Loading...
HomeMy WebLinkAbout16981 (42) �\ CITY OF DIAMOND BAR � � � DEPARTMENT OF COMMi�1ITY 8c DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS '•��� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE � ,��,. ;� APPLICATI PERMIT P/C o ADDRESS � ■,�g � 1 Y DATE �� D NUM�ER/�9�/ p � ISSUE TYPE ' OCC APN LOT TRACT DATE CONST. GROUP p OWNER P � � "' ADDR SS� �-� � ZONING SETBACKS z CITY � r ZIP�i 1?l_�TEL.��� FRONT RW � O � APPLI ANT TEL. REAR ❑ � SIDE/SIDESTREET RW ❑ � CONTAACTOR C -• � p,�, l��,r G� ��C SIDE ❑ � ADDRESS CIT'- rf7��- % PROPOSED USE �' I� i 1 (s o CITY ZIPl�� TEL.�(���/•'��° �i�r. ,.'C�. � !;f � � z DESIGNER/ ""�L�"rY�—��'`t-��-v'v' ' ��! W NO.DWEL. NO. NO. a ADDRESS UNITS � STORIES �EDROOMS � CITY ZIP TEL � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•DUILDER DECLARATION SFRlADD/REM O I HEREBY AFFIRM UNOER VENALTY OF VERNRY T/1AT I AM E%EARPT FROM iME LONTMCTORS LI• G2f0 JO/CBfpDR W GENSEUwFORTHEFOLLOWINOREASON(SEC.70.71.SBUSiNE55ANDVROFE55lON5CODE:ANVGT70R (n U CIX.NryWHICHREWIRESAPERMITTOCONSTRUCT,ALTERMPpOVE.OEINOL15H2ORRFPAIilANY57RUL• W PaIiO/DBCk � W TURE.PRIOR TO ITS ISSUANCE.AL50 REOUIRES ThIE APVLICANT FOR SUCM 7ERMIT TO FIIE�SIGNED W STATEMEM TNAT NE OR SME IS UCENSED OURSU�NT TO iNE OibN510NS OF THE fANTRACTORS ll• � CENSELAW(CFWTERY�COAI�ACNCINOWITHSECTION7000)OFDIVIS�ON7OFTMEBUSINE55A4DPRO� � Pool/Spa FESSIONSCOOE)ORTHATHEORSHEISEXEMPTTH[REFROMMIDTNEB�SISFOATH[MLECEDE%[1AP. (!� � TION.ANY VIOLATqN OF SECTION)OJ1.5 BY ANY APPLICANT FOR A PERMIT SUBIECT9 THE APFI�CANT TO Z �9-ROOI A CIVIL VENALTY OF NOT MORE TNAN FIVE NUNORED DOIURS(f500�r Z04��N�EROFTHEPROVERTY,ORAIYEMPIOYEE5YA7HWAGCSASTHEIFl50LECOMPENSATqN, ❑ COmm6fCi01 WILL DO THE WORN.A4D THE STRUCTURE IS NOT IHTENDED OR OFFERED FOR SALE ISEC.70u,BU51• J N NE55 ANO PRDFESSIONS OJOE:THE CONTRACTORS LICENSE UW DOES NOTAD7lY 70 AN OK'NCN OF ? DROPERTY Wlq BUII.DS OR IMPROVES THEREON,IND NMO DCES SUdI WORN HIMSCLF Oil MERSE:F OR (L TMROUGHNISORNEHOWNEMPLOYEES,P0.0VIOEOTNATSUCIIIMPROVE�ENTSARENOTWTENOE00�1 m � O�FERCDFOfiSALEIF,HOWEYEiliHEBU'�LDINGOqIMPROVEMCM15501DN^.THINONEYEAROF�pMPLE� Z TqN,TME OWNER�BUILDEF WILL FNVE TME BURDEN OF GROY:NO TMAT NE OH SME D�D NOT BUILD OR DAPqOYE FOR THE VURPOSE OF SALEF w Ol�.