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Home My WebLink About13859 (14) �� CITY OF DIAMOND BAR /T ,, DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES / 21660 E.Coplcy Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS �� BUII.DING PERMTT APPLICATION FIRM LY 4 ADDRESS (�,(',, �,�t�f �Y• I�U APPLICATIOtJ ZG�, � PERMR �� P/ � p `�'"�O � � DATE 1 NUMBER it � APN LOT TRACT ISSUE TYPE OCC DATE CONST. GflOUP p OWNER ]�I•SO�J�C3`Q�1�C,JC'�� ADDRESS ZONING SETEIACKS �w CITY ,f�-r- ZIP TEL. � FRONT RW ❑ APPLICANT _»G� .H�Z`^«� TEL. a CDC7-ZSIO REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOR C"�. P�^p{� SIDE ❑ � CrD�DRESS r,.' ZIP 9l'�G.2 TEL /Q ROPOSED USE D� � ' ��(CI- 1"'l`ti� � ARCFUENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES DEDROOMS � CITY ZIP TEL. y DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION p� OWNEFi•BUILDER OECLARATION SFRIADO/REM O p 1 MENE81 AFFlfq1 UNOER iENAIiY OF PERJURY TMAT 1 AM EZEMPT fi101A TNE CONTMGTORS ll• (�'dfagB/COIpOA W CFNSEUWFORiMEFQLOWwOREA50N(SEG7WI.SBUSPIESSAhOPROFE5510N5COD[:AYYpTYOR (n ZCOIA(TYYMIGIREOAIIRESAPEFWRTOCONSTRUCf.ALTER,MPROVE,DEIAOLJSH,ORREPAIRANYSTAUC• W PII110/DOCk TURE.VWOR f0 RS ISSUANC[.ALSO REOUIRES iME A7PLICMIT FOil SUCM PERMIT TO FILE�SIGNED �L 6TATE4EHT TTUT HE OR SHE IS UCENSED WRSU�NT TD THE P(iOVIS10N5 OF TME CONTMCTORS Ll• W � CENSEUw(CHAP7ER�(COA1uCNCwOWIT15ECilON)ooCIOFDINSqNlOFTMEBUSM[SSANDORO• LL' Pool/SPa FESSqNSOODE)OAh4lTHEORSM[ISEXENPTiHEREFROMANDTMEO/SiSFORTHE/�LLEGEDEXENP• � T10N.ANYVIOIAiIONOFSECTION70�1.68YANYAFVIICAt�fTFOqAPERMiTEUBJEGTSTHCAPPIICNlTM Z RB-ROO� � I�CML►ENALT70FNOTGOWETHANFIVENUNDREDDOlURS(f5C0�J: p 04��NEFOFTHEPROVEqTY,0i1A1�EMPlOYEESN'i7MWA�LSAiTHE1R50LECAMPENSATqN, 0 �ammorcial � L WILL DO ME WORN.AND THE STRUCTURE IS NOT MTCND[D OR OFFERED FOR SALE ISEC 70u,BUSI� J N NE55 AN�GHO�ESSIONS COOE:THE CONTRACTOHS LIL£NSE UW DOES NOTAPPLY 70/ul OWHER OF ? iROPERTY MHO BU0.D5 OR N.IPROVES i11ERCON,IlA NAq OOES SUCH WORK NIMSELG OR MERSEL�OR Q iHRWOHM150RHCROriNEYPLOYEE5,P0.0V10EDTHATSUCMWPROVE4CNT5MENOTNTENOEDOR m � OFFEPEDFORSFlEIF.NWIEVER7f7EBUlDWCORIIAPROVEUEMIS..OI..DWITMIf10NEYEAflOFC061PLE- Z TION.THE OWNEfl�BUIIDER WILL FNYE TNE&1RDEN OP iROVVJO THAT ME OR SME OID NOT BUILD OR = MPRpVE FORTME PURPOSE DF SA:E} w Ol�OM1NEHOFiH[VROPERTY,MIEIf".,LUSNE.YCONTMCTlI�WTNUCLNSEDCOffTMCiOfYS � TO CONSTRUCi TME ViIOJFCT(SEG 70t�.