HomeMy WebLinkAbout17774 J� CTTY OF DIAMOND BAR �.J��
DEPARTMENT OF CO�UM7Y&nEVELOPMENT SERVICES
21au E.cop�ey vrive
(909)860.3195 Fax(909)B61-3117 PRESS
'�:�' . BUILDINGPERMITAPPLICATION FIRMLY
y JOBSITE ���� S�Iv �V� � j, O Z �
o ADDRESS_ ��ZO � APPLICATION PERMIT P/C
DATE� NUMBER #
� ISSUE TYPE OCC
APN LOT TRACT DATE Z d Z— CONST. GROUP
p OWNER
u" ADDRESS 20NING SETBACKS
Z CITY ZIP TEL FRONT RW ❑
g APPLICANT TEL REAR ❑
� SIDFJSIDE STREET RW ❑
� CONTRACTOR � G C� SIDE p
� ADDRESS
o CITYQ�-,,E'�[(�,f�.rL/y ZIP E TEL.�I � �- QCI PROPOSEDUSE
o ARCH/ENG/
zW DESIGNER NO.DWEL NO. NO.
n. ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION
� OWNER•BUILDER DECLARATION SFR/ADD/REM �
O
p I HEREBY AiFlRM UNDER PEWLLTY Of PE0.RIRY THAT I 11M E%EMPT FROM THE CONTMCTORS lL Garage/Carport
LLI CENSEUWFORTHEFOLLOWMOREASON�SEG7o77.68USWESSIW�VROFE5510NSCODE:ANYCITYOR (n
U COUHTYWMp/REOViRESAPERMITT000NSTRUCT,ALTERM.�PROVE,OEMOLISH.ORREVNRANYSTRUG W P8(10/OBCk
� TURE.PiUOR TO RS ISSUANCE,ALSO REOUIRES TIE ACPLIC�M FON SUCH OEN/II7T0 illE A SI[iNED W
STAiEMEM TNAT HE OR SHE IS UCENSED PURSUANT TD h1E iROV�SIONS OF THE CONTMCTORS L4
� CENSE UW(d/APTER 0(COMIdENCEJO WITH SECTION 7000)OF DN4S�ON!OF TNE BUSINESS AN�VR0. u' POOVSp2
fE55qN5CODE)ORTHATXEORSHEISEXEMPTTHEREFRdAANDTHE8AS15FORiHEALLE6EDEXEMP•
� TqN.AN'/YIOUTIONOFSECTION70�1.6BVANVAPPLICANTFOqAVERMITSUBJECTSTHEAVPLICANTTO Z Re-Roo1
�„� A CMt,PENALTY OF NOT MORE iMAN fIVE MUNDREG DIXURS(fw%.1: .
0 04�aM1EROFTMECl70PERTY.OR/AVF�PLOVEESWITHWAGESASiHEIqSOLECOMPENSATqN, O CDrtlff�efGWl -
Z WILL DO TME WORKAN�7NE STRUCiURE IS NOT INTEN�ED OH OFFERED FOR SALE(SEC.701I.BUSI• J
� NE55 MIO PipFfS510N3 COOE:TlIE CANTFACfOR4 LICENSE Uw DOES NOT AVVLY TO AN OWNER OF �
PIqVERTY YR10 BULOS OR IMViqVES 7MEREON,M70 MI/IO DOES SUCH WGRK NIMSEIF OH MERSELF OR
� TMROUGHNISORHEROVMEMPLOYEES,PRWIOEDMATSUCHDAPROVEMEMSARENOTNITENOEDOR m
pOFFEREOFORSKEF,IqWEVERTMEBUIIDMaOqYAPROYEMENfI550LOWIiMNONEYEMOFGOA�PIE
Z TqN.THE OWNER-BUI�pER MALL HAVE THE BURDEN OF PROVW�iHAi NE OR SME D�D NOt BUIID OR
= IMPROVE FORTME PUHP0.5E OF SALEI.
