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HomeMy WebLinkAbout13714 (16) �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)860-3195 Faa(909)861-3117 PR ESS '��*��� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION , Z, PERMIT . P/C r' o ADDRESS Z��,0 �- �P�Y �R• DATE �.NUMBE I N � �� � APN LOT ZZ TRACT 3�1 �O'�I q DA EE����^�-I• CONST. GROUP p OWNER � AODRESS ZONING SETBACKS � CITY ZIP TEL. R�RT RW � APPLICANT TEL � SIDE/SIDE STREET RW ❑ CONTRACTOR Lz F P� I�.1L. SIDE ❑ � ADDRESS �o�-��TNE_ PROPOSEDUSE �I I��� �_�_� .��� CITY O RA A��E ZIP �A TEL 71�•9'1�i•677 - - – � � p�.��— � ARCFUENG! - DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CfTY ZIP TEL N DESCRIPTION SQ.Ff. FACTOR PSF ADJ.ARENVALUATION p� OWNER-BUIIDER DECU1RA710N SFR/ADDlREAA O p I HEREBY AFflRM Uh9ER VENALTY OF GEit,URY TMAT I MI E%E4Pi FRO6�TT1E CONTMGTORS ll- GafeflO/C81pOR LLl CENSEUWFORiHEiOL1.OWNOREJ150NI5EC.7N�.6BU5WE55AN�DROFES^iON5CO0E:ANYd7YOR (n COUHiYYMKNREOUWESAFERurt7000N5TRUCf.A1TEILMPROYE,pEMOlISr�ORPEPuqI�NYSTRUG W POtiO/DOCk TURE,VRqq TO R4155UAHCE,ALSO ilEOUIRES iHE M�IILANT FOR SUCH PERAIIT TO FIIE A SiGNEO W LTATENENT TWIT HE OR SHE IS LICENSE�PUfiSUMR TO iHE PROV1510N5 OF THE CONTMCTORS U- � CENSE UW(QUIPTER Y�COMMENCPIO VATH SCCT�ON 7000)OF DIVISqN 7 OF TME BUSINESS M!D GRO- u- PooUSpe FF6510N5 CODE)Oil iHAi ME OR SHE IS E7(EMPT TNEREFROAI MD T1E&lS15 FOR THE ALLEGED E%EMP. TION.ANYYiOLATIDNOFSECT10NT0]1.60YANYAPPLILMlTFORAPERMITSUBJECTSTMEAPPI�CANTTO Z ReRoof � ACIVI.VENAl7YOFNOTI,IOHETHANFNEHUN0AED00LLAA5(f500).): . � O11501N1EROFiHEPRDPERiY.ORMYEMPIAVEESNATMWAGESASTNEIRSOLECOAIPENSA•1DN, 0 CGRIR1BfCial ' WILL DO TME WORK A'A 7HE STRUGNRE IS NOt IHTENOED ON OFFERED FOR SALE(SEC.70a�,BU54 J � Nf55/10 FROFESSION4 COOE:THE CONTN�CTORS LKFNSE UW OOES NOT�P7LY TO AN OWNER OF = , PROPFiRY NT10 BUlD9 di MPi1pVE5 TM[REON.AND KHOOOE4 SUCN NORK HI415ELF OR H[RSELF Oq � TNROU(iHHISORHERONRIEYPLOVEES,PROVIDEDTNA75tJCHIMPROVEAIENTSMENJTPITE�DEDOR m OFTERED fOH SILE 6.FqWEVEiITHE BU0.DW OOR MG{qYEMFMIS SqD W�T/YN ONE YEAR Of COMPLE- � 'TU1.7HE O�M�ER�BVIIDER VnLL NAVE TME BURDEN OF VRO�NO iNA7 ME OR SnE 00 nOT BUILD Ofi pAPROVE FOq T1E PURPOSE OF 6ALE1. O 1,/S OMMEF OF h1E PROPEfiTY.AM IXCLUSIVELY COHTMttNO WIM LiCENSED DONTMCTORS � TO ODN57RUCT THE PRNECT(SE4 7aM.BUSIN[SS A,YD PROFESSIONS CO;:E:TME CONTMCTORS LI• alUB�iOn AQI.AREA C&ISE UW DOES NOT MPLY TO AN OWNER Of A PROPEHiY1Mq W LDS OR IUPRpVES THER[ON.AND � MFqCOHfpACi9FIXi5UCMVH0.1EGiSWITHACOHTMCTOR(S�LICENS[OPURSU�WTTOiHECONTMG