Loading...
HomeMy WebLinkAbout16604 (23) � �� 1 CITY OF DIAMOND BAR DEPARTMENT OF COMMiINITY 8c DEVELOPMENT SERVICES � 21660 E Coplcy Drive Suiu 190 � (909)860-3195 Fax(909)861-3117 PR E$$ `'w'� BUII.DING PERMIT APPLICATION FI MLY � JOBSITE .- 1� APPUCATION � PERMIT 'n P!C o ADDRESS I � �-A�V DATE NUMBER �y �r � ISSUE� TYPE OCC APN TRACT DATE CONST. GROUP � OWNER ���� � ADDRESS ZONING SETBACKS � CfTY ZIP TEL � _- � R�R RW O APPLICANT TEL SIDE/SIDESTREEf RW O � CONTRACTOR �/gl � SIDE ❑ � ADDRESS t- �' PROPOSEDUSE ' jN "�'L( � � W�l/ CfTY ZIP TEL � 7-- � ARCH/ENG/ � _ _ .. DESIGNER NO.DWEL� KO. NO. ADDRESS UNRS STORIES� BEDROOMS � CITY ZIP TEL v� tn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OVJtJER-BUILDER DECLARATION SFR/ADD/REM O . p I NEREBY AFFlRM UAER VENAL7Y OF GERIURY THAT I AM DtEMPT iROM THE CONfMCTORS L4 Gaf8g91CafpOA � lL CENSEUwFORTHEFOILONVINOREA90N(SEG70.1f.68USiNE55AN00ROFE5510NSCODE:INYCITYOR (n S7 COUNTyWH1G1pEOtAqE4ACEWARTOCONSTRUCT,1LLTf0.�P��E.DCMOLISH,ORREPNRANYSTAUG W �V 7URE,Pf110q TO RS ISSUANCE.ALSO REWIRES TNE AVPLIGNT FOR SUpI PERAnT TO iILE A SIGNED W Patlo/Dedc � STA7EMENT TFIAT ME OR SHE b LICENSED PURSUANT TO iFIE PROVISIONS OF THE CONTMCTORS Lb � � CENSE UW(i.MMTER Y(COMMENpNO WfiH SECTION 7000)OFDMSqN 7 OF THE BUSME55 M10 PRO- PooVSpa � FESSIONS OCOE)OR iHAT XE OR SME IS EXEMPTTHEREFRqA ANDTHE BASIS fOR THE ALLFOED ExEMP• TqN.AHYYqLATqNOFSECTI0N7W1.68YANYAP7LK,+WfFORAVERMITSU&1ECTSTHEAPPLICMlTTO Z pe-Rppf ZZ � ACIV4.VEWLLTYOFNOTYOqETHANFNEMMDRED00LUAS�fSoo�.)� � OLASO�MNEROFTHEPROPERTY,ORMVEYPtAYEESWI7HWAGESASiHEIRSOIECOMPfNSATqN, D �mmerclal . - WILL 00 THE WOi1K NA THE STFX1CTl1RE IS HOT IMENOED OR OFFERED FO{i SALE(SEG 70��,&156 J � HESS Af0 PROFE5510N5 CODL TNE CONTMCTOItS LICENSE Uw DOES NOT APPLY TO AN OWNEH OF ? PNOPEHiY YVNO BUlDS Ofi YVROVES i11EREON,AND WMO DOES SUCM WORK MIIASELF OR MERSELF OR Q 7Hfi0U011 NIS qi HER OWN EMPLOVEES,iHDWDED iHAi SUCM M1PpOVEYENfSME NOT WTENDED OR m � ,OFTERmiOHSALEF,FpWEYE0.THElULDINf]ORMIPROVEMINTISSOLDWRIENONEYEAqOFODMPIE- Z 'TqN,7HE OWNERSUILDER WILL MAVE THE BURDEN OF PROVW6 TUT HE OR SNE DD NOT BUILD qi = IMPRDVEFORif1EVURPOSFOFSALE} ' W OI.ASOWNE110FMEVROPERTY,AAIE%CLUSNELYCOHTMCTWONrtTML10ENSEDCOHTMCTOR3 � TO CONSTRUCT THE YRQIECT(SEG 70N.BUSINE39 AND iPOFESSIONS CODE 7HE CONfMCTOR4 L4 VBIUBiI0f1 ��_ AQI.AREA � CENSEUWDOESN0TIIPPLYTOANOWNEROFAYROPERTYW/qBUIL�50RIMPHOVESiMEHEON.IWD