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HomeMy WebLinkAbout15516 (39) �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT 5EKVICES �� 21660 E.Coplcy Drive 5uitc 190 (909)860-3195 Fax(909)861-3117 . . PRE$$ �^�M�� BUQ.DING PERMIT APPLICATTON FIRMLY � JOBSITE APPLICATION �7 PERMR P/C Q ADDRESS � � � a/� pqTE ,0 �NUMBER �/� M $ ISSUE /) TYPE OCC APN LOT TRACT DATE �� CONST. GROUP p OWNER ►'1%4 OZ'f 4�^ 1 "" ADDRESS ZONING SETBACKS � CITY ZIP q 76S TEL. FRONT RW O APPLICAIJT TEL REAR ❑ � SIDFJSIDESTREET RW O CONTRACTOR {$ SIDE O � ADDRESS � CffY ���e ZIP TEL'714��J3A� PA�POSED USE � ARCHIENG/ DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDflOOMS � CITY 21P TEL. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION u� d OWNER-BUILDER DECLAHATION SFFUAD0.'REM Op I HEREBY AFFtlW tMCEA PENALTY OF GEFWRV Tut 1 AA1 E%fYPT FRdA THE CONiMCTORS Lt� G2fefle/CBfpOfl W CENSEUWFOR7HEFOLLOWWONEASUN(SEG7471.60USWESSMIDVROFESSIONSCOOE:ANYpTI'OR (n � CoUMfTMRaGIREOl1M1ESA7ERMR1000N5TRUCT,ALTEitMPROYE,DEAqUSfLORHEVAIRANYSTRUG W Pati0/DBCk 1UiE,PiYOR i0 R9 65UANCE,11LS0 NEOUIRES 7HE MPlIG1NT FOR SLCH VERMIT TO FILE A SiGNED W fTAiEMEM 7HAT ME OR SHE IS LICENSED VURSUANT TO TNE FPOVISIONS OF iME COHTAACTOFtS L4 � CENSE lAW(p41PiFR Y fCOMMENCPIO MIITH SEGTION 7000)OF OrYL510N]OF THE WSiNE55 AND Piq- LL- PooUSpa FESSqHS ODOE�O(i T/A7 HE OR SHE IS EXEMPf THEREFROM ANO iNE&tSlS FOR TNEALLEDED E%E4P- 710N.ANYYqLATIDