Loading...
HomeMy WebLinkAbout17168 (19) � �`� �` CITY OF DIAMOND BAR DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES 21825 E.Copley Ihivo (909)860-3195 Fax(909)86l•3117 PRESS '�%�� BUILDING PERMIT APPLICATION FI RM LY o� JOBSITE �J�L��?�n__-_ � � APPLICATION `��(1 PERMIT P/C (,� ADDRESS J �`"�u' DATE � `� NUMBER N O�' �.J c� ISSUE � _,�ThfPE OCC APN LOT TRACT DATE GONST. GROUP p OWNER �- "" ADDRESS ZONING SETBACKS Z CITY ZIP �1(o TEL • �{ 'II FRONT RW ❑ g APPUCANT TEL. REAR ❑ � SIDE/SIDE STREET RW p QCONTRACTOR SIDE ❑ ADDRESS PROPOSEDUSE S�NLf.t ��_����+NJj� � CITY ZIP TEL. ��-�, ,,,� �� � �i�x��-��-- wo ARCFUENGI � DESIGNER NO.DWEL NO. NO. ADDRESS UNITS � STORIES � BEDROOMS � � CITY ZIP TEL. � DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION � ONRJER-BUIIDER DECUIRATION SFR/ADDhiERA b O p 1 MEREBV AFFIRAI UNDER VENALTY OF PERAIRY THAT I AM E%EMPT FROM THE CONTRACTORS LI• Gefe90/C81p0A W CENSEUWFORTHEFdlOAMN�REASON(SEC.)0]1.S8USINESSRNDVROFESSIONSCOOE:ANVdNOR (n U COUNTyWHICHRECNRESAPERMRTOCANSTRUCT,A7E0.�MPqOVE,UEMOL15H2ORREDAqANY57RUC- W PBIIOIDOLk � � TURE,VRIOR TO RS ISSUANCE,KSO REW IRES TIE APPUCANT FOR SUCH VERMIT TO FILE A SICNED W STATEMENT THAT HE OR SHE IS LICENSED iURSUANT TO THE PRONSIONS OF THE fANTMCTORS LI- � CENSE UW(d/APTEN Y(COMMENqN6 W1TH SECTION 7000)OF DINSION�OF iHE BUSINE55 M!D PRO- � PooUSpa FESSIONSWDE�ORTHATMEORSHEISEXEA1PTiHEREFROMANDTIIEBA515FOHiHEALLEGEDEXEMP- (� TION.ANVVKKAiqNOFSECTION7031.60�M7VAPPLICMiTFOHAPERMITSU&lECiSTHEAPP�IGWTTO Z Re-Roof A CMl VEN�LTY OF NOT MORE T W W FNE HUNDRED DOLURS�i500).F 0 04ASOWNEROFTHEPROPERTY.OHMYEMPLOYEESWITHWAGESASiHEIRSOLECOMPENSATqN. ❑ �mmercial - � Z NnLL DO TNE WOPK AND THE STRl1CfURE IS NOT INTENDED OR OFFEHEO FOR SALE(SEC.7W1,BUSb J � NE55 AND PROFESSIONS COOE:TNE CONTRACTOHS LICENSE LAw DOES NOT APPLV TO AN OWNEF OF ? VROPEHTY W/iOBUIlDS OR IMPROVES 1MEREON,AND W110 DOES SUCH WORK NIIASELF OR HERSELF Oq Q T1IROUCHHISORMEROWMEMPLOYEES,PROVIOEDTMATSUd/1MPROVEAlENTSMENOTWTENDEDOfl m w OFFEREDiORSALEF,YIOWEVERTMEBUIL0INOORMPflOVEMENTI550lDWITMINONEYEAROF�OMP�E - 0 TqN,iHE ONlNER�BUILDER WILL MAVE TME BURDEN OF PROVw6 TMl1T ME OR SHE DiD NOT BNID OR Z W PROVE fORTXE PUflPOSE OF SALE). �= OI.ASOWNEROFTHEPHOPERiY,AYE%CLUSIVEIYCONTMCTWOWI7MlICENSEDCONTMC70R5 TO CONSTRUCT THE VR0.IECT(SEG 70N,BUSINESS AND PROFESSIONS CODE:THE CONTMCTONS LI- V3luetlOfl A0.1.AREA W CENSEUWDOESMJTMPLVTOANOWNEROFAPROPERTYWHOBURDSORIMPROVESTHEREON,AND � MM1I000N7RACTSFORSUCHDR4IECTSWITH�COMMCTOR(5)LX:ENSEDCURSUANTTOTHECOMMP QUANTITY DESCRIP710N FEE Y TORS UCENSE UW.