HomeMy WebLinkAbout11430 - CTTY OF DIAMOND BAR ' �� �x� CaMMUNITY DEVELOPMENT DEPARTMENT .,,,.� 21660 E.Copley Dme Suite 190 PRESS (909)8603195 Fax(909)861-3117 '�^' BUILDING PERMIT APPLICATION FI RMLY y JOBSITE APPLICATION'1 �D � PERMIT PJ�� (Z o ADDRESS S DATE �7 NUMBER # � o� ISSUE TYPE OCC APN lOT TRACT DATE CONST. GROUP p OWNER "" ADDR ZONING SE7BACKS w e FRONT CYDIQC�1 RW ❑ o CITY IP . � . gLPL' S��I REAR ❑ o APPLICANT TE�• SIDFJSIDE STREET RW ❑ � CONTRACTOR r t SIDE O oADDRESS pROPOSED USE cirr zi 7 S �. 9'�q2292 w ARCH/EN W DESIGNER NO.DWEL. NO. NO. a ADDRESS UIViTS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. 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LL POOVSpB � FESSIONSCODE�ONTHATHEORSHEISEXEMPTTHEREFROMPNDTHEBAS�SFOfiTHEAlLEGEDE%EMP• (� /J� QiION.ANV YlIX ATION OF SECTION 7031.5 BY ANY AVPLICANT FOR A PERMiT SIIBJECTS TME APPLICAM 70 z q�'q 6� v r A CIVIL PENAtTY OF NOT MORE TiAN FNE HUNDRED�OLLARS(f5ao).): Z ❑4ASONMEROPIHEPROPERTY,ORMYEMPLOVEE5WITHWAOESASTHEIRSOI.ECOMPENSATbN, � Commercial Will DO THE WORK,RND THE STRUCTIRE IS NOT INTENDED Ofl OFFERED FOR S�LE(SEC.70N,&151- J � NESS AND PROFESSIONS CODE THE CONTMCTORS LICENSE UW�OES NOT APPLV TO Pfl OWNEROF ? PHOPERTY�NHO BVADS OR MPROVES THEREON,AND NMO DOES SUCH WORN HIMSELF OR HERSELF OR � THROU6HHISORHEHOWNEM7LOYEES,PROVIDEDTHATSUCHIMPROVBAENTSAPENOTINTENDEDOH m QOFFERE�FORSALEIF,HOWEVEF,THEBIIILDINGOflK.IPqOVEMENTi550lDWIiHNOlIEYEAROFCOMPLE- Z TION,TME OWNER-BUILDER WILL HRVE THE BUR�EN OF PROVING THAT ME OR SNE DID NOT BUILD OR � IMPRWE FORTHE PUHPoSE OF SALE). ❑1,AS OWNER OF THE PROP�pTY,AA1 IXC1t1SIVELY COMf1ACTING WiTH UCENSEO COMMCTOPS J� � TO CONSTflUCT THE PROJECT(SE0.70/6,BUSINE55 AND PROFESSIONS CODE:THE CONTRAC7OR5 U- dlUfltlOfl !/Q� ADJ.AREA W CENSELAWDOESNOtAPPLVTOANOWNEROFAPROVERlVWF108U1L�SORiMPROVESTHEREON.MID � WHOCONTRRCTSFOqSR7CHPROJECTSWITNACONTflACTOR{S�LICENSEDPUqSUANTTOTMECONTRAG (�UANTITY DESCFiIP'fION FEE Y TORS UCENSE LAW.). � ❑1 AM E%EMPT UNDEH SEC. B.6 P.C.FOR THIS REASON Q � � � LL' OATE OWNEH U . � LICENSED CONTRACTORS�ECLARATION W IHEREBYAFFIRMUNDERPENALTYOfPERJURYTHATIAMUCENSEOUNOEflPflOVISpNSOfCHAPTER � d 9(COMAIENCINOWITHSECTIIX�17a00)OiDNISKKJ30FTHE8USINE5SMIDPPOFESSbNSCODE,ANO Z IX� X MY IiCENSE IS IN FULL�-0flCE AND EFFECT. � LICENSE CLASS �— 3• UC.NO. ��� � O j �� •`�) ~ DATE `�— 3 9� c«�-rw,croR .T. a U W � � WORKERS'GOMPENSATION DECLAHATION � _ �'3a-� � � IHER�VAFFIib.1UN0EHPENALTVOFPERJURVONEOFTHE�OLLOWINGDEIXAM7pN5: l/) ZQ � �HAVEANDWILLMAINTAMACEHfiFlCATEOFCONSENTTOSELFdNSUREFORNKMICERS' $ � � COMPENSATIOH,AS PAOVIDED BY SECTION 3700 OF THE LABOR CO�E,WR TNE PERiORMM10E 'U OF THE WORK FOR WHICN THIS PERMR IS ISSUED. � � W I HAVE AND N'ILL MJUNTAIN WORKERS'COMPENSATION MSURANCE,A4 REOUIRED BY SECTI�1 Q37000F Tl1E LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOP