HomeMy WebLinkAbout15583 (20) � ��� CITY OF DIAMOND BAR
-"�� DEPARTMENT OF COMMiJNITY di DEVELOPMENT SERVICES
• � 21660 E.Copley Drive Suite 190
' (909)860-3193 Fax(909)861-3117 PRESS �
��`M^�. . BUII.DIlVG PERMTT APPLICATION. FlRMLY
N JOBSITE / APPLICATION � PERMtT I�C,'� PIC
o ADDRESS_�C7S � ��?/ �i.`7'� l�::r+�»i�h DATE � NUMBER FJ•��� N
e� ISSUE � TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER _ ��l.�f_�/r/� �• I�T!'LJ��}r���—
ADDRESS ZONING SETBACKS
� CITY ZIP TELG � � FRONT RW ❑
REAR ❑
� APPUCANT�d[}�� - TEL _ �- SIDFJSIDE STREET RW ❑
CONTRACTOR • ' SIDE O
� ADDRESS 6'{',r�l �='�S� ry� v , f •• pROPOSED USE " '
CITY /nii'��f n ZIP n�TEL�-iO�1 1Z-f'f'�'
r�—" .
� ARCHlENG/ �
DESIGNER NO.DWEL NO. NO.
ADDRESS UNITS STORIES ' BEDROOMS
� CITI ZIP TEL
y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNER•BUILDER DECLARATION SFR/ADD/REM
O
p 1 HERE9Y IIFF�FM WDER PEN/�LiY OF Of0.A14Y M4T 1 MI EXFUOT FF04 THE C[W1A�CTOWS L4 (�i8f89�8ryOf1
[lJ CENSEUWFORTHEfOLLOW7N3REA90N(SER7WI.SBUSNE39ANDVi70FE551dlSCOOEANYCRYOR (f�
CJ COUNTtYN71O1REW1iiE5APEFYRiOCONSTRUCT,ALTEFZb1PFpVE,DELqU31,ORREPAIflM1Y5iflUG w
�L IURE PRqR TO R��SSUANCE ILSO itC-0UWES iHE ADRIGWT iOR SUCH VERutT TO fRE A StGNEO W PatiOlDeCk
STATEMENT TTUi HE OR SME IS UCENSED PVRSU/WT TO THE PFIOWISIONS OF THE CONTRAC70R9 L4
� Cf1SE UW�RUPTER i(OOMAtENGSKi WIT/SECTIQV 7Do0)OF DMSION 7 OF THE BUSME55 M1D pRO� �-' P��Pa
FESflqN$CODE�Oq THATHE OR SHE 19 EXEMFT THEREFROIJ AND THE 811St3 iOR THE ILLIE�ED EXEMP•
na�.�wrwawnwoFSEcnor��mi.seru+r�rn�vrrron�rerwrtsua�crsn+e�rr��xrro Z Re-Roof
F e avw v�+a,r oF r,oT r�ofle,w„me M,r+onEn oowws�ua�.r.
O ❑4��EROF7HEiROPEiiTY,ORWEMPLOYEE3WITHWAGESASTHEIRSOLECOA/7EN5A710N, � (`,Ort1TeM101 �
Z W41 DO THE WOq(AND THE STRUCTURE IS WT IMENDED OR OFFFFED FOH SAIE(SEG 7oW,8U54 J
NESJ MD PROFES"IM19 LOOE TfE WNfMCTORS ULENSE UW DOES NOT APVIY TO AN OWNER Of �
� PipPEPTYMIY/OBUIDSORIYiROVE9T/1EREON./UAMIHODOE95UCIIWORKMIASElFORHERSELFOR
(t TWOlKY/MSORI�NOMMELPLOYEES,OROVIDEDT7WTSUQI�AOROVEMENfSARENOTMENDE00A m
Ll OFFEi1ED FORSALE IF,HOWEVERiNE BUlD01�OR MPIqVEMEHf�S SOID W�7NM ONEYFAA DF WMPIE
Z TqN.TFIE OY/uER�BURDER W�LL MRVE TNE BURDEH OF YRW�NO TUT HE OR SHE D�D NOT BUM1D Oq ,
� MPROVE Fdi iHE PURPOSE OF S/LE} '
O l AS ONMEROF THE PFqPERTY,AM IXtLU3NELYCONTMCTNO WT/UCENSED CONTMCTOH3
ro wr+srracr n+e vnaccr�sec rou,ausn+ess n�w rra�ssa�+s 000E n+e axrnucrajs u� Valuation ✓/ ADJ.AREA
CENbE UW OOE9 NOT MPLYTO AN OMTIER OF A VROVERTYN110 BUlO4 DR 4VIqYE3 TIEREON,M1D
� WIqCOHTMCTSFd19Up1iMlECTSWI7HAOOHTMCTOR(�UCENSmPUASUAHfTOT1ECONTMG pU DESCRIPTION FEE
� TOfR UCENSE UW I.
