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HomeMy WebLinkAbout15977 %. .. I ' . . . _... .. . ' " " � CITY OF DIAMOND BAR ' � - J� -- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 !,� �� �� (909)860-3195 raa(909)861-3117 Lt PRESS ��'�^^� BUILDING PERMIT APPLICATION FIRMLY o DDRESS �� g�S �'� C�r�-£Y S�L � n� APPUCATION PERMff P/C S1 ^� DATE O � NUMBER��l M V �"W � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER ��� p ADDR SS 21 �(oS iz., f�C.lt� 1 ZONING SETBACKS "' CITY ZIP TEL. FRONT RW � � APPLICANT T� 8.�:.ltK TEL.��� `B'� 1N-� ' REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACT E� Mi.�' '�! N TRuLi 1a^� SIDE ❑ � ADDRESS � �� -+ PROPOSED USE O � � o CITY r��+��� �h'ZIP r7 u _TEL. ��3�� 7'�� � ARCH/ENG/ n,, DESIGNER S 1'T��ES NO.DN�EL. NO. N0. ADDRESS L_ 73Z c�R �`� /S UNITS STORIES BEDROOMS � CfTY 1(2 V 1 wI� [� ZIP�L�/Z TEL.Cl4A� cn DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION Q ONMER-BUILDER DECLARATION SFR/ADDiREM O p 1 HEREBY AFFlRM WOER VENAIN OF VE0.URV TM117 I AY ExEIAVT FRdA THE CONTMCTORS LI• Gd(8g0/C2fpOfl [ll CEMSEUWFORTMEFOIIOWINGREASON(SEC.70.11.6B1AWE5511NOPpCFE5510N5CODC:/UYCITYOR (� � OOIMTYWT4CHRE0UIRESAF67MRTOCONSTRUCi,ALiFfLIMPROVE.DEM�USFI,ORREP�VR1NYSiRUC- W patiolDecic � TURE,PRqq TO rt9 ISSU�NCE.ALSO REWIRES TME APPLICANT FOR SUCH 7ERMIT TO FLLE A 8IONED STII7EMEM THAT ME OH SHE IS lKENSED PUM1SUAN7 TO TME PHOYISIA�S OF 7NE CONTMCTOFS U- � CENSE UW(QIAPTER Y(CpAMENdNO N7T/SECTION 70ao)OF DMSqN l OF THE OVSIN[55 AND PRO� �l" P��SPe . ' . � FESSIDNSCOOE)OIIIHATHE0R511EI5E%EMPTTHENEFROMANDh1[BAiISFORTMEALLEGEDEI(EMP- C7 T10N.ANNVIOIATqNOFSECTION7oJt.6BVANVAPOLC�NTFORADENYITSU6IECTSTHEAPVIICJwTTO Z Re-Roof � ACN4.PENAL7YOFNOTUORETWIFIVEMUNDREDDOlUR5�fs00).�: '` � OL�.:��EROFiHEPROPERTY,OIiMYEYPIAYEESWITHWAGES/uiHEIR50LECOMPENS�TqN, 0 �mmerciai uU V " YIKL 00 T11E W WV(Ilq T1E STRUCTURE IS NOT INTENDEO OR OFiERE�fOR SALE(SEG 70�1 BU51- J N NESSAHDPROFESSIONSCOOE:TNECONTMCTORSLICENSEUWDOESNOTAPPLYTOANOWNEROF � . � ' 7ROPEfifY YA10 BUILDS OR MPROVES 7HEREON,AND MT10 DOES SUCH MYNiK HINSELF OR HERSELF OR CC T}/q0U0H MISOR HER OVM E4PLOYEES,iPOViDED 71U7 SUGH IMPROVEIAEHTS