HomeMy WebLinkAbout18010 ------- --- _._
.._..._-____�-------- .__ _
_.. . _ .___.__. ._�__. ---,,
CTTY OF DIAMOND BAR �
�� DEPARTMENT OF CONIIvfUMTY&DEVELOPMENT SERVICES ��
��y 21825 E.Coplry Drive
(909)860-3195 Fax(909)861-3117 PRESS
�`<��� BUILDINGPERMITAPPLICATION FIRMLY
o ADORESS�� �� f DATEICATION� d� NUMBEFl����b p�
� APN LOT TRACT D TEE ONST. �F��T GROUP
p OWNER D ' � �i
LL ADD SS O\ �YY1�..CS7J ZONING SETBACKS
gCITY�\ Q3�'� C�' ZIP �TEL. - � A�R RW ❑
APPUCANT TEL Q
� SIDE/SIDE STREEi RW ❑
� CONTRACTO� • C� i SIDE Q
� ADDRE , �
� CITY ZIP TEL. PAOPOSED USE� ��
o AFiCFUENG/ ,
� DESIGNER NO.OWEL NO. NO.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
N DESCRIPTION SQ.FT FACTOR PSF ADJ.AREANALUATION
� OVJNER-BUILDER DECLARATION SFRlADD/REM
O
p I HEAEBV AFFlqAI UNDER PENALTY OF VEiWRV iH,IT 1 AM F%EAIVT fROIA THE CONTMCTORS l4 Gafepe/CBIpOR
UJ CENSEUWFORTMEFOLLOWINOREASONf5EG.70.71.68U5INES5ANDPROFE5510N5000E:ANYpTYOF (n
CJ �pUNTyyVHipiREWIRESAFERMITTOCONS'�RUCT,AliE0.�MPROVE.DEAlOL1SH,ORREPNRANYSTRUC- W p0tlp/DOCk
� NRE,GRpR TO RS ISSUANCE ILL50 REOUIRES 7HE APPUCANT FOR SUCM PEfWIT TO FILE A SIGNED W
.2r STA7EMFNT 7HAT HE OR SHE S UCENSED PURSUANT TO TME GROVISIONS OF THE CONTMCTORS LI�
� CENSE UN�(CMA7TER/(COMMENCPIO WIiH SECf1ON 7000)OF UIVISION 70F TME BUSINE45 AND PPO- � POOUSpB
FESSIONS WO�OR 1T1AT HE OR SME IS E%EMPT iHEREFHOM AND THE BASIS FOR THE ALLE6E�E%EMP•
� 7pN,M1YVIO�AT10NOfSECT10N7W1.6BYANYAVVLICANTFOqAGERMITSUfl1ECT51NEAPPLICANTTO Z Re-Raol
A CML 7EN.LLTY OF NOT MORE hUN fIVE MUNOHED DOLURS(f5o0).�:
� OLti40WNEROFTMEPf00PEHTl.ORAIYENPLO�'EESWITHWAGESASTNEIRSOLECOMPENSATIDN, � COrt1rtIBfClel ��
WILL DO iHE wORK�NO 7HE S7RUCTURE IS NOT IMENDED OR OifEHED FOR SAIE ISEG 70u.BU54 J
� NESS AND PROFESSIONS COOE:THE CONiRACTORS LICENSE UW DOES NOTAPPLV i0 AN OWNER OF �
Gf10PERTYMh1OBURDSORIYVHOVESTMEREOKANONT1000E55UQ1YYVfiKHIMSELFOflHERSELFOR m
� TFIROUGMHISORNEqOWNEMPLOYEE3.PROVIDEOTHATSUd1MAFROVEMENTSARENOTRlTENDEDOR
w OFFEREOFORSAIEIF,HOWEVERIHEBUILDINdORMPROVEUEM1550LDWRINNONEYEAROFCOI�PLE•
� TION.TME OWNEN�BUILDER WILL W1VE TME BUHDEN OF VROVNO T1AT ME Oil SHE DID NOT BVIID OR
= p/PROVEFONTHEPURPOSEOFSALE}
O L/V`OWNER OF iHE PROPERfV,AM E%0.USIVELY CONfMCTW O WITH UCENSED GONTMGTORS
� TO CONSTRUCT THE PHQlECT(SEC 7oN,BUS�NE55 AND PROFESS�ONS CODE:TNE OONTMCTORS U� V01Ueti0fl �''Y�• ADJ.AREA
W CENSEUM�DOESNOTAVPLYTOANOWNEHOFAPHOPEfliVWH09UM1D50flIMPROVESTHEREON.ANO
� WFiOCOHTMCTSFOHSUCMGROJECTSVAiHACONfMCTON(5)LICENSED►UHSt1ANTTOTHECONTiL�4 QUANTITY DESCRIPTION FEE
� TORSLICENSEUMU.
