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HomeMy WebLinkAbout13504 �-- . . -- .. �---- - -�-- ----;-- -�`-___ - - _ ._ [ � �� CITY OF DIAMOND BAR ' � \� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� . 21660 E.Copley Drivc Suitc 190 (909)860-3195 Fax(909)861-3117 PRESS ��^��. BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE n'n APPLICATION C-��_ PERMIT 3 6 P/C ��C/�� ADDRESSLI'15O E COPLEY DK. DATE � NUMBE M c� ISSUE `_����C� TYPE `OCC • APN LOT TRACT DATE CONST. CaROUP � OWNER T • " ADDRESS ZONING SETBACKS � CITY ZIP TEL. R�R RW Q APPUCANT TEL. SIDE/SIDE STAEET RW ❑ � CONTRACTOR SIDE ❑ � ADDR 55 � ' •PROPOSEDUSE./�EW ov��tucAD FIQE SI�L/�/R'Lt�C CITY ZIP TE �' � /0/N� � � o ARCWENG/ • � DESIGNER NO.DWEL NO. NO. , ADDRESS UNITS STORIES BEDROOMS = CITY ZIP TEL � DESCRIPTION Sa.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER D�CLAAATION SFR/ADD/qEM O p 1 HEREBY AFFlf#1 UN�ER PENALTY OF iEfWFiY 7MAi 1 MI E%E1IPT FRON ME CDHTMCTORS LF G8f8p6/CO�pOR ' ill CfHSEUwFOfiTHEFdlON�N�aFEiISON�SEG7m1.6BU5WE55ANOPROFE5510N500DEANYCITYOR (n C,� COUNTYYM1p1REQNRESAPEMIrtiOCONSTiri/C'f,ALTERMPiqVE.DEMOl15H2ORHEPA1qFNYSTRUG W patio/pecic 6 711RE,VWOfl TO R$ISSUINCE.PLSO NEOUIHES iHE MPL�CAMT FOR SUp1 PERMIT TO FILE�SIGNCD STA7ENENT THAT HE OR SME IS UCENSED PURSUANT TO THE PROVISIONS OF ME CONTMCfOiL.lL � CENSE UW(QU7TFR�(COMMENCNO WITN SECTION T0001 OF DIVISION 7 OF 7HE BUSINE55/1N'J PRp. �- PooVSpa FESSUNS GODE)Olt TFNT HE OR SNE IS EXEUPT 7MEREFROM/wU 7HE BA515 FOR iHE ALLEGED E%EMa• TqN.ANYVi0lAT10NOFSECT10N70.7t.68VANVADGLICANTFOqAPERMIT5UB1ECT5TMEAPCLIGWTTO - Z Re-Roo1 � I1 CIV�PFNILTY OF HOi MORE TUN FNE MINOREO OOlURS(fsool): O Ol1lSOWNEqOFTHEPROPEHT'l,ORMYEMVLOYEESWITMWAG[SASiMEIR50lECOMPENSA7pN, � Commereial - . � WILL DO THE WOfYC►fD TNE STRUCTUNE LS NOT INfEtaEO OR OFiEREO FOR SALE ISEG 7ou.&1S6 J � NE53ANDPROFESSIOHSCOOETNECONTMCTORSLICENSEUwDOESNOTAPpLYTOANOwNEROF ? PROPEHiY 1NM0 BUlDS Ofl MFROVES MEREON.MID IM70 DOES Sl1CM Y✓ORN HIMSEIF OR HERSELF OR ' � T/V1d10HHISORHEqONMEYVLDYEES,VRDVIDEOTUTSUCFIMPROVEIAENfS/�RENOTINTENDEDOR m OFF6IFD FOR SILE,IF,F10VlEVER7NE BULDINO DR IMPi10V[MOJT IS SqD Wfil#N ONE YFi�R OFCOMPLE- •TION,7HE O'NMER�9URDER wILL INVE TME BURDEN OF PROVINO iNA7 ME Oi1811E DU NOT BUIID Oq MPpOVE FORTHE RIRCOSE OF S1LLF1 