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HomeMy WebLinkAbout16244 (29) I . �� CITY OF DIAMOND BAR �' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � �� , 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRE$$ '���� BUII.DINGPERMITAPPLICATION �" FIRMLY o� JOBSRE ��"]Q/\ /]nn�l���(n \��STl1 APPUCATION � r.��l NUMB R�• IJ #�� OI�OI) ADDRESS !(:LJ l J r�(/`1����1L r I fT DATE -� � • ISSUE . TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER LL ADD SS ZONING SEBACKS � CITY ZIP TEL I REAR RW OO APPLICANT TEL SIDFJSIDE STREET RW O � CONTRACT SIDE O � ADDRESS � � ' CITY ZIP TEL PROPOSED USE��.____I.'. ; �r:�.,:, �,_.'•' � AfiCFUENG/ • ' _ OESIGNER NO.DWEL NO. NO. AODRESS UNITS STORIES BEDROOMS y CITY ZIPQ��n TEL - � ������������ DESCRIP710N SQ.FT.�. FA OR PSF ADJ.AR ALUATI N � OVYfJER-BUILDER DECLAMTION SFR/AD0IREM - i O p I HEREBY AfFIiW LRlDER PEWLLiY OF VERIURY THA7 I AM E%EIAPT FROM THE CONTMCTORS U� Gefe9B/C8fp01I �- � � LLl CENSEUWF011THEFqlON9N(iREA.�ON(9EC.70.71.6BUSINESS�NDPROFESSqN5C00[:ANYqTYOR� (f) U COUHTTWIqCNRE0Uf�5AVERMRTOCONSTNUCi,KTER�NPA�VEDEMOUSH.ORREPAIRANY$iqUG w patio/Deck � � NRE,iRIOH TO RS 65UANCE,ALSO REQU�RES THE�7PLIGWf FOR£UCN PERMR TO i1LE A SIGNED ' ' BTATEMENT THAT HE OR SME IS UCENSED PUKSUANT TO T11E PROViSIONS OF TME CONTMCTORS U• � CEHSE UW(CHAPTER 0(ODMMENCSNa WITH SECTION T00010F DIVISION]OF THE BUSMESS ANO PRO• V"' POOVSpO'� FESSqNSCUO[)ORTHATHEORSHEISEXEMPTTHEREFROAIAN�THEBASISFORiHEALLEGEDEXEMP• TpN.ANYVI0LAT10NOFSECT10N7Q'11.6BV.WYlIDGLICANTFORAVERIIRSU6IECTSTHEAPOLICMlTTO Z Re-Roo1 1 • � ACMLOENKTYOFNOTIAOH[TlNNFlVEHUNDREDDOILAAS(f5u01.1: _. � p�ASqN�EROFTHEGROPERTY,ORMVEYPIAYEE5N17HWACESASMEIRSOLECdAPENSATqN, 0 (',pmmBfCl81 i ' WLL DO TME WORK ANO TME STRUC7URE IS NOT iMEtAEO OR OFFEREO FOR SALE ISEG 7oH,BU51• J NE58 ANO PROFESSIONS CODE:TNE CONTMCTORS UCENSE Uw DOES NOT AiPLY TO AN OWNEfl OF (! y iROPENTYWHOBUlD50RIMVRDVESTNEREON.ANDYV/10DOE55lX71Y�ONKMIMSEIFORNERSEIFOR = - � Y � ([ THHOUCaHNISORHEROWNEMPLOYEES,VFi7VIDEDTf1l1TSUCMMVROVEMEMSAFENOTINTEN0E00R m .. • (� �jOFFEREDFOHSALE6.FqWEVERIMEBULDIN�ORIMPHOVCMINTIS50lDWITHINONEYEAROFCOMPLE• X V � Z �T10N,7ME OWNER�BURDER MnLL HAVE iHE BUROEN OF PROVINO THAT ME OR 8HE DD NOT BUttD OR _ �,1PppVEfORT/Eq1RPO5EOF5ALE} W ❑6ASOVMEqOFTHEPROPERTY,MAE%CLUSNEIYCONTRAC71NQN7THUCENSEDCONTMCTORS (= TO CaNSTRUCT 7ME PRO.IECT(SEC.70M,BUSINESS MA PROFESSKKJS COOE:THE COItTRAC70RS LI- V01Ud110t1 � ADJ.AREA LLJ CENSEUWDOESNOTAGPLYTOANOWNEROFAPROPERTYYrt/0BU1LD50RMPflOVE5T1ERE0N.AND � 1MqCOHTMCTSfORSUOfPROJECTSWITHACOMMCTOft(5)LICENSEDPURSUMITTOTHECONiMG QUANTITY DESCftIPTION. . . � FEE � TO(iSUCENSEUW.1. ..J ❑1 AA1 EXEYPT UNDER SEG B.t P.C.FOR