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. i _ . ... _. . . . J� CITY OF DIAMOND BAR ` DEPARTMENT OF.COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 . 'w (909)860-3195 f�����s6i-s i i� PRESS - ���=�'f BUQ.DING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION/f_/O- PERMff ' J P/C o ADDRESS DATE I � NUMBE � ` M � ISSUE TYPE OCC APN OT T T�I b�_ DATE CONST. GROUP p OWNER " ADORESS ZONING SEBACKS � CfTY I ' TEL. FRONT RW ❑ APPLICANT TEL.� 1 REAR ❑ � SIDEJSIDE STREET RW ❑ CONTRACTOR SIDE ❑ � CDn,DYRESS O ZIP�� TEL��� PROPOSED USE � � ARC ENG/ � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STOFiIES BEDROOMS � CITY ZIP TEL y DESCRIPTION SQ.Fi. • : FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION SFWADD/REM � O p 1 NEREBY AFFlRAI UNDER►ENALTY OF P[1WRY THAT t AM E%EMPT Fi00N THE CONTMCTORS L4 Garepe/Carport W CENSEUWFOfiiHEfOIlOWNORFA50N�5EG70.71.6BU5P1E55ANDiROFE55qN5CCOE:ANYCRYOR . (n ZQOIA(S7MMR71REWWESAPERMRTOCONSTAUCLAL7EItMPHOVE,DEM7LI5M.OlINEMIRANYSTRUG W Patio/Deck TURE VRqA TO R9 RSUANCE�LSO REOUIRES iHE AP7LICANT FOR SU�1 PERMIT TO FILE A SICNED �l� STATEYEM T3UT ME Oq SME LS LICENSED VU0.5l1ANT TO THE VROVISIONS OF THE COHTMCTORS L4 W � CFNSE UW(CHAPTEH�(COMMENCPIO NiTH SECTqN 70D0)OF OMSiON�OF THE BUSINESS/NJ VRO• LL' Poal/Spa iESSqNS COOE)��T HE OR SHE IS E%EMPT 1HEREFNOM AND TME&l^>IS FOR iHE ALIEGED EXEMP. TION.ANYVIOLATIONOFSECTION7071.6BYAHYA7VUCJINTFORAVEflMITSUBJECTSTNEAP7UCANTTO Z Re•Roo1 � AC7VIL7EN�LTYOFNOTMORETWWFIVEFRlHDREDDOlLAR5�f5oo).�: � � OlASOMMEROFTHEPFiOPERTY.ORGYEMPL0YEE5WITHWAGE5l4THEIR50lECOMPENSATION, � 'COfi1R10fGI21 ' WILLDO THE WORK AND THE STRUCTURE IS NOT MENDED OR OFFERE�FOR SALE(SEC.TM�.BUSI• J NE55 AHD DROFE5510N5 COOE:THE CON7MCTORS IICENSE UW DOES N�T�DPLV TO AN OWNER OF � N PROPfRTYMM1IOBULDSORYPROVESTHEREON.IWOWMODOE55l1CHwORKH11A5ELFORHE0.5[LfOR � � C� TI/qOUGHH50RHERONTJEMPIOYEES,VHOVIDE�IYIATSUCMIMPRDVEiAENTSARENOT!lTENDEDOH m 0 OFFEREDWRSALEIF.FiOWEVER�DUILONOORMPROVEMENTIS50lDWIiHPJONEYEAROFGOMRE- � TION,THE OWNEH�BURDER WILL 14�VE TME BURDEN OF YROV W6 iNAT ME OR 511E DID NOT BURD OR NPRDVE fORTIIC PURPOSE OF SALE1. w OLASOYMEROFTIEVROPERTI:AIAEIfCLUSNELYCWfTMCTN6KTTHLICENSEDCOhTRACTOP3 • � TO OONSTRUCT T1E VROJECT(SEG 7oal&151NE53 AND iRDFE5510NS CDDE TNE CONTMCTOHS LI• V21118ti0f1 ADJ.AREA CCfISE UW DOES NDT APPLY TO Ml OMMER OF AFFOPEHTY WFq BU4D5 OH W PPoDVE4 TMEREON.AND � 1Nq00N7flACT3FOf15Up1VROJECiSWITHACOHTMCTOR(5)LICENSEOPURSUAMT0711ECONTM4 pUANTfTY D[SCRIPTION FEE � � NFS UCENSE UW.