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HomeMy WebLinkAbout17860 (17) i - -- - , 1� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � u�oE.coP��ynri��s���90 PRESS (909)864-3195 Fax(909)861-3117 ����� BW.DING PERMIT APPLICATION FlRMLY y�, JOBSITE - APPUCATION (.,��,,,� I,�v ER 8 R '�g�,�� �IC o ADDRESS DATE 1 V � , ISSUE TYPE OCC APN T l � TRACT DATE CONST. GROUP p OWNER "' ADDRESS d 20NING SETBACKS — � CITY�i7/lIl{ ZIP rZ TE - " �R RW ❑❑ APPLICANT Si0-�e - TEL SIDE/SIDESTREET RW ❑ � CONTAACTOR�.+? SIDE ❑ � ADDRESS PROPOSED USE CfTY ZIP TEL � ARCH/ENG/ � OESIGNER,Cf� � NO.DWEL NO. NO. ADDRE S � TA �1 UNITS STORIES BEDROOMS N C(TY ZIP� TEL7i�4�t�-'97T y DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECL•ARATION SFR/ADD/REM O � p I HEREBY AFFlRAI UHDER PEN/�LT'OF GEiWRY THAT 1 AM EXEMPT F{IOM iHE CONTMCTOiL;LF Garapa�Carpan W CQlSEUWFOR7HEFalLOWNOPEA50N(SE4Jm1.SBU5WE33ANDVNOFE35lON5COOE:ANYdTYOR � (n S2 OOU!(TYNM10/REOUWESAVER7ARTOGONSTRUCT,ILLTERMPROVEDEMOLISKORREGAIRANYSTRUG W PeIiO/DBGk �� TUHE PNOfI TO RS ISSUANCE,1LL50 REOUIRES TME MVlICA1.T FOR SUG1 PEftMIT TO FlLE A SIGNEO� W BTATEMEM iNAT HE OR SME IS UCENSED PURSUANT TO THE 7ROYISIONS OF TME COMMCTORS L4 � CENSE UW(CNAMFR O(COUYENGtYO WITH SECTION 7000�OF DMSION!OF TNE BUSINESS AND iRO� u- PooVSpa � FESSIONS OOOE)OR THAT HE OR SHE�S E%EIAVT TIEREiRd11WO T11E BASIS fOR THE ALLEGEO EXEAIP• TqN.ANYYqIAiqNOFSECTION7W1.68YANYAPPLIGWTFORAPERMITSU6)ECTSTHEADPl1GWTT0 Z Re-Roof �,_, A CMl VENALTY OF NOT AIORE T1AN fNE NUNOREG OOLUIF3S(f5D0).): � OlASOWNEROFTHEPROVERTY.0i1MYEMPLOYEESYATHWA0E5A5hIEIRSOLECOMPENSATqN, Q �mmertlal � WILL DO THE WOf1K AN�TNE STRUCTURE IS NOi RlTENDED OR OFFERED fOR SKE(SEG 7W1,BU51�� � J NE55 AND PROFESSION9 CODE:THE CONTMCTORS UCENSE UW DOES NOT APPLY TO AN OWNER OF � ViqPER'TYWF108VILDSORINPROVESTHEREON.ANDMAIODOESSUCNMNRKHiMSEIFOHNERSELFON � � � Q 771ROUGHHISORHEROWNEYPLOYEESpROV1�EDTIUTSUd11YPROVEUEMSIAENOTMENOEDOR m � OFFEREOFONSKEIF,110VhYE0.7NEBUlDPlOORM�RDVEMENT1350lDMTTMWdJEYEAROFC04P�E• Z �TION,TNE ONRIER-BUIIDER VnLL HAVE TNE BURDEN OF PROVWG THAT NE OR SME DID MOT BUIID OF = IMPROVEFORTMEPURPOSEOFSFLE7. W DL���EROFiMEPROPERiY.A/AEXQU3Nfl.YCONTMCTNOWT1UCEtYEDCONIMCTOR3 Q TO CONSTRULT THE VRQIECT(SEG TOM,BUSINE53 ANO PROFESSIONS CODE.iME CONTMCTORS U• V81U8IIOf1 ADJ.AREA LLI CFNSEUWDOESNO1MPltTOANOWNEROFAVROPERTYWMOBUILOSOR�/PROVESiMEflEON.ANO � YR/OCOHTMCTSFOqSUG1VRO.lECTSWITNACOF7TMCTOR(SJI�CENSE�PUNSUl1NTTOlHECONTMG OUANTI7Y DESCRIPTION� FEE . � TON9LILENSELAWJ.