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HomeMy WebLinkAbout13141 (16) i . . , CITY OF DIAMOND BAR �� DEPARTMENT OF COMMUNITY dt DEVELOPMENT SERVICES , / Zi�o E.coP��y n„�e s�c�i90 PRESS '� (909)86Q3195 Fax(909)861-3117 ��'��� BUQ.DING PERMIT APPLICATION FIRMLY y JOBSITE � // /_ O n� � ! � A LICATION � PERMIT P o ADORESS < <(� �f� (,,,' DATE �ZS NUMBER�I��7_ 11 � ISSUE TYPE OCC APN LOT TRA T DATE CONST. GROUP � OWNER "' ADD S ZONING SETBACKS Z CITY �r IP TEL. REAR RW O � APPLICANT TEL. SIDE/SIDE STAEET RW ❑ CONTRACTOR S SIDE O ADDRE S 'T-1'1 7 L l� Fc.� OPOSED USE S� O dJ IE.C.l: 1 g CIT1!�vN T70 � ZIP, Zj3�fEL 3'� '�(o J � C � ARCH/ENG/ ., DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION y � ONMER-BUILDER DECIARATION SFFL�ADDhiEM O p 1 HEiiEBY AFFIRM UNDER►ENALTY OF PERAIIIY THAT 1 A)A E%EUPT Fi101A 7HE COffTMCTORS U- Gd�9�Ca�h W CENSEUWFOitiNEFOLLO4IIN�RFA50N(SEC.70]t.68USWE55MlDFROFESSIONSCODE:ANYCtTYOR (n � COUHiTYN11C11REOU1RE5APERMRTOCoN57RUCT,ALTER�PROVE,0EIMJLISM.OflREPNRMiYSTRUG W patia'Deck 7URE.PRqit TO RS 65UANCE.AL50 REW�RES 7HE AVPLICANT FOR SULII PERA1rt TO FILE A SiGNED W � 5TA7EIAENT h1AT NE OR SHE IS LICENSED PUHSUMR TO THE PROVISIONS OF hiE CONTMCTOR9 LI- � CENSE I�AW(CNAPTER Y(COAIA1ENdN0 WITH SECTION 7ooa)O�DmS10N 70F THE BUSINE55 AND PR0. � PooUSpa FESSqNSCODEJORTHATHEORSHEISE%CIAPTTNEREFROMANDTH[BASISFOf1THEALLEOEDE7LMP• (� TION.ANYYiOLATqNOFSECilON7Wt.60VANVMPLICMlTFORACENMIT6UOJEG757HEAPPLiCl.NTTO Z Re-Roof � ACML YENFLTYOF NOT MOHE 7HAN FIVE 11UNDRED DOlURS(iSoo).): � OL��ERDFIMEPROPERTY.Of1YYEYPL01'EESNn7HW.tGE51L:TNEIR50lECOGPENSATpN, � Commerclal - WILL 00 TItE YK�K,IUA iNE STRUCTI;RC IS NOT INTENOEO OR OFFERE�7 FOR SA`E 15EC.70tr,BUSH J NESS AHD VROFE5510N3 COOE TNE CONiMCiORS LIC[NSE UW DOES NOT AFPIYTO AN OWNER OF N VROPEHTYVAiOBUtDSORILIPROVESTHEREON.ANDYAIODOE55UC1/Ylq1KHIN5ELFORNERSEIFOR = Q 7T610UOFIMISORHERONNEUPLOYEES.PRONDEDliUTSlICHO.IVROYE/AENTS�RENOTRRENDWIXi m L}7 ,OfFERmFOR4ALEtF,IqYhVER7HEBUlDwCORIUPROVEIAENi15" WrtMNCNEYEAFiOFCOMPLf- Z 'T10N,TME OYVNER-0URDER YALL MAYE iHC BUROEN OF PROVIN�THAT ME Ofl SN[OID IqT BNLD OR = MPROYG FOpTXE VURPOSE OF SALE} � DI,ASOMMEROFTHEiROPERTI:NAEXq.USNEL►CONiRACiINON'IT}ILICENSEDCONTMCTORS TO CONSTRUCTiHE if10J[CT ISEC.IW1.BIJ:;INES3AND PFiOFF55i0N5 CADC:iME CONTfUCTOflS U- yl�fl[idl .