YY/qCONTRACT5FOR5UR1PR0.JECT3WITHACONTMCTOR(SJI�CENSEDPURSUulTiOiNEWNTPAF QUANTIN DESCRIPTION FEE � lOfiS UCENSE UWJ. . ._"_�_' ' ' '__ ' .. . O I MI E7(EYPT UN�ER SEC. B.1 O.C.FORTHIS REASON Q � � � / U LL ¢ DATE ONNER V . � � LICENSED CONTRACTORS DECIAFiATION w J � W IHEREBYAFFIRMUNDFRFENILLTYOFPEiWRYTNATIAMLICFNSEDUNDERVROV1510NSOFCHAPTER � s �(COYMENCtJO NrtT1/5ECT10N 7000)OF DM510N]OF iHE BU51NE55AND PROFE55�ON5 C00E,AND Z X W LICENSE IS IN FULL fORCE MiD EFFECT. m ��.... UCENSE CUSS C �� ���.No. (�r 9 3 0 4�i � _ � t> DATE��CONTMCTOR �� d . . . � .- — LTJ � WORKERS'COMPENSA7ION DECLARATION 4 . NIHEREBVAFFIRAIUNDERPENALTVOFCERIURYDNEOFTHEfOLLOW:NODECLIIRATI0N5: Z � _IwtVEANOWILL1.WNiNNACERTIFlGTEOFCON5ENT705ELFaNSUREFORYpluCERS' $ � CpAPEHSATION,/lSPROVI�E�BYSECTIONJ7000FTNEU80RC00E,PoRiNEPERFORMANLE W T. Q OFTHEWORKFORMM1Ad1TM5PEiWIT19155UED. � �I HAVE iV70 VALL MARrtAP1 W'O/MERS'WIJPENSATION INSURANCE.AS PEOUIqED BY SECTIWI � ]7o00FT1fELADOR000E,FORTMEGERFORAIANCEOFTHEWOR1CiORWHICM7H15GEN.�R15 ISSUED.A(YMIORKERS'COYPENSAipNINSURlU10ECARiYERANOPOLICY'NJUA�ERAR[: CONSTAUCTION � CARRiER G��j��� ''�N J�� PLAN REVIEVI .. . � 0 POLICYMl1ABER_ ��'7 I� � �--�—�.—T—T� ELECTRIC � (ri�55ECfnNN[�Noi6Em.ptFfIDOFTEVEii.risPoRONEMf��Ootil3YSR�m�Ot�lF55} PLUMBING Z 1 CERTIFY TIAT N T1f OEPfORMANCE OF THE WORK FOR VMICH THIS PER/AIT IS ISSUED,1 MECHANICAL (} SWLLLNOTEYPLOVl1NYPENSONNANYIAANNERSO�STOBEC0IALSUBJECTTOTHE � WORKEflS'CA4VEHSATqNUWSOiCALIFORNI.\ANDAGiiEETMATIFISHOULDBECOME INSPECTIONFEE � S SUUJEGTTOTHEIMDPoCERS'COYPENSA'pNPROVI5qN50F5EGTqND7000FTMElA80R e,� wuJt nrcoua�rwm�n+osEVRo�sans. ISSUANCE o ^ � p DA7E: y� AaPL�CANT: . L �SMIP � v_ � ENEi7GY P/C WIlRM1q:FARURETOSEWREWORKERS'COMPENSATIONCOVERA EISUNUwFl1LAND5wLLlBE � SUBJECTIWENPLOYERTOCRIMPULPEN/�LTIESANDCMLFINESUPTOONEFRINDRCDTHOUSWD ENERGYPERMIT D�LURS It100.OW).N ADDRION TOTHE COST OF CqADENSATION.DMIAGES AS PROVIDED FOR W ¢ SECTqN77oe0iiNEUi80RCOOE.NTEREST,AND�lTORNEY5FEE5. ' RETENTIONFEE: � oCONSTFUCTION LENDING AGENCY PRE•ALT FEE � IHEAEBYAFFIiWIIN�ERPENAL7YOFPEPJURY7HATTHEREISACONSTRUCTIdJLENDIIJ�ACENCY � Z FOR T11E iERWM1ANCE OFTME WORK iOR Vn/1O1 THIS VERYIT 6155UE��SEG]OY7,CIV.G). W � LENDERS NAYE . � lENOER'SADDRE55 � ICERTIFYTHATIM�VERFlDTHISAPPUCATqNIN�STATE7NATTHEABOVENFORMATqN15CORRECT. TOTAL FEES � I �5� I � � IA6REE TO CdAPLY N7TN�LL CRY AND COUNTY ORD WANCES AND SiATE UWS REUTIN6 TO BU0.01NC � CONS7RUCTqH,/�NpNEREBYAUT1qR12ERECR[SEMATfVE50FTMISCOUHTYTOEMERUPONTHE ' - � ABOYE•MEMTqNED VROPERT'/FOR INSPECfUN FURPOSES. COMMENTS _ ��� . . . m iERAUTTEE NiWE�FRI ' " � � 4 � �- o ( y S�ONA7URCOFVE DATE J/ � RECPT.NO. PAID 8Y VALIDATION 1NFiITE—Deperlment Copy,YELLOW—Finance Copy,PINK�Assessor Copy,GOLDENROD—File Copy,GFiEEN—Applicant's Gopy / , ..., .... ;T.