�4���ER OF THE PROPEi#TY,MI E%GUSIVELYCONTMMN6 WITN LICENSED GONTMCTOR4
Q TO OONSTHUCT 1NE YROJEGT ISEC.TON.BUSINE55 NiD PROFESSIONS CODE THE CONTMCTORS LI• V3lueti011 ADJ.AREA
L11 CENSEUWDOESNOTAPPIYTOANONMEROFAPROPERTYNR108UILDSORWOpOVESTHEREON.AND
� NnqCOMMCTSfORSUGIPRRIECTSWITMAWKfMCfOR(5)IICENSEDPURSWJfTTOMECOMMG QUANTITY DESCRIPTION FEE
Y TdL UCENSE UW.). / .y�
� OIMIEXEIAPTUNDERSEG B.BP.G.FORTHISREASON a ��Io �/"�'�'�'
� U �
Z DA7E OWNER � �
W �
�Q UCENSED CONTRACTORS DECLARATION w . j _ ' /�,
CL �HEREBYAFFIH6IUNDERPENALTYOFVERRIRVTMATIAMLICENSEOUNDERPRONSIONSOFCMAPTER � � . C �/.� D
� Y�Cd.lA1ENCYX3WIiM5ECfION7000)OiOM510N70FTHE8U51NE55ANOPROFE551DN5CODE.AND ➢�'v/S
X MY UCENSE IS W FUl FOR E M1D EFFECT.
� UCENSECUSS � �� LIC.NO. ���u+� � �� ' r' ,��� ' D O
V DATE ��Z�O� CONTRACTOR a
W
� - WORKEFiS'COMPENSATtON DECLARATION �
� IHEREBYAFFIRMUNOERPENALTVOFPEiWRYONEOFTHEFOILOWINdOfLIAMiqNS: � Z
Q
� _IMAVEM7�INLLIMRITNNACERTIFICATEOFCANSENi705ELFiNSUAEFORWORNERS' _
COMPENSATION,ASPROVIOE�BVSECTION]7ooOFTMEU80RCODE.iOR7HEpERFORMANCE W
OFTHE WORK FOq WXIp1THIS PERMIT IS ISSUED. �
� - /
O �1 HAVE ANO MALL AWMAIN WOHNERS'OOA�7ENSAiION INSU0.WCE,AS REOUIRED BY SECTqN
�7000FTNEUIBORCWE,FOflTMEPERFORMANCEOF7NEWORKFORWMICH7NISVEHM1T15
J ISSUED.MYWO�S�'C�O,�Mf ENSATIONINSUIIANCECARRIERANOPOLICYNUMBERME: CONSTRUCTION'�
j CARRIER 7`lL�Ll� .-�' PLAN REVIEW
� POLICV NUMBER � � � ^ ELECTRIC /f ,
� (I/S55EGTX1�NEmNOTBE00AplE1fDOFhEPEibdT6FOR0�dEFtl�DfimDOLLIFl5R��10i11E5S} PLUMBING
Z ICENTIFYTMATNTHEPERFOPMANCEOFTHEWOHKFORVM�CMMISPERMRISISSUED,1 MECHANICAL
C7 SHALL NOT EMPIAV M!Y PERSON IN ANV IAANNER SO AS TO BECOME SUBJEM TO TNE
� WORNERS'COMPENS�TpNLAWSOFCIWFORNIAA ACfiEETMATIFI51qULD8EGOME INSPECTIONFEE
S�ECTTOTHEWORKERS'COMPENSATqNPRO 5 NS999 SECTIO o00FTNEUBOR
oame,i sw�u Famnvin�cw+vir wm�nro E v vi�. ISSUANCE
� p ; --/z�oy AVPUCnNT. � SMIP
NIN .FAIL E� SECURE WORKERS'COMO ,,ATION COVE� IS UM,AwF AND SXALLBE ENERGY P/C
� S ECiANEMPLOYERTOCRIIAWAL�ENAL7IE CMLFWES DONEFN REUIMWSAN� ENERGYPERMIT
OOLLMS(ilao.000),INADDITIONTOTHEC0.5� FCOMPENSATIO ,OAM�GESASPHONDEDFORM `�
J SECTpN»OBOFTHEIABORCOOE,INTE0.E ,/�NDATTONNEY5FEE5. RETENTIONFEE:
�
a CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� IHEREBYAFFlRMUNDERiENPLTYOFPEHJURYTHATiHEHE15ACON5TRUCT1ONlENDINOACENCY
PoN TNE GERFORIAANCE OF TME WORK FOR WNII]I TMIS VERAIIT IS ISSUEO�SEC.]OY7,GV.C�.
