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HomeMy WebLinkAbout15254 .� � CITY OF DIAMOND BAR '" � DEPARTMENT OF COMMUMTY&DEVELOPMENT SERVICES . � , 21660 E.Copley Drive Suitc 190 (909)860-3193 Fax(909)861-3117 PRES$ �„"��� BUII.DING PERMIT APPLICATION FlRMLY � ���� j� APPLICATION PERMR P!C /� o ADDRESS 1'1 y S A-n a I��e v o i/r' DATE �? ^ 1 rr�,��— 'Crt] NUMBER��ZS Y � �" g �ssuE IYPE occ APN LOT TRACT DATE `) �{�^G�') CONST. �"H GROUP�_ I p OWNER � ADDRESS 17�15 n a n.y 1'• ZONING SETBACKS ' � CITY n• C3. ZIP TEL. REART RW ❑� APPLICANT TEL. SIDFISIDE STREET RW � a� CONTRACTOR SIDE ❑ � ADDRESS ', ROPOSED SE T�F.1u(L dFF T\L�z � '��tT . o CffY ZIP TE � I � ARCHIENG! �R�l4 11L �h�eSGr ��E�: ADDR SS NO.DWEL�`.�� � NO. NO. � C� Z'P �� UNITS STORIES BEDROOMS � DESCRIPTIOlJ SQ.FT. 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' W A � � 1 W.YE A1A WILL AWNMMI M/ORCEP5 COMPENSATION INSLKLWCE,AS PE�URiED BY SE � UQ 97000F7FiELAAORO00E,FORTHEPERFORMANCEOFTHEWORKfORWHICH7HiSPER � iSSUED.MYWOFlKER3'CWAPENBATION� CMN�ERANDPOIICYNUMBEqME: � CONSTHU ION �,�, � }, caaAiEa , ' ,�N REVI � POIICY MIMBER � ��j�(�' 0 tnassecnond�noreEa�.�IDOFn+Eam..rsa�ao��oawisa,am I F�u ai w ANICAL Z 1 CEHiIFY 7HAT IN iHE PERFORAIANCE OG 7HE WORK FOR`NMCMTM�B PERMR IS ISSUED,I (J $iIAL�NOT EMPLOV ANY PERSON R1 At'N YANNER SOAS TO 9ECqAE SUBJECT TO THE ' � NpPo(ERS'COMVENSATqNUW50FC11LIFORNIA,ANDAGREEhURffISHOULO ecwae SPECTIONFEE S Sl1�CTTO7HEWORKEPS'CAMPENSATIONP VISIDNSOFSECTION37000F ELABON moe,�sruu Fnrm�vnrn caar�r mrn rrvansans. ISSUANCE � � T�_�_ pATE:��� APPLICANT: �,_. SMIP � • �v W � W�IqI(1:FAlLRETOSEWiiEM10HKEfL4'COMPEN�TIONGOVEMOEISUtMWFl14ANP5MALLBE ENERGYP/C � SIJBJECT�NEMPLOYEflTOCRIMWALPENALTIESANDCIVILFWESUPTOONEHUNDREDh1W5ANU ENERGYPERMIT pp�J,Ap9(=ipp,p(q),R1 hDDITON TO THE COSTOf COMPENSATIDN,OAMAGES AS PNOVIDED FOR IN ¢ SEC710N 97W�7HE 490R COOE.R7TEFE5T,AND ATfORNEY'S GEES RETENTION FEE: � M � CONSTFiUCT10N IENDING AGENCY PREAU FEE: 5 O � 1 HEREBY AFFlRM IN�EP PENALNOF PEM1NRV THAT iHERE IS A CONSTRUCTION IENOING A6ENCY I�H iHE PEqWPMANCE OF THE WORI(WR�MM�G917Mi5 VEfiMIT IS ISSUEO�SEG 3aYl,CIV.C.�. Z W � IENDERSNAMf � f- LE1J�R'BADORE55 � I CERTIFY THAT I WIVE RE1D THIS APGLICAT%7N M1D S�A7E iFIATTiEA80VE MFOPMATION IS CORRECT. TOTAL FEES � IAGf�ETOCqAPLYWIiHALLG7YANOCOUNTYORDINANCESANOSTATEUWSFElA77NOTOBUWDING � CONSTRUCTION,AND HEREBYAUTHDWZE REPRESENTATNES OF 71N5 COUNTY TO ENTEq UPON THE S� /�Qp�-MEMqNED VROPERT'I FOq INSPECTION PURPOSES. COMMENTS - . � Dnnc� I r m re, e tw,��rwrm y -! -DO � a oFpEn+�iTTEE OATE R��� pND BY t�� 2 O VAVDATION � � WHITE—DepeAment Coql,YELLOW--Faianoe Copy.PINK—Aseeasa Copy,GOLDENROD—Fk Copy,GREEN—Applicant's Copy ' _ ., . , . . . . , . C17Y OF Dip►Mt7ND BAR fNSP�CTt4N 4�ECO�i�3 ' � * � ..� i � • � , � . . a. '+�� �,. SET BACK ! FLOOR JOlST ( ; FTGSIFURMSiSTEEI� � FHA REQM3S ' �=`-+-- ---__ _-__ ,:�`'T�: ELECTRiC GROUNE} UNDER FLOC?R DUCT _.__ ; : ___�--� — ` .r-'..,.t"_.�_t i� __.._ GR�UND PLllMBING { . UNQER FLC30R CC�n?CIL�IT ..• � .. . C _ .,_..__.�..,:� .--,...-, ......_ ---____ SLAB GRADE � FIREPLACE FdUNDATION :� _ � — - --'. _.__ _ TEMP PQWER / � F€REP�ACE BOND BEAM � ._-� WATER SERVIC� MID HT. BOND BEAtvt ; 7 � .�: . � n� .� i� �(3OF SNEATFIING -/ -,C7 8 FT. BO�(D BE�Ni " . 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