WNICFI IHIS PERMR IS �2. J ISSUEO.MYWORKERS'COMPENSAT `INSUqANCECA�IERMAIDPOLICV UMBERARE� CONSTRUCTON 1 y CARRIER o`_' �� PLAN PEVIEW 1. '—_ Z va-�'r�an�BER — EIECTRIC ' ¢ � (M55[L'fpNNE�trDTBEOJ�.TiEi�CFT1EPEiMi45F0AONEMAqiEDOQ1Ai6P3toa�oR PLUMBING W MECHANICAL Z I CERTIF'/THAT M THE PERFORMANCE Of THE WOflK FOR WHICH THIS PEPMR IS ISSUED,1 (} . SH�LL NOT EMPLOY ANv PERSON W 11NY MANNER SO AS TO BECOME SU&IECT TO TNE � WORKERS'COMPENSATIONUM50FCALIFORNIA,ANOAGREEi{{qTfGtSHOUtDBEODME IN5PECTIONFEE ? SU&IECTTOTHEWORKERS'COIAPENSATIONPPOVIS�ISOFSECTION oOF ELR80H cooe�7,�sHu.�qco�a/nrwinica.�v�vNnn� a vis +s. ISSUANCE • ) p DATE:�J 7��<O APPLICANi: -..�WV SMIP I Y i ' J � ENERGY P/C J WAflNM(�..FAILURETOSECUREWORKERS'COMPENSATIONCOVERAGEISUNIAWFU�ANUSHNLLBE � SUBJECTAN EMPCOYEH TO CflIMINAL PENPLTiES ANO CIVIL FINES UP TOONE HUNDRED 71KH1SAMD ENERGY PERMIT OOILARS(f��,�),N A�OITiON 70 7HE CAST OF COMfENSATION.DMIAGES AS PftOVIDEO FOR IN � SECT�3�oa OF TNE UBOP CODE,INTEPEST.M1O NTTONNEY'S FEES. RETENTQN FEE: � a CONSTRUCTION LENDING AGENCY ppE-ALT FEE: 0 � IHEREBYAFFIRNUNOERVENI1LiYOFPERIURYTHATTHEREISACONSTflUCTIONIENDINC.AGENCV Pofl THE PEHFORMANCE OFTHE WORK FOfi WHICM TNIS PEAMIT IS ISSUE��SEC.3ori,CN G}. Z ' W � LENDEi75 NAME H lENOERSADOflE55 W TOTAL FEES �j � �Q � lCERTIFYlHAT)HAVEREADTHISMPLICATIONANDSTATETNATiHEABOVEINFORMATiONISCORRECT. � IAGREETOCOMPIYNATHALLCITYANDCOUNNOPOINANCESANOSTATELAWSREIATINGT00UIL�ING � CONSTRUCTION,ANOMEREBVAU7HORREREPRESENTATIVESOFTIISCWNiYTOENTEPUPONTHE Z �00VE-NE('=�Efl OH INSPECT i I P OSES. COMMENTS O J � � Q PEFMITfE ME(&RiNn f]U ./ �_� `^� � / ' D y- �.' �, �.�. IJ � l S � SI�N TUREOFPEqMIT7EE DATE = RECPT.NO. PAIO BY ALIDATIO � � WHITE—Department Copy.YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENRO�FiIa Copy.GREEN—Applicant's Copy - ,. . , _ , : „ ,. . , . � � � �. , � ' � . ._. . .. ..�. ,. , . . . , - _ , , . ��C�1`� OF DIAMC��� ��►R iNSPECTION Fi�CORD � � � r � r � . ■ , � � • � � SET BACK FLOOR JOIST FTGSlFORMS/STEEL FHA REQMTS ELECTRIC GRQUND UNDER FLOOR DUCT GROUND PLUMB(NG °���'�`�" �` •� UNDER FLOOR CO�IDUIT S�AB GRADE FIREPLACE FOUNDATION TEMP PUWER '�`� ` '` �'��' FIREPLACE 80ND BEAM - WATER SERV(CE MID HT.BONd BEAM � RpOF SNEATHING 8 FT. BOND BEAM FRAMINGNENTiLIATION FtNAL BQND BEAM RDOF COVER PRE-GFiADiNG HOUGH HEATING BENCHING RQUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERITUB TEST POQL ELECTRIC EXT.LATNlSIDING POQ�FENCING WALI.ENSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. BEPTIC TANK LANDSGAPE/IRRIG. SEEP PITiL.L. QN SITE IMPS. GAS AIR TEST ' FINA�ZQNING FINAL CONST. FIRE DEPT. FINAI FINAL HEA7ING HEALTH DEPT. FINAL FINAL E�ECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY s � # COt�AMENTS � - � ' r� .-. �i��►�►" � � ����' SEPTIC TANK SIZE SEEP PIT/U SIZE q � B 2 ,