} O IAA1 IXEMPT UNOER SEG B.i P.G FOq 7MI5 REASON Q OO � � /'� b 2 � � Z OA7E OYWER f' �I. � W �� � � UCENSED CONTRACTORS DECLAFiATION W � � INEREBVAFFWMUNOERPENALTYOFVERIURYiHATIAAIUCENSEDUNDEHiROVISIONSOFCHAPiER � s �(COUYEUCN[3VATHSECTqN7000)OFOIVI510N70FTHEBUSINESSANDPROFESSi0N5C00E.AND Z x W IICENSE IS IN FU1 fORCE M'D EFFECL m � /� ui /� � v � UCENS�E C1LA55 S -��� LIC.NO. �J �� V DATE�/�IL��Fl C7 CONTRA � ���yyy��--- a � �� WORKERS'COMPENSATION DECLARATION /� � 4 � IHEREOYIIFFlWAUN�ERVEN�:7YOFPERIURYONEOFMEPoLLAWPIGDECURATqNS:'�� V N Z 1 Q � �IHAVfANDWILLIUNTNNAGER7�FICATEOFOONSEHTTOSELF�INSUREFORYARKERS' _ � COYPENSATqN,ASPHOViD'eO8Y5ECTtON77aoOFTH[UBORCODE.FORiMEPERFO11idu10E W OF TNE YYORK FOR VA71GM T1n5 DENI/IT IS ISSUED. � � �1 HAVE AND NnLL MAPfTA1N M/ORKER5 COUPENSATION INSUfUNCE,AS REWIRED 8Y SECTION Q 770o OFTHE LAOOR OOOE.FOil THE PERPoRMANCE OF iHE wORti FOR W111CHTHIS PERMR IS , � i55UED.4YWORKERSCOMPENSATpNINSUnANCECARRIER/WDPOIICYNUAIOERME: CONSTRUCTION � GiWiER�'��ZE' �1915] f�I S �(/�lI'II IPLANREVIEW � , � POUCYNUM6ER.!��Q�� �� ELECTRIC � p �ssccm+rr�mwreeoor.+�naFncoEa�nrtsa�a+E��.*n�moouusK lrn�Essl PLUM6ING _� Z ICERTIFYTNATWiHEPERFOAMANCEOfTH[YIOAKFORYn11CH1HI5GERMRI515SUE0,1 MECFINNICAL () SM.LLLNOTEYDLOVANYVE0.SONNA.WMMlNERSOASTOBECOMESUBJECTTOTHE NORNERS'OW.�oENSA7qNUW50FCALIFORNI�ANOAGREE7N�TIF15 lD0[COY[ INSPECTIONFEE SUBJECTTOTHEWORKEAS'COAIPENSA710NPROV15qN50F5ECTqN] F UBOq � s COD[,ISNALLFdtfINA7MC04PLYW�T1Tq5EPRDVI �$$UAN(,'E .��j��_.g__�nnn � ppATF��IO�V f7 APPLICAN. � SMIP � � W ENERCaY P/C F DIAMOND BAR WARNiNG FMURE TO SECURE WOAKERS'COMPENSATION COVEiiAGE IS UNUwFUL.AND SVULLBE � SUBJECTANEMPLOYEHTOGRIMItULiENALTIE5/WOCMLFNESUP700NEMUNDREOiMOUSAN� ENERGYPERMIT ILAINGANDSAFETY DOl1MS(f 100.OD0�N AD�I710N TO THE GOST OF COMPENSATION,DAIMCES AS PROVIOED FOfi W JOC SECTION]7a!OFTHE LABOR COOE.INTEFEST,I�MJ ATTORNEYS FEES. RETENTION FEE: pW., CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHfREBYAFFIRMIMDERPEN/�LT/OFPERIUH'/TMATTMEREISACONSTfR1CTIONLENDINaAOENCY " dZ FOR TME VERFOfIMANGE OF TME WORK FOR WNICH TMIS iERMI715155U[D�SEC.7oV�,CIV.C.) W � lENO£N'S NAME � LENOER'SADDRE55 . ¢ ICERT7FYiHAT11UVEREIDTHISAPPIICAilONM1D57ATETUTTMEl1BOVEINFOMAATqN15CORRECL TOTALFEES /� W IACREETOCOAIVLVWITHALLCRYMi0C0UNfYOROwANCESANDSTATELAW5REU71NOTOBU4DIN0 � Cp�STRVCTIQV.ANDNEREBYAUiMOW2EREDRESENTATNE50FTMISCOUNTVTOENTERUPONTNE ` � � � z ABOVE•MEtlT10NEDPROPERTViORIN50ECT10NPVRPOSES. j j COMMENTS O � V � - m EE E(PRINTj ¢ �-�fl'4n � y Tu o VERMITfEE DAiE - , � RECPT.NO. PAID BY ALIDATION WHITE—Department Capy.YELLOW�nance Copy,PINK—Aasessor Copy,GOIDENRO�FIo Copy.GREEN�Appl�r.�nt��y J • . . . . . ,. . .., . , ... . . . ,. . , � . . . . . . . . . - . , . . , ., . ,. , . , .. CITY OF DIAMOND,BAR . : . __., . , � , . .. � . .,. ,, :.�, .:�-.-. �. � •: INSPECTI01�l�RECORD ,.:_, . �:. . •� ; . . ,.,�_,,.... - ,,�,, ,,,,, ,, ,, , , , ,,; , : ,. ,. . . ._ ._.. ;. ,. . .. . . . _ ._. �- —,._..