W OI.ti:01MlFROFTHEPROPERTY,IVAEXCLUSNELYCONfMCT1NONTiHLICENSEDCONTiUC70RS ¢ lq CONSTAUCTT7E PRO.lECT(SEG 7oN,BUSINESS IND iROFE5510N5 CODE:T1E CONTMCTORS U� V8IU8UOf1 - � � �ADJ.AREA u1 CElLSEUWDOE9NOTAPVLYiOANOYMEROFAPROVERTYWHO8UILDSORL�PROVESTHEREON.MO } � MAqCONTMCi9FOfiSUCHONO.IECfSWITMACdffMCTOA(S�UCENSEDVURSUANT70TMECONTMG pUANTITY DESCRIPTICN FEE � iORS UCEHbE UW). . . OIAME%ELIMUNDERSEG B.IP.GFORTMISRFASON a 3 " .. � � � D�TE OMrt�ER V � UCENSED CONTRACTORS DECLARATION W J � W IHERE9YAFFGWUNOERPENALTYOFPERIUHYTWR111MUCENSEDUNDERPROVISION50FCHRPTER Ur �S 0(COLY.IENC►W WRH SECTION 7oao)OF OMSION 70F iHE BUSINE55 ANO DPOFFSSiONS CDOE,AW Z � MY UGENSE IS N ML FOnCE IwD EFFEGT. m � LICENSE CU55 St+�_��.No.254 93� j . � a�� 1'�-q 9 corrrrucTon ApVAAI C���E� a w � � WORKERS'COMPENSATION DECLARATION a � IHCitEBYAFFIRMIMDER7ENALTYOFPERMiYONEOFTXfFOLLOYANODECLARAT10N5: U C!l a O _I/1AVEM9VnLLW�:MA7IRCERfIFlCATEOFODN5EM705ElNN5UREFORWOfiKERS' _ ' a COYPfNSATqN,ASDiiONOEDBYSECilONS7oaOFTNELA80RCO0E.FOR7HEPERFORMANCE �U OF T1E WORK FOti WMiCH 7Tu5 PERAIIT IS ISSUED. � / � � IHAYEANDYALLMAMAIHWOqKERS'CqAPENSATbNMSU1UNCE.ILSREOUIREDBYbECT10N Q f7000F7NEt1BORCODEFOflTNEPERFORMMKEOFTMEW011KFORYR11CMi17157ENM1T15 O �O ISSUED.MYWORKERS'COYPENSATqNINSUMiN�LEGtRRIEHANDPOLICVM11A8ERME: CONSTRUCTION � CAA0.IER STATE FLlM J PLAN REYIEW .�.��� � '� � �kY��fA �-�I� ELECTRIC _ . P � I o �nasstcnor�rcmr�orecao�.q�moFn[�ra,rr�sraaa+Ewor�voaunsR+ceioatFssi PLUMDING Z ICERTiFYiHATk1h1EPEPFORUANCEOFTHEWORKFORwNid1TM5PEiWRISI55UED,1 MECHANICAL (,'J SHFLL NOT EMPLOY Ni'(PEfl50N N ANY MANN[R SO AS TO BECOME SUBJECT TO THE y /� ,1 � WORNE0.S'�AIPENS�TIONUN50FGlIFORN1AM10AGREE7MATIFISMOULD6EWM[ INSPECTIONFEE .� f�•1�;� )._l•vU S 6U61ECTTOTHEWORNER^+'C0IACENSAl10NVROVI5lON50F5ECTiON]7000iTHElABOH � CDOE,�SMAl1 FORT1Vn7H COMPLY Yn E PRC SqNS. ISSUNJCE � � ��I �i-99 - � SMIP � p DATE: APPLICANT: � `j/ J � WMNINO:iMURETOSECURENONCERS'CAMPENSATIONCOVERAGE WFUL.MlDSMALLBE ENERGYP/C�I�;1 � ll ��!.