Q �7y DESCRIPTIOV FEE � TONS ucENSE IJiw�. ❑1 AM IXEYPT UNDER S[G B.i P.C.FDR THIS RERSON Q 3 � � � pATE OwNER V . - � UCENSED CONTRAC70RS DECLARATION w - J � W 1 HEREBVAFFW4 UNOER iEWLLTY OF iERNRV TUT I MI UCENSED Uh9ER PROVI510N5 OF CMMTER Vr ry �(COAIYENLNOWTISECTION7a00)OFDMSKK170FTHEB:151h[SSANpVROFE551IXVSCODE,AND � �L W LICENSE LS N FlAL FORCE AND EiFEGL w— m � IICENSECUSS Lq—I� IIC.NO. �vZ�lr7^� � �j DATE C7•�� • /,� CONTRACTOf1�P�)• a ,� .. .. .... . . . .. � �`!/ WOAKERS'COMPENSATION D[CLAFlATIOY �/ —� � a � INEREBYAFFINAUNDERPEN�LTYOFiE0.1URYONEOFTHEiO:LOW:NGDECUM710N5. U f!J Q � _IHAVEANDWILLMNNTAMACEFiTIFICA7E0FCON5EMTO5EtHN5UHEfORYKNi1(ERS' _ WMPENSA7qN,A4VRWI�EDBVSECTION77ooOFiNELAOORCODE,FORTHEPERFORMANCE W iNE WORN FOR VR11CH iH�S VERuIT IS ISSUED. � C IHAVEANDWILL4IFlTMlWORNERS'COMPENSATIONINSUFUNCE,ASHEWIHEDBYSEGT�ON ��� ��j O Q �7aoOFTNEL{BOROOOE.iOitTHEGERFOF1M.wCEOFTHEWORKPoRWHICH7H15PEA1A1715 1 � SSUEO.YYWOi1KFAS'COF1PENSATIDNINSURANCEG1RiL'ERANDPOLICYNUMO[N11RE: CONS7RUCTION �}�� � � CARNIER ��NSGO N T 1�.1 ClJTAL �,JS• �• PLAN RE�nEvl d'1.J� _ � POLICYNUABER � 0 �_2� ELECTRIC o (nass[enonr�c�wts[m.rtFrmornfa�r.rrswnouc�+�.wr�ocuhtis�,oeion�c.. PLUMDING Z ICERTIFYTUTNiHEPERFOiUA�NCEOFTHEMlOR%FORWHICHTHiSPERM�Y1SI55U[D,1 MECHANICAL (} SWLLLNOTEMPLOYANYPERSONNANYM�WNERSOASTOBECOMESUOJECTTOTNE N WOR1(ERS'CdAPENSATpNU�OFCALIFORNi.lM10AGREETMATIF15HIXADBECOUE INSPECTIONFEE SUBJEC7 TO TNE YlOqKERS'CAMPEN3A7ION PROVISIONS OF SECT�ON 3700 OF 7HE LABOR � (, s caoE�s��a.�FOAnrcnnrcouairvnn� s yor�s. ISSUANCE � 1•99 ��� DATE: S� ( APPI.ICANf: SMIP � � —� ENC-RGY P!C J . WARNINC:FA WRE TO SECl1RE WORKERS'Ld�PENS�TqN COYERAGE IS UNUWFIIL,ANU SNALL BE � SUBIECTANEMPLOYERTOCRIMPIALPENALTIESANDLIVILFWESUVTOONEMUNDREDTF70USAND ENERGYPERMIT DOLU0.5(t1o0.o0�.N AD01T10N TO THE COSTOF COMaENSATICN,DAMAGES Il5 PNOVIDED fOR IN ¢ SECTION17000FTHELABORCODE.NTEH[ST,ANDATfOPNEMSFEES RETENTIONFEE: h�. lAr/� � a CONS7FiUCT10NLENDIhGAGENCV PR lT EE� I d � � IHERCBYAFFIRI.IUNDERPENAL7YOFPCRIURYTHATTNEREISACONSTRUCTIONLENDINCACENCY _ Z FOR iME iERFORIA�NGE OF TME WORK FOq WMlpf iH15 PERMIT IS ISSUED�SCC.7Dc�.CIY.G). W � IENDEitSNA1AE �S IENDER'S�DDRESS W ICERTIFTiHAtIlI�VEREID7N�SAPVL�LATqNANDSTATEi1NTTMEA�OVENiONAATIW�ISCORRECT. TOTAL FEES�Lj���� � p� IAGREETOCd�PLYWITNALLUiYANDCIXINTYORDINANCESANDSTATEUMlSREUnNOTOBUIWING � �N^TRUCTION.ANDHEREBYAUi}ION�IEREPPESEN7ATNES�FIHISCOVNTYIOENTERUPONTHE Z /DOVE�YEMqNEDVROVERTYFOIiINSPECTqNPUNPOSES. COMMENTS � pnT ��s+-��� � PENARTEEHM�[(PR�Hij�� /,� C��`,� 'J � tn I r" � 6Kiw�TU�[OFiEWni7TEE DATE � � RCCPL N0. PAID BY - VAUDATION WHITE--0eparlment Copy,YELLOW—Fnenee Copy.PINK—Assessor Copy,GOLDENROD—Filo Copy,GREEN—Applicant's Copy , CIT�' OF DIA���fOPJD BAR � �� I�dSPECTIOtd R�CORD • . . � _ ._. _ . _ . , . �--.;2..