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HomeMy WebLinkAbout11397 (5) _ ..i. _.. . - -- _ _. -- ��� ---• CITYOFDIAMONDBAR . ' , I i COAIMUNITY DEVELOP�IENT DEPARTMENT <' ��,��,,.� 21660 E.Copley Urive Suite 190 • ' (909)860-3195 Fax(909)861-3117 PRESS '�^' BUILDING PERh1ITAPPLICATIOy FIRMLY � JOBSITE QQ APPLICATIO 2�7j � PERMIT P/C a ADDRESS z�vv �9N �N �'�FYt� DATE �_NUMBER # c� � / ISSUE TYPE OCC APN LOT�z_ TRAC � DATE CONST. GROUP p OWNER ����/ o ADDRESS�/ • 3 ZONING SETBACKS , OCITY��!_L��ZIP EL. �iGl�f" '"/ FRONT RW ❑ APPUCAN� �� •TEL. ���� � J REAR ❑ � / SIDE/SIDE STREET RW T_ O � CONTRACTOR �V'"�`��'� _ - SIDE ❑ � ADDRESS PROPOSED USE •� � CITY ZIP TEL. w ARCH/ENG! ' iz DESIGNER ' NO.DbVEL. NO. NO. . a, ADDRESS UNITS STORIES �EDROOMS = CIN ZIP TEL. N DESCRIPTION SO.F7: FACTOR PSF ADJ.AREANALUATION � � . - OWNEFl-BCILDERDECLARATION - SFFi/ADDlREM � � � � � O W CENSELAW ORiHEFOLLOW M1'6R SON SEC.707�SBUSINESSANDFROFE55 NSCODE:ANYCITVOR Ga�'f.9e/CdfpOrt� � U COUNTYYhIICHREdJIRE5A7ERMiTTOCONS7RUCT,ALiER.IM7ROVE.DEMOUSH,ORREPAIRANYSTRUG W Patio/0eck � � Z TUR[.PRqR 70ITS ISSUANGE.ALSO FCOUI(i[S THE A7FLIG4T FOR SUCH VERMIT TO FILF A SICNED w S STATEMENT THAT HE OR SHE IS UCENSED PURSUAhT TO THE PROVISiONS CF 7ME CONTRAC70R5 LI- LL - CENSEUW(CMAPTERi(CAMMENdNOWITHSECTqN7000)OFOIYISIONJOFTHEBUSiNESSMIOPRO- POOUSP� � FESSIONSCOOE�ORTHATHEORSMEISE%EM?TTICREFNOMANDTNEBA315FOR7HEALLEGEDE%EMP- (� V TION.ANVYIOUTIONOFSECTIpN70]1.59YIWYAPPLICANiFORIIPERMITSU&lECTSTHE�PVLICANTTO Z Re•Roel � A CIVIL oEYALTY OF NOT MORE THAN i1VE M:NDHED DOLURS(f50o),I: . � ❑4ASONMEROFiHEPR07EFTV.ORNVEM7LOVEESW�THWAG[SASTHEIRSOIECOMPENSA170N, � COmmOrCial � Z NALL DO 7ME WOPoC.AND TME STRUCTUNE IS NOT IN7ENDED OR OFFERE�FOR SALE(SEC.7a�.BU51• N NESS ANO PROFESSIONS COOE:THE CONTRACTORS LICENSE UW DOES NOT AV7LY M AN OWNER OF � VRO7EHTY YR10 BUILOS OR IMPROVES THEREON,AI.O WHO DOES SUCH VKJRK HIMSELF OR HCRSELF OR CL THROVGHHISORMEROWNEM7LOYEES.FROVIDE�iHATSUCHIM?ROVE�AENTSARENOTWTENOEDOR m w OFFEREOFORSALEIF,HOWEVER111EBNllkNGORIA!PROVEMCNTISSOIDWITHiNONEYEAROFCOMP�E- 0 TION.THE ONTIER�BUILDER WILL HAYE THE BUFiJEN OF PFlOVMC THA7 Y.E OF SME OID NOT BUiID OR Z IAAPROVE FOR TNE PURPOSE OF SALEI. = OI.ASOWKEROFTHEPROPERTY.IWEXCLL'SNELYCONTMCTWCWITMLICEI:S[DCONTMCTORS