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HomeMy WebLinkAbout11138 ---�� --- CITY OF DIAMOND BAR • r COb1h4UNITY DEVELOPb9ENT DEPARTMENT x-.•C . 2166DE.CoplcyDriveSuite190 PRESS (909)860-3195 Fax(909)861-3I 17 - '^^' BUILDING PERMIT APPLICATION FI R M LY o DDRIESS �1 0�+� � �J�L�%�/ V� . APPLICATION � �.� PERMIT P/C - DATE� NUMBER 1t c� ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER �''� ADDRESS �L EaS F GOPI.�r �D ZONING SEfBACKS oCIN R'�"� ZIP ' TEL. FRONT RW ❑ APPLICANT / / TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR T4iE }{OW�Q�L-�-T�e-- � SIDE ❑ � ADDRESS�1+1.LE'iJTJKY.RLLLD. Z12 � � � CIN L- ZIP TEL3�� 2��7[1-G� PROPOSED USE O / w ARCH/ENG/ z DESIGNER NO.DN�EL. NO. • NO. a ADDRESS UNITS STORIES BEDRODMS � CITY ZIP TEL. � DESCRIPTION SO.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER�BI;IIDER DECUIRATION SFR/ADD/REM � O p 1 HEf1E8Y AFFIRM UNOER PENALiV OF PERJI:RV TWtT 111M E%EMPT iROAI TNE CONTRACTOR;U� G�fBgB/C�rpOR " • � � � W CENSEUWFORTHEFOLLOWINGRUSON(SEG7071.SBUSINESSANDVPOFESSIONSOODENJYCITVOR (/� U GOUNfI'WMiCHREWIRLSAGERMITTOCONSiRUCT,ALTEFtIMPROYE,�EMOl15H2ORREPA1flANYSTRUG W Pd1i0/DBCIC w NRE.PRIOR TO RS ISSUANCE,1450 RLOUIRES THE APPLICANT FOR SUq1 PEMIIT TO FILE�SIGNED w � STAlE4ENT THA7 ME OR SHE IS LICENSED PURSUM7T TO TNE VROVi510N5 OF 7HE CONTMCTOR9 ll� � � CENSEUW�WAPTERYICOMMENGINGWITHSECTION7000)OFDIVISION70FTHEBUSINESSANDPRO• � POOI/Sp3 FESSiONS CODE)OR THAT HE OR SNE IS E%C12PT 7HEREFR0IA AND THE BA515 FOR THE ALLEGED E%EMP• � TION.ANVVIOLATIONOFSECTION70JI.68VANVAP�LICANTFO�iAVERMIT5U0lECTSTMEAVPLICPNTTO Z Re-Roo1 A CML VENAL7Y OF NOT MORL 7MAN FlVE HUNDRED DOl1ARS(f soo)J: ZOI.ASOWNEROFTHEPROPERTV,ORMYEMPLOYEESWITHWACESASTHEIASOLECOMVENSAT70t�, O Commercial WILI DO THE WOHK,AND TM[STiiUCTURE IS NOT INTENDEO Oq OFFERED fOR SALE(SEC.70a�,BU51- J NE55IW D GROFESSIONS COOE:THE CONTRACTOHS LICENSE UW OOES NOT�PPLY TO AN OW N[R OF � PROPERTYW/K)BURDSOHIIA7ROVESTMEREON.ANDYh10DOES5UCHWORKHIMSELFORHERSELFOR = ' [[ TNROUGHNISOftHCROV�NEM%.OYEES,GROVIDE0T1UTSl1CMWPROVER�EMSAR[NOiMENDEDOR m � OFFEREDFORSAIE.IF,HOWEVERTMEBURDINCORIlAPROVL1AGfTIS50lDWITMVONEYEMOFCOM7LE- Z TION,TNE OWN[R�BUIIDER MALL HAYE THE BURDEN OF FROVINO THAT HE OR SME DID NOT