ME NOT INTENDED DR m �j1 ,OFFERED�ORSALEIF,11DwEVE0.TMEelAqNGORIYPNOVEMOVTI55dDNrtTHNONEYEAROFC0AIPLE• Z TqN,THE ON7�ERbUtDER wILL HAVE T11E BURDEN OF VROVWQ TNAT NE Oq SHE OD NOT BURD OR � YPiqVE iORTHE PURPOSE OF BALE} W 04ASOVMEROFTHEGROVERTI:AMEXCLUSNELYCOMMC71NON7RIL�CENSEDCOHTMCTORS � TD CDI�lSTRUCT THE YRQIECT(SEC.TOM.BUSiNE55 AND Pi10FL55KK+S OOOE:THE CONTMCTOFiS LI• V31U0ti _ ��._AQI.AREA GEN6E lAW DOE9 NO7 AVPLY TO AN ONMER OFA VROPENTY WMO BUttDS OR MPRDVES TMER:ON,I�ND � WIpWNTMCTSFORSUCHDR0.1ECT5NATH�CONTMCTOR�S�LICENSEDPURSUMRTOTNECOHTMG QUANTITY DESCRIPTION FEE � T00.5 LICBISE LAW.�. O IAIA EXEYPT UNDER SEC. 8.1 P,C.FOR THIS REASON Q �• � 3 � . � � DATE OWNER � � � LIC[NSED CONTRA�TORS DECLARATION � � w IHEREBYAFFIRMUHOERPEWLLTYOFPEIWRVTHA7IAMLICENSEDUh'DCflPROVI5lON50FCHAPTER V. � Y�COMAIENGNON7TT15ECTION7o0o1�OM5iON70FTHC8U51NES5MOPROFES5�ON5CODE,Ah'D ` X HYUCENSEISNFULLFO�ICEAN�EFfCCT. m LLl � UCENSE CLASS LIC.N0. ry�� � J V DATE CONTMCTOR� �CJr� _ d W � WORKERS'COMPENSATION DECL4MTION Q y U � IHER[BYIIFFUWU4DERVE4ALTYOFCE0.IURYONEOFTNEFOLLOWINGDECLARATUNS. Z Q � �INAVEFNDWILLMANTNNACERTIFICATEOFCONScNTTOSELFdNSUF[FOflWORKERi' $ COMPCNSATqN,ASPROViDE�BV5ECT10N7/OOOF7MELABCRCOCE,FOR1HEiERFOfWANCE W OFiME WONN FOR wr1id17MIS FERu!T IS ISSUED. � 0 MAVEANDYALLMA:MRNWOPo(ENS'CAMPEI:SATqNINSUHANCE,ASRCOUIREDBYSCCTION � /��,,^ I�O ¢ ]7000FTiE LABOR COOE,PoH THE GENFORMANCE OF iHE WOFK FOq WHICMTHIS PERMR IS �I �L 0 ISSUED.YYWJN(ERS'CfJ11PENSATIONIN URANCEGHRIERANDPOLICYNUM9ERARE: CONSTRUCTION U 1 j uwwEn —V� PLAN REVIEW I � � � va�cvruue�a �Z.Z VN/'T-Ol� 'V ELECTRIC � DAT� c �s�croru,e�wreeaa.nt�noFneaw.+rsaaa+e�+..rorx�ocuix�s,omrn�ssi PLUM6ING ��`'a� Z IC£RTIFYTHATPlTHEFERFOAMANCEOFTHEWORKFOR`h7upliNiSPEiWRI5155UE0,1 MECHANICAL U' SMALLNOTEMPLCYAhYPERSONWANYMANYER50A5TOBCCOMESUfl.IECTiOT11E (/� Y.C)fLCERS'CDNPENSATqNUW50FCALIFORN111WDAOR[ETVITIFISMOVLDBCCOAIE INSPECTIONFEE S SVBJECTTOTHENKKiI(ERS'COAIPENSATIONVROYIS�ONSOFSECTqN770DOFT1IE. OR U� COOE,1 WLLLiORiTM1NiNCO�PLVM7iH EP VISIONS. ISSUANCE �LT1Z�L�11:.A1de�L1�_���� • � O 11 1 tJL'111t11��1 lYD-D p DATE: � 0 APPLIWM: ._ SMIP s O � ENERGY P/C WARNINQ iA0.URETO SECURE VIORKERS'COM NSA -RAGE IS VNLAWFUI.AND SMALL BE � SUBIECTAN E6IPLOVER TO CHIMWAL VENALTI AND :N FINES UP TOONE NUNDRED TK)USANO ENERGY PERMIT D011AitS(f ta0,0oo),N hDOR10N TO TNE C0.5T OF COUPENS�TqN.DAMAGES ll5 PROVID[D iOH W � SECTION7l000F7N(LAgOqCOOE.MEREST,ANDATTORNEY5FEE5. RETENTIONFEE: ` �_,OO d CONSTRUCTION IENDING AGENCY PRE•ALT FEE: � IHEREBVAFFlRMUNDERPENAL7VOFPEiLR1RYTMATTHERGISACON5TFAICTONLE�DWGAGENCV � FOR TMC PERFORAUNCE OF TH[WORK FOR MMICH 7N15 PERAaT IS ISSUED(SEC.7007,CIV.CJ. � LENDERS NNAE - F— IEN�ER'SADDHESS ¢ ICERTIFYTMATIMAVEPEADTMISAPPUGTIONANDSTATETHATTHEAFfOVEIN�ONAATIONISCORRECT. TOTAL FEES t� � � 1110REETOGOMPLYKIMALLCffYAND00lA�TYORDINANCESMIDST�TEUNSREUTWGTOBULOINO � CONSTRUCTION,ANOHEREBYI1UT110RIZERC�RESENTATIVESOFMSCOUNT'/TOEHfERUPONTHE ABOVE�MENTICNED YROPERTY FOR INSPECTION VURPOSES. COMMENTS O � �'�� — c,r( QPERIJRTE IwE 1� �n 10 Q� � SIGNATV EOF R fE OATE � RECPT.NO. PAID BY VALIDATION WHITE—Depertment Gopy,YELLOW—Finance Coyy,PINK—Assessa Copy,GOLDENROD—file Copy,GR[EN—Applicant's Gopy . . . ., , . .. . �. . . . . . . . .. ,., , ... � . � .... . .. . ... .. ,. . .. 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BOND BE.AP�9' �.�'• -• ' • �- ' ':ROOF SHEATHIPdG - ` _ � _ ' � F F-T.BQhJD 8EA�11 . . . .: - —• � ,, . iFRAF�!I�JG.NENTILlATION i� '7�Id'� . • FINAL�BOND E3rANA . � ' _ , _ �ROOFCO��ER .. � PRE-GRADI�1�,, .� ��, ,�- -�• ' �. .' ` „ ,.-;.�_ --�.-.-,;.,^,=z.:t ;�^�— ��. �RJl1GHH�ATING .. _ . - BENGW�pJ..at.<<-�,,�,a :. .;:�,•�.�.,�.. �. .--�'^I,'.y� '.ROUGH ELECTRiC I�_2_./0 f .� ROUGI-t GRADINU� RO:l:�hl PLU;�'E31NG � ' FINISH GRADING , 5�104"JER.ri'UF.�TEST - POOL ELECTRIC � E�T:L1ITH!Si�ING � ---- POOL FENCING � J I ��.^:�;t�lMSU�',TION I 1�Z3/D_f � POOL FINAL __ (,C'tI�IN^a ii•1SULf'�i ION 1 OFF SITt IMPS. __ ' � - - ' — �'vR`r�4'r�LLP1AfLIi�G I� 3_p � DEDICATIDNS Srl"r`cR- - _ - - FINAL�EtdG. � - ;SEPTIC T�'1NK LI�NDSCF�PEIIP,R(G. � ;SEE:'FiT/L.L. � •.�,'-. � ON SI?E IMPS. , G�,S F:If3 TEST . ' � FINAL�ZONI"dG � ' �rl�•;rL i3O��5T, 3 � Q�� � FIF.E DE�•T. FIN^1_ -If_:�_�H:�l?ING -- - . _ � � IiEAL7H DEPT. FI��f:L � ; ' . 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