&151�'ESS ANO PROFESSIONS CGDt.TX[COHiMCTORS Lb l8lUetiOn AQI.AREA � CCN9EU�MDOE3NOTAPVLYTO/WOWN[HOFAVROf'ERTYNTqBUM1DSON11APfiOVESTMERCON.AND VAqCOMMCT5FOi15UCNCROlfCTSWRHACONTRACTOA�S)UCENSE�7URS;lIMTOTHECONTRAG UANTITY DESCRIPTION FEE � TOii5L10EN5EUW�. � OIAMEXEMPTUNDERSEG B.1P.C.FORTNISREASON q � � �'�` 3 � . _ , . � � DATE OYMEH U J � UCENSED CONTFL4CTORS DECIARATION W OC iNEtiEB'/AFTIfOAUNDERPENALTYOFVERIURVTUTIIWLICENSEDUNDER7ROV1510N50FCMAP7ER � Lt 91�MENC4J0YlITHSECTi0h7000IOFDIVISIqN]OFTHEBUSING55AN�PfiOf[SSqNSCO.^.E,u:D X W IICEHSE IS Pl F11LL FORCE AIlO EFFECt. ` o ��ENs«�s �--1 ��.�o.�31(00 O � V DATE�� CONTRIICTOR��Q' . � W ! � WORKERS'COMPENSATION DEGLARATIGN � a- , � IHCREBYAFFIMAUNDERPENALTYOfPERNRYONEOFTHEFOLLOW^lCOCCUMTIOhS:I�'� Z 4 � _INAVEA�DYNLLMAiNTAWACfRTIFICATEOFCONSENTTOSEIF•INSUFEFOrlY.9RKER5' _ COYVEN5A7qN.A5CROND[DBv5ECT1oN77oaOFiHELA9CRCO0E,fORTHEVERf-0RMANCE W OFTHE WORK FOfi WHid/iMiS VERMiT IS ISSUED. � � _I IUVC AND V/'LL MAM/lN WORNERS'COMPENSA7ICN INSURANCE,�5 F`e WiRE�BY SEGTION Od �70o OF iNE UEOR LOOE,FOR iHE VERfOfiMANC[CF TME WOi1K FOR NT1Ip1 THIS PERN7i15 65UED.MYWC7FiKE�!5'COMVE}1S�T WSV�+�:CECARRiERAN�COLIGYNUM7ERME: CON,�iTRUCTION _ ��M � CAFIRIER� , ��.��, - PUINREVIEN! '_ � POLICY NUABER ��" �7S3 C"�—O — = ELECTRIC �a /��- 0 (i1L�SECIfONUCFDNOTBEOd�S'lFT�O�iFEPEFi.TT6fuq01�HIDLiY�D�l1AtLSR'm10R1E551 PLUMI3ING � z ICEPTIfY7HATNTHEPER�OHMN�CEOFiHEri'O�.KFORWHICNTHISCERMrtI5155VED.l MECHANICAL � (J SFNLLNOTEMPLOYANYVERSONWANYMANNF:RSOA5T09ELOMCSI,'&JECTTOTME � WORKER+'COM7ENS�TIONUWSOFGLL�FORN�AAN�AGREEiNATIFISi10UlDBECOME INSPECTIONFEE EtAJECT TO TME VIOFINERS'COMPENSATION DROVI;qNSOF SECT�ON 7700OF TH[LABOR s CODE.ISMALLFORTN\VITHCdAPLYMfTF1T1105EPROVISIONS. �SSUANCE - � SMIP • � DATE: APPLICANT: � ENERGY P/C f�I�f WARNINQ FAiLURE TO SECURE Y.qfiKERS'CONPENSATION COVEMCE IS UNUWi UL AN'J SHALL BE qL� � SVBJECTANEMPLOYERTOCR'YiNALVENALTIES/WOCNILFINE511VTOONEHUNDRCDTN0U5AN0 ENERGYPEFiM1T �� DOLURS(i10a,0oa).W ADCITION TO TNE COST Of CqAPENSATqN,D�AGES AS VROVIOEO FOR IN /� �� A � 9ECTIDN97olOFTHELABORCOOE.WTEREST,/ND�TTORNEYSFEES. RETEN/TIONFEE: �' TT`''-ITY�F�T1j�MQIV1��`,�� d CONSTRUCTION LENDING AGENCY PRE�T FEF��/) ►�1IJIL,DT�i� �l�I]�Aj'L'��Y O �f1 � 2 1 HERCBY AiF1AAI UNDER OENALTY OF PE0.NFlY TIUT THERE IS A CONSTRUCTION IENDiNO AGCNCY � FOR iNE VERGORMANCE OF TME WORK�OR YRllpl iHIS PERIAIT IS ISSUED�SEC.]oil,CIV.C.