Loading...
HomeMy WebLinkAbout17016 (19) C�' 'G��+ CITY OF D[AMOND BAR / - ��5�"" "` ,�^ —— ---- – , � DEPARTMENT OF COMMUNITY&DEVELOPMENTC�CES I � 21825 E.Copley Drive I � (909)860-3195 Fax(909)861-3117 PRESS �'%�� _ BUILDINGPERMITAPPLICATION FIRMLY o� JOBSITE�q,��r � I DATECATION ,, 1 PUMBER��O q/ �►3 I� ADDRESS�++�-�'LJ C�F�- � � APN LOT TRACT ' D TEE ��' PE OCC p OWNER � �ONST. GROUP o ADDRESS 20NING SETBACKS z CITY ZIP TEL. FRONT Ryy p � APPUCANT TEL. REAR p � SIOE/SI�E STREET RW p o� CONTRACT�R -- ,,,�, SIDE p CDDR�S;�� ��sb� Z� u TE - PROPOSED USE W AR�hUENG/ a ADDIG SS / � l,.L_ NO.DWEL. N0. Np, � CIT�e,f�L� ZI TEL� UNITS STORIES BEDROOMS � � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBV PFFIRM UNOER VENALTY OF GEIWRY T1AT 1 AM E%EAIVi iROM iHC Cp(TpACTOR5l4 Garage/Carport W CENSEUWFORTHEFOLLOWIN6REASON(SEC.70.71.SBUS�NESSANDPROFESiiONSCODE:ANYCI7YOR (J) U CWNi`lWHIGHREOUIRESAPERMITTOCONSTRUCT,ALTER,0.1PflOVE,DEA10115H2ORREFAIRANYSTRUC- W W iURE,VRIOR TO RS ISSUANCE.QSO REOUIRES TIE APPLICANT FOR SUCH GERMIT TO iILE A SIGNED w PatiolDeck � STATEUENT THAT HE OR SHE IS UCENSED PURSUANT TO TME PROVISIONS OF TNE CONTRACTOFS L4 � CENSE UW�CHAPTEF Y(COMMENCWO WITH SECTI�N 70D0)OF DIVISqN J Of TME BUSI4ES5 AND CR6 �- PooVSpa iE5510NSCO0E�ORTHATHEORSHEISE%EMPTTHEFEFROMANO7HEBASISFORTHEALLEGEDEXEMP� � V TION.ANVVqUTIONOFSECTION70.71.SBYANYAPPLICANTFORAPCRMITSU0..'ECTSTHEAPPUCANiTO Z Re•Roo1 � A dNL PENALiV OF NOT MORE TYIAN FIVE/NN�RED DOlURS(f500)): � ❑L���'�NEROFTHE7ROPERTY.ORMYEM7LOVEESWITMWAGESASTMEiqSOIECOM7EN5ATqN, 0 COmm6fCidl Z WILLOO TME WORK,AND THE SiRUCTURE IS NOT IM.ENOED OR OFFERCD FOR SALE ISEC.70u,BUSb J � NE55 AND VROFESSIONS CODE:THE CANTMCTORS IICENSE UW DOES NO7 A77LY TO AN OK7JER DF PROVERTYWNOBUILOSORIMPROVESTHEREON.MIDWHDDOESSUCHK'ORKHIMSELFORHERSELFOq � Q THROUGHHISORHERONTlEMPLOVEES,PRONOEDTHATSUCH1IAPROVEAICNTSARENOTINTENDEDOR m O OFFEREDWRSALEIF,HOWEVER7HEBNLOINGORIM�ROVEMENTISSOLOWITMINON[YEAROF�OMPLE� Z TqN,THE OWNER�BUILDER N1LL HAVE THE BURDEN OF PPOVING THAT HE OR SH�DID NOT BUILD OR = IAIPROVEFORTHEPURPOSEOFSALE�. � W ❑I.ASOYMEROFTHEPROPERTY,AMEXCLUSIVELYCONTMCTWCWiTHIICCASEDCONiRACTORS (r TO CANSTRVCT iHE 7R0.1ECT(SEG 70tt,OUSINESS I�NO PROFESSIONS COD[:TME CANTMCTORS LI� VaIUBIiOf1 ADJ.AREA W CENSEUWDOESNOiAPPLYTOMlONMEHOFAPROPERTYWMOBUILDSORYAPROVE5IHEREON.ANO � WMOCONTfUCTSFORSUq1VRQlECTSWITHACANTMCTOR(5)IICENSE�PURSUAHTTOTHECONTMG OUANTITY DESCRIPTION