•.. . .l•: � "i'. ,.: . . � �' . .... :l� , .. '�'..ti: ./`... a..n�l�. ....� i.. ..� � o..r�.a .. .. . ..._.. „ .. . .:1 . ... . % . _ -- . � CITY OF DIAh4�ND BAR . ,� , . � ',; . -. � RJ�SPECTi lON RECQRC? '. � . . . , � � ��1�.���� 6 r`�� .1R: � I� e _`�S`F��,, .. � ��F'.�Es�..�: � ����I��.�F�. 'SET BACK., : '. � `, . . i� : I; :_= :I •. � FLOOR JOIST - u• • . � !FTGSlFORP,AS/STEEL '- � - ' -•.; �-� FHA R�C2MTS . - - ELECTRIC GROUND _.._ __._. ; ` ' : - .! :'' . - UNDER FLOOR DUCT •• • - iGROUND PLUP�161NG UNDER FLOOR CdMDUIT = ' ' ' ' ' - iSLA6 GRADE `• - --- � - ` FIREPL.ACE FOUNDATION , �. ITEMP POWER . � � � FIREPLACE BOND BEAM - � � ' � WATER SERVICE MID HT. BOND BEAh1 � � � . — -�- � � �• iROOF SHEATNIPdG•�• b�;�-pi 6 Ff.BOND BEAhII� : � ` ' � ; ; � FRAMINGNENTILIATION •- � ` � � "� FINAL�BbND BEAM I ' ROOF COVER .. ' �� ' �'-'-'-'-- ' PRE-GRADING - - - � ;ROUGH H�ATING BENCHING • 'ROUGH ELECTRIC _ : . . ROUGH GRADING �ROUGH PLUh1BING - ---- - ' �� FINISH GRADING ;SHOWER/TUB TEST POOL�ELECTRIC • �EXT.LATH/SIDING - � ---- - - POOL FENCING ;WALL iNSULATION � - -:- POOL FINAL � � ;CEILIfVG INSULATION OFF SITE IMPS. ,DRYI,'VALL NAILI�JG DEDICATIONS �SEWER FINF�L ENG. �SEPTIC TANK LANDSCAPE/IRRIG. �SEEP PIT/L.L. "' ON SITE 1��1PS. ;GF,S kIR TEST FINAL ZOhI�JG 'FINAL CONST. ^"'�DEPT.FIPJAL FIiJAL HEF�TING _ _ HEALTH DEPT. FINAL FI�JAL ELECTRIC - DEV. FEES FAID � � #�f"!AL PLUD�BING ENERGY . }— . _ � .. . .. . . ..- � - -. .,. _ .. _ .. `x��:�i��;r�Y�.G��..�,.., . � . . . . . . .. . . . .. . . . . . , ..... . . _ .. . . . . .._.._.. . . - -- - — - _.. . . • �_ :1 . . . .. . , . � . i ... . .. . ._ . . . �COMMENTS � ':�' , . -, � , . � i : � ! '. � i � �. , . - , , . � . � . ; . , , ,_ , � - ; . , , � ,:. _ . � ' • _ � . � ..� � _ SEPTIC TANK SIZE - ' � SEEP PIT/U SIZE ; , . . i -�---�-----------� - i� ��F � ����.� . ��' .. . � , . � , , . ;�`�., .3:. i � , . . .. . . � ..ir��-.,+�``.�... - ... r 1 . � � ' � � - y .. .,.., �. . � • � ; .. . _ . . - � . ' ' �.:�G � � . . . . ' . . , . � . . :.: � ._..'-" - . .. . , ' .. . � , . .� . � 1 � � ' ^ ' • . . / V�.-------------�' �' ` '1 t � - . - • - .