THIS REASON Q U tt_ ' � "• OATE OYMER V � � w 'Q L. 0 UCENSED CONTRACTORS DECLARATION W —�,�-f � IHEREBYAFiIfWUNDERPEIULTYOFVEiWMiHATIAMLICENSEOUNDERVROVI510NSOFC1uPTEH � � s �(CCMMENCW(iN"iH5ECT10N700010FOMSION�OFIHEOUSINESS/�HDVflOFESSiONSCOOE.AND Z X W UCENSE LS N FULL FOFlCE AN�EFFECL m � � �... UCENSE C S _LIC.NO. J V OATE COI�lrMGTOR a � I� • WOFKERS'COMPENSATION DECLARATION • 4 S� . � IHEREBVAFFUIMUlAERPENALTYOFOE0.AIRYONEOFTHEiOLLO'MNGDECURATIONS: U `�' a � � _IIUVEANDWILLMAIN7A7NACERTIFlGTEOFCONSENTR1SElHNSUREFOfiWORNERS' � _ � n� y � G�OMPENSATION.ASPROVDEDBYSECTION�7000FTHEU�BORCODE,fORTHEPERFORMANCE W �'� OFTHEY/OHKFORWHId/THIBCERMITI5155UE0. � � - O �� _IIUVEIWUIMLLMAIMfAP1VfOFUCERS'COMPENSATIONWSUMNCE.ASREOUIqEDBYSECf10N �^� a y��'('y�1 � 97000FTHELAf70RC00E,FORiHEPEHFORNANCEOFiXEWORKFORWHICH7MRPEIWRIS �l" � Y� � � 0 LSSUED.LIY Wt7 R5 FNS TION SU F CARRI R Ml[1 FOLICY N ER A CONSTRUCTION ll J l)� � CARF�ER � � PLAN REVIEW � � � R1� ELECTRIC ' � R��ffino �t�ppFnEverar,�rtswad+��+mpaur�sR,oqon� PLUMBING �. ` W MECHANICAL � .J Z I CER7IFV THAT N TME�ERFORAUIICE OF fHE WORK FOR WHICHTHIS PEfUAIT IS I55UED.l (J SHALLNOT EM�LOV ANV PERSON W ANV 11ANNER SOAS TO BEfAME SIIQIECT i0 iME Uj M/OHl(ERS CO�.�PENSATqN LAWSOF CAUFORNIAANO AG{iEE iM�i IF I SHOlAO BECOME INSPECTION FEE . S SUBIECTNTHEWORNERS'CaMPENSAT10NPiqVISiDfJ50FSECTION]lOOOFTM[UBOR caoE,�swut.roan+wirn coMr�r nase aao�nsaHs ISSUANCE -� ��, Om�_ SMIP p DATE: APPLICANT: . � ENERGY P/C • � WMNINO:FAILURE TO SE W RE WOfiNERS'C06��ENSA7qN COVERACE IS UM.AWFUL.ANO SNALL BE �y SU6.IECTANEMPLOYERTOCRiMINALFENALTIESANDGVILFINESUPTOONEHUNDREDTMOUSAND ENERGYPERMIT DOlURS(f 700,000),IN ADDITION TO THE COST OF LOAIPENSATION,DNAACES AS PROVIDED FOR IN l � SECTIOM]7oeOFTMEUBORCOOE,INTEREST,IwDATTORNEYSFEES. RETENTIONFEE: ��. `" n.. CONSTRUCTION LENDING AGENCY PRE-ALT FEE: 0 � IHEREBYAFFIflYUNDERPENNTYOFP[IWRYTHATTHEREISACONSTRUMIONLENDINQAQENCV , � FORTIIEPERFORMINCEOFMEWORK 11p1iHISPERMITI5ISSUED(SEC.7oV/CN.C.). � �11nR1"��U L,TE }t01��p� � ' � IENDER'S NAME }�^ � IENDERSADDRE55 . WICERTiVTHATINAVEREADTHISAPPl1CATqNANDSTATE7NATTME�BOVEWfORMATION19GOfiPECi TOTALFEES yO,�� � IAOHEETDCAMPIVWtT11JLL1CRVMlOCOUIlTVORDINANCES/�NDSTATEUWSREU71NO70BU1LOIN0 r^ COf15TRVCTION,AND HEREBY AUT/IOiiIZE REPPESGNTATNES OF THIS COUNTV TO ENTER UPON THE s. hBOVE�MENTqNEDGROPER7YFORMSVECTIONPUAP0.^5E5.M COMMENTS � I I 1I`l� � 'v QiERMRTEENMAEIPRINTJ ��_/7 ) O/ . Cn �..C/�C/ i� y SIGNATUNE iEE OATE � RECPT.NO. PAID BY VALIDATION WHITE-0epanment Copy.YELLOW—Fnance Copy.PINK—Assessor Copy,GOLDENROD—Fle Copy,GflEEN—Applicant's Copy , . , . . .,. . .. . ,. , _.._ . . � . . ' --- CITY OF DIAMOND BAR . .. ._ —- . . :.::1P�SPECTiIOfV�RECORD ,-: � �:. `i . , , , . , . . . � - _ ,... .