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HomeMy WebLinkAbout12955 (11) i , ' CITY OF DIAMOND BAR ' � --��...._ . � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drivc Suite 190 (909)860-3195 Fax(909)861-3117 PRESS ���^' BUQ.DING PERMIT APPLICATION FIRMLY OJOB5ITE ��q i� G����R,�� � � DATE CATION f-Z�-G�q NUMB R � p/C 4 ADDRESS 1 � � � ISSUE TYPE OCC APN OT TR T OATE CONST. GROUP p OWNER �"' ADDRESS ZONING SETBACKS RW ❑ CITY ZIP G TEL. REART ❑ APPLICANT TEL. ' �- SIDFJSIDE STREET RW ❑ � CONTRACTOR O - .!J I� SIDE ❑ - c� ADDRES � 'r� o CITY � ` � ' ZIP TEL. -� PROPOSED USE o ARCH/ENG/ , ��,, DESIGNER NO.DWEL. NO. NO. N ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. N cn , DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADDIREM O p 1 HEREBY AFFlRM UAER VENALTY OF VEiWRY TMAT 1 AM E%EMPT fROY iHE CONTMCTORS LE Garege/Carport � Lll CENSEUWFORTNEfOl10WPlOREASON(SEG709i.68U50JE55AN0VROFES510N5C00E:ANYCITYOR (n U ppUNTYWH1CMqC-0UIqESAFERIARTODONSTAUCT.ALTER�APilOVE,DEMOLISN,ORRE7A:RANYSTRUG . W patia�DeGc �� TURE PR�OR TO R4 155UANCE,ILL5011EWIRES THE APPIICANT FOR SUCH DERMR TO F0.E A S�GN[D W ' 6TATEMENT 7HAT HE Oii SME IS UCENSED PURSUNR TO THE PROVISIONS OF iHE C01RF1ACTDflS L4 � CENSE UW(CFIMTER Y(Cp.�MLNCRIO Y11TH SECTqN 7000)OF DM510N]OF TNE BUSINE55I�ND PHO� � PooUSpa FESSqN5000E)OH71uTHEOR5HEI5E%EMPiTM[REFROAI/NDiMEB.�515FORTl1ElLLLE0EDE71EMV- (� TION.71NYVqUITIDNOFSEGT10N7071.6B7ANYAPPLICANTFORAVEiWITSU&IECTSTMEAP7UCANTTO Z Re-Roo( � A C7VIL VENALTY OF NDT E10RE iHAN FNE MINDRED DOl1AR5(f'+00).1: � OIASONMEROFTHEVROPERTY.ORMVEMPIOYEESWITHWACESASTHEIR50LECOMDEN5A710N, � (`,pmfllBfClal - YNLL DO T1E WOR�C AND THE STRUCTURE IS NOT IMEND£D OR OFFERED fOR SALE(SEC.7ou.WSI- J � NESS M!D PROFESSIONS O�OE:T11E CONTRACTORS LICENSE U�M DO[S NOT�PPLV TO AN OWN[q OF ? i110PER'iY WHO BULDS Oq 61PROYES THEREON,AND WNO OOES SVpI WORK HIMSEIF OF H[RSELF OR ' Q TNiqUOMNI50RMEflOVMEMPLOYEES,iFOVIDEOTNATSUGIMPFOVE�lEMSARENOTME�DE00R m � _OFFEAEDiOR5l1LE.IF,FqYYEVERTMEBULDINQORWPROVEMENTI550lDWRHNONE1FAflOFCpAP�E- Z TION,THE OWNER�BUILDER WILL IUVE THE BURDEN OF PROVIN�THAi NE Ofl SHE DIO NOT BUIID Oq = 4VROVEFOHTHEVURPOSEOFSALEI . �y,� ��ASOwNEqOFTHEPRODERiV,AME%f1USNELYCONTRACTWOVAi11UCEN5EDCONTRACiORS ¢ TO CONSTPUI.'T TME iHO.1Ett(SEC,7G1,BUSINE55IUJD 0{qFE55iDN5 