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I �� CITY OF DIAMOND BAR � � : DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS '^^'� BUILDING PERMIT APPLICATION FIRMLY � ��BS�TE APPUCATIO � Q PERMlT P/C�Q_ � ADDRESS ��0� S. /gQC�74 Ci¢✓/o�+ � DATE ��� 1 NUMBER IF -�-�-� �, 15SUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER Sc^�no�R. M�i.«nA�. � ADDRESS ���� 3. a�C�o�A G.�i+ye.+r I� ZONING SEfBACKS � CITY '����VT ZIP 9��Q TEL FRONT RW ❑ APPLICANT ��e't 7`Je��� TEL.7iN �.le-3�84 REAR O � SIDEISIOESTREET RW ❑ CONTRACTOR_ �MKD CONS�Cl2U GT10A1 SIDE O � ADDRESS.ZI� 4?. CR��C�r.�T AV�ak121 � _ C(Ty ANAk�iFd ZIP C'A`�K,�FEL�IiC QYI��Y'� PROPOSEDUSE �r"�r�•• 'i+�'•'-•0 5 ��a4� p --,- CMOv�- .+ST�i« UTPS' Co�rm-S � ARCWENG/ �.Q4^Ci � /o.+�$ — ' Gs'�JTR✓�-T' d" ��•[µ •.�Iw � eeJZ DESIGNER ✓ NO.DWEL N0. NO. ADDRES (�� �/ ✓('7'f�'�so� 5'�•sY' � UNITS STORIES �BEDROOMS� N CfTY �`''0 ZIP_4�� TEL"]�'/ �.�o'3�SG v� DESCRIPTION S0.FT. FACTOR PSF ADJ.AREAlYALUATION Q OWNER-BUILDER DECLARATION SFRlADD/REM O ' 1 HEREBY AfFW►1 UNDER VENKiY OF GE0.AIPY TNAT 1 AY E%EYVT fiqN iNE COHtRAC70R5 U� Garage/Carport W CENSEUWPoN7HEFOLLOYYM(iRFA50N�5EG70]1.68VSWESSANDPROFESSqN5CO0EANYGTYOR (f) CQUNfYWVUf]ffiE04WESADFAWITOCOlLSiRUCT,KtE0.YCROVF,DEY0U5N,ORflEVAIHIHYSiRUG W PatiolDeck 7UR6 PiWR TO RS ISSUNJCE.AL50 REW WES TNE MPLICANT FON SUGf PERAUT TD FllE A SIGNED w � STATEMEltT THAT HE OR SF1E IS LILENSED PURWANT TO i/1E PiqYi5lON5 OF TME CONTMCTORS LF CEttSEUW�G41➢TERC(COYMENCYXiWITNSECTION)000)OFDIVISqN30FTHEBU5WES5ANDPND. LL PooUSpa FESSqNS OODE)Oit T/NT HE Ofi SHE IS EXEIAPTiMEREFROAI AND THE BASiS FOfi TFfE ALIEGED EXfuP- TqN.Ni'fYqUT10NOFSECTAN)WI.SBYfNYMGIILINTiOfiADERANTSUBJECTSTNEAGKIGWLTO Z qB.qoo� � A GVIL FENALiY OF HOT YOHE iYIAN FIVE IWNORED OOUM511500).1: ^ � OL�OMRIEROFTHEifqVERTY,ORNVEMPLOYEESVATNWAGESASTNE�qSOIECOAIPENSAiqN, � '�(',pmmefCia� � " WILL DO h1E VfORK,N�O THE STRUC7URE IS NOT WTENDED OR OFFERED FOR SALE(SEG 7Wa.BU54 �J N HE55 M1D VROFESSIONS CODE iME CONTRACiORS UCENSE UW DOES NOT AVPIY TO AN OWNER OF � VROGENTY WFq BUlD40i1 M1iR�VESTHEREOf{AND N1q OOES SUCN WORK HIMSEIF OR MERSFLF Oq (= Tw7U61/W50qNEROwNE►�GLOYEES,DROYIOEDTMTSUGiw7ROVEMEMSAFENOTMENDEDOR m - � OFF61FDfORSIlE�MOV�ENFR7HEBlA.DW60fiMPRDVEMENiI5501DW17WNONEYEAROFLOMPLE- � TqN.il1E OwNERBUtIDEN MALL HAYE 1)fE BUFiDEN OF iROYN/0 