A IAM IXEMPT IRAEi13E0. B.l P.0.FOR THIS REASON � � f�.
�` V +
� � _
D1lTE Ov'MER V �
� W
IJCENSED CONTRACTORS DECLARATION
� IHEREBYfFFIiYUOEAVENILLTYOFFEFUUHYlMAT11WlICENSEDUNDERVROVI510N50FCHMTER _
s �(OO�WE�NCN�WITHSECTqN7000)OFDMSIDN70FMEBUSINE34ANDVROFESSIONSCOD�AND Z
LLJ W UCEMSE IS N FVLL FORCE MrD EFFECf. m
ti �
� uc�xsE«�ss r'—�1,�_uc.rro. y � J
U oxrEQ�'��—S1t3_corrra�croa N � a
dWORKERS COMPENSATION DECU�ATON Q
� 1 HERE81'AFFlRM UNDER PENKTY OF PE0.AIRY ONE OF hiE iOLLOWwO DECUMTIONS V
y Q
� _I HAYE I/A WR1 MAINT.VN A CERTIIICATE OF CONSENT TO SElF�N9UN£iOR WORKERS $
OOLIPEN9ATqN.J5PF10VDm875ECT10N77000FTHEU80RCOD6FORTMEPERFpRMANCE W
OFTHE WORK FORYNiICN TMS PEIWIT IS ISSVED. �
�
Q _I NAVE MD WILL I,UMAN YIORKERS'Od1GENSAT10N INSURANCF.A9 REOU�RED BY SECTION ry� ^ n'
]7ao OF iHE U1BOR CODE FOA 7NE iERFORM1tNCE OF TME YVORK FOR wH1CH THIS PERMR IS �� P'C!
� tSSUED.tlYNdixERSCOtIPENSATKININSURANCEGRRiER1VlOPOLICYMIMBEAME CONSTRUCTION
� �Ep PLAN REVIEW
� aaicrr+uw��r+ ELECTFiIC
� �gsc�norir�aotgE�rmpcnepw.ir5waar�rtrv�noou�smao�ora� PIUMBING --�y!���
Z �JICERf6l'T1ATNIMEVERFOiM11NCEOFTT+EMqPoCiORwM�p1TM40ENMRIS�SSVED,I MECNANICAL �t���'
X 511ALL NOT FJAOLOY ANN VERSON N ANY 1AANNER SO A4 T(1 BECOME SUBJECT TO ME
N ��hewcEnrcoravexsAna+UwsoFulnoarn�+o+o�cncEt�uT��sNouneeoaeE - INSPECTIONFEE -
S SUBJECTTOTHEMIORKERS'WidCEN`•.ATIONPROVIS�ONSOFSECTION3lo00FTME
000E i sww.�oanMnn�couv�r wm�nose vrarnnsroNs/. � �R ISSUANCE � � —��
pDAiEl���'„i�DAPPIICANL•�g�� J �f'�'�—'�-� SMIP ` � �� • �.
ENERGYP/C �T�]'V ()T' 1J1t"" c A
WARNINQFAlURETOSEQ�EwORKER5COMVENSATqNCOVERAGEISUNUwFUL,MASMALLBE z� �`�
� SUBJECT/WEr.��LOYERTOCRO.�PULDENALT1E9M1DCMLFHE4UPTOONEMUNDREDTqU51WD ENERGYPERMIT r T11NJ t�'��'�•
} OOL1ARSptoo.000�N/�D01710NTOTNECOSTOFWMPENSATION.OMU0E5/�SPROVIDEOFOHMI ��j
...i sEcraN»oeoFn+ev�or+coo�.�aesTa+v�rrorw�^sr�Es. RETENTIONFEE:
� CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� IHEREBY/�FFIRMUNDERPENALiYOF7EKIURYTIUTTHEREI3ACONSTRUCt�ONLENDR�f3AOENCV
Z FON THE PER WPoAANCE OF THE WORK fOR WHiR1 THIS VERMIT IS ISSUED(SEC.�ov7,pV.CJ.