CODE:TNE CONTMCTORS L4 VdIU8110f1 ADJ.AREA �l� CENSLUWDDESNOTMPLYTOANOYRlEflOFAPROPERTYWHOBUKDSORIMPROVESiHEREON.AND `Z- MApC01RRACTSFORSUpiiROlECf9N1THACONTMCTOq(5)LICEN4EDPURSUANTTOTXECOf1TMG QUANTITY DESCRIPTIO� FEE � T00.5L1GENSEUw.J. � O IMI EXE4PT UNDEH SEG B.i V.G FOR THIS REASON Q 3 � � ¢ DATE OWNER U � UCENSED COPITRACTORS DECLAFiATION W � , , , J � INER[9Y1lFFWlIUImERVENAL7YOF0E0.1UpY71UT1A/AUCENSEDUN�[R7ROVISIDNSOFCHAPTER U, !' � �(COYYENClW WffH SECf�ON 7o0D)OF DMSqN]OF THE BUSINESS ANJ PROFESSIONS COOE,AND Z U a �� W IICENSE IS W Ml iORCE IND EF LCf. � A �` � i �J�� � LICENSECLASS � LIC.NO. �� � � � V DATE ��L� _ CONTRACTO�i . a W � WORKERS'COMPENSATION DECLAFiATION Q N IHEREBYAFFIPMUNDERPENALTYOfPE0.A1RY0NEOFTHEFOLLOW:NCOECUMTqNS. Z � � �IHAVEANDNALLM/JNTAeIACERTIFlCATEOFCONSENTTOSEtF-INSUFEFORWORKERS' _ � CpAPENSATqN,ASPROVIDEDBY5ECT10NS1000FTMEUBORCOOE,FORTME7ERFORMANCE W OF THF yrORK FOR WHICH THIS PERMIT IS ISSUEU. � � I IUVE AND WILL MA.7fTA47 WWKERS'COMPENSATION MSUiLWC£.AS REOUIRED BY SECTION Q �700 Of ME UBOR CODE,FOR THE VERFOFMANCE OF iHE WOR`(FOR WHICH TNIS PERMR IS � ISSUED.MYWORKERS'COMPENSATIONWSURA�NyCEC�AR�R:ER�ANDPOUCYNUMOERARE: CONSTRUCTION � CARRIER ���� � FB� Cl7F�z-� PUINREVIEV! 11 � OOIICYNUM6E��W /%�-C�� ELECTRIC �y � (n�ssecna+r�rcmwreeca.*�moFnEv�nMrswna:eM.ror�ooaUruR+rolrn�ssl PLUMBING � w Z ICEHIIFYTHATNiHEPERFOMIANCEOFTHEVYDRNFOfiWHICHiHISPEHMITLSI55UE0,1 MECHANICAL (} SMALLNOTEYCLOYANY7ERSONRIANYMMINER50A5TOBECOMESUBJECTTOiHE ll ' (/j YK1FV(ERS'C011PENSATqNUW50FCALIfORNIA,lWOAGREETM4TIFISHOVIDBECOME INSPECTIONFEE �y], •'�'�'�,� � ,•� '� SUBJECTTO THE M/ORNERS'COAIPENSATqN VROYI510N5 OF SECiqN 9700 OF T1E IABOR � � rj COOE,ISMALLFORhM'17MC01APL7N7MTq5EPROY15iON5. ISSUANCE 1r�'�� �� � Z PPIICANT: SMIP � p DATE: f- '� -S �, W �EF�/C �'1 t"� WARNINO:FA0.URE TO SEIXIRE WORKERS'COMPENSATqN COVEMGE IS UNUN'FUL AND SHALL BE � SIAJEGTANEMPLOYERTOCRIMIWI{,FENALTIESANDCMLFII:ESUPTOONEIUNORCDTMOUSAND ENERGYPERMIT ¢�• DOIURS{3100.OW 1,IN ADOI710N TO THE CAST OF CpdPENSATqN,UN.IAGES AS PROVIDED FOfi IN � SECfION]70e OFTHE L�BOfI COOE,NTEREST,AND ATTORNEYS FEES. RETENTION FEE: a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFIRMUNDERPENAL7YDFPERRIRYTHATTHEREISACONSTFUCTIDNLENDINOAGENCY ' Z FOR TME PERFOPAIANCE OF TH[WORK FOR WHlpi THIS