-_._��_____.� i��.� ��1�C.��', ��,:��� �. '�►i�� �1��' �1��-��?�� ��'���f� �li���i�.�. �(� �I' �c��� � a � - - - �� ' ,....,m.�,�� --- - �' ."...�r,...�,;..� ..��� iSET'BACK �� � \.�.; �, � �., '� • '.� � FLOORJOIST �\1- �_� ��1� ,. �.�. .,?.., ��, FTGS/FORl�1S�STE�L . . ._ . :• I..._ _ . . • ...� . FHA REQb�1TS..� '..:. ' '._ " ` :_.""`'.-'.. �I' '_...'_ ._.. -.::.- - � _ �ELECTRlC GROUNQ __. ._ _._.. �;�.'• _ UNDER FLOOR DUGT' : �:- � Fl� "�' - + , . .. , , ... . ._... , _ —---.. IGROUND PLUMBING � r=.. UNDER FLOOR GUi•10JIT� � �� ;,;:,-,.`;�`= �,�= `,��� .." .:.:,'„ I . _.., . ,_. . . .. . . . . , -- • -• . •-- �SLAB GRADE:_..... ._. '�•'. ....---..__... .--. - " FIREPLAC �F.OU�JDA`CION �.. , �.! :_ r �, i•. ' ' �. (.r ��;;., I ,. ;TEMP POWER �- -- - �,,,, - - -._. --.. _ ; . ,. - . FIREPIJaCE BOI�Q BEAM , . !-';. � _' _„ ,-- . ...�.�. .• �_�.-- iWATER SERVICE-- � -, _- - . MID HT.BOND BEAM J � �'i� � ,� -� �,: �� . .. ' . ' � , � �flOOFSF.EATHING-�-� I '1 � I � � 8 FL BOND BEAF11 !;� %•, • ` -' �_. __::,�,�-'. , . ,... V .. . .� .. ;FRAMING.NENTILIATION --- FIPJAL`B• ND�EAP�1- � �' � '�� '� y -� ; .. _. .. ' IROOF COV�R '�•' ' PRE-GRADING __.. . _ ._ :., ' I : ._ _ . . ._ ..� . IROUGH HEATING ._.__... _ .. � BENCHING- _ ;. ,;,,, ? ; , ':ROUG'i ELECTRIC --', '7 _ / ' ' " ROUGH GRADING . . - - . - - ----- - --; � �ROUGH PLUD�1BING--' - � - `� ��'�`� - FINISH GRADING � � ' �SHCWERrfUBTEST-; - - ----- •- -- - - POOL�ELECTRIC � � ; . iEXT.-L-tiTH,�SIDING ; - . ._ .. . POOL FENCING ' � . � • , j1NALL-iNSUL.EITION -. -- - - . � - - - ----- POOL`FINAL ;CEILtI`!G-IrdSULATIOiJ'--- - - - � ; - OFF SITE IMPS. , : i -- jDRYVVALCNAICWG- ', " � ! DEDICATIONS ' = �SFV���R . . FINAL'EPdG. . SEPTIC TANK ' LANDSCAPE/IRRIG. � • � . ' . 'SEEG PIT/L.L.. .. .. • ON SITE IMPS. G�;S F,IR TEST ' FINAL'ZONING • � - '.FIr;,4l_.CaNST. . •�',,`;:�: f; ';•::\' FIRE DEPT. FINAL . - . _ . - -- - . ._. . ---- _ '�t�.f:�4-IEATING ._..'+�': • ( � . "c.' :' ,..:J;�'. . \ HEALTH DEPT. FWF�L .. .... , - _...--- � — - �.:�• -S���• '�. �` ``' 1 ., DEV. FEES PAID :..._ . . , �,�t.�ELECTRIC� 1D'I.� � -- -..... .. _ ';i=�'���.I..PL�1PA81NG -- � •��'_'•••• - .:v�a :� EhJERGY . : . , -- - - , '� � � �' � _ • � ;;`--- .` _ ... ..._, '; -. . .-";� - - �� ;c��.u� i;j�r��;c"'� f:J.�_� �_ / �� r.i.a�>�_.az w.��_�..�..� ..,... � _.. . _. � . _ . _ . . _ `. . . . _ . \`_-� ,`- - . :):.J " �'\-.�� . � _ . • _.... -. _..__....,_._ _... ._ : . . . .... . ` COt�1MENTS - ._ _ ._ . _._. .. : . . .. ... . . .. - • .,- . '� 1 1 `� . . ._ � I J 1 . : �.. 'I � . . . � � . . ' , �.—. .. �-... . . _. . - . - . . . . . , I � . 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