� . . . . OIMIDfEMPTUNDERSEC. B.l7.GFORTNISREA50N U l Q �= �ATE �� OM'NER V � ? W ��q . LICENSED CONTRACTORS DECLARATION —' OC ' W . ,�. _ . . INfREBY/FFUtAIUNDERVENALTYOF0ERAINYTHATIN.ILICEN5E0UN[1ERDROVISIONSOFCHMTER V. 1 ' !- 'I. (� �(CO�dYENCNON7TM5ECT�ON70oo)OFOMSION70FTHEBUSiNESSIWDPROFESSIDNSCOOE,ANO Z - X W t10EH5E IS N FULI FOi10E ANO EF�ECT. m 11J � � 110EN."�iE CL�A�SS � ��7 UC.NO.� 7 V p/�7cG7C/J.�3n^�1 CONfMCTOR a W —..�— � i WORKERS'COlAPENSATION DECLARATION ¢ ' • � �, _ , � U " N IHEREBv AFGIRMUNDERPENALTYOFVERR1ftYONEOFTHEfOILOHAN(iDECLAMTI0N5: � -� � , y ��/1�y/ Z � � �y(ZIlUVEANDMALLMA1NTAtNACERTIFICATEOFCONSENTTOSELNNSl1REFORWORKERS' S `/� PENSATION,ASPf10VIDE00YSECTION]�OOOFTMEUIBOFCOOE,FORTNEFERiORNANCf W OF 7ME WO�iK FOii WNIGM TMIS GERMR IS ISSUED. � 0 � I NAVE AND N1LL MAiMAW VfOFiKEHS'C041PENSATN)N WSUiUNCE,AS RE WIREO BY SECTION 1� �1 4 370aOFTHEU�BORCOOE,iORTH[VERFORAUNCEOFTHEWORKFOHVMIq1THISPERM1T15 �S�LC�P/� � ISSUE�.MY ERS' PENSATqNWSU CECARRIERNJOVOIICVNLNIDERME: . CONSTRUCTION � CMfLER � � .T_/J�� PU1N REVIEW � POLt.Y NUMBER ��� -�� ELECTRIC .` � �srCT1�NN�NOTgF2A{�[7Ep�Flyfp67MisiY%iOhLtuDItEDOttIAfLSRta�)OItlES51 PLUMBING �+ Z ICERTIFYTHPTNTHEPERFOIiMUJCEOfiHEWOPICFORWHId1THI50ERMI715155UED,1 MECHANICAL (} SHALLNOT EMPLOY ANY PERSON M ANY MANNEH SOAS TO BECOME SU&IECTTO TME y VYORKERS'COMPENSATIGlU'NSOFCALIFORNIA,ANOACREETwlTIF151/OULDBECOME INSPECTIONFEE S SUBJECT TO TME WORKERS'CCMPENSATION PROVIS�ONS OF SECTqN 77000F 7HE U�EON �SSUAPICE �� COOE,I SH�J.L fOR711wRH COMPLY YnTy'�NSEyRO�A'�7FN8.__� �� ��- � SMIP p pATE: ^�g �2 APPLICANT:1,71�/1Y�� GI/f4� . � ENERGY P/C WARNINO:FIUUIRE TO SELURE WORKERS'COMPENSATION COVEMGE IS UNUWFUI.AND SHPLL BE � SUBJECTANEI.�7LOYEFTOCRIUWALDENIIT7ESANDdVILFWESUVTO0NEMINOREDTMOUSAND ENERGYPERMIT DOIURS(f10o,000),IN/�DDITION TO THE COST OF COMPENSAiION,OMIAGES AS PROV�EO FOR IN ¢ SECiKN!97oe OFTIE LABOR COOE,INTEREST,AND ATTORNEYS FEES. RETENTION FEE: � � CONSTRUCTION LENDING AGENCY PREAIT FEE: � IHEREBVALFlRMUNDERDENALTVOFFERIURYTIUT7HEREISACONSTRULTiONIENDINGA6ENCY a- FORTHEPERFOFWWCEOF7MEWOnKFOR/YYN'IC111MISVE/RIAITISISSUEO(SEC.�OY7.CN.C.1. � LENDEH'S N.u.1f�QJ�'F�IJ,` ����� � LENOER'SADDRE55 WICERTtFYMATIHAVERL/�DTN�SAPPLICAT10N�/A5TA7ETHATiNEAeOVENFORM�TqNISCORRECT. TOTALFEES �j �,:.