BUIID OR � MPROVE FOR TME PURPOSE OF SALE). w C4�OwNEROFiHEVROPEF7Y,AME%CLW^IVELYCONTMCTINGWrtTIIICENSEDLONTRAGTORS fL TO CONSTRUCT THE PHOJ[CT(SEC.7011.BUSIN[55 AND PROFESSIpNS COOE:TNE CONTMCTORS U� V2W2tlOf1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPERTVNh10BU1;DSORY.IPFiOVESTHERE0N,M1D � NM1IOCAMMCiSFORSUCHDRQIECTSWITHACONTRACTOR(5)LICENSE07U0.SUANTTOTH[CONTiUC- QUANTIN �ESCRIPTION FEE � TORS UCE�SE UW.). �j �.p �` � ❑IAME%EMPTUNDERSEC. B.�P.GFORTHISRERSON Q �O fOWC►� v�/TC.t� '� � � � A-.C. UNIT c.o�N�Cf'co . � DATE OWNER �" Z w I L� H Swt't'cN E r �Q UCENSED CONTRACTORS DECLAFATION w S L F� l7?e.0 v CY I HEREBY AFFIRu UN�[R PEN�L7Y OF PERIURY TMAT I AM IICENSED UNDER GROVISIONS OF CMAPTER Z . , '`: • d 9(COMMCNCINGWITHSECTION70W)OFDNISqN30FTMEBU51NE55AN�PROFES5iON5CODE,Ah9 X ►IYIICENSEtSRlFULLFORC[ANDEfFECT. m � LICENSE CLASS C�� �,�.No. 56l 3 8'8 ? V DATE ��I � CONTFiACTOR a w EL�E�� ' � " WORKERS'COMPENSA710N�ECLARATION � � � � ��- - ��- —•�— 3b J� Q � ��" z I NCHCBY AFFIRM UNOER PENAITY OF FERIURY ON[OF THE FOLLON'IYG DECUFAT , � �IHAVEANDWILLMA:N7AINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORNERS' 2 CpMPENSA7qN,ASPROVIDEDBYSECTION77aoOFTHELA00RCODE,FORTIE7ERCORIAANCE U Q OFTM[WORKFORYAiIC11TM5iERMITI5155UED. � � w _I HAVE AND WILL IAAINTA:N WORKERS'COAAPENSATION INSUFANCE,AS REOURED BY SECTION Q ��oo OF TNE LABOR CODE,FOR THE GERfORMANCE OF iHE WORK FOR WHICH THIS PERA�IT IS ISSUED.MYWORKERS'COMP[NSATqNINSURANCE AR:ERANDPOLICYNUNOLRARE: CONSTRUCTION j GAM�ER S�Tn�F'T� PLAN REVIEY! Z FOLICYNUMBER �L ' �T �� � _ CTRIC � ' Q 0 (fN6SECTCNf:EmNOTBEW�.REfEDOFMPER.ff6Wii0NEFl1�Df7EDDOl1JJL :mj �css PLU67BING Z I CERTIFYTHAT P!THE PERFORMANCE OF iHE WORK FOR Wlllpi iHIS VERMI715155UE�.I MECHANICAL U' SMaLL NO7 EIAPLOY ANV PERSON IN ANY MANNEq SOAS TO BECOME SUBJECT TO TME � WORKERS'COA�PENSATIDNLAWSOFCAUFORNIA,ANDAGREETMATIFISHdIILBECOA!E INSPECTIONFEE � S SU&IECTTOTMEWORNERS'COMPENSATqNPFOV1510NSOFSEC710N7�ODOFTHGU80q . ♦ CODE,I SHALL fOFTMWITH CAMPLY WITH iHOSE PROVIS�ONS. ISSUANCE � SMIP �j � 1 DATE: APPLICANT: WWARNINO;FAILUFiETOSECUREN'ORKERS'COMPENSATIONfAVEPACEISUNUWFULANDSHALLBE ENERGYPlC � � SWJECiANEMPLOVER70LRIMI4RLGEN�LTIE5MIDCMLFW[SUPTOONEMINDREDTIKKISAND ENERGYPERM1IIT