�. �y SUBJECTIWEMP�OYERTOCW�I�NIIL7ENAL7IESANDGVILFNESUC EHIMDREDTHOUSAND E����EP�j pOLLARS(f1oo,0oaJ,INAODITIONTOTHEC0570FCqAPENSATIDN,D AGESASPROVIDEOFORIH �)t�� %..f, T � �� D . � SECf�ON 170!OF iME UDOR CODE.INTEREST,AND ATTORHEYS FEES. FETE[i7�QN�E��� � ' _y '•' - • ' � CONSTRUCTION LENDING AGENCY PHE•ALT FEE: O � INERFBVAFfliIAIUNDER7ENALTYOFPERA/RYTNATTNEREISACONS7RUCTIONLENDiNOAGENCY iORTHE FERFOMUNCE OF TNE WORK FOR WNId1 iMiS PEPIAR IS ISSVED(SEG]OYl,qY.G). � � lE1J�ER5 WWE � t� C LENDERSIDDRESS � ICERTIiYTUTINAVEREADTMISAPiLIGTqNANDSTATETUTiHE/HOVENFpR1AATqNISWHRECT. TOTAL FEES � � ���/ �� � IAGREETOCAMPLYNITIALLCITVANDCOIMTYORDIWWCESANDStATEUWSREUTMIOTOBUIDINO CONSTRUCTION.M1D NEREBV MJTIqRIZE REPRESENTATIYES OF 7H15 COIMTY TO EHTER UPON iHE . S� ABOVE�MEHTIONEDVROPERTYfORINSPECT�ONVURPO5E5. COMMENTS � � �iBBEQTO E���S(J�1LF7 m PE ry . 2 � . � y EE `�E RECPT.N0. PA1D BY�.:�� I.!'I���AL10AT10N �•�`-�. � WMITE--Depertment Copy.YELLOW�nance Copy,PINK—A�eeesaCopy,GOLDENROD--FileCopy,OREEti�llpplicanPs Copy � . CITY OF DIAMOND BAR - , INSPECTION RECORD �� . � • • � � . � . . � � , � . SET BACK ; '�' ' ' FLOOR JOIST ,.;; V', Q' `l �`\;1 j�c(` � F'i:� OFi�jAS/STEEL • � • ! FHA REQMTS - t_ � - ELECTRIC GROUND UNDER FLOOR DUC�;-r, ..•�,. y�,• t, .;.T•. � GFiOUND PLUMBING UNDER FLOOR CO�IDUIT SLAB GRADE � FIREPLACE FOUNDATION - � - � TEMP POWER - � - ' FIREPLACE BOND BEAM . WATER SERVICE - - � - MID HT.'60ND�BEAM' .�•. =': �::�:_�:;`''' . . - 1 'i ROOF'SH�A`fHiNG-�='�- •. :,� � :;.,� 8 FL 60ND 6EAM: � ��� ',�' . • •� •� �;: ! • FRAMINGNENTILIATION � � FINAI 80ND BEAM � ROOF COVER � PRE-GRADING ROUGH HEATING BENCHING ' �� ROUGH ELECTRIC �, - � ROUGH GRADING ROUGH PLUMBING � " � - � FINISH GRADING SHOWERITUB TEST - POOL ELECTRIC • EXT.LATH/SIDING POOL FENCING • ; � � WALL INSULATION POOL FINAL • �. ' CEILING INSULATION OFF SITE IMPS.. � . .-" DRYWALL NAILING � DEDICATIONS. � SEWER_.. _: . • '_', , FINAL ENG. SEPTICTANK -....' .- . _ . LANDSCAPE/IRRIG. SEEP PITIL.L. -=- -• - ON SITE IMPS. GAS AIR TEST; - -- - FINAL ZONING FINAL CONST.: - Q - FIRE DEPT. FINAL • - FINAL HEATING - - - � HEALTH DEPT.FINAL � FiNAL ELECTRIC- - DEV. FEES PAID • - � - FINAL PLUMBING ENERGY � �d- • • -, � - , - ....., ., . .,...... . . � ��, . _ . . _. --• --- - — -----� - -- .: COMMENTS _------.__ _ ..------- �---� ---. . _ _ ��, _ ; :� . . , ,'�� _ _ . _. � � - i �.;:.. , •�I ,', , _- - , .. , � '. • ,r, �, . � -.. - �, -- _ _ - � SEPTIC TANK SIZE . SEEP PIT/U SIZE . . , � i � - : � . .I� --.• - �. . -_;• .t�,'_•, _.. ._ , . .l. , 1 �\ `. '. \ '. - -- , , �--� ; ' - - _ �^ --... . � I