THAT ME OH SHE DD NOT BUItD Oq MVFqVE FOR iTiE PURPOSE OF SALEI ❑l�S OMMER OFTME PROPEHIT.AY IXGLUSIYELY GONTIiAGTwO MrtTH LICEHSED CONiRAGTORS W TO(YINSTRUCT i1/E if101ECT(�G 704.BUSINE53 AtiD DROfE5510NS CO��E:TME�NiRACT00.S lM Z O O j� � GENSfUWO0E5NOTMPLYTOANOMMEROFAVFiOFEfliYWFqWtD50RWPilOYCSTMEREON.IWD VaWatim /��./�flE/1 � NR/DCOHiRAGT8fOf45UG1PN0.JECfSWIT1IACONTRACTOH(S)LIGF.t:SEDPURSUANiTOiMECONTRAF pUANTITY DESCRIPTION.. FEE iOfiS LICENSE WN.} j � O IA11 EXFIIPT tR�DEA SEG B.l P.G FON TMIS REASON Q . U � � DATE OYMER V � UCENSED CANTFlACTORS DECIARATION w J � IHEHEBYAiFIPo/UNDERGENAITYOFDE0.1UfiY7)UTIAMIICENSEDUPIDERDROV1510N50FCMAPTER V. s �(�MENGwO WITH SECiqN 7000)OF DmSqN]OF TNE BUSwESS AND PROFES510N5 GOCE,AND Z LL� YYl.IGEN5E IS N FULL FORGE AND EFFEGT. m � UCENSELLASS L1C.N0. j � at� 6— — "� coHTa�croa � a � WORKERS'COMPENSATIONDECLAMTION 1 �l.} a N l��� U � IHEREBYAFFIRYIX�ERPENK7YOFPERAIRYDNEOFTHEFOLLOWwGDECLARI�TqNS: Z � �INAVEANDWILLMAIMiAP1ALERTiF1GATEOFCOnSEMTOSELf�U15UREFOqWONCERS' S COA/DEN4ATpN,A4 DROVfDEO BY SECTION 3700 OF TME LABOH CODE,FOR TME PERFORMANCE U � OF TNE WOPoC FOH MRiGf THIS iEFWi L4155UED. � O �I FUVEAND WLLLMNNUW WORKERS'COMPENSATqN WSUR.wCE.AS REWIRFA BY SEGTqN �O Q �)00 OF iF1E UBON OOOE FOFI TME PERFOFYAANCE OF TME WORK FOR WMiGM THIS PERMIT IS tswW.urwotvc�tas'taaP�TarrwsuwwcEuaa+ERtivOvo��cYHuc�eEauae CONSTHUCTION - _ � � w+wea �T�C� ��N U PIAN REVIEW Z � � ��A l�3�S 4—`�� C-�►�� E�craic 0 (IIISSECfpNPE�rqTBEoU.iIEfIDOCT1EVEaARsfaHor�l4tnaEDOnURS(Sim)aiLE�� PLUMBING Z 1 CERTIFY ilui IN iHE VEfiFONAANCE OF THE WORK FOR WHICH THIS PERMIT LS ISSUEO.I MECI-IANICAL T����x'� (� 511ALLNO7EMPLOYNlYGE0.50NWANYMIVINFRSOASTOBECW�ESUBJECTiOTNE � NORKER5COM7EMSATqN UNS OF CAIIFORNiA N+D AGREE TYUT IF I SIIOULD BECOME INSPECTION FEE S SU6JEC7TDTHEVIORI(ERS'COA/VENSATqNYROV1517N50F5EG7qN77ooOFTMEUBOF COCOE,I SrMLLFOpRT)M'ITH COM7LY W17M THOSE GROVISi N5, ISSUANCE /1 L � DATF: v-41Q"� APPLICANT: SMIP •��J1� �i,Q(� � — � WARNi1HI:FILl1RETOSECUREKO(iKERSCOMPfNSATIONCOVERAGEISUKAW ANOSHALIBE ENERGYP/C CL�r^i� • - •r--^ ; �-. LL SUBJEGTANEUPWYERTOCWMWFLGENALTIESMiDCNILFWES�PTOOriEHUNDREDTNOUSAND ENERGYPERMIT.tC� �a�`�`�;�'f V•�` �S111o400aNWADO1T10N70iHECOSTOiCOMPENSATqN.DAMAGESASPROYIDEDFOfiM! SiY lY.�,-�. . - ¢ SECTION]70!OF 7/1E IABOA COOE NTEHESL AND ATiOHNEYS FEES - .•��'•f • �••a�� _...