DOU.ARS�5100.000),IN ADDITION TO iHE COSTOF�pMPENS�iION,OAAIAGES AS PROVIDED FOR IN • �,}� � SECTIDN770BOFTMELABORCOOE.NTEPEST.ANDATTORNEYSFEES. - RETENTIONFEE: IA� l � '��V� a CONSTFiUCT10N LENDING AGENCY ��� ��_�— � PRE•ALT FEE: O Q 1 HEREBV 11iFIHM UNDER PENALTV OF VERJURV THAT THERE IS ACONSTRUCTION LENDING AGENCY d FOa iME VERFORMANCE OF THE WORK FOR WMIGH T�IT IS ISSUCD 15EG 3D97,CIV.C.1. W � LENDER'SNAME S F-� LENDER'SADDRE55 � ICERTIFYTHATIHAVFR[ADTHISMPUCATqNANDSTAiETNATTMEABOVEWFORIA�TIONISCORRECT. TOTALFEES � � IAGREETOCON.PLYWITMAL�CITYANOCOUNTVORDINANLESANDSTATEUWSREUTINGTOBUILDING � CONSTRUCTION,ANOHERE6VAUT110fU2EHCPRESENTA7IVESOFTH15COUNTYTOENTERUPONTHE Z ABOVL� NTIONED�ROPERT`/FORINSVECTqNPURPO5E5. COMMENTS � J � m PERMI � ME�PRINT) ' � ¢ '� �-�6= �'8 � N SIGN�TUREOFPEHMITZEE , -DATE , ��� �� � • • � , �,". `. ' . RECPT.N0. � PAID�Y ✓ VALIDATION� WHITE—Departmenl Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fila Copy.GREEN—Applicant's Copy � . . .. . . � . .,... - - . . _ - . . .,_. . . .�.. . . ,. . CITY OF DIAMOND BAR ' � INSPECTION RECORD� , , . ... ' � � � ` e - e � • • - SET BACK ' FLOOR JOIST ' ' FTGS/FORMS/STEEL � FHA REQP�ITS �,;t_ .- , ELECTRIC GROUND "C��FLOOR pUCT `, -._•� ':.'. � ' �•' � .;• GROUND PLUMBING U Fi�`OOR CO�IDUIT � � �',G � + : SLAB GRADE FIREPLACE FOUNDATION TEMP POWER • - FIREPLACE'BOND'�EAN1,`' ='', `.' '�'�" �'' •• � WATER SERVICE �� - MID HT.-:BfJND;HEAM= •;,�.,� � • � � - ��__; ROOF SHEATHING �• 8 Ff. BOND BEAM � FRAMINGNENTILIATION FINAL BON�M ROOF COVER ., PRE-GRADING ROUGH HEATING - BENCHING ROUGN EIECTRIC Z ;?��.� �,,:��K';?� ROUGH GRADING ROUGH PLUMBING ' FINISH GRADING SHOWEFt/TUB TEST - - -� POOL ELECTRIC EXT.LATH/SI�ING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE Ih1PS. DRYWALL NAILING DEDICATIONS ' SEWER FINAL ENG. SEPTIC TANK . 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 ELECTRIC ��� _ ' � ' DEV. FEES PAID FINAL PLUMBING ENERGY • �" � .. �,��. ... �-� o) • ., . ,;�- . . . COMMENTS ' , , .. , . , _ , � ,,., ,. ,. , ���----. . , _; � . ; ..� , . �L:� iK��� SEPTIC TANK SIZE � '" - SEEP PIT/ll SIZE � .\ / f '� -'1`:�, �.�.'`' ',�.i',. '�`.'�;4 � � � � . �� >�•� � i�-��i� �'r..�: y �i . . V �� ��/� `�r '' `' .... �^ ' .. �. ,..,.