HomeMy WebLinkAbout18318 (44) _ I _�\ CITY OF DIAMOND BAR - �
� ,� DEPARTIv�NT OF COMMUNTfY 8c DEVELOPMENT SERVICES
21s2s E.copiey Drive PRESS
~ (909)8603195 Fax(909)86l•3117
�""'� BUILDINGPERMTTAPPLICATION . FIRMLY
� JOBSITE j APPLICATION / PERMR P/C
o ADDRESS � �� e�' l�'ryn' DATE � jt7 �Z� NUMBER� � �f a2, Z�R
� APN LOT TRACT DA EE ` �� O ONST. GROUP
p OWNER
"' ADDRESS ZONING EfBACKS
� CITY ' ZIP TEL.�Q�1�. FRONT RW O
APPUCANT � TEL SIDE/SIDE STREET RW O
� CONTRACTOR ' no SIDE p
O CrD�OrRES� � ZI TEL - .. ������� PROPOSED USE • G �Q T� O• ,
o ARCFVENG/�� ��_���''
� DESIGNER NO.�WEL NO. NO.
ADDPESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
�n DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION
p� ONRJER-BUILDER DECLARATION SFR/ADD/REM
O
p (HEREBY AFFlRM UNOfR VENALTV OF PE0.AIRY THAT 1 AM E7(EMPT FROM THE CONTMCTOPS l4 G9IBQB/C8ry0fI
W CENSEUWFORTHEFOLLOWWOREASON(SEG7a71.6BU5INE53ANDPROFES510NSCO0E:ANYG7'/ON (n
�.7 COUNTYWMIQIREGNFlESAiERMRTOCON3TFiUCT,ALTERMGROVE,DEMOLI9N,ORREPIUH/WYSTRUG W PBfIQ�BCk
u NRE.PRIOR N RS ISSUANCE.AL50 REQUIRES T/1E APPLICAHT FOR SUpI YERMIT TO FILE A SiGNED W
� STATEMEM iHA7 HE OR SHE IS LICENSED R/RSUMR TO THE PROVISIONS OF TME CONTMCTORS L4 �
� CENSEUW(CHAPTER�(COMMENCINf�W1THSECT10N/0D0)OFOMSION]OFTHEBUSIHESSANDVR6 POOI�Spe
FESSIONS COO�OR TFiATHE OFI SHE IS E7CEMPT THEREFROMAND THE BA515 i0R THE ALlEOED EXEMP•
TION.M('IVIOlAT10NOFSECT10N70�1.68YANVMPIICANTFORAVEIIMIT5U61ECTSTMEMPUGNTTO Z Re-Root
F ACMLPFNALTVOFNOTMORETHANiNEWN�REDDOLLARS(i600).�:
� OL�"OM�NEROfiHEPROPfR7Y,ORMYEMPLOVEESNATHWAGESASTHEIqSOLECOMPENSATION, � �mmerGal . —
WILL DO THE WOiLC,MA TIE STRUCTURE IS NOT ufTENDED OR OFFEREU fOR SALE(SEC.7oa�,BU51• J
N NE53 AND iROFES51ON5 CODE:TME CONTHACTORS LICENSE UW DOES NOT ACPLY M AN OMMER OF j
iROPER[T WNO BU0.D9 OR IMPROVES THEREON,/�NO WHO DOES SUpf NORK NIMSELF OR HERSELi OR
Q THROUC,HHISORHERONMEMCLOYEES,VROVIDmTHATSUCHMPROVEMENTSARENOTN7EtAE�OR m
� OFFEREDiORSALE.IF,110WEVE0.7HEBULDIN(lORIMPROVEYEH7650LDWRHINONEYEAROFCOAIVLE-
Z TK)N.THE O'AMERBUIDER YALL FUVE THE BURDEN OF pROWlU THAi ME OR SHE DID NOT BUILD Ofl
= WOqOVE FOR THE VURPOSE OF SMF4
w OI.ASOWNEROFTIIEVRO�EHiY,M1f7lCLU5NELYCONTMCTwOWfiNLICENSEDCONfRACT00.5
� TO CONSTRUCTTHE PRO.IECT(SEC.7Du,BUSMESS AND PROFESSIONS CODE TNE COHTMCTORS U- V91W({Ofl � ADJ.AREA
CENSE UW DOE9 HOTMPLY TO AN ONNEH OFA PNOPERTY W/q BURDS OR MPROVES TNEREON,AND
� WFIOCONIMCTSFORSUp1PR0.1ECT5MATHACOMMGTORIS)UCENSEDiURSUAMTOTHECAHTMG OUANTITY DESCRIPTION FEE �
� TORS IICENSE LAW.�. 'i J
0 O IAA1 E%EAIPT UNDER SEC. B.l P.C.FOR THIS REASON Q
3 �
u" DA7E OYMER �
Z W
�¢ i UCENSED CONTRACTOAS OECLARATION W
CL IMEREBYAFFIRMUImERVENALTYOFVEiWMTHATIMILICENSEDUNDERVRDVISqNSOFCMAGTER Vr .