} � . � O IAM EXEMPT UNDER SEC. B.a P.G FOR TMIS REASON U ' � � � DATE �� ONMER � U , � W � LICENSED CONTRACTORS DECLAHATION W I HEREBVAFFIfuI UNDER PEN:1l7V OF PERJUHY THAT IAId UCENSEO VNDER 7ROVISIONS Of CHMTER �, p� i�COMMENCINOWiTHSECTION7o00)OFDMSION70FTNEBUSINESSANOPROFESSIONSCODE,AND Z `X MY LILENSE IS M FULL FORCE M!D EFFECT. m � LICENSE CUSS LIC.NO. j V DATE CdJT{iACTOR n- . _.. W � WORKERS'COMPENSATION DECLAHATION Q D = U � IHEREBYAFFIRMUNOERiEWLLTYOFPERAIRYONEOF7MEFMlAWINGDECLAMTIONS: Z Q � _IHAVEMIDWILLMAIMAMACERTIFlCATEOFCONSENiTOSELF•INSUREFORV/ORNERS' - 2 � COAIVENSATION,ASPRONDEDBYSECTtON]70oDFTHEUBOiICODE,FOHTHEPERFORMANCE U Q OF THE WORK FOR WHldl iMIS PERMIT IS ISSUEO. � � W _IHAVENJOIML1MAiNTAMWORKERS'COMPENSATIONINSURANCE,ASREOUIREDBYSECTION O 37aoOFTHELABORCODE,FORTHEVERFORAIANCEOFTHEWORKFOHWHIp1THISPERA11iIS ���� ISSUED.MV WORRERS'COMPENSA710N INSUHANCf GARIER IND POLICV NUMBER/JiE: CONSTRUCTION _ J j CARRIER PU1N REVIEW _� _ o va�crr�un+BER ELECTRIC O �� ¢ - (R+65ECi�d1NEEDraTBE006RE7EDOFTHEPEW.R6FORONEMA�DREDOCILaFtSO+�IOHlEss1 PLUMBING "'�,� /,:• ---r- - -�--••� �p . .. . , �, .! i�� i� Z ICERiIFYTHATNTHEPERFORMANCEOfTHEWONIfFORWMICNTHISPEHMIT15455UE0,1 MECHANICAL � Z•�� (,'} SNALLNOTEMPLOYANYPERSONWANYMANNERSOAST08ECOMESUBJECTTOTHE 'I - ' i . � VYORNERS'COMGENS�TqNUW50FC�LIFORN�h�NDAGREETHATIFI5F10ULDBECOME INSPECTIONFEE 1_ �C�D �]�1_�1,m i . S SUBJECT TO THE WORKERS'COMPENS�TION VROVISIONS OF SECTION 0700 OF THE UBOR I ��7 • — 000�,i sN�u roarnvrin+ca.+v�r wirn nase vaohsror+s. ISSUANCE ���/7� � � SMIP I 1• /� � p DATE: APPLICMIt . � � � WARNIN6;iMURETOSECURE�MDRKERS'COMPENSATIONCOVERAGEISUNUWFUL.ANOSF4lLL8E ENERGYP/C �� �l � SU&1ECTNIEMPIOYEflTOCRIMINALPEfULT1ESANDGMLFWESUPTOONEMUNDREDTMOUSAND ENERGYPERMIT DOIURS(it00.000).N ADOITION TO THE G0.5T OF COMPEN511TION.�AMAGES�S PROYIOED FOR IN ¢ SECT�oN�7oe OFTME LABOR COOE,plTEaEST,I�HD ATTOaNEY'S FEES. RETENT�ON FEE: pW.. CONSTRUCTION LEND�NG AGENCY PRE•ALT FEE: O Q IHEPEBVAFFIRMUNDERVENALT/OFiERJURVTHATTNEREISACONSTRUCTIONIENDINGAGENCY �Z FOR iME PERFORMIWGE OF THE WORN FOR WMIp/TMIS PERMIT I5155UED(SEG 709�,CIV.G�. W � LENDER'S NAME � � LENDER'SADORESS /�/� � ILERTIFVTHATIMAVEHEADTHISMPL�CATIONANOSTATETHATTHEABOVEWFpRMATIONI5CAi1RECT. TOTALFEES � ' • 1 a • � w IAGREE7000MPLYN7TNALLCRYANDCIXIN7YORDINANCESANDSTATEUWSREUTINGTOBUILDIN6 � CONSTRUCTION,N1O HEHEBYAUTNOFIZE REVRCSENTATIVES OF TMIS COUNTY TO ENTER UPON TME ZABOVE-MENTIONED PROVEflTY FOR WSPECTION PUflPO5E5. COMMENTS 0 J � � PE E NAA1E RI ) � a 92 � � � SIGNATURE OF PERMI E D�TE � RECPT.NO. � .PAI�BY VALIOATION WHITE—Department Copy,VELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy � ., ,. ._ - - - ,,:, ,�,. ... :,,,,, .,,�..,,, . , . .��.�,�; : _ �� . ., , .. �,,,. ..�•., . .,, . . ... . ;<<. �.• � - - _. . . , � . . ... , �[�i"'r` C�F f�i�;�i�iv!E3 ��'�,[� . . !i�'�E'��'�IQ��W F���;;t7�� �;I►��-�;�1�;61(��1►4N �_.._.�� '�- 11►`h�`t.# '�.t'cji:� �..__�...����f^4�� .c;;�(e`li'G_._._._..�e���p;:�. �►��-���r�d.�:# I .._.�________� - __ _._ .__ , ._.._ ._.�. __ _.� . . _ _ .__. ___ _._ ___�___ ______._----__ .. SET BAGK , � ; ' � • �:-' I I FLO�R JOIST � -�--- ' -- FTGS!FORMS,'STEEL I�L���_,�j ; � FHA REQ"v1T`� j ELECTR�C GROUfJD I ; UNDER FLOOR DUCT —1— � � } ( GRGUND PLUiJ181NG I _ �_�I UNDER FLOOR CU�iDUIT � __ SLAB GRADE I �_ __I_�_FIREPLf�CE F�UNDATION TEMP POWER _ � I_l_FIREPLF,CE E30ND BcAM WATER SEFiVICE ; i I MID HT. BOfJD BEAP.A ROOF SHEATHING �_��Z:_ I II FT. E30ND BEAh" FRAMING,NENTILIATION ��` _ ____ FIPJAL F30ND BEAh4 ____ ROOF COVER ��_�G��2.� � � PRE-GRADI�dG j ROUGH HEATIfJG � 1 � BENCHING I ROUGH ELECTRIC � -��� ROUGH GRADING . ROUGH PLUiJ1BING f FIPJISH GRADIi�G SHO`fJER/TUB TEST • POOL ELECTRIC EXT.LATH/SIDING (j � —_._. POOL FENCING �� - f / -t--- WALL INSULATION I C� �-�`� POOL FINAL � 1�� .�� �-� T CEILING INSULATION � ��/���¢`'L OFF SI i E IMPS. ___� pRYWALL NAILIPJG y/ � "�'�� DEDICATIONS �,3�6 t.� � SEWER � � FINAL ENG. SEPTICTANK • � �.1 LAPJDSGAPE/IRRIG. SEEP PIT/L.L. O�J SITE IhAPS. GAS A!R TEST, , FINAL ZONiNG FINAL CONST. /JJ, �_ � 1 F!RE DEPT. F1NA! FINAL HEATiNG ,Q�_ •�'_ � � HEALTH DEPT. FINAL FiNAL ELECTRIC a__l_ � DEV. FEES PAID FINAL PLUMBING � � � ENERGY S'f����v�GL ,3��z-�—_ ' _...._._.. r , t � f.a � fv�. r:�" Ir��:�. - ----- —`-------- —.�_� cor�nr,�Et�-rs_ � � �25—1 / o v ,� j���'I� s�� 2 �� �c1dr��a�J _ ���c-- -- �'�� �daT��—S'��e_��—L//�/��1-�i��P%�_,�es�r�.���r� —/e�-G�t��----G���G?�G�'� �.z��o�, , SEPTIC TANK SIZE � SEEP PIT/U SIZE ���,__.��_.__._� , � _ � � . .- ; ���� . . - - � . ,� , ``I ,