+`�MINEROFTHEPROPERTV,AMEXCLUSIVFLYCON7MCTWGWi7HLICCNSEDCONTMC70RS Q TO CONSTRULT THE PRQIECT(SEG 70a.BUSINESS AND 7NOFESSIONS CODE:TML QDFfiMCTORS U- V01U�tiOn �� ADJ.AREA W LENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTYWMOBUILDSORiIAPROVESTMEREON.A4D z MA/OCOMRACi5FOR5UCHVROJECTSY/iTHACONTRACTOR�S)UCENSED7UFSUANTTOTMECONTPAG OUANTITY DESCRIPTION FEE � TORSUCENSEUw�. Y ¢ O I M1 E%EMPT UNDEH SEC. B.6 C C.fOR TMiS REASON Q � U li. � DA7E OWNFR U Z W �4 LICENSED CONTRACTORS DECLARATION w CL IHEfiCBY�iFIRMUNOERPENALTVOFFEMIRY7NATIAMLICENSEDUNDERPROVI510N50FCHAPTER � � Y(COMMCNCWO WITH SECTqN 70a0)Oi OrvISiON]OF TME BUSiNF55 M1O iHOFE5510N5 CODE,AYD Z ��� WLILENSEISNMLFOHCEAh9EFFEGT. m � LICENSE CLASS � LIC.NO. 3�. / / j ! J V OATE �], ` ��C���f COMMCTO r--� _i_� a W � WORKERS'COMPENSA710N DECLARATION 4 � I HEREBV AFFIRM UNDER OENALM OF VE0.IURY ONE OF THE FOLLON^.NG D[CLAMTIONS Z Q 0 _IIUVEANDNALLMAINTtiN�CERTIFICATEOF�pNSENTTOSE�FiNSUR[iORWOPI(ERS' _ . � COMPENSATION.AS PROVIDED BV SECTION�7000F THE U[iOq COOE,FOH TNE VENFORMANCE U Q OF iX[N'ORK iOR WHICH THIS FERMIT IS ISSUED. � � _I HAYE AND WILL UAMT�:N WORNERS'COMPENSATION INSURAflCE,AS PEOUIRED BV SECTION / Q 770D OF TME LABOR OODE.FOR TME PERFORMMiCE OF THE WORK fOfl wNICN iM15 PEPMi715 �/ %O ISSUED.MYVADRKERS'CDMPENSATIONINSURANCECARRiERANDGOLICYNUA!CERAFE: GOYSTRUCTION C•� ¢ �AAqIER ' •� � =�r� �-�t�V��-LT� PLAN REVIEW > Z vai�crrauua[A� ������-/�� ELECTRIC ¢ 0 (h65ECilOHNEmNOTB[CL7.a�ETEDOF7IE�EPMT6RxtO�EM1��ORED00ILAF�,R'OoIOHlF55} PLUMOING Z ICERTIFViNATINiNEFERFOFlGANCEOFTHEWORN�ORMMICHTHISPERMITLI55lJED,I MECHANICAL -�--•���� �- -��•�• �� - (J SHALL NOT EMPLOY ANV VERSON pl/�M'MMINER SO�S TD BECdAE SUBJECT 70iNE I'_��I'�'\ I I I � � WORI(ERS'COMPENSATIONUWSOF�IFOANIA,ANDAGREETHAiIFI5HOl1LDBECOME INSPECTIONFEE S SUB.JECTTOMEWORKERS'COMPENSATiONiROV15qNSOFSECTqN370oOFTHEUBOR CO�E,I SHALL FOfiTMY1TM WMI'LY WITM T1q5E PROVIS�ONS. �SSUANCE p OATE: APPLICANL SMIP � � ' •�� W ENEFGY P!C —� WARNINC:FA4UfiETOSELVREWOfVCERS'COA�GENSATIONCOVERAGEISUNUWFk,ANOSHlLLLBE LL SU&IECTANEMPLOYERTOCRIMINALPENALTIESMDCMLiWE5UP700NEMUNDRCDTHOUSAND ENERGYPERMIT OOIURS(5100,000�.IN ADD�TION TO THE CAST OF�OMPENSATqN,DMUGES AS YROYI�ED FOR IN � SECT�oN�7oeOFTHEUIBORCOOE.NTEREST,ANDATTORNEV'SFEES. RE7ENTIONFEE: • �•� � cwi.. CONSTRUCTION LEN�ING AGENCY PRE-ALT FEE: Q INEREBVAFiIRMUNDERVENALTYOFPE0.7URVTHATTNEREISACONSTRUCTIONLENDINGAGENCY n- FORTHEPERFORMANCEOFTHEWORKFORWHILHTHISDERMiTI5155UED(SEC.7ov7,CtV.G.). Z W � lENOER'S NMAE S F_- lENO[RSADORE55 �J W ICERTIFYTMATIMAVER[hDTHISAPPLICATqNA4DSTATETMATTMEADOVEWFOR1AATqNISCORRECi. TOTAL FEES /O^' �v � IAGFEE TO COMP�V NATH ALL CRY AND COUNTY ORDINANCES