Loading...
HomeMy WebLinkAbout12620 �.., CITY OF DIAMOND BAR --- — DEPARTMENT OF COMMUNiTY&DEVELOPMENT SERVICE3 / � �.�� 216b0 E.Copley Drive Suite 190 �-•` (909)660-3195 Fax(909)861-311? rRESS ��^�^�+ BUII.DING PERMIT APPLICATION FIRMLY oJOBSfTE APPLICATION � ,,.� PERMIT 7/� P!C ADDRESS��►�- 3�13 �o`� �"�A�o'� pATE_ NUMBER `"f/' �I � ISSUE TYPE OCC .- APN��- LOT TRACT OATE CONST. GROUP � OWNER 17►'C� Na� ' ADDRESS� � 't�A 6e'� 6 ZONING SETBACKS CITY �n�r4 �+"R ZIp 4J?6+r TEL�a9`��'�Z FRONT RW ❑ APPtICANT Grt� /�e. '' TEL. REAR ❑ SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ � ADORESS ROPaSEDUSE R�QF • A V�'� �'✓ �.v t � RCWENG/ ZIP TEL twGwA C���i��S3 �, � . _' A rM�`l/lCrrC DESIGNER NO.DWEL. NO. • NO. ADDRESS UNITS STORIES � BEDROOMS � CITY ZIP TEL. � v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDEH DECLAHATION SFRUDO/REM O I NEREBY AFARM UNDER PENK7Y OF PEFiIURY T/NT�AM E%EMVf FROM TNE CONfRAC70R5 LI• Q8�9e��rt CFNSEUWFORTMEfIXLOWINOREA90N(SEC.7031.681AINE53ANUYROFE5510N5CO0E:ANYCIIYOR (n COUMYYYHIo1REOUWESAPERMRTO00NSTRUCT.ALTERIMPROVE,DEMOUSH,ORREVAIf1ANY3TAUC- W pgtiolDBdc TUqE.PqIOR TO ITS ISSUMICE.ALSO REW IRES TlIE MPLICANT FOR SIICH PERMIT TO f0.E�SIONEO W l7A7EAIEM THAT ME OR 9HE IS L1CBdSEO PUpSU1WT TO THE PROVISIqJS OF THE ODAfTRACTORS Lb CENSE tAW(C1IAPTER�(f�1AMENCIN0IMTM CECT�ON 7000)OF DMS WN 9 OF 7ME BUSINESS NJD PNO- LL POOVSpB FESSqN3 COOE)OR T/NT IE Wf SHE IS EXE4PT THEREFiqAI MID THE BASIS FOH hIE ALLEDED EXEMP- �� TqN.ANYYqUTUNOF6EGf10N7Wt.68YANYAPiLICANTFORAPEflMITBUBJEGTSTFIEAPPLICA�f�TD� �•ppp} � ACN0.iENJILII'OF NOT MORE TNAN FNE NUVOREO DOl1AR5�t5o0).�: � ' � �tA60WNEROFTlEif10PERTY,OiiMYEMPIAYEESWITHWM7E5A9THE1R90lECOMVENSATION, � (',pmmBfC181 -� WILL 00 THE WOPoC AND THE STRUCTURE IS NOT INTENOE�OF OFFERED FOH SALE(9EC.1014.8U51- J N NE55 ANO VROFESSIONS CODE TME OONTRACTORS LICENSE LAW OOES NOT ACPLV TO AN OWNER OF MOP6RTYNM1IOWID&ORIIAPFiOVE91MEREON,ANDWHO00ESSUCHWORKMIMSELFOpHERSELFOR � � TFAiWOH HIS OFi MEA ONN EMPLOYEFS.PROVIDED 1'FU1T SUqi IMPROVEMEMS ME NOT IMENDECOR m OFFEREO FORSALE IF,HOYVEVEF�iNE BUILDINOORMIP110VEMFNT19 SOID WIIHNONEYEMOF COMPIE� TqN,hIE OIMIER-0URDER YALL W1VE TME BURDEN OF