLLARS(f I00,000).W�DOITOH TO TME COST OF LdAPENSATqN,OAMAGES AS PROVI�EO fOfl IN
� SECTqN770lOFTHEUBOi7CWE,IN7EFE5T,IW0ATiORNEY5FEE5. . REjENTIONFEE:
pw.., CONSTRUCTION LENDINO AGENCY PRE•ALT FEE:
� IHEREBVAGFIRMUNDERiENALTVOFDERIURYTHATTNEAEISACONSTRUCTIONLENDINGAGENCY
n- FOF THE VERiOHMANGE OF TNE WOAN fOR WHICH MIS PERMIT IS ISSUEO(SEC.30Y1.CIV.C.�.
�
� LENDER5NAAIE
F,�- LENDER'SAD�RESS )
wICERTiFYTMATIN�VEREADTMISAPOLICATIONANOSTATE7NATTHEABOVEWFORMATqNISCORRECS TOTAL FEES / ��� �O
� IACREE TO COA�PLY WITH ALLCT'ANO CWNTY ORDINANCES AN�STIITE Uw5 RELAtINO TO BUILDING 1 �
CONSTRUCTION.MID HEREBY AUT110RIZE HE7RESENTATNES OF TMIS COVNN TO ENTEA UPON TNE
Z ABOVE�MENTIONEDVROPERTYFORWSPEC710NPUAPOSES. COMMENTS
O
J
�
QPERMITTEFNN/E(v 'TJ I
N
N SIGNANAEOF ITT �AT ,
y RECPT.NO. PAID BV � VALI�ATION
F WHITE—Departrnent Copy,YELLOW—Finance Copy,PINK—Assessa Copy.GOLAENROD—File Copy,GREEN—ltpplicanl's Copy
_J
- • • . � . I . .. .. ./•. ' .. , . � � . . . . . .. . �1..4. .��rl .. . i r.�.. .. �I . . . .. ��. �. .. . ._ • � � 1 ' _. .� _ '
CIT"4' OF DIAf�70ND BAR
Ii�SPEC i I�f�! RECJ�D
(►��-�:��c;:�t�1►�k �s)���- ����-�:1�1�;�?�7�� f►�.E-'�►��c';:�f�li�d o���:ir.� '�1���-'i:�,�E~�?c��,� �
.�____..___�;_.....:�--__._�_"._.._-_.-___----------- ..._.__.___--______-__-_-=--------_.._�_________._.__._.:.______
SET BACK � � � FLOOR JOIST j
FTGS/FORMSISTEEL ' � FHA REaMTS
ELECTRIC GROUND UNDER FLOOR DUCT I I
GROUND PLUMBING UhJDER FLOOR CUf�IDUIT ;
SLAB GRADE FIREPLACE F6UNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT.BOND BEAh4
ROOF SHEATHING J� G �'� � 8 Ff. BOND BEAM I
FRAP�IINGNENTIL�ATION . � FINAL BOND BEAM
ROOF COVER �Dy _ PRE-GRADING
ROUGH HEATING BENCHItJG
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER�i"UB TEST POOL ELECTRIC
EXT. LATH151DING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION �FF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEP71C TANK `� ' LANDSCAPE/IRRIG.
SEEP P1T/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL COPJST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV.FEES PAID
FINAL PLUMBING ENERGY
'�;1=iC�+t�¢�1..� riCr��:
. JX��_..._�.s....�.�vl.b4l:�._.....J.�..��.�..�1
COtJiMENTS
�
�
SEPTIC TANK SIZE
SEEP PIT/U SIZE
I�"�I
I
i���, ,�;
__._____,.._`I'---------__...__� l�' .