PERuIi IS ISSUE D ISEC.7ov7,pV.C.1. W � LENDEHSNAME � IENDERS/�DDR[55 � TOTAL FEES 5� U w 1 CERTIFV iHATI HAVE REAO iMIS APPLICATION ANO STI.TE TIUT TNEABO'!E NFO{UI�TqN IS[0{iRECT. � IACREE7000MPLYN7TM�L�CRYANOCOVNTYORDPUNCESANDSTATEUwSREUTINO70BVRDINC . � CONSTRl1CilON,MJDHEREBVAUTVqRl2 REPHCSENTATIVESOFiH�.SCWNTYTOENTERUf`ONTHE �/ � ABOVE�MEMf10��ED iROVERTY FOq MSP qN PUfIPOSES. /��r n)( � COMMENTS� �G C�U� �l, �FI L � _ _ � - m PEfWiTTEE WNn � Q N �/�� Uj S�aN�TUHEOfPE MITTEE E �Jj �� � . RECPL NO. 1" ` PAID BY VALIDATION WHITE—Oepertrnent Copy,YELLOW—Finance Copy,PINK—Aseessw Copy,GOIDENROD—File Coq,GREEN—Applicant's Copy .. � .. ... ' ' , � �. � . . . . . . .. . ... .�1� � .. ' .. . �.•.1'. . � . . . •' . r .. � � . . '� - , . . . 4 ' ; CITY OF DIAMOND BAR . :.� ;; �, . ' ' � � � �iNSPECTlON RECORD' , � : � 's�e� e �� • - • � � o - SETBACK ' � . FLOORJOI�ST"" C i,ltit�,'���� .;�.. �. ,=1�.�..f., FTGS/FORMS/STEEL FHA REQMTS � - ELECTRIC GROUND ��- UNDER FLOOR DUCT-,-•�� ',�'.•. ,•; �;--,'. ; • ', :,1,% GROUND PLUMBING UNDER FLOORGO�IDUIT��'•:'�.� ',:� '�.� •1�,•1:L` � 5LA6 GRADE �� FIREP CE�� O�I�NDATION��' � ''=' ��� TEMP POWER � ' � FIREPLACE BOND�BEAP,A '-�� - WATER SERVICE MID HT.BOND gEAM-�.':�' ' � _ � ' ��� � ROOF SHEATHING 8 FL�B ND�BEAh1 �:' it'..: ��. �` �` `• ! FRAMING,NENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING � ROUGH HEATING - BENCHING - - � ROtJGH ELECTRIC - � ROUGH GRADING ROUGH PLUD�IB(NG- � " � � � FINISH GRADING SHOWER/TU8 TEST � - � POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULf1TION . ; POOL FINAL CEILING INSULATION OFF SITE IMPS. , DRYWALL NAILING � DEDICATIONS SEWER FINAL ENG. SEPTICTANK. . _ .- LANDSCAPE/IRRIG. � SEEP PIT/L.L. - ON SITE IMPS. . � GAS AIR TEST FINAL ZONING FINAL CONST. - - - - FIRE DEPT. FINAL • FINAL HEATING HEALTH DEPT.FINAL _ FINAL EL:ECTRIC �� ' DEV.FEES PAID �' FINALPL�IMBING -�`' (� ' � ti' �:! ENERGY -� ;� .. , ..� � - � ��--_�,� s� - - - � ,..,..= � . . - connnnErv-rs . .__— . - - — . �, _- :. .�.. .,_ .�.., . ,�.�� ��� ��::� ..,�. . � ; - . , . �� ,. , � ,,:, . _ - � . - . `.�. _ . �. . . .. . . �--..----_____� . _ . .- . . . SEPTIC TANK SIZE SEEP PIT/U SIZE , . r r �' � , . � :.��. �: . . . , .. `'�i� �.- - ' :,'•`;;•J . .. ' I' . "� � _.- ,-. � ; •-, . � � �. ' � ' _ ; � � , ;: - - -. ,� _ �i �