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HomeMy WebLinkAbout11455 � -- ---.__ _-- - --------..-- ----- .i- ---..-----._._.- -------.._� --�-�--- ...-- ---------- ----�--._...... ----- - - �,, --- �� ---. CITY OF DIAMOND BAR � � COMMUNITY DEVELOPMENT DEPARTh'IEIVT ' , ..,,.� 21660E.CopleyDriveSuite190 • ' ' ` PRESS - (909)860-3195 Fax(909)961-31 l7 . - '�^' BUILDINGPERh4ITAPPLICATION FIRMLY � � JO�SITE 2'L V�� f►A,w�LL�N � ,��� APPLICATION �.. �� PERMIT I !C o ADDRESS O l.����T DATE �NUMBER p � ISSUE TYPE OCC � APN LOT TRACT DATE CONST. GROUP ; p �OWNER 2� p ADDRE S C 6 (J l Y�� ZONING SEIE3ACKS , Z CIIY JAIu�N 4�A�IP TEL: FRONT - . RW ` ❑ o APPLICANT TEL: S DE/SIDE STAEET RW ❑ � CONTRACTOFi L✓�'` �ti C• SIDE ❑ � ADDR�S•S,� I Z• �t � CITY(J�U�ND�ILA ZIP ��V5 TEL L' PROPOSED USE oARCH/ENG/ iz DESIGNER ' '" NO.DWEL. NO. , NO. n� ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. c�i� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � p� � �� - � �� OWNER-BCILDER DECLARATION �. -� � SFFi1A0Q�'REM � � - �� �� O p 1 HEREBY AFFIRM UN�ER PENALTY OF PERAIRY THAT I AM EXEMPT FROM THE CONTMCTORS lb Gefe9B/C31pOR • � � W CENSEUWFOHTHEiOLLON7NGREASON�5EC.70]1.68USINESSANOOfX)FESSIONSCODE:ANYCITYOR (n ' U COUNTYWHIGIREWIRESACER/.�I7TOCONSTqUCT,ALTER,MPROVE.DEAIOLISH,ORREP��RANVSTRUC-. w . TURE.PRqR TO ITS ISSUANCE,ALSO REOUIRES THE MPLICANT FOR SUCH PERMIT TO FIIE I15�CNED Patio/�edc w STATEMENT TMAT HE OR SHE IS LIGENSED PURSUANT TO THE FROVISICNS OF THE CONTMCTORS Lb �� W ' -� GENSE lAW(CHMTER Y�LOMAIENCING WITH SECTION 70aa�OF DIVISiON]OF TME BUSINE55 AND FRO-� � � PooVSpa � � FESSIONSCOOE)OHTHA7HEORSHEISEXEMPTiHEREFROMANDTHEB�5�5FORTMEALLEGEDEXEMP�� . 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' � L� UCENSE CL/lSS C �UC.NO. `��`��` , , � • � V OATE •Y 'r'I�' �corrrrucroA� '. �•h 1I t'►�(�- � a . w� - -- + � WORKERS'COMPENSATION DECLARATION ���� � N IHEqCBYAFFIRUUNOERVENALTYOFCE0.IUMONEDFTHEFOLLOWWGDECURATIDNS: � ' � �IHAYEANDM/ILLAUINTAINACERTIFIGTEOFG17N5[NTTOSELFdNSUREFORWORKERS' � COMPENSATION,ASFfiONDEDBY5ECT10N77000F7HEUBORCODE,FORTHEPERFOWAANCE � OF THE WORK FOR WHICH iH15 PERMIT IS ISSUED. _ � � w _IHAVEANDIMLLMAiN7AINWORKERS'COMPENSATIONINSUMNCE,ASREWIREDBYSECTION Q 37000FTHEUBORCODE,FORTMEPERFORMANCEOFTHEWORNFONWHICHTHI57EHMR15 . ISSUED.MVNqRKEFS'COAIPENSATIONINSt1RANCEGARIERANDPOLICYNUMBERAR[: CONSTRUCTION J 7 CAFRIER PLAN REVIEW � � VOLICYNUMDER ELE RIC _g6A',_�`� r� �':l .� . G � p1iSSECiIONNEmNO'TBEWIARFTmOFhEPERMfSfOROhEH1rDRE000LlARS(St0010RLE551 �. �� ' Z ICERTIFYTMATINiHEPERFORMANCEOFTHEWORKFORWHICHMISPERMITIS�SSUED,I MECHANICAL U' SHA:LNOTEMPLOYIWYPERSONWAN'(MANNERSOASTOBECCMESU&IECTTOTHE ` � �'N WORRERS'COMPENSATIONUWSOFGLIFOHNII�ANDIIGREETHATIFISMOULDBECOME INSPECTIONFEE (�� � .'I ' SUBJCCTTOTH[WORKERS'COMPENSATIONPRONS�ONSOFSECilIXJ77000F R r�� O _ COO .IS�LL^FOR THCOMPLYWITHT vRONSIONS. ISSUANCE � ' p DA7E: �� ` APPLICANT: SMIP , � J WARNING:FARURE TO SECURE WOfU(ERS'COMPENSATpN COVEMGE IS UNUWFUI.AND SWLLL BE � ENERGY PJC� �y SU0.1ELiANEMPIOVERTOCR:11P1ALPENALTIESANDCMLFIhESUPTOWEHUNDRF�THOUSAND ENERGYPERMIT DOILARS(S�00.000),W ADDITION i0 THE COST OF COMPENSATqN,OA/AA�ES AS FROYiOED FOR IN � secnoNnoeoFn+eunoacooe,wrenesr,u+o�now+ErsFEEs. RETENTIONFEE: ' a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � .O . .. . . . . . I � IHEREBYAFFIRMUNOERPENA�TYOFPERIURVTMATTH[REISACONSTHUCTIONLENOINQAGENCY � � - � FOR THE PERFORMANCE OF THE WONN FOfl WHIp1 THIS PERMITIS ISSUED(SEG 7097,CIV.C.). .. , . . Z . . . . . . . . . . . . W � � LENDEfY3NAME � F— LENDER'SADDRE55 � � � � � � � TOTAL FEES � ' � I CERTIF`/THAT I HAVE READ THIS APPUCATqNAND STATE THAT THE ABOVE PJFORMATiON IS CORREGT. W UGREETOCOMPIYWITMALLL17YM1000UNTY0H01NANC[SM105TATEUWSREUTINGT08URDING - - - � CONSTRUCTION,MUHEREBYAUTIqRRENEVRESENTATIVESOFTHISCOUNTVTOENTENUFONTHE Z /�[�OVE�4EMIONEDPROOERTYFOHINSPECTIONWRPOSES. . �^ � COMMENTS � �if11 11-�1:L m FERMITTE 4L(PRIM� . • .. . . .. . . . Q _ �_q� � � SiGNATURE PERMiT7EE DATE � � RECPT.N0. _ _PAID BY VALJDATION, � _ � � � �- -�� WHITE—Depanment Copy.YELLOW—Finance Capy.PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy - , �,. . . . . - .. . , . . ' ' . � . _ " �.{•. .va..l`., �;•. . . .� .<. :1.s., � �.i"' . . .. . ' , . .. . . ,. �.,,rP . ... , . . .. �. . , . , CITY OF,DIAMOND BAR '� . � � � � INSPECTION RECORD " , • � � • , . . � � , . . SET BACK ' - FLOOR JOIST - -- --- - - - ' FTGS/FORMS/STEEL FHA REQMTS '�. . : ' ELECTRIC GROUND UNDER FLOOA DUCT �- i:. : • • • � - GROUND PLUMBING - UNDER FLO�R CONDUIT � "' ' �'` SLAB GRADE �� ' � ' FIREPLACE FOUNDATION TEMP POWER . _ - . � FIREPLACE BONR BEAM= '� .' . � ` ', WATER SERVICE � � - � ' MIO HT.BOND BEAM • � - RO�F SHEATHING 8 FT.BOND BEAM FRAMINGNENTILIATION FINAL:BOND BEAM �� • ROOF COVER -� PRE-GRADING ' . . ROUGH HEATING -- - - - � BENCHING - ROUGH ELECTRIC - ROUGH GRADING ROUGH PLUMBING � FINISH GRADING SHOWER/TUB TEST - --� - - POOL ELECTRIC` • • EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL'FINAL � CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER . . t �Z�` � FINAL ENG. SEPTIC TANK. ._. LANDSCAPE/IRRIG. ' . SEEP PIT/L.L. -- . � ON SITE IMPS. =� GA5 AIR TEST - FINAL ZONING FINAL CONST. -- -- - - FIRE DEPT. FINAL , . FINAL HEATING -- � HEALTH DEPT. FINAL �..- - FINAL ELECTRIC - - { DEV. FEES PAID . FINAL PLUMBING ' � ENERGY _..._ ----- ---' -' C ' , , . , �� . .. . � • � .. -- . _.. _... _ . COMMENTS ` �'°' ' . � _ . -- -- _ � - .•,:� . . � r-^tr . . • � �� ' �). . � �`;.�1 .��� ��. ' .. . . • � E _ .. . - � il�)i)i ' � . . . .. � , �- . . ' :� l: �;, i � •� _ � � --- , . '_ - , • � , , • . SEPTIC TANK SIZE � . - � . . ._ SEEP PITN SIZE - , . , � � _ �:.i 1 ��. �' � . '�:`��_ � -t- •; �-- --- ' �.. . . . - _ , t . _ . , � i , ;... ;.. . . _ , � _ . . ...._... ._ - --- - - - - - - '