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HomeMy WebLinkAbout14035 (17) - �'' ' J,� CITY OF DIAMOND BAR ' � DEPARTMENT OF COMMUNITY 8z DEVELOPMENT SERVICES 21660 E.Coplcy Drive Suite 190 � (909)860-3195 Faa(909)861-3117 . PRESS �`'�^'� BUII.DING PERMIT APPLICATION FIRMLY � JOBSITE �I�� �J� p_ „ [�� APPLICATION ()-� PERMIT P/C �' o ADDRESS ��L� s� DATE � � _NUMBER � J3 $ ISSUE TYPE M OCC � �APN LOT TRACT DATE CONST. GROUP p 'bWNER /"� "' 1ADDRESS L � ZONING SETBACKS �'+ t�ITY ��/ IP��L� TEL. . ' FRONT RW ❑ � APPLICA TEL.� REAR � � SIDE/SIDE STREET RW O CONTAACTO � flrr 4 ( �j SIDE ❑ g ADD�SS � pROPOSEDUSE A �' v�lT G1��6Ei�'U�1'� fJ)�y CfTY + � ZIP?j�2� TEL:'�,S'�Z PfI/ � ARCFUENG/ DESIGNER NO.DWEL. NO. NO. = CnDRESS Z�P TEL. UNITS STORIES BEDROOMS � �n DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECIARATION SFR/ADD/REM O � p 1 HEREBY AFFIRN LNDER►ENALTY OF PEFWRY TMAT 1 AM ExEMVT PFqM 7HE CON7RACTOi15 U• Ga.17g0/C81pOh 11J CENSEUwFOqiMEFOLLOYYIN�RFa50N(SEC.70]1.68'JSPICSSIWOYfiCFE55lONSCOOE:ANYC1iYDR (n y �COU1R1fWWQ111E0U1RE5APEW.IR7000N5T.iUCi,ALTER�PROVE,DEM�LISH,OflHEPAIRANYSlAl1C• .. �yf �L TURE.PIIqA TO ITS 68UANCE.AL50 NEW�RES THE APPLICA!!T FOR SUCH VENMIT TO FLLE A SIGNED W Patio/Deck � STATEMEM iHAT HE OR SHE LS LICENSEO W0.5UANT TO THE FRONSIOuS OF 7NE CONTRACTdiS LI• � CENSE UW(dUPTER 0(COAI1AENdN6 WI7M SECTION 7000)Of DINSION.1 OF TME BUSINESS M1D PRO- LL PooVSpa fESSqNSCODE�ORTHATHEOR5HEI5EXE4PTTIEREFpOMANDiHEBA515F0lITMEALLE�EDEXEA1v (� T�OH.AHYYIOIAipHOFSECi10N7a7t.6BYNIYMPUtlUlTFORAPEwAiT5U61EGi5TNEMiLiGWTTO Z Re-Roof � A CML iEN/LTY OF NOT MOfiE 7wN FrvE MUNORED Dq.URS�f 500).�� � 04��NEROFTMEPROPEFiY,OR1AYEMPLDYEESWITHWAGE5A5THEIR50lECOMPENSATqN, � Cpmm0fCL71 - MALL D07HE WOFK AND THE STRUCTUAF IS NOT NTEHDED Oq OFFERE�FOR SALE(SEG 7M�.CU51• J � NESS A!ID GROFESSIONS COOE:THE COMMCTORS UCENSE lAW DOES NOT A7CLV TO AN OWNER OF � VR07ERTV W/q BUIl.D50R MIPROVES TNEREON,ANO WIq'>OGS SUCII WORK NIMSELF OR HERSELF OR � THROUGHHISORHERON/NEIAPLOYEES.ViWV10EOl/UiSUCHIMPROVElAEMSAqENOTN7EN0EDdi m O OFFEi1EDFORSALGIF,/fDWEVEqTHEBUILDwOOfiMPROVEYENiIS50lDmTHMONEYEAROFC04PLE- Z 'T10N,TME OWNER-0UM1DER YALL MAVE iHE BUflDEN OF VFOY'NU iHAi NE OR SNE DID NOT BVIID 011 MPROYE FOR TME PURPOSE OF SALEF �L OLASON4IEROFTTiEPROPEHTY,l1ME7(ClU51VELYCOHTMCTNONTTHLICENSEDCONTMCTOR3 � TO CONSTAUCT TME VNd1ECT(SF.G 70u,HUSINESS AN�FROFESSIONS CODE 1ME COHTRACTDNS U• V01Ueti0n ADJ.AREA CENSE UW DOES NOT AVPLY TO AN OwNER OFA PROPfRTY MM1q BURDS OR MaROVES THERCON.IWO ' � W1qCONTMCTSFOpSUCHPR0.1ECT51MT1ACONTMCTO�S�LICENSEDFURSUANTTOTHC4Vt7TMG QUA��ITITY DESCflIPT1ON �E � TORS L/CENSE UW.). O I AM EXEYPT UND[R SEC. B.d P.C.FOR iHIS RCASON � C U � � DA7F OWNER V � LICENSED CONTRACTORS DECLARATION W J � W IHENE6YAFFYiNUNDERPENALTYOFGERNiIYTHATIAMLICENSEDUNDERPROVIS10NSOfCHAP7FR � [� �ICOAINENCNOWfTNSECTIDN7o00)OFCMSION]OFTHEOUStNESSIWDPROfESSiONSCOC£.11ND Z X W UCExSE IS N Ml FORCEMID EFFECT. lL � ,/�/� m � LICENSE QAS L LIC.N0.