�� ADJ.AREA CEN5E IAW OOES NOTAC7LV TO AN OwNEN OF A GHOPERTY YMO BURDS OR 0.1FROVES iHCPEON.A.�PJ � W/qWHiMCiSFOFiSUCMGROJERSWITHACON71UMOii(S�LIC£NSEDPl1R5UANTTOTHECON7{UG UANTITY DESCRIATIO� FEE � Tqia LJCENSE Uw.l• OIAME%ENPTUNDERSEC. B.BP.G.FORTrU5REA50N Q 3 � � u" DATE OwNER �" Z V � J LICENSED COPlTRACTOFtS D[CLARATION W � I NEREBYhiM1A UNDER PENQTY OF VEit1UFY TNT I M1 UCEN5E0 UND[R 7FlOVi510N5 0F CHAPTER U. - � - �f�EHCYJOYATH5ECT10N7000IOFDMSqN�OFTHEBU51NE55ANDPROFE55iON5CWE.N:D Z X MY UCENSE i5 N FIILL fORCE AND EiFECT. m LLl ^� � � � LIC£NSE CUSS c�— ��, uc.No.� S V? Z � � ��jt DATE�� CONTiUC70R���fW �� a od WORKERS'COMr ENSATION DECLAFlATION�-3�"\'1 ¢ � ' � U � 1NEREBVAFFlRMUNDERiENALTYOFPEfUURYONEOFTHEFOLLOWWGDECUM710N5: " y Z Q � _INAVEANDWILLWMAINACERfIFIGTEOFLONSENTTOSELFdNSUREFORIYJRKERS' S �i CpIOENSA710N,A5PROViOEDBYSEC710N77ooOFTHEUAORC00E,FORTMEVERFO�uANCE W OF 711E K'OFiK iOR WHIp1 TMIS FERMIT IS ISSUED. � Q 1 HAVE AND N7LL►WHTAN WORKERS'CWAPENSATION INiUf1ANCE.AS REW IpED BV SECTICN �/'� Q ou OF ME VBOR OOOE FOq TIE VER�ORAUINCE OF THE WORN�OR WM1CN MIS PERAlIT15 �L.0'�/� RSl1E0. ERS' E �ONINSUfLVlLECARRIERANDPMICYNUMOCRAR[: CONSTRUCTION i � l � GRPoER �/Ny �I�R� PLAN REVIEW ��, � POLICYNUMBER �LL_Z�—�—J ELECTRIC � �ncscct�,y[�NotBEon.«ncDocnfvErarrs�ona.Er+uan[o 'R+�1 i� �? PLUMBING Z ICERTIFYTFUITNTHEVERFORAIA.4C[OFTNEN'ORKfORWMICNTH�S�EAM1715155UED,1 MECHANICAL �� (} SV4LLLNOTEMPLOYANYVERSONNIINMMANNER50ASTOBECOMeSUBJECTTOTHE � WORKER5Ll7MPENSATqNLAW50FCALIFOiV:I,tANDAGHEETHATIFI511IX1LOBECd.1E INSPECTIONFEE _ SUB.IECT i0 TME WOAKFRS'COYPENSATqN VRONSIONS OF SECTION]70oOF THE LABOR Oicooe,7is+��utFonnnnn�cou n�nas ao�saNs. ISSUANCE � p DATE��APPLICA . SMIP �� W ENERGY P!C ��;,� —�� • WMNMQFAILUflETOSECURENOFLCERS' ENSA710NCOVEMGLISUNUWFUL.ANOSH/U1BE �('� ` � SUBJECTANEMPLOYERTOGRnAINALPEwLLTiEs/NDCIV4flrvE5UPTO0NEHUNDREDTMOVSAND ENERGYPERMIT • y' `� OOLURS(S�oa.Ooa).W ADDITtON TO TME COST OF COMPENSATqN,DAAIAOES AS PNOVIDED FOR IN ¢ SECTqN�lOeOFTHELABORCQDE,INTEREST,/NDJ1770RN[Y'SFEES. RETENTIONFEE: a CONSTRUCTION LENDING AGENCY pRE-ALT FE • �� Q IHCREDYAFFIIIMUNDEHPENALTYOFVERNRViHATTMEREISACONSTRUCT10NlENDWGAGENCY � FORTHEPERWRMIWCEOFiMEWORI(fORWMIpi7NI5VEHMITlSI55UED(SEC.]OY7.CIV.G1. � IENDEi7S NAM[ f�a�-J �.