�, _ � e�a. ,� .�' ` ° _�-, . �S. e_r . e � M _:'��-�;��G�1F���%� _ !FTGS FORMS,'STEEL I , , f ,. �:� . FLOO _J � Sl":, •,� 1, � . :-, r ' �` . � ' � � ; � ' � .. , .. •___ - • . . ._ FHA�iEQMTS"�. . -- - '� �_ - -_ _ �._. _ . i ELECTRlC GROUND___ � ` _ _ --_- UNDER FLOO bUCT; ' = �`•-'•' " ' _ ,. � , --- - ' _ _ ' ' -__ _ _ _ _ -. , . , � R QP,ICt IT� ,.,• �i�. i` ```�, ..s�}f 'I.. _ GROUND PLUMBING UNDER FL _ _ ISLABGRADE-_-- _ - - - - FIR�P C�-FOt.(P�! ' TION . � ` �r � ,�I' !.� ; ^ ITEMP POWER � � FIREPLACE BOND BEAM -;.. ,-� !r' '�I; :{ ;: ' , �WATER SERVICE -- - - _- - - _ ',_ MID•FjT.BQND BE�'�F�1�_��;- 1 i _,t ��.' '-'� - . . , . • �ROOF SHEATHING �.�1 I 8 FT.jB;Or1f�$EAM' ',t,� �-_���}�'t"i ,_�: �::;��c., _ 1 .., �FRAMINGNENTILIATION �L FINAL�B f���AI�� ' �•� � � . � IROOFCOVER • PRE-GRA�INE'u „ '� -' •; ~J ' iROUGHHEATING' - -- _ . . .. __ __ BENGHItJ6._�', •��:.;',; .'� '`'•. ,.- �. •,` -.a"•,;.J i . � ROUGH ELECTRiC_ ' . ' OUG� GRADING � • • ' _ _ . _�_._ , ,ROUGH'PLUMBING--�= :-` ' - ` - - FINISHGRADING ; �'; ;SH�WERITUB TEST ;` ` ' ---�% �� , } POOL ELECTRIC _. . EX�'.LATN/5tD1NG� -,- - �L• -1 �1 : � _ _ POOUFENCING i ; `WALL INSULATION- j _ _ -- __ _ POOL FINAL � I ; i : 'CEfL1NGfNSULATION (i� . _ �FFSITEIMPS. ' '' ' ' � : DRYWALL NAILING ; �-pl . �:, . DEDICATIONS _ ,. SEWcR �.-�� - , ,�L,('� `�t, �FINAL ENG. - SEP71C TANK ' LANDSCAPE/IRRIG. �SEEP PITILL. _ l ' "•r ' �� ' ,%;-' ON SITE IMPS. ! '� ;GAS AIR TEST__ _ ._ _ �' ! -•----..�_�; FINAL ZOMNG � r�t 3 � �FINF,L Gt��dST. :--- ---_ _ _ ' � �� ` ' •; '_ Fi�DEPT.FINAL � iFJ�tA.L HEATING-- ____ _ ' y-�'"�" NEALTN DEPT.FINAL - I .. ���N�L ELECTRIC - _ _ , � . � �_� ,� ., DEV. FEES PAID ___ __ _ _ __ :__ �P�iP.t PLUh1�ING - , ,_. � EhJERGY _ : ,� . � ,. , .. . . . ._��- - � - __ , . . _. , _ _ . -. , ; � � . _ - _ _ . .. , �,.,.,�..��-�.--^—` , �r. %^ �r � �, I � y�tr _ _ � ��; _ __ _ _. ._. . -" - ' '— . _ ..__. � I � . . . ��' . � .t�'-% ..�{ ,. i..4..i' � t� •! .. � �i !COM f��NT5 — —.-- .— ; , -'—\ ., : .��'. . -`__! _ __ _ _ — _ _ - — �: ; . , . , . . � , _ . . , , — . �._ , _ _ — ;— __ _ . . , �\ ; -T I ` i ; � _ , , ' . ' � -- I _ _. .. _ _ � �... _ . . , rj.�. ., � 1 ! '�� , ,;,�' '•'�' l� :;'f, .;(-; � ___ , . _. . . ; �.�� + � �l-ey . : i , � I ; • " • . � i�..� ' r C. -- ; _. .. . .'_ � � , . , : , , ' -- �- �.- � _ � i - , _. . , _ . . �� , • _�i � _. �� .'1 ' ' � � ;SEPTIC T�1NK SIZE _ . ,, ; , �SEEP PIT/U SIZE _ , . � ; �., , , ; � � ,;j��. _T�� . , , - ` _ i _�s...y,► .:�: . , 1 `� � V Ct.l� . �.. �`\_.. �,.f. �r . � � � . �. . . .. 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