W
� IENDEN'S NAME �
C IENpE1r5AppRE55
� iAoqEETO�pyR yi�TN/J1CR`f/WDOOUNTYORDINANCESAND3T�UW9R��m roe�"'uwEn`r+o TOTAL FEES ' )
CONSTRUCTION,/.HO HEAEAY�IJT/10RIZE REPRESENTATIYES Oi TH�S COVNTY 70 ENTEH UPON TME .
�. A00VE#1EMIONEDPROPERTY(OR�NSVECTIONDURPOSES. CO�MENTS �
9 C�?�-�cr I .,•,�ri�r�z
� Q rEr�m�wu+E maHn� - ' --� _�
�
. � �o ,� �--,::_�f J� � O
I (n tUNREOFPERMIiTEE OA7E
� RECPT.NO. PAID BY VALIDATION
, WHlTE-0epaR'nent Copy.YELLOW—Finnnee Cepy,PINK—AssessM Copy,GOIDENROD—File Copy;GREEN—ApplicanYs Cop�r
I
CITY OF DIAMOND BAR . -
. -. � � INSPECTION.RECORD � � - .- . � .
. . ,
.� r---.;..----.— � rt�� --- --��
1 '1:�1?�-.t: y AI ��:�yr'-•- i �1!'�����1� 1�'{����� io �[��---'�.v.�'��-e;�E.p '�
SET BACK .... �I ' � � � . r ; � I ' FLOOR JOIST � .- .
;--
FTGS/FORMS/STEEL ' ; , _' ! , FHA REQMTS _ �' ' " �" � � - - �
ELECTRIC GROUND - ' • UNDER FLOOR DUCT- • - � ' -
GRDUND PLUMBING UNDER FLOOR CdMDUiT �' " ` ' - '-^ ' ' � " ' -�
SLAB GRADE - FIREPLACE FOUN�ATION ! `
;TEMP POWER FIREPLACE BONQ BEAM - I.� �� ��_ • ' � ' �
�WATER SERVICE MID�HT. BOND BEAM ' �
'.ROOF SHEATHING CJ- - �� 8 FT.BOND BEAM ` • •= • � - � _ -'
�FRAMINGNENTttIATION FINAC BOND BEAM '
ROOF COVER a S d6 PRE-GRADING -- ���
�ROUGN HEATING' BENCHING �
ROUGH ELEGTRIC ' ROUGH GRADING -� -
ROUGH PLUMBING-- FINISH GRADING
SHOWER�fUB TEST - - - POOL ELECTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION � POOL FINAL
CEILING INSULATION � OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS -
;SEWER � FINAL ENG. � '
SEPTIC TANK - LANDSCAPElIRRIG.
SEEP PIT/L.L. -- -:1 :'�.-:.'.'.'_�, ON SITE IMPS. "`
GAS AIR•TEST � FINAL ZONING
FINAL CONST.___ 6,r� � . • ' �' `FIRE DEPT. FINAL ,,
FlhAL HEATING' �� . . • -�. -�.�- HEALTH DEPT. FINAL '
FINA�ELECTRIC �. � , � DEV. FEES PAID -- -
i=fhJAL PLUM8ING • - � -- - � - �ENERGY � �
.
�E�..-�,�_ — --- -i
-- - - - - �:,;.:�..rf���- ��c+,'c-� � -
� • -.__ -.:: � _ '_ -_ � ...� ___ .. ._. - - , .. _ _ �
�COMMENTS
� - —
� `., t , �'
;
I - - ` " _ �, --
. . . . _ - - _ . - .
SEPTIC TANK SIZE -
'SEEP P�T/U SiZE
�� '�,..����..__-- ------� — '
. � �� a � '_—
�:', ;��: .:..j
���� � �t. . . .��� . - ;
�' � , -� � ,
!�� ,-���'�� � _ �T� - - - - i � - - - � � , �� .� �. . � _, �
• �r`�� ' , . . 1 . � �. ` . �l. , \ ..
J�;11 . ; � 1 .. _ . , . . , . .. .. , . . . __
' . � _ . ._ . _ . . "- I