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HomeMy WebLinkAbout13734 � �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS '�^'� BUILDING P RMIT APPLICATION � FIRMLY o� JOBSfTE ��Ii ��� - �, APPLICATION� � q PERMfT >� /C ADDRESS ��� DATE � NUMBE p � ISSUE TYPE OCC � APN OT TRACT DATE CONST. GROUP p OWNER o ADDRESS ZONING SEfBACKS �W CITY ZIP TEL. FRONT RW O APPLICANT TEL. REAR p � . SIDE/SIDE STREET RW p • CONTAACTOR C G SIDE ❑ � CrD�ORESS � ZIPQ1So TEL�� PROPOSEDUSE �N �'6C � ARCFUENG/ DESIGNER NO.DWEL. NO. NO. = CRDRESS ZIP TEL UNITS STORIES BEDROOMS � v� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER•DUILDER DECIAHATION SFR/ADD.'REM O p I MEREBY AFFIRM UNDER PEtU1TY OF PEfiRIRY THAT 1 AM E%EIAPT fHOM THE CONiMCTORS U- GIIr.1g0/C�1pOft W CENSEUWFORTNEfOLLOWINGR[ASON(SEC.7011.68USINESSANDPROFESSIONSLOOEANYCITYOR (n �) COUNTYMRAdfREOl11RE5AVEMIRTOCONSTFUCT,ALTE0.111VROVE,DElqL151/,ORRE7A:RANYSTRUC• w u� iURE,Pf1qf170 RS ISSUNICE,/LSO REOVIRE5111F APPLICAu7 FOR SUCH PERMIT 10 FILE A SiCNED W PdSlO/DOCk � $TATFUEM TWIT HE OR 6H[IS LICENSED PURSUAN?TO THE PROVISIONS OF THE CONTMCTOit3 LI• CEH6E UW�ClUPTER�(COMMENCINQ VA7H SECTION 7000)OF DIVISqN 7 OF TXE BVStNE55 AND PRO- U" PooVSpa FESSqHS CODE)OR 7!UT ME OR SME IS EXEMPT TNEREFRqA INO TME BASIS FCfl THE ILLLECED E7IEIAP• TION./NYV10.AT10NOFSECTION70]1.68YANYA7PLIGlHTFO1IAPERMITSUBICCTSTMEMPI��TTO Z Re�Rool � ACMLiENALTYOfNOTAqRETWNfNEHUh9REDDOLU0.S1i500)): � 04ASOW!IEROFTIiEP1iOPERTV,011YYE1IPLOYEESWITHWAGCSA5TV/EIFSOLECdAiENSATION, CpmmBfC13I � NALL 00 ME WORK,AND TNG STRl1CfURE IS NO71N7fYDED OR OFFERED FOR SALE(SEG 7a�,BU51- � N MFSS AND iROFESS10N5 CODE:hIE CONTMCTO(iSIJCEN.SE UW DOES NOT 117P1Y TD AN OWNER OF = VROVENTY W/q BUILDS OR MPP.OYES THEIIEON,MA WI10 DOES SUp1 WORK MIMSELF O(i NERSEIF OR � THROUONWSORNEflONNE1JPLDYEES,VROVIDEDTINTSUCMMVROVE�EN75AflENO7NTEN0EDIX1 La � WFEREDFORSALE.IF,NON�[VEi�iNE8U0.DWaOflAlpiqVEYE1RI550lDWITHWONEVEAROFCOMPLE• Z 'iION,iME OWNER�BUILDEH WiLL MAYE T}1E BURDEN OF VpOYINO TNA7 HE OR SHE DiD NOT BUILD OR = MGROY[FORTHE PURPO°[OF SALEL W Ol�^OWNCROFT/EVfiOGENT�;AYD(f.LUSNELYCOMRA'„'TUiGWITNLICENSEDCONTMCTOHS � TO CONiTRUCT TME VNOJECT�SEC.70u,BUCINESS AND PROFE5510N5 CODL THE CONTMCTORS LI- VylU2SiOf1 AOJ.AREA CENSE UW OOES HOTMPLY TO AN OY�NER OF A PROPEflTY NR10 BUILDS OR W PRpVES THERCON,AN� � WIqCONTRAC79FORSUCHPRO,IECTSWITIACONTMROR(S�LILENSEDPUFiSVANT70iMEGONiMG puavnrv DESCRIPTIO+1 FEE � toas ucc�+sE uw.�. OIIWEXEYPTUNDERSEC. B_1CCFORTNSNEASON Q /Va�'j 1 � / f C � � � OATE OwNER U � �O LICENSED CONiRACTORS DECLARATION � � W - �� � IHEREBVAFF6UIUWEIIPEIULTYOFVE0.JURYTHATIAMIICEN5E0Ul9ERPROVISIONSOFCMAC7ER V. / � �(COUYCNCNO YA7M SECTION 7xo)OF CMSqN]OFTMc BU5:NE55 AN�PRCFESSKKJS COCE.AND Z � I • � �� W LMENSE IS N FLAL F .CF MA!D EiFECT. m � •x �/j(�L � � L10EhSE CUy�S �V IIC.NO._�l297.� � �j OATE �v �CONTfiACTOR_� � W K� WORKERS'COMPENSATION D[CLARATION 2'� �(J U � IHEREBYAFFRMUlAf:RF[WLLTYOFVERAIRYONEO�iMEFOIIOW:NG�ELUMTqNS. Z � �INAVEMAWIILMMMAINACERTIFICATEO�CONSENTTOSELFaNSUR[FORWCMKERS' a S COYPENSATION,ASPi10VI0E08Y5EC710N]�OOOFTHEl1BORCOCE.FORTIEGERFORMAACE U Q OF iM[YYOfIK FOli WNlp1 TMIS VENAIIi IS ISSVED. � _I NAVE MA W.LL tWMA:N WORKEFlS'COAIDENSATION INSU{UNCE,AS RCIXIIRCD BV SECTION O ]7000FTHEUBOR E,PoRTHEOERFORNANCEOFTHEWORKFORWMICMTInSPERMITI3 J ISSUED.A�fYY+Ofi COAICENSATIONWSURAI: E RRIEHM'�POLICY�"MOERAf1E: CONSTRUCTION O CAFF4ER �J!�y��tiL��� PLAN REVIEW -��'],7/.-`/ - � POIICYM11A6�R �� �j ELECTR�C —--- � I - � � � (1�SCCiib+r�[FDHOTBE¢�.a'LETIDOc71�EPC�M•s�ON[�DDCU�ItSR:bOnlE55F PLUM6ING Z ICERTIFYTHATINiHEPEHfOR1A�V:CEOFiHEWOP.KFORWNipiTMI5FEN4i1151SSUF.D.1 MECHANICAL (7 51411NOiEMPLOVANYPERSdJNAN'IYANNERSOAST08CCOMESl1&IECiTOTHE � (q WORI(ERS'COu�ENSATqNLAWSOFCALIFOR , DAGREETMATIF151KK1I.DBCCOIIG INSPECTIONFEE S WQ![CT(OlHEWORKEflS'COM7ENSAT �70\':IONSOFSE . J�OOOFMEUl90R � e,�sruusonnnvin�eoe�r�rmn+ ose . �orrs. ISSUANCL � 0 Gc p DATE: �d �7 7 APf'LICAI�lT: _ �� SMiP � WARMNO:FIULURETOSECUREv.WiKERS' v. 5�7pNC0 .:EISUNU� 4�DSnAIIBE ENCRGVPIC � 6Uf1JECTANEMPLOYERTOCA:AIINALPE ANOC7VILFN PTOONEHUNOREDiNOUSAND ENERGYPERMIT ¢ DOl1Afi5�il W.000�,W ADDITqN TO THL C �T Of COMPENSATION,DAMAGES AS PflOVID[D FOR IN SECTIJN77DeOFTNEWORCOOE.WTERE5T.M10ATTORNEY'$FEES. RETENTIONFEE: '� oCONSTRUCTION LENDING AGENCY PRE•ALT FEE: � � IHEREBVAFFlMIUNOERPENALTYOFPE0.1URY7NATIH[AEISACONSTRUCTIONLENOWGAGENCY FOfI TMC PCRFORMANCE OF iHE WONN FOR WMICH iNIS iERMITI5155UC�(SEG 90a7,CIV.G�. Z w � LENDERSMME � LENDERSADDRESS � TOTAL FEES � I LERTfYTHAT I HAVE READ 