�y��p�p� j �j DATE CONTAACTOfi��{���� d W ' � WORKERS'COMPENSATION DECLAFiA'TION Q � �- / � � � 1 [i � IMEREBYAFFlRAIUN'JERVENALTYOFVEiWMONEOFiH[FOUAW�NGbECUMT10N5: ��, z ' .l� � / �/ � _IHAVEANDMnLL►wMANACERTIFlGTEOFCONS[MTOSELFaNSUREFORNOiiKERS'� : _ " 1 � OOUPEN5AT10N,AS PROVIDED BY SECTqN J70o OF 7HE tA[iOR CODE,FOR iH[PERFOR6IANCE U Of iHE WORK FOR WMCH TFrS PERMIT IS 155UCD. W r � . • � . � ' i� �_ � � . _IHAVEANDWILLWIMAAIWOiL(ERS'COMPEHSATIONMSUfUNCE,ASRCWIRE�8v5ECT10N� f O f7000FTNEU80RO00E,FORTHEPERFORAUNCfOFTH[WOPI:FORWHICHiH15PERMRIS� � ' '� , ISSUm.YYW011KERS'CpIiEN5AT10NINSU�RA,N�CECARRIERMDPOUCYNUMBERAR[: 'CONSTAUCTION '' jCAWCER��a�`'y � � PLANREVIEW �. ., . . . , .. � POLICY NU4BER���G � 7� fi �ELECTHIC � V �� ¢ P (I}655ECT10NNE�NOTBEODI.PLEfIDOFT[PERATfSfdIONEFIU�OHEDDd1A0.5(itOmORLE:S) PLUMBING L }'� Z ICEHIIFYTHATINTHEPFRFORMA4CEOFTHEN'ORKFOflNM111p17M5PERYRt5155JED,1 MECHANICAL t'J ., �� 1 • C7 SNALLNOTEMPIOYINYPER50NNAN1'MAHNCRSOASTO6ECOM" U&1ECTTOTHE ' � YVORKERS'COMPENSATIONLAWSOF ALIFORWRAND�CREET/UT �MOULDBECOYE INSPECTIONFEE SUOJECT70T11EWORKERS'COMP N �N7HONSqN50FSECT -oOFTNEUDOR CAOE 5 IFOHT/fiMT1COMPL iH sEP�5iON5. ISSUANCE . �� A o Q qq Lr 1 u i�:,� p OATE:�7�L, � APPLICA . • SMIP � WAqNMd: MURETOSECVRENURNERS'COMPENSATIONCOVERACEISUM,AVYFVL,/WDSHALLOE ENERGYPlC l.T�'�i. T'`�_: = � SU61ECfANEMPLOYERTOCRVAwALVENALTIE5�1NOqVILFWESUPTOCN[MUNDHE�T�I�NO ENERGYPEiiU1T __F3T,J71 r��'n • J � � ' DOLLARS(itoo,0a0),PlADDR10NTOiHECASTOFCOMPENSATqN,DM/Af,E5A5PROV,DEDFOFIN �_,, ' ¢ SECf10N770lOFiHEU00qCO0E,W7ERE5iM1DATTORNEY'SFEES. RETENTIONFEE: • ,✓ r ������ � oCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEREBVAFFRMUNOERPENILLTYOFVEIWRYTNATTIIEREISACONSiRUCTqNLENOINOAGENCY Z FOfi THE iCRW RMANCE OF iHE WORK iOR HR11A1 TNIS VERAIiT IS ISSUE�(SEG 70Y7,CN.G�. W � IENDER5NMIE � � LENDERSADORE55 w ICER7IFYTHAiIMAVEREADTHISMPLM•ATqNNlOSTATETNIITTHEA80\'ENFOIUTATIONISCORRECi. TOTAL FEES � 3��a � IAGREETOCOMPLVM7iHALLCliYANDCOUNTYOROINANCESAN'JSTATELAWSNEIATINOiOBUILDING � CDNSTRUCTION,ANDHEPEBYAUi110RIZERECqESENTATNE50CTHISCO'JNTYTOENTERUPONTHE ' ' /I/ , ABOVF-4FMqNED PROPER7V FOR INSPERION PURPOSES. Irj-�+ p COMME TS --� �W� !,}�a �hti�3C� �1 "v � m E ENN�E�PRINn � , • ' � � (� � — � N � PEHMITTEE D E � RECPT.NO. l PAID�Y VALIDATION WHITE—Ooper,ment Copy,YELLOW—Finance Copy,PINK—Asaeswr Copy.GOtDENROD--File Copy,GREEN—ApplicanCs Capy CITY OF DIAMOt�D,BAR , , . � � ��:�. , • . - � • : II�SPECTIOf��RECORD ...