W , Q Tp CONSTRUM iHE PRQIECT(SEC.70Ia.BUSINESS AN7 VHOLESSIpNS CODE:TME CONTRAf`T(1nS t I. V�IUaIIOfI ADJ.AREA W CENSEUW�OESNOTAPP�YTOANOWNEflOFAPROPERTVWMOBUILDSf�o' ru.M, � � N?1000N1MGTSFORSUCMFR0.IECTSNATHACONTMCTOR(51 '^ ,_..rUHiUANTTOTHECOHTRAV OUANTITY DESCRIPTION �� FEE Y TORSUCENS[UW.). � � ❑IAMEXEAIPTUN�ERS[C. B.dP.0 �MiSREASON U � _ _ LL � DATE _ �.� `_. . V Z .....� . W . . �Q LICENSED CONTRACTORS DECLARATION � d K IHEREBYAFFIRIAUI:DERiENALiYOFVERJURYTHATIAMLICENSEDUNDERiROVISIONSOFCMAPTER V. ' p_ i(COMMCNCINGWRNSECTION7000)OFDMSION]OFTHE�USINESSAND7iWFE55lON5CODE,M70 j MY LiLENSE IS IN FULL FORCE AND EFFECT. 0 m � LICENSE CLASS r LIC.NO.��� �/ . D V DATE � I�,�` CONTRACTOR _.���7�LD���C( '� � Wd KERS'COMAENSATION DECLARATION Q �'� � �s � � = U A � IHERCBVAFFIRAIUNDENPENALTYOFVE0.NtiVONEOF7HELOLLOw.NG�ECLARAT10N5: Z [j(J L?� / J � _IFNVEANDWILIMAINiAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' _ � �/, � � COMPENSRTION.ASVFOVIDEDBYSECTION77000FTMElABORCODE,FORTHEPERFOFMANCE �U � Q . OFTHEWORKFORWHICHiHISVERMITISI55UE0. /Z D a� w _IHAVEANDWILLMAIMAINWORI(EFS'CA�PENSATIONINSUMNCE,ASREOUIRE�BVSEC110N Q 770a OF T1iE U90R GODE,FOR TME PERFORMPNCE OF THE wOFW.FOFi WMLMTHIS VERMiT 15 ISSJED.IAYWORNEHS'COIdPEN5A710NIN5URANCECARRIERAN�VOLiCYNUMDERARE: CONSTRUCTION J � GRq;ER PLAN REVIEW � Z POLICYNUMOER ELECTRIC Q 0 (IMSSECfqNN[mNOT8E006V�LETEDOFTIEPEN.fTSiOfiON[Ml�DilmD0.lfILSR�Oo)011LES5} PLUM _ ,ti Z I CER7IFV TMAT P1TH[PERFORMANCE OF THE N'ORK FOR WHICH THIS PERAIIT IS ISSUED,I • CHANICA � C7 SHALLNO7EMaLOYANYPER50Nw�NYAAANNERSOASTOBECA�u[SU&1ECTTOTHE . • N WpRKERS COMPENSATpN UWS OF LALIFORNIA AI:D AGREE TMAT IF ISHOULD BECOM[ INSPECTION FEE � � � �_���� /^). SUBIECT TO TME WORKERS'COMPENSATION PROVISiONS OF SECTION 370o OF TH[UBOR ��� rj OOOE,ISNAI.�FORTHWITHGOMPLYWI7HTHOSEPROV15!ONS. ISSUANCE � SMIP 0 onrE: aav��cnnrt: � � ENERGY P!C � J WARN:NG:FAILURETOSELUfiEYJORKERS'COMPENS�TqNGOVERAGEISUNUMTUI,ANDSHALLBE �� � SUBJECTANEMPLOYERTOLR:MINALPENALTIESIWOCIVILFINCSUPTOCNENUNORE01YqU5l1N� ENERGYPERMIT DOLLARS�f I00.0001.W ADDITION TO THE COST OF COMPENSATqN,DPMAf,ES AS PROVIDE�FORIN J SCCTION 77080F TNE U[iOR COOE,WiERES7,ANDATTORNEYS FEES. RETENTION FEE: Q � a CONSTRUCTION LENDING