� � � I AGREE TO COMPLY WIiN ALL CRV AND COUNTY ORD�NINCES AHD STATE UwS REUTIN6 TO BUILDIN6 CONSTRUCTION,MIOHEREBYAUfHOHREREPHE EN7ATNESOFTHISCOUNTYTOENTERUPONTXE Z /1BOYE�MEHTqNEDPROVERTYFOflINSFECT ut�vosts. COMMENTS � J _ ¢ PERMITTEE E(PfUNn ���� � N SIGNANR MITT E OATE � � RECPT.NO. � PAID BY VAL1DATlON � WHITE-0epartment Capy.YELLOW—Finenee Cotry.PINK—Assessor Gopy,GOLDENROD—File Gopy,GREEN—ApplicanCs Copy �-'� CITY OF DIAMOND BAR . , _, . _. . . .If�iSP�CTION RECORD ' �. ' ��!-��!���"�j��►'P� .�`�i�'� {.1�.��.3�'��� • �_1���`.I�''"'��'�r'Ci'� �I►�.�-`��a �;,��:� �. SET'6ACY..,.........._.......__ �......,�.........,,.,. FLOORJOIST �...,..�.,.�_�....w .-0�9....._, i _....,. .,,_. '. ._._. !FTGS/FORMS,�STEEL _ .. _._ FHAREQMTS_ , . .,. . , . . . _ - . _� ELECTRIC"GROUND _ _ : - ' "� _ UNDER FLOOR DUCT� ' - ' ^ - ---: �GROUND PLUMB!NG . - UNDER FLOOR CUraDUIT � ' : -' ; � � ------ 'SLAB GRADE - _ `': _ __ _ _ _ . FIREPtACE FOUNDATION `- _ � �� , , . , ;-- iTEMP POWER - -; , .- FIREPLACE BOND BEAM ' . ` ' ! �WATER SERVICF- -- - --:- � � MID HT. BOND BEAM � ' ROOF SHEATHING � f3 f�T. BOND BEAM - ` � I FRAh11NG/VENTlLIATION FINAL BOND BEAM ' 'ROOF COVER .�� " __ PRE-GRADING . .. . . _ .'. . .. .. .. . . . , i ROUGFi HEATING - - _ _ _ _ _. _ . BENCHING -��: ;..�. _•- -.. ,. , , _ ; •. ',ROUGH ELECTRfC ; . � ; ; - � ROUGH GRADING- ___ _._ __ _ . _ ___. .ROUGH PLllNIBlNG - - - - - - - - : - - - FiNISH GRADING i _. ;SHOr'4'ER.�i'UBTEST - -_ - - ' POaL'ELECTRIC , ' ;EX�'.lATH/SIDING - POOL'�FENCING : . L^JALL-INSt1�ATION - . - POOL'FINAL i ; SCEiCif TG-iNSULATiON - _ OFF SITE IMPS. - ' j ;, DR`(�"JF:tL NAILIPJG - DEDICATIONS � t `SEINER- _. _ _ FINAL ENG. , , ;SEPTICTA�vK LANDSCAPE/IRRIG. � � '� ;SEL-P PITILL. � ON SITE IMPS. � •� � • ; ;G�,S AIR TcST FINAL'ZONING ; _ ^ - � (� �2� , '�-I��i�:._CrJ"JS7.- -- - - _ _ FIRE�EPT.FINAL � _ . i ; ;i-1^1:..Lt��',TING - - _ HEALTH DEPT. FINAL . _ -,: _---- -- ;=;vt,'.._�LEGTRIC _-_ - _ DEV.,FEES PAID _ � ��= PI.UP.'i9ih•JG -_ � � . ENERGY 1 _ __ : - _ — , �,.� /l� 0_ : � _ , , __ _ -- _. _ � --- ---_. _. _ . _ _ �-�-- .� � ���������z. ------•� � ' i -. � _. . . . . , .. -- _ __. _. - - -- , .. . . , , � , � � . '�cor,r;r�_ENTs.�=to-o�_e�����_cav�.�,�; . ' , ��/1(•6� ��rc�� �sT �,u_, c�.�re+� �j• ' . , ', , � � -_ __ , ,. . - . ,. ! �._� 1�; _ . '.. : - _ ; i ' �'_'�. i -� . _ I - . . _ . 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