FEE Y iORS IICENSE UW). ', � ❑IMIE%EIADTUNDERSEC. B iV.C.fORTH�SREA50N U �! � /'� I��� � /.i��_i �� `/ 1��y{ �-''��•J l� � DATE OWNER F- � � LICENSED CONTRACTORS DECLARATION w � IHERE9YAFFIRMUtiDEFOENAL7VOFDERIURVTHATIMILICENSEDUNDfRVRON510NSOFCHA7TER V, p`_, Y(COMMENCINGWI7HSECTqN7o0a)OFDMSqN00FTNE8U5INE5SANDPROFE55�ON5CO0E,A4D Z X MY LICENSE IS W FIAI�ORCEANO EFFECL m � IICENSE�AS� �M CIOMRACTO���� ��+ d V DATE {,.� ��vai �'� f W I � WORKERS'COMPENSAT�ON DECLARATIO�J � ¢ �J� '�� `�� ��p �,�,�J �' , .J� � INEREBYAFFIRMUNDERPENALTYOFPERJURVONEOFTNEFOlLO'MNGDECUIRATqNS. Z ` � _IHAVEAN�WIILMAMTNNACEFTIFICATEOFCONSENTTOSELF�INSURLFD4lWRKERS' a Q COAIPENSATION,ASPROVIDEOBVSfCTION]1o00FTNEUBOfiCODE,PoRTHEPERFORMANCE U Q OFTHE WORK FOR VMICM TNIS PERMIT IS ISSUED. ', � QW _IHAVEAN�WIILM�MTAINWORNERS'COMPENSATIONINSURANCE.ASREOUREDBYSECTION � J7ooOFTNELABORCOOE,FORTHEPERFOR/�ANCEOFTNEwORKGORWIUCHTHISPFRMi71S ^�( 0 �SSVED.MYWO 5'CAMPENSATIQ,y}y.�IRANCECARRIERAND70LICYM1Al0ERME: CONSTRUCTION ����� ' ,���/ �� j CMRIER �^ __J(,7;6�u+�..� PLAN REVIEW 3`� � fOUCY NUMBER � I/ l� Z✓ � ELECTRIC L ,�b Z Q � �sEctnrrr+Emwre[a�.siErman+EVEro.rtswaa.�uu��uu��s�m�oa�Fss} PLUMBING ;,�_ —� �V -� \' � . , ..+ Z �CERTIFYTMATINiHE7EflFORMANCEOFiMEWORKFORWNICHiH'SPERAIITISISSUED,1 MECHANICAL � I� ��I.1.1� C7 SM�LLNOTEMPLOYlWYPERSONINANVkANNER50115TOBECOM[SJ&IECTTOTME �\ (q WORKERS'COM7ENSATiONUW50FCALIFORNIA,ANDAGRCETHATIFISHOULOBELOME INSPECTIONFEE �-. � SU0.IECTTOTHEWOAKERS'COMPENSATIONVROVISIONSOFSECTqN77000FTHElABDR ��O/ � S coo is uLroartnvm�cana�vwin�rHosEvaowsior�s ISSUANCE � 7,�-i ��r�_v� O C'� �q p DATE: • � APPLICANT. � /L� ��X2.� SMIP „� `y C��J —W+ ENERGV P/C�1 I I I ��:�:' G;,Li-_1 � WARNING:FAILUflETOSECURENJOPICERS'COAIPENSATqNCOVERAGEISUNU'NFUL.ANDSHALLBE �y SU&IELTANEA1PlOYERTOCRIMINALVENAlTIESAN'�CMIiWESUPTOONEXUNDREDT110USAND ENERGYPERMIT DOLWtS(S 100.000).W ADDITON TO THE COST OF COAIPENSATION,DAMAIES AS CiiOVIDED FOR IN ¢ SECTION770BOFMELABORCOOE,NTEREST,/NDATTORNEYSFEES. � RETENTIONFEE: � CONSTRUCTION LENDING AGENCY ' PRE-ALT FEE: � IHEREBV/�FfIpMUNDER�ENPLTVOFPERJViivTMATTHEREISACp�STRUCTIqJIFNDWCACENCV � FOR TME CERf-0RAIANCE OF TNE WORN FOR WHICH TNIS PERMIT IS ISSUED�S[C.�oGl,tIV C.) �`J � Z W � LENDER'S NM1E F LENOERSAOORE55 1 w ICERTIFViHATIHAVEREADTH15APPLICATIONA7JD5TATETHATTHEA80VE1NiONAATqNISCORRECi. TOTAL FEES `X/„ � � � I AGREE TO COMPLV WITH ALL CfiY INO COUNTV ORDIYANCES ANO STATE U'�REUTINO TO BVLLOING ';J ) '� � � fANSTRUCTION,ANDHEREBYAUhqR12EREPRESEMATIVE50FTMI5COUNTYTOENTERUGONTHE � (� O!