� OIANE%EIAPTUN�EHSEQ B.lO.GFORh11SNEA50N U
u" DATE ONTIER �
Z W
� LICENSED CONTRACTORS DECUU7ATION W
� IHEREBYAFFlfWUNOEHPENALTYOFiEiWRVTMATIAMLICEN5E0UNDENPROYI510N50FCMMTER V. '
p. i�COMMENqNOMATMSECTqN7000�OFOM510N70FTHE8U51NES5ANDPROFE5510N5CO0E.AND Z
X YY UCENSE IS N FULL FORCE M1D EFFECT.
If� m
� LICENSE�CL+A55 C� 1 LIC.NO. � j
V DATE__2'IS`�� CONTMCTOR a . . ..... . . ..
W
� WORKERS'COMPENSATION DECUIRATION �
N IHEREBYAFFIRMUNDERVENN.TYDFPERIUMONEOFTHEiOLLON'INCDECLAMTid15: V
N
0 �IIAVEMIDWIlLMA1NTNNl10EATIflCATEOFCONSEMTOSELF•INSUREFOAWONI(ER5 =
� C9MPENSATqN,ASFROVIDEDBVSECiiON�7ooOFTHEUBOHCOOE.FORTHEPERFORMANCE w
OF THE WORK FOR NMICN THIS OERAIIT IS ISSUED. �
C
��I NAYE ANO VYILL MAINT/JN WOH1(ERS'CdAPENSATION INSUMNCE,AS HE0�IIREU BY SECt10N
d JTaoOFTHELABORCOOE,FOATHEVER�ORMANCEOFTHEWORKfORNMiCHTHISPERYRIS /D yU
� ISSUED.M,YWfORNERSCAMPENSA710NINSURANCECARPoERANOPOI�CYNUMBENARE: CONSTRUCTION �
� CARRIER�+�C}11I}(� F('C�- � _C�• PLAN REVIEW
� vaicrriuueEa��1 C�'�Al� ^ ELECTRIC
� (M1GSECT17�KmN0TBE001.1PLETEDOFTFEVERNTSfORONEHIR�(7EDDaU1tSK+m�OqLE55} PLUMBING
Z I CEHTIFY 7HAT W THE�ERFORMANCE OF TME WORK FOR WHIp1 THIS PERMITIS I55UED,1 MECHANICAL
(7 SHALLNOT EMPLOYANV PERSON IN ANV MANNER SOAS TO BEC0IAE SUBJECTTO iHE ��,� ��'
N WOHNER5COMPENSATIONUWSOFGALIFOPNIAANDAGREETUT�FISMOULDBECOME INSPECTIONFEE _._
S SU&IECT TO THE N/ORKERS'COMPENSATION PROVIS�ONSOF SECTION�7a00F THE 1A80P " �
COOE,I SNALL iORTM1N711 COMPIY WI7M T11OSE vROVI51oN5. ISSUANCE \ � L `"� � a+���f
� SMIP � �� 1 �; 9/1f1�1 � . /�
W pATE: APPLICANT: ,
� WAANINa:FNWPETOSECUPEWORKERSCOMPENSATIONGOVEMGEISUNUWFULANDSHALLBE ENERGYP/C �
SUBJECTANEMPLOYERIDCe1MWALGENALT1ES/�NDCN4FWE5UPTOONEHUNDREDT1/0U5AN0 ENERGYPERMIT - �
DOLURS(f�ao,oD%.W A�OIiION TO 7HE C0.5T OF COMPENSATpN.O�AUGES AS PROVIDEO FOR M
� 6ECTiONl70eOfTMELABORCODE,NTEHESLANDAITORNEY5FEE5. aJj. , I / e
REiENTION FEE:
a CONSTRUCTION LENDING AGENCY pRE-ALT FEE:
� IHEREBVAFflRA1UNDER7ENILLTVOFPE0.NRY7HATTNEREISACONSTRtIL710NLfNDIN�AGENCY
� iORME FERFORMANCE OFiHE WORK FOR WHIp1 TH15 VE WdiT IS I55UED�SEC.JOW,UV.G).