p� •(COMMENCPION7MSECTION700010FDMSION70FTHEBUSINESSMlDVNOFESSIONSCODE,MI� Z
X W LICENSE IS N ML fORCE AND EFFECT. m
� UCENSE CU55 C 3 9 UC.NO. � �� � j
�- ����/�3- coNrrucroa a
DA7E
W �T
� WORKERS COMPENSATION DECLARATION 4
� ! U
N 1 HEREBV AFFUUA UNDER PEtULTV OF VE0.1UM ONE OFTHE FOUAN'iN0 DECURATIONS
N �� _IHAVEANDWIILMNMNNACERTIFlUTEOFCONSEMTOSELNNSUREFORWOqNERS'
C0�IFENSATION,ASVROVIDEDBYSECTION�MOOFiHEVBOHCOOE,FORiMEPERFOfiMANCE W
OF iME WORK FOR YVIIICH THIS PERYIT�S ISSUEO. �
0 I
Q _I HAYE AND VALL MNMAM WORICERS'COMPENSATION W SUMNCE,AS REOUIRED BV SECTION
�7000fTHEU1BORCOOE,FOHTHEiERFORMANCEOFTMEM'OPoCFORWHICMTHISPER1AiT13 1
� ISSVED.MVMUPoCERS' FENSATION INSUJi�N CE CARR�ER/N�VOLICY MIMBER ME CONSTRUCTION '� Z •��+
� GRRIER ���. �' A CI PLAN REVIEW t�Z• l
� va�Yt+uuBER � _ � ELECTR�C
!-�fiz-.�r
o �ssEcnor+r�wrgeme.nFrtvoFnEv�+rsronor+e�ua�ooauru�s+ao�oatEss} PLUMBING
Z I CERTIFV THAT W THE PERFORMANCE OF THE WORK FOR WHIp17H15 VEfUAiT IS 65UED,I MECFIHNICAL
(} SHALINOTEMPLOYANYVERSdJNI7lYMANNERSOASTOBECOMESUBJECTTOTME
N NORNERS'COMPENSATIONUWSOFCAIIFORNtA,ANOAGREETIUTIF151qULDBECOME INSPECT�ONFEE /y�
S , SUBJECTiOTHEWD(U(ERS'COMCENSATIONVROVISIONSOFbECT10NJ7oDOFTHEIABOR �SSUANCE '� •vv
COOE.I SHALL FOHri1vATH G�MPLY WITH TIOSE PROVISqNS.
� DATE��� SMIP •�''Q
� APPLICANT: _ .
w ENERGY P/C
WAiWINQFAILURETOSECUREVIORKERS'COAIVEHSA710NCOVEM0E15UMAVYFLA.AND BE
� SUBIECTANEMPLOYERTOCRIAIINALPEWlLT1ESANOCMLfWESUPTOONEMINDREOT/qUSANO ENERGYPERMIT
OOLLMS(ila0,0007.N ADqTON TO T1E COST OF COAIPENSA710N,OAAIAGES AS PROVIDED FOR IN
¢ SECTIDN770lOFTHEUIBORCODE,INTEREST,ANDATTORNEYSFEES. RE7ENTIONFEE: ' O�
a ' CONSTRUCTION LENDING AGENCV PRE•ALT FEE:
O
� IHEREBVAFFIRMUNDERiENALiYDFPERR1RYiNATiHERE15ACONSTRUCTIONLENDWOA�ENCY
FOR iHE YERFOMWICE OF 71/E WORK FOR N7�ILN TMiB iENMiT IS ISSUEO(SEC.M7�,CIV.CJ.
� LENDER'SNAIAE 1
� IENDER3/�DDRESS ' 1/�
� �CEpTIF'/TUTIHAYERFADTH�SMPIICATIONANDSTATETHATTHEA80VEMFOH1AATqNISCORRECT. TOTAL FEES lo2r 4� � � /�
W IACREETOCOM7lYWITHALLCITYANDCOUNTYORDINANCE5NID5TATEUN5REU7MaTOBUILpNO
� CONSTRUCTION,MIOHEREBYl1UTMORREREFRESENTATrvE50F1/uSCOUNiITOENTERUPONTME �
� ABOVE•IAEHTIONED FR/O'VER7Y FOR R15PECTION GUFiPOSEA COMMENTS ��
�J �Y"V�,lO �
�
¢ OERutTTEf NAAIE ryRINn ' �{
�n �� �//�/.Z
� 9�TUREOFPEMUT7EE OATE� '
� � RECPT.NO. PAID BY VALIDATION
. WHITE—DepartmMt Copy,YELLOW--Finence Copy�PINK—A6sessor Copy,GOLOENROD—Fik Copy.GREEN—ApplicanCs Copy
\
� . 'L�2,� 3
... ,,.,.: ,. . _ . , ...: . . . ...
CITY OF DIAMOND BAR •
INSPECTION RECORD ~,`^`�`
�i`�-�:1���[�►�C �'r��� �1��-`��3c��c�� _ . . ll}�-����`�FI��w �:���:_� . I�ti�-��I.��:'.o=�
SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING � UNDER FLOOR CU�IDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE � MID HT.BOND BEAM
ROOF SHEATHING �02 8 FT. BOND BEAM
FRAMINGNENTILIATION + � FINAL BOND BEAM
ROOF COVER �12 a2- , PRE-GRADING
ROUGH HEATING BENCHING
. ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWERRUB TEST POOL ELECTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION ' POOL FINAL
CEILING INSULATION OFF SITE IMPS.
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
� �;�!s iej: �c c; �
..�,�,�_____._.._,_
COMMENTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
�1�.� '
�
�;,�f� -i�
J
r