� `�`` � Z ABOVE�MENTIONEDPqOFERttFOflINSGECTIONVURPO5E5. i COMMENTS �r � V� �j 0 � �1 CnC�t�-�Oi 1G'-!�P-�►s�U ¢ .�EacatrrcFNM+E.(PB�rAf�_ 1 /p-� (� ,� f � ��_ �'V(I,J .���t%/i —1 ��[/2�rf A � SIGNATURE OF PERAIJTTEE� ' �TE/'I � I \ � , RECPT.NO. (U-J I PAID BY *� VA�IDATION - WHITE—Department Copy,YELLOW—Finance Copy.PI4K—Assessor Copy,GOLDENROD—File Copy,GREEN—AppticanCs Copy ; ^1 ` �a-L 'i ,��- Q:i�:[.�'G�i`.'� i.=:T": Ci+.�, �-6.,v"s^i�P'f,' �';i:':r�.:.:r.j �, -------f---- .,._ _ ____... __ - .. __ �.,. ..' -- .__—-_.. _.. ,_.�_.. _...--------.._ .----- �_'qv lal..--- —f,C ._ �.. I����,"�C ,r.,,�Crla`E "7�..� = 1;'!= "_ )Rt li�1:iC �'1', li'� r . ' `t:a:.�; �I�� - � . , - - , ; - - SET 6ACP; ! , FLOOR J�I�T ' • , --- -- I ------- - •--- ' � --- ---- FTGS!FOR'�1S!�TEEL � '� ' i FHA REQ'l.TS I ELECTRIC GROUfl� , ' Ui�:�ER FLO�R DU�T � � I �-�-- ' --- - ----- -- — �— GRQUi1D PLUi:iolt�;G �I _�_! U�1��R f�LO'J, CU`��DUIT i __ _�_ SLF,B GRAD� I ' FIREPLAC� FOUt�!DATIO'1 ~ I TE��iP PO4VCR � _y� � __i I FIRFPL.AC� BO�J� 6EA��" � , _ �VATER SERVICE I ' � P�11D f IT. EO.'J�J B�."�t' ' ' ' ROOFSHEl�THIN�, �--_�1_�- --I , � FT. 6C�,.'� BE:n�" -•- ...--- _'_—__.- -- ----- �: i . , FRA�AIiJG.NEtJTILII',TION � � __ � i FINAL 60idD GEF,P: _ ROOF COVER 'i I � � PRE-GRADiiJG - - • � • .-�'^� . `, , ROUGH HEATIN� I� BE�1CF�llh;�a _ � � .. �� �. • ' ROUGH ELECTRIC �� _ � ` _� ROUGFi GR_ADIt1� ' I � ROUGH PLU`�"BING �— j--_ ��FI[��L'SH GR��Dl�JG �-- � ---, Sf-{�1�^JER:TUB TFST � I � � POOL ELECTRIC � EY.T. L1'�TH'SID!�JG � � � ; POOL FEPd�RdG � � . l'J,4LL IfJSUI��TION �— -- �-- — � ' PCOL FIidAL --- I I - CEI�Ii�G IP��SULATIO��; ! OFF SITE I".1FS. I ; �_i DRYI"1F,LL flAI�I�JG � � I � DEDI�ATIO��1S _ _ � � —1--- — 5E4VER � ( � FINAL ENG SEPTICTAtJK � , ( � LANDSCI'+PEIIRRIG. � SEEP PIT/LL � 'I � OfJ SITE I":iPS. GAS�IR TEST _ � rRJqL zordlydG � � FINAL CO`�ST. �9_I y-�, } �-� �lr.E D�rT. FINAL � FINF,L HEATIPJG I ��• �.�'�--{_ HEF;LTtI DEPT. FI�JAL FI'�!',L ELECTRIC ��� � DEV. FEES ?AiD } FItJ/'�L PLU`l;EIPJG � � EPJERGY �_ -�'-('�-/t-_ ��?�,�.� � - ,.- .:-,-�-_ .__-. -�---- . . ---.__._.,_.__ �. . . ,_ _._ . .. , . . ---- ----- -----._� _ .._ . � � CUiJi1+�ENTS -- --- -- - -------. - -- .- - - -------_�,_. SEPTIC TA��I�: SIZE SEEP PITiU SIZE ----- -- _____-- �,I ��i�, _ _ �, ' _ • , 4 � � . • ' , w a+ . . . 1