Ml�STATE LAWS RELATINO TO BUILDiNG � CONSTRUCiKKJ,AIVDNERE6VAUh10RREREONESENTATNE50FTH15COU1fTMTOENiEiillPONiHE Z c TqNEDPPOPERTYiORINSPECfIONPURPOSCS. COf1rME'NTS O j � ��'� � `- �c 1— m TTE ME(PRi �� � Q //��� N iG�1„tE0 4EF RMIT'fEE DATE � �tt/ - R[CPT.NO._ PAID BY 5Cti- VALI�ATION WHITE-DeDartment Copy.YELLOW-Finance Copy.PINK-Assossor Copy.GOLDENROD-File Copy.GREEN-ADPI�wnYs Copy . , . . . . . , .. ...__........ . _.. .. __........ .._. . .. .. . . . .. . . .. .. . , . •.��� , ., - , . . , . . . . . ' a�.� l '�' r;[: 1r`��-'�f�iQ�'vn' Fi/�� � �!'i..�?i''�i�� : ��i��� �:r�L�J!E� -- ----'�.' �._. . . . _--.._�_.. (►�E-�7:�=��"I�1�1►! ��it:i I:`�`�:�_ 'f:z'J:. fi'F:i:�- !'l�J�'I rj�'t!'= ����`i�a=:.[`i{'[IC1 __... .._...._.. -.._ _-.. ---. . _ . . . . . _. . .. .._ .. __----•----_. ._. _... .... .... ....... .... - -. .. . . StT B�CY � ; ( ; FLCOR J::�;;,T � _ _i -- �-- -----.... - ---- - ---------- ------�----- -- -.... _....-- FTGS/FOR'�1SISTEEL I -- � --- --- i [=HF, fZEQ—.1 S --- ' ---- I - ELECTRIC GROJ�J� ; ' ' ; U�•;D�R FLOOR DU�T ! - I GR�'JUND PLUi:iBltvG —�--- ..--� --- ---- --- I ! Ui1D�R f=LOOFi CG,`•I�UIT - - +----- ----------- ---- -- — ----- SLAB GRADE ! I I � �IREr L.f.CE FOJF:Ur1l"10„ • � TEP,?P PO'�"JER � � I � fIREPL.F.CE r30P�D E3�F,t,.1 � � V;�ATER SERVICE I � ^ I ��1!D HT. �O°�[�'CEF�.�"-----;-- � . � o I � e �. g���v�.��-�,�.t_—�- ---I— —•- r�ooFSH=_E�T�ir�a � �Z-- l_l_%-�— - '� -�-- - -- �--- --� FRI',M.ING,NEtJTILIATION I � ��_ -~ � FINAL F�O;JD EEA�.1 � _ � _ ROOF COVER 1�/�a� ��Q_/r""- " _ I FR�-GRAD�N_� I i _ — ROUGH HEAi I�JG , � � oEi•;�HiN� _ i � fiOUGH ELECTRIC � ; �_� ROUGIi GriF;Dl;•JG � � -- -----i-� ------- -�-� --�- ROUGH PLUt�'F31Nu � � I � FI�•liSfi GFiADIi•�IG f_ _� __ _ SHO�'JER,rfUB TEST I I I I E'OOL ELECT-RiC � �_ EXT. L{1TH/SIDING � _� I i PCOL FCh:CIPJu I I _ �"JALL INSULATIO�! � ------�-I PCO(_Fli�'AL — � I CEILING I�•�SULATION �__ __� j OFF SITE i^APS. _ � DRY4"JALL PJAILI�JG I I ; DEDI:ATIO�dS ' SEVJER I �- —.--- I FI"J/�L 6"dG. 1_ --- - - SEPTICTANK � • I LAPJDSCAP.r/IRRiG. � SEEP PITlLL. � � • � O'� SITE I�:1PS. _ � � _ GAS AIR TEST j • � FI�:AL ZO;JIP.G _� � _ FINAI_CONST. � ( !� F!RE ULr T. FIP�A! � FIiJAL HEF,TIfJG � I ; I HFF,LTH CEFT. F=1Nf�L I I FItJAL ELECTRIC I � � i DEV. FEES Pr11U r— FINAL PLUPJI9ING � � � , E��ERGY I i ---� I --�-..._ �� ...:- ' -����:r-__.._.�_' i -- cor,nMEr�Ts .� � SEPTIC TAP�1K SIZE SEEP PIT/U SIZE -- . _ _____. .1�I; __ , .-- ►��� ,� — - , . y� .` l