��a �, REfENTION FEE: � oW., CONSTRUCTIONLENDINGAGENCY PRE-ALTF�^ , 1� � II/EREBYAFFIRAIIR�DERPEHALTVOFDERIURYTHATTNEAE15ACON5TRUCTiONIFNDWGAGENGY �� � �- FORTNECERfOR4ANCEOFTF�EWORKFORNRIIp1THISPERA/ITISIS5UE0(SEG7097,GV.G�. Z�r . Z ����, W � LFNOERS NAME "�'�-� F_- LENDER'SADDRE55 W ICEFTI%THATIHAVEREMTHISMPUUTIONNIOSTATETHATTIEABOVEWFORA1ATqNISCORAECL TOTAL FEES I � � IAGflEETOCOMR�N7MALLCliYANDCWNT'OHOIlLWGESANOSTATEU�WSREU7W6TOBVIIDING CONSTRUCTION..wD NEREBV AUt110fiIZE ilE7fiE5EN1ATIVES OF THIS COUNTY i0 ENiEH UPON THE Z ABOVE�MEMqNED PNOFERTY FOii NI5PEC710N PURPOSE& COMMENTS g �— E{ L�C�. � m PF.RMITTEE NAME(PPI Q N � � SIONATIIHEOFPERA11TiEE DATE � flECPT.NO. PAID BY VAtJDAT10N WHITE-OeperUnent Copy,YELLOW-Finanoa Copy,PINK-Assessor Copy.GOLDENROD-File Copy,GREEN-Applicant's Copy . . ,. •y, r�e• . , . ..k ....�., .r., ,.. , . . ..e .�,n..� .., . .,r•. � �e,. ' ., . + ... � .. •.. . .,. .. ,.. . - - , � CiTY OF DIAMOND BAR , , INSPECTfON RECORD � r ij►'�:j:��y�!'�7.�' ��a�f1a i��.�.��'l�n.f �1►�k�'����=1!11..�.��.f �,3.4'=�ti�. ����.fi��.;�.-�1*S � 5FT BAC(:_� ; � ^ ; - --_�-�. � `i� FLOOR JOIST ^ -�,� ,`, a' - ,..,� — -- iTGSIi=OF�T.4s/STEEL ' y- � � FHA REQP�ATS j FLECTRIC GROUND � UNDER FLOOR DUCT GrOUI`!D PLUti4Bf�lG � UNQER FLOOR CUfdOUIT ._ .., _, �� ,`,,,, �---�LAF3 GRADE FIREPLACE FOUNDATION • - � ,��'�-� � i�",1P POWER FIREPLACE'BOPJd B�Ah1 "" � ' • � ' 'AT�R SE!�VICE — MID HT.BOND BEAM' � �' •. � R05E8FiEA�t-IING= �= ' f -� •� S FL BOND BEAM - - • � F�i1.�.'�f��r�ni�r��r��azioN , �/�� FINAL BOND BEAM _ �r!;C)C)F COVGR ,��/ PRE-GRADING , ' '" ' '' ' �'v"JGHHEATING ' 6ENCNlN�:�-��.� �.�;- � .--,,1:' -.ti.'..':1 r--- � ROUGf! ELECTRIC � ' ROUGH GRADING - R.^.,UGH PLUMBING FINISH GRADING SF!O�^JFR,�T UB TEST POOL ELECTRIC ' � FX7'.{t1TH/S�DING POOL FENCING + 'r'r,LL IPlSULATfO�f POOL FINAL �C��LifdG irJSULATICN OFF SITE IMPS. � D'�1;�J!',Lt PJAfLING �EDICATIONS • iSEI,'v'ER FINAL ENG. j �',:?TIC'fANK � LANDSCAPE/IRRIG. �='::C�PITI�L.L. ' ' •> " ON SITE IhAPS. � .,�.�,. � �a=S ralR TEST FihlAL ZOMNG � ' L C�"dST. FtRE DEf'T.F(NAL ` �''' -�� i�`�°� - � ; ;����:�.!HFATIflG � J HEALTH DEPT. FINAL � ,__:];.L�LECTRIC DEV.FEES PAIp -- -- �i'.�P;i_PLi'"J�BIP�G E�7FPGY � . , - - , --- � � t �r�� -"'�` '�-a-- � ,' .. 3 ----T--- �� - , . .. . _ - . . 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