7HISAPPLICATIONAND STATE i1uT THE�OVE MiORUATION IS COanECi. � I AOREE TO COM�LY WITH ALL CITY 11N�GDUNTV ORDINANCES ANO SJfTE UWS RELATNO TO BU0.DIN6 � '^ CONSTRUCTqN,ANDNCREBVAUi1qRIZEP'cGRESENTATIVESOF MSCOUMVTOfHiEAUPONTHE L ADOVE-MEHTIONECPROPER7YFORINSPEC��RPOSES COMMENTS � � Qm PERMiTTEE E F• � �_��� � � N SIGNAN .O VEW.AITfEE DATE � � RECPT.NO. PAID BY . VALDATION � 4VFIITE-Dopartment Copy,YELLOW-Finance Copy,P�NK-Aesessa Copy.GOLDENROD-file Copy,GREEN-Applicanfs Copy � - �. , � � . • � . • . • ,. . . ., � . . . . . • . . � - CITY OF DIAMOND BAR " ' INSPECTIOhI RECORD ,� � ..l .,;� ��,,� _- .i � -c,— #�� ►� � 1.=, .:h— l,tiEw t' �I �� � A:1_ ��;_:1 .I►.��- ��1�..t:..►�....._ `��� J►�.��������. ._._.�..� E- �. �'._lc� '..,.. �_. �F=,. „ l►F-�.._��';.!`-�'�'..._ SET BACt: •- , M i • ' , 'I I FLOOR JOfST � � '. - . •_ ..I` ..... ., �FTGS;FORI,IS/STEEL - -� FHA REQMTS �. ��� ' � 'ELECTRIC GROUPdD ' ' j U�dDER FLOOR DUCT . ',� I_ � 'GROUND PLUh461NG U�dDER FLOOR CUi�D'JIT ; ' � ' ' • `SLAB GRADE ' FI(�EPLACE FOUNDATIOP! I � iTEP,AP POWER � FIREPLACE BOND BEAP.1 'WATER SERVICE - Mlb HT. E30ND BEAt�+ �� ' . '- � . - � ti -'� i ROOF SHEATHf;JG`•.- ' • '. • 8 FT.BQND BEAP�1, , � ' � ' ' �FRAF�11hJG:NENTiLIATI�N FINAL BOND BEAP�1 � ` �ROOF COVER I PRE-GRADIPJG ' +RO'JGH HEATING BENCHING ROUGN E�ECTRIC ROUGH GRADING !ROUGH PLUP�981NG FINISH GRADING SHOy"J�R/TUE3 TEST � POOL ELECTRIC 'EY,T.l.4TH.�SiDING - POOL FENCING � '.NALL INSJLATION POOL'FINAL CEiLING It:SULATIO�J OFF SITE IPJIPS. - DRYIr'JALL PJAIIING " DEDICATIONS � 'SE�"ti'ER FINAL ENG. ' SEPTIC Tl1NK LANDSCAPElIRRIG. ' SEEF PkT/L.L. OPJ SITE IPAPS. GC.S F,I�TEST FINAL ZOPJING (=i;:��l_COPdST. ' � ' •• " � — �- FIRE DEPT. FINAL i•I;•:%•. �i-IEATING _ ' - •`, HEALTH DEPT. FINAL ��'.:•�ELECTRIC . ��� - ' - DEV. FEES PAID - ' �`.•%��.PLUA,�BING • ' ' � � • � � � � E�JERGY • .-- . . . � .. . \ -+ , — — ---- � .C:�7'l`! �:);-��j('^.f . ,- j. _ �r.,;�.._.��'.��':i= _._......_--• I - . . ------. -- ' - ---- _� .-- . .. ' • „ , � . .. . . ' COi��11ViENTS ' � ' _ � i , ' • ' ' • , . ,. _ -"M . . . . . . .. . � . • . . � � SEPTIC TANK SIZE � � SEEP PIT/U SIZE � �� ._�`I. _____._� ,��ti` �;•, � � . ' , � . , . , ._..� - y .. .. . I ' �� . _ � � .- ". _ . � . , ._"_.�...'_"__��.._........ _..._..l � 'i _ ." _� � , �