• � � . .,. � �,f�_E������1�10�.�� ��.�.� �.1.►_�������:"�� .�i►��-y����'.a�i�l�_cr� +�� ;��'�'x�� �1�.�' �i���!]r� _ SETBA�CK , � ,. I '� �..��--, �1:, FLOURJ�IST :t ,c-�. � '�. �.•.. . ��r •i�l _ �... �� r. , � � , , . '—�^— . ..�--;c�r;--r�-`--T�- . ' __ !FTGS/FORMS/STEEL � �� � � ` ' 1 FHA REQMTS ' � ' 'ELECTRIC GROUND. _ . _ � UNDER FLOOR DUCT � ' � - �• • ';-T:—==---•; `r�7-�••�:.:. .��'',Y .. —. �GROUND PLUMBING UNDER FLOOFi CGP•iDUll'� i. f, ., �;•��•� '• . •. . _. - ; -, -- �SLAB GRADE -- � � - � FIREPLACE FOUNDATION �,. �S�'• � -,, `���"-�;=:: ,: ' •.TEMP P01,NER - _ _ - FIREPL.A����Di"v�J�'B�AM �--�-- -.- ---_.,_ c - - iWATER SERVICE � P�11D HT. BOND�EAP�A-= �-:. - �%r` i'`%s;: �•_i.�:�.'. . � - AOOF,SFIEATHIP�.^a ��.'' •��l.,) �� -�:, .-� �'� . 8 FT.BOND•BEAF�7 '�: > . :r ; , -� � _ *.��. � . !FRAF.11Na,NENTILIATION `'�'+ -�:`•"`"' i`1 FINAL�Of�D BE�A�-v1' �� � � • ' `' !ROOF COVF_R PRE-GRADING - - � 'ROUGH HEATING - BENCHING � ROUGH ELECTRIC _ .... . ' � � __• R�UGH GRADING , • ROUGH PLUti161NG � -- FINISH GRADING ; �:__ iSH�'JVER.�UBTEST POOL ELECTRIC • ' �EXT:-L4'iHlSIDING POOL FENCING . � .. • � � ,t�NALLINSULATiON� -- - POOL'FINAL CEIUNG R•:SULF,TIO�d - -- OFF SITE IMPS. ' - �DRYWALL NAILiNG " DEDICATIONS � - �S�1,•�JER . . FINAL.ENG. . 'SEPTICTANK � LANDSCAPE/1RRIG. ' . !SFEP PITILL. '-' ,�:► ON SITE Ih1PS. GAS F;IR i CST ' FINAL ZONING !f=1�:,",t_+�QNST.. FIRE DEPT. FINAL • F=1;•1.•.L HEATING _ __ HEALTH DEPT. FINAL - i -. __--- --- - i:�E::,".;_ELECTRIC-- - - - - DEV. FEES PAIO - - - ' i- •�f t_PLUMBING - ENERGY , . I.. . _ . .. �Cj�:C!i� t�l:�s,'(L�f;. -yy' � ": ;\' _: , ' _ _:c.�..�_�,..—.�.:_r__�_ac.;.�.� `..� � - .. .. S'�; � '���� �''�• � �, � �\���.9' r -�r t r ' '_ r I , .` . , '._ . _.._...._ .._. .. ! . . !1 1 r � S :.�..i,yilVt�. i j �' �.•.i 51,. 1' � ! C�/��C_�. ; �,�a�- ;�%�. . . � � � r �—��= . , � � -- . F1 "��j t��c l-�����c,�,��-�; —- � — /' — � - �(f!�ar �—G,���—�c.--�``�i,���/���{�7 5���c.. . , ,� .� � , �_�. _ , �;s _� �,, _. ;,, , . - - a :;��-�: . :,:,, , , . - _ . , - . i _ •� , ... _ . . . .. �_.. �, � - . � .., ' � , ,ii�1 . _ . "_ �� l'.- . . i I SEPTIC TANK SIZE ; � . - SEEP PIT/U SIZE � � � __. _� : _ __�___-__�__�__� ; '�"'.I:. � . . , i .. � . � � . ; � - _ . � -, i ;����� :�i - : . . . .. -. -; ; - � � _�. . . .. -:" _. . . ' I � . , , , � . - _ ., , <�� �:a.' f,c'� r-.1"'�..l�l�.-1 . , � � r� � � � � �\. 1,�� � ' '__� �._W_._�__�.,..._......��.w� : � C i ? \i� _ 'I� � ` '�- --': - —