PHOVINO TFUT HE OR 6HE OID Fp78UIL0 OR� W PIqYE FOR T11E PURPOSE OF SALE} 04�D'NNEROFTHEPROPEHfY,AMEXp.USNElYODNfRAC7W0`MTHLICENSmCONTflACTOfiS � � TO CONSTRUCT fT1E PROJECT(8EG 7GH,BUSINE58 MA PHOFESSIONS COOE:TME CONTRACTOpS U-' VelU9liOn o o a a ADJ.AREA CENS[LAW DOES NOTAVPLYTO AN OriNER OF A PROPERTY YYFIO BUILDS OH MPROVES 7HEREON.MD WIqOONTAACT8PDR8UCMVROJECT9N7h1ACdl�RACTOR(5)LICENSEDPURSl1AMTOTHE00NTMG QUANT�TY DESCRIPTION F�E � 1bRS LNYN66lAW.�. . . . . O 1 AM IXEIAPT WIDER 9EG. 8.!P.C.FOR THIS REASON 4 U � – '�� � DATE OWNER .� � L�CENSED CONTRACTORS DECLARATION W � I HEREBYAFFiVA UbER PENKTY OF PERNJRV TH�71 AM LICENSE�UNDER PROVISION9 OFCNMTER � � f(COMMENCNO YATf SECTION TaoD)OF OMSION 9 OF THE BUSINE55 AMD PROFESSIONS COOE,AND Z �V W LICENSE IS W FULL FOHCE AND EFFEC7, m � Uf;ENSE CLA33 LIC.NO. � � pATE CONTAACTOR d WORKERS'COMPENSATION DECLARATION � � I NEREBV AFFIRN 11MDER DEWLLTY OF PE0.IURV dJE OF THE FOLLDWING DECLARATIONS: Z � _IHAVEMIDMIILLMAMITNNACERTIFICATEOFCON9ENTT08ElF-INSUREFORWOHKER9' _ CpIPEN5A7pN,A3PROV10B8Y8EC710NS7000FTHEUBOACOOE,WNTHEPERFORIMNCE `U OF THE WORK FOR WHICH 1HI3 PEpYIT 18 ISSUED. � eF _I FUVE AND WILL YAIMAIN YVORKER6'CCMPENSATION IN6URJW CE.AS RECUIREO BV BECTION /] Q870o OF T/fE LABOR OODE,FON 7HE iERFOXMANCE OF THE YNOR1c FOH WHICH THIS PEHMIT IS . 2 v+ J ISSUED.MYNpRKERS'COMPENSATIONINSUFUNCECARRIERMDPOLICYNUMBERME: CONSTRUCTION �4)t, Y � CARRIER PLAN REVIEW � ra.�cYNUMeER ELECTRIC � �nfssEcna��woreeca.R�DOFnerendrt�xAor�eM�moau�Rim�art�ss� PLUMBING Z I CENTIiYTHA7 N THE PEHFORAIANCE OF THE NIORK FOR YNilpi THIS PERMITIS ISSIIE�.I MECHANICAL (� SHALL NOT EMPLOY ANY PEASdJ IN ANY YI,AINER 60 AS 70 BECOME SUBJEC7 TO TNE �j WORNERS'COMPENSA?qN UWS OF CALIFORNI,�AHD A4REE THAT IF 1 SNOULD BECOME INSPECTION FEE � 8U&IECT70 THE WORKERS'COMPENSI1TqN PROYISIONS OF SECTION�700 OF THE UBOR OODE,I SMALL FOR7MVA7N COMPLY WIh1 TIqSE PROVISIONS. �SSUANCE ♦ � DATE: APPLICANT. SMIP WMMNO:fALURETOSECURENKNV(ERS'COMPENSAipNWVERAOEI&UNLAWFLL,MIDSHALLBE ENERGYP/C�rt.�..