�I � LENDER'SADDRESS WICEiiTIFYTHATIH�YEREADTi15APFlJCATIONANDSTATETU7T1EA80VEINFDRNATpNISWqaECL TOTAL FEES � IAGREE TO COMOLV WTI ALLCT'AND COUNT`I ORDINANGES AND STATE U'NS REUTWG TO BUdDINQ CONSTHl1CTqt1IND MEREBV AUTMO(iIZE FEVRESENTATNES OF TMIS COUIfTY TO EMER UPoN iHE ZYEMqNED FHOPERTY FORINSPECTION WRPOSES. COMMC-NTS 9 �f�'L�S �t-�s�.J�- m RA1tTiEENA1AE(PWNf) r v¢i - —� �'�. J' N COFVEHUITTEE DATE � Fl[CPT.NO. PA1D DY VAUOATION WHITE—Oepartment Copy,YELLOW—Finer�ce Copy.PINK—Assessor Capy.GOLDENROD—File Copy.GREEN—Appicant's Copy .. ... .. ,. ... . . ,. . . . .. ... . .... . �. -.. .-., .. ,__ ... .. .:;. . , . . . -:. > , . . .. ,. ., , . ,. CITY OF DIAMOND.B�►R , , - ., . . it�!SPECTION RECORD �'� � *��►����a���rG���� :Q�= 1��'���1���� � ��iy�7p'=g���.l��►�Ew. : •���^��.�= I►`�sl�f:^i'o� _____._____r_._..__ __ __..�. .�. ___ _..� __...,... .�.._._,.. ...w..�. ... . ,._ SET 6ACK � ; • � •, : i �, �• FLO�R JC�IST ` �..�.\ � .`; ' - ` ;., i\` ` ' - ,� . . � 1 . � • _— —i-�.�1�.:—i .. �•J� � � . FTGSlFOR".1S;STEEL, -� • ' � � FHA REQP�iTS � -'._ ' � . ' ' ELECTRIC GROUfJD . _ '� UNDER FLOOR DUCT � r— ,. ' ' �� " -^- -- --- GROUND PLUPv1BING I - UMDER;FL•QOR CU��'•��JIT ., " i � � t J � SLAB GRADc • - - ' �_:�•.��.�`.`.' __... � FIREPL.A�CE FOUNDATION � <.. •. .; •..�•.;� � TEP.1P POVJER FIREPLACE BOidD BEAh9 � � WATER SERVICE - - - � PJ�ID HT. BONC�,��A��1. "�— '� '� l 1 t \ 1.'...!� � Robr,SHEATHING'�. _�., �' ! � ,-.�� " L � � 8 FT.� ND.�EAh1:�, ;^� .� . . :< � � :; � - FRIIP�I!�G.�I�N71L'1�1TION r `. 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'. � � ; ,� . .. . :. ���- , ,i , r.—� .- -,'-'=-i . . ; , .i.. .. ; -n . _ ._ _.{ ---i---=i;=-�-- ' , . , , -. t. - .� SEPTIC TANK SIZE ' . � SEEP PIT/U SIZE -- - - ---.,.._.,.,�., _ . . . ;� . F1� : , . � I—�, :; ; - .. . `. . ; �� _ 'i��1��� ,1� - � :. ' �.. : , 1 :�.'�..± . ) � t �:� ;!•.!-p.. .. , � � . . � . � � �. . ( � � -- -- -- • _ ' . ` -%' ., .._____ -- __.__.._W.__...,._.__i • �---- -� _ .�- , '� i