AGENCY PRC•ALT FEE: �� � � IHEREBVAFFIRMUNOfRPENALTYOFPE0.IURYTHATTHEHEISACANSTRJCTIONIENO:NCAGENCY � FORTHEPEp�ORA1ANCEOFTNEWORKFORWHICHTNISVEAMITISISSUE�(SEC.JOB7,CN.C.). . � IENDER�SNAME�/'/� ���L1 , F= LENOERSADORE55 y��� 1_ _ � /� w ICEHTiFYiHATINAVF ' ..,r�iSMPLICAT10NAnOSTATETHATTiEA80� wra�� ,rpNiscoanccT. TOTAL FEES � �D, / / � IAGRCETOC ' i7MALLCITYANDCOUNTYOROINANCE5AND5TATEU ' �tLATiNCTOBUILCI4C - . V � CONSiP ..,i;N,AN'JHEREBYAVTMORIZEREPRLSENTAT'VESOFT1il5 iYTOENTERUPONTHE � . Z � :�MENTqNEDGROPEHTYFORINSPECTIONVURPOSE'+. COMNENTS � � _ ` . m PERMI ecNAME(7R',NT) . . ¢ . . N � _ '� .SIGNANREOFPER�ITTEE., ' DATE � � � ��• . RECPT.NO.���� PAIDBY . _VALIDATIO _ � � WMITE—Department Copy.YELLOW—Finance CODY.P�NK—Assessor Copy,GOLDENROD—Fite CODY,GRtEN—App,.anCs Copy ' , � .. , ._ :�1 t . ... 1 i .. w) '1 • . r .�t..� _ . .v✓�w..�. "t.. .- � � .'.1 �5 . . 4 i _ � . . .. .. .. . . . . . . ... .f` :1. . . .1 .. i .. " ... . .... . �.- ' . .. ' � . .. w CITY OF DIAMOND BAR ; - � INSPECTION RECORD � � ' '���c, o � e ' • �� • - •� , o o ` j������1��� 4 SET BACK � ' � FLOOR JOIST -- � _ Fi'GS/FORMSISTEEL FHA REQMTS \ � � � � ' ELECTRIC GROUND UNDER FLOOR DUCT•= :; .�; ,� . " - GROUND PLUMBING -UNDER'FLO�N CONDUIT �:� . ' . = SLAB GRADE '. FiREPLA,CE FOUNDATION ' TEMP POWER . • - - ! ' � FIREPLACE BOND BEAM � '�-• � � �"' -" � ' � WATER SERVICE � • MID HT.BOND BEAM � ----`-�' — " ROOF SHEATHING 8 Ff.BOND BEAM . FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING � ROUGH HEATING - BENCHING � ROUGH ELECTRIC ROUGH GRADING � ROUGH PLUMBING � FINISH GRADING � SHOWERrT'UB 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 _ . LANDSCAPEIIRRIG. � SEEP PIT/L.L. ON SITE IMPS. � GAS AIR TEST FINAL ZONING • ' . , FINAL CONST. FIRE�DEPT.FINAL�--- . - � ,., r <; �. , FINAL HEATING -� � • '.HEAITH DEPT. FINAL FINAL ELECTRIC DEV.•FEES PAID , FINAL PLUMBING ENERGY . , , . , . .._ �,z.'.•�et� �. _._ �-- -- -- .. _._ . ._._ .. ..� ' ` ;' - -� . - � _ . - --�� ' COMMENTS • - � - , � . . .. ._ � - --� , . .. ' � . - 1 ' • - ,�-"� � � �'t',� . CH i , � .. � , SEPTIC TANK SIZE � ' SEEP PIT/U SIZE �,� .;� , -.,- . . . .. .�--- . . . - . , �,11 r----- - . , .. .. i �� � ds/ � - ' _� - �,;� . , �' ; `� .' - � _ .. . . . _ �'''/' d �'7