�
�Z LENDER'S NA1AE
�
� IENDEII'SMDRE55 ���I
¢ ICERTIFYTMATIHAYEREAOTHI511PPl1CATIONANDSTATETHATTIEABOVEWFOR1AATqNISCORRECT. TOTAL FEES
W IAGREEiOCOMPLYWIMALLCITYMIOCOUNTYORDINANCESMlDSTATEIAWSREUTINfiTOBULDIN6
� CONSTqUCT10N.11ImNENE9YAUT110HIZEflEPRESENTATNESOFTHISCOUNTYTOENTERUPONiHE
Z ABOVE�MEMIONEDPROPER7V FO i vecTar�waros6s. COMMENTS
�
J
_
m PERMiT7EEN �(PRi )
¢ �/Z'dTi �-
�
� s�aruniaEo E ��1TE
� AECPT.NO. PAI BY VALIDATION
W E-0epartment Copy.YELLOW—Finance Copy,PINK—Assesaa Gopy,GOLDENROD—File Copy,GAEEN—AppuranPs Copy
.._..., .., ,..,.._........ ...._..... ��..,,�....�.,,,....,.. . ,,.,. ...., —.'r..•�c!.: ,:r —
. . .,., . .�.... ,. . -� ... .,. .. . . . ._. ..... _ .
�ITY Of� DIAMOND BAR
, � ll'dSPEC i lOh1 RCCUf�D �
`_.';���.���.���►�,� _.. ���f�: 1���-�F�_����a�a�'. . . . . . � c� e� �� . . _ � � _. _ ! y �' o
�: ;:la�i�'.�. :��.�.0��:�.� . Y�.`��i.� I �� � ,
. SEr BACK __........ - - ___ ...___I --.---,--�--- ;-�` FLOOR JOIST._._ .__._ -: :�- _,�._.._ -- - W....... -
_".. 4. •
FTGS/FORMSlSTEEL I FHA REQMTS
ELECTRIC GROUND ' UNDER FLOOR DUCT �
GROUND PLUMBING � UNDER FLOOR CUMDUIT
SLAB GRADE � FIREPLACE FOUNDATION
TEMP POWER - � FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM - � -
ROOF SHEATHING � � � 8 f-T. BOND B�AM
FRAMINGNENTILIATION FINAL BOND BEAM
ROOF CaVEFi ' PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC 3 ��oL �Q� � ROUGH GRA�ING
ROUGH PLUMBING ' � FINISH GRADING
SHOWERITUB TEST � POOL ELECTRIC
EXT,I..ATH/SIDING POOL FENCING
WALL INSULATION i POOL FINAL
CEILING INSULATION i OFF SITE IMPS.
DRYWALL NAILING ; DEDICATIONS
SEWER j FINAL ENG. .
SEPTIC TANK . LANDSCAPE/IRRIG. � �
SEEP PIT/LL. � �N SITE IMPS.
GAS AIR TEST FIt+IAL ZONING
FINAL CONST. ' ! . �lRE DEPT. FINAL
FINAL HEAT�NG � HEALTH DEPT. FINAL
FINAL ELECTRIC ' �' � �'�=--''' •�••. i. DEV. FEES PAID
:����,....,_.�._-
FINAL PLUMBING � i ENERGY
� �?DF�- — �'� •-r_ �
'�'^(�L ' , I y"S e ;c.� et�e� � e��; _ ' i
� � . �
• - - - . _______ _ _----- -- ---- _ .
COMMENTS.3-t�-oZ,_c.mt_pu�e.�Rcve�-_�'�l�e-�Js,o ��. _._ _ __ . _
SEPTIC TANK SIZE .
SEEP PIT/U SIZE
`���
_ _ __ _ _ �
_ ,
� �i1�� � � _6�
.. . . . ... . . , .4 .
�.
_._.. , , , .. ... ' I
. ... . .. . . . . . �
� .... . �� - � - . .'i , . ; .. ' . . .