--•-----_�__•___-.�.�....�.._�........� �;+�j;lyc:�js,l��� ie}�'�`►'= I!F-y����'I��1� �il►`�-'1;�=a'nlcl�l�+ .i4��y.�P= 1►�-`1:1�r:�p'o��'{ ...._.._....,._...._ , .�.....: - _...__.._ ._.�,._..- - _W..._.._ �..�W.:.__.� �__......_...�.. ........ ... .. �SET.BACIC ; ,� _,..�.� ,..,. -._I,w , , 1 � � � FLOORJOIST ^ .�,, : - __ . ' FTC'aSIFORP��:S!STEEL '� . ' •. ... . _� FI-1A REQ1•ATS � . ' _ _ iELECTRIC G�OUND . .` � ' ' '�� UNDER FLOaR,DUCT� � ' GROUND PLUMBI^JG UNDER FLOOR CUi,:7UIT i ' ' SLAB GRAD� - - FIREPLACE FOU�JQATION I � ' ' :TEh4P PO4NER FIREPL_ACE BOP�D BEF.h1 :�NATER SERVICE � P�11D HT.BOPdD BEAtA � �! , 't ; • iROOF SHEATHING� �, : . ; � � � � � I -� , 8 FT.BOND BEAFA � ' ��,, � , � � - ,I., �FRAtAfh:GNENTILIATION ' '' , „ ' : � �rINAL BEAPh � - j � . � � ;ROOF CO'JFR � PRE-GRADING ' �Fi.7�1GN.FiEATiPJG ' BENCHIP�G � • IROIIG�{".���CTRIC R�UGH GRADING � � - - (RO:1GN F'l.U'�"BING - FINISH GRADING ISHG'�4i:F�;UB TEST - POOL ELECTRIC �� -?;�.-U,THrSIDING POOL FENCING � `•AiF+L+ l"dSJLATiON POOL FIPdAL � i_l�� - ' ..�itrl�-ir�r�.uLtiTiow oFF siT�irnPs. ' �7riY'rtii,CC�dk1LI�dG ; �EbICATIONS ; �crt�rCR ----....... _ . ..; � FWAL ENG. � . . ��StP"IC iANI< LAFJDSCF�PE/IRRIG. I � ��'�°�.ii/L-�---- -- - -I ' � _ , ;Of•J 51TE IP.4PS. � , ����`•'yY i't�T FIPJALZONING ;�: �f�.l:' � I —1----- - ------- — �:_._._...._ )"�`___ :,Di�ST.!—,--. ---... . -.- -- FIRE DEPT. FIfJAL � ' ' , iEAT1NG'.. - _-.----.. _..._..._. .----. . HEALTH DEPT. FINAL � . -�, �,• : ....... , •-••- � ....._.. ;. . ; !'.;-.�..._ELECTRIG---- -- -�---- -----......... DEV. FEES PAID l : , -- - � -- ;._._..:.:,.:PLUP.1BfPJG---- ---- -- -- -�---.. --- Et•lERGY i iI---- ----�--- ------- --. .. ---- ------- -- � � � -` , — ' -_ - ----- �---�- -- -- ._ -�--p-,.;,,r -...- ---------- -- f`"'���'� � � ..4�.e-� i':_.r4�w -f�rra:.. __ ....._...� '� , .. . ._"'" .. � , _ . —____"'.'___....___. __'__ __ .._- , _ '___._ ' ' ______..._ . _ , .. � -. . , �. � �,.` � � . . . • ' . _ _. ' ' ." " '"_' '. � -...�.�... ` . .�_. _""" _ . . . .. . �;:,`��.�MENTS - -- � �. . �, . . _� . .;__ . � , . . � � ., , ,. , . - �. . � , , . .— - , . ;' - . , •- . , • , , . 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