��.,,� �y BUBJEGTANEMPLOYERTOCRIMINILLPENALTIESANOCIVILFINESUPTOONENUNDREDTYKKISMID j OOLlAN3(ilOD,000J,INKIDITIpVTOT1ECA5TOFCONPENS11TqN.DAMAGESlSPROVIOEDFORIN ENERGYPER ¢ SECTI�N370eOFTNELABORCOOE.NJTEREST,ANDATTORNEYSFEES. RETENTIONF OCANSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 XEREBVAFFlRM UNDER PENALTY OF PERJURY THAT THERE 19 hGONSTRUCTION{.ENOINQ AOENCY Z fOfl 7HE PERFOflMIWCE OF TME WORK FIXi VIMIGI TTi15 PEflN1T IS ISSUEO�SEC.709'/,CIV.CJ. W � LENDER'S NM1E � LENDER'SAODRE55 W� TOTAL FEES ,. ICERi1FYTNAT111MEREAD77115AVPLIGTIONAN03T11TETHATTMEA90VEWFORM�T10N1900fiflECT. d IA�RE�NCOMGIYWRHALLCRYANDCOUNTYOROMLWCESANDSTATELANSREUTNO7OBUILDINO , "� CONSTRUCTION.M1D MEREBY AUTIIOHRE REPRESENTATIVES OF iHIS COUNTY TO EMER UPON THE � ABOVE-AAENTbNEO VHOPERTY FOH NSPECTqN PURPOSES. COMMENTS � Grt�j fVo�lb�+N � PERMITTEENNAE(PHINT� . �, � �,� N—d-s'� 1 �cC Vj iNiNA7URE0 7MIT�EE OATE ��/� - � / � RECPT NO. PaD BY _LQ VAL1DAl10N 4VFIITE-0epartment Copy,YEILON!—Finance Copy,PINK—Assescor Copy,GOIDENROD--File Copy,GREEN�ApplioanPa Copy CITY OF DIAF�tOf�lD BAR � INSPECTION RECOFiD � � ., •'� � i + ' � ' ' � � + ' t ' SET BACK R. ' i I FLOOR JOIST ;,. ,, ;., �., ;„w�•�, ••� 1' r, :;,.. FTGS/FORMS/STEEL � FHA REflMTS ELECTRIC GROUND . UNDER FLOOR DUCT �, ,,, ; . GROUND PLUMBING UND�R FLOOR COI�IDUt7' • ` '•'• �'=�� ' ' 1'r.' SLAB GRADE FIREPLACE�C3UNDA710N '- `' ` � '``' • TEMP POWER � FIREPLACE BOND BEAM ` WATER SEFIVICE MID�MT.BOND BEAM R OFv�'H�ATHI�fG � : ��� =14+� ��"a��x� � S.F7.BOND BEAM FFiAMINGNENTILIATION � �•�� �f •' '•� � �4� i FINAL BOND BEAM ROOF COVER /�-e13 PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING � SNOWER/TUB TEST POOL ELECTRIC EXT. LATHISIDING P(�OL FENCING ' WALL iNSULATION •1 j.�', 'POOL FINAL CElLING INSULATiON OFF SITE IMPS. � DRYWALL NAILiNG DEDICATIONS � SEWER� FINAL ENG. SEP7iC TANK LANDSCAPE/lRRIG. SEEP PIT/L.L. � ON SITE IMPS. ` GAS AIR TEST FINAL ZONING FINAL CDNSi'. l�-a3�4' I FIRE DEPT. F1NAL � FINAL HERTING � HEALTH DEPT. FIMAL+ "��'. �'- 7' � �i FIh1AL ELECTRIC ; DEV. FEES PAID FINAL PLUM8ING � ENERGY i � � — -- - - CONi�V1ENTS _ ; , . �� , . �� �;Ar�--- - - - � . 3t?�' � C'� �,(i r -- --� �,�i��.�i��}lv'113�._�'��:.% �'����l�.e — 1 SEPTIC TANK SIZE �'''�':�`1�+�''=r�<"-,Y31{.,_t,:;;Tf� E SEEP PIT/U Sl2E �, . _ ,, :-,�_�` -- , �.�-� �t '�... �, ,t:, -.