�
� LENOER'S NM1E
� lENOER'SADORE55 /�
� ICERTIfYTMATIHAVEqEADTHISAPVUCA710NANDSTATETXATTHEABOVENFOPMA7qNI5CARRECL TOTAL FEES / ,.JW. �O
� IAGREETOCOMPLYN7TIALLLRYAN�COUNTYORDINFNCESANOS7ATEUN�SRELATWfiTOBU0.01NG
CONSTRUCTION,AND HEREBV AUTHORIZE REGRESENTATIVES OF TlqS COIMTY TO ENTEfl UVON THE
Z /�BOVE•AIENTIONEOVROPEH7YFORINSPECTqNPUfiPOSES. COMMENTS
�
J •
�
m VERM�TiEENAAI 1 �+
¢ s�5^b-�.�_
� �-
� SIGNAT S�1F ERMITTEE DATE
� RECPT.NO. PAIDBY e �I VALIDATION
WHITE—Depanment Copy.YELLOW—Finance Copy,PINK—Assessa Copy,GOLDENROD—File Copy,GflEEN—ApDlicent's Gopy
..r . , .. .- .. �r...;�-..i. r ... ,.at. m.a., •.t;�:-�.. r , •�.k:�S .;�-''`�: , � .��.�,7;n.r _.,F.. ...�v--�--.__ ,�.. .. n...,. , ,,.. . . ..,. . . . � - .
Clf4' OF DIAMOND BAR
i«'SFECTlON C�ECOt�D
',�� ���C��.� ;:_. ;�'��:�� ,:I��������'�(.��.. . _ �(i���������R!� . IB�r�;.�� . .:il►�.���'��.@�.� ;
SET BACK._..r..:_....... ..,._._._......��;�_�.......-_� �.�FLOOR JOIST --� - - i �-�-- �
FTGS/FORMS;STEEL . � FHA REQMTS '
ELECTRIC GROUND � � UNDER FLOOR DUCT �_ , �
GROUND PLUMBING i UNDER FLOOR CUAIDUIT �
SLAB GRADE FIREPLAC�FOUNDATION
TEMP P�WER I I FIREPLACE BOND BEAM
WATER SERVICE � ! MID HT.E30ND BEAM
ROOF SHEATHING �,�Ti � I 8 �.BOND BEAM i ' ;
FRAMINGNENTILIATION y_-�, . ,' FINAL BOND BEAf�1 I
ROOF COVER �,j ���— PRE-GRADING
ROUGH HEATING � BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING I � FINISH GRADING
SHOWER�TUB TEST ' POOL ELECTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING IN�ULATiON i OFF SITE IMPS.
DRYWALL NAILING j DEDICATIONS �
SEWER FINAL ENG. �
SEPTIC TANK ; LANDSCAPElIRRIG. �
SEEP PIT/L.L. ' ' . ON S17E IMPS. j
GAS AIR TEST FINAL ZON1�4G I
FINAL CONST. ! � FIRE DEPT. FW,�L �
FINAL HEATING i HEALTH DEPT_ FINAL � �
FIIJAL ELECTRIC I DEV. FEES PAID
FINAL PLUM�ING I ENERGY
�
;�. r�l`�aj�{�e e�
, �� ,
_ .,._........�. __. .
� - _ _ _. _ . ___ ---- ----- _ __ .
; COMMENTS
SEPTIC TANK SIZE
SEEP PITJU SIZE
I�,� �
,;��� . '�,
� _,..,
�� . � , -- , . .