�. tt W � IEHDER'S NA/AE C� IENDER'SAODRESS w ICEflTIFYTMATIH�YEREADT}aSAPPLICATIONAND9TAiETH�TTIEABOVEWfDNMAT10NI5LORRELL TOTAL FEES Sy� d IAGNEETOCOMPL`IWITNILLLCfi7ANDCOUNTYORDINANCESANDSTATEUWSREUTWGNBUlDINO � CONSTNUCTqf{M/DNEHEOYAUTHORIZEREPRESENTATIVESOFTHiSGWNTYTOENTERUPON7HE Z ABOVEJAEN?qNED PHOPERTY FOR WSPECTION PUNPOSES. (',OMM[NT$ � �;s` \ � . 0 � m 4 oE�� E ro��, - �r-r y � �Z ,�.•r/ (/) SIG :U ERMIJTEE D�TE / � RECPT.NO. PAID BY VALIDATION / WHITE-0oDe�ent Cop�,YELLOW—Fnance Copy.PINK—Assessor Copy.GOLDENROD—File Capy,GREEN—Applican['s Capy =�;� CITY OF DIA«OND BAR , � ��.If�SPECTlO�� RECORD � � � ��)i�F.�.a�c`�i(�+;�►°}_ :o��.�", •l.►��E-��_��r. ..�_�1��-7:i��c;��lc1�i..�.� �;��r= ._._,'l►�!-'1:.lac:'t!c�:t ' 5ET 6ACY• �_._ .� .._.I_.._...___..,........__' . I FLOOR.JOIST�.� I� _i....__. .__._I� "1' --- --- - � �FTGS;FOR"."S�STEEL - � FHAREQ�v7TS ' . ' � � ELECTRIC GROUPdD .. .. . UNDER FLOOR DUCT • ' , i • _ :_ GROUND PLUMBING • UNDER FLOOR CUi��DUIT � - ' ' . SLAB GRADE • - FIREPLACE FOUND/',TION ^ 'TEPJIP POWER . FIREPL/�CE 60N�BEA(t1 ' � - - • + . �tNATER SERVICE - ' Pv1�D HT.BOND�BEAM �• • � ROOr SHEATHING .- .' f3 FT.60� D.F3EAPA • ' - � - � - 'FRAF.1ltJGNENTiLIATION { - ' FINAL BOND BEAP:1 'ROOF COVF_R .: ' PRE-GRADIPJG I �ROUGH N�ATING BENCHING ' . ROUGH ELeCTRIC . : ' I ROUG}i GRADING ROUGFi PLUMBING j FINISH GRADING SH04VER�'i'UB TEST '� POOL'ELECTRIC EX�. LriT'HlSIDING - POOL FENCING tti'Al.t�INSULATI�N - - - POOL FINAL ;CE1Lti•1G IP•:SULATION • OFF SITE Ih1PS. j �D:;Yb'J.AL.L�dl;ILING DEDICATIONS SE1"iER - � FINP,L ENG. +SEPTICTANK LA�dDSCAPFJIRRIG. � � S�cG.?ii/L.L ' . ON SITE IhfPS. � .. G;�,�r,l�TcST � --� FINAL ZONI�JG 7= ''F�;`,",-:_{;t7PJST. �� J�S'( rG / FIRE DEPT. FINAL ��—...._ Fl�•:=•.:.}-IE/`iT1NG HEALTH DEPT. FINAL ' :�:::_ ELECTRlC � DEV. FEES PAID ' ''.l. PLU^ABIhJ� Et��RGY : --- ,:"'^"�"•--�•r ----� , .I �.i='..r' �,I, t1W-l!...�.-. • � � _ ..... . "�_..'Y.' _�"'_"._"_"'"""' �• ".__'_ '. _". . .. . ... �.., . . � . . _ . .. . ._ It' . . ,. . . . . . ` CO`4�MENTS ' . , . _. , , `SEPTtC TANK SI�E . SEEP PIT/U SIZE' - — , . �.__!y&._,.--.._R..._ • ' i �'`� `�i -- — � � ; • i. �.a . ; ,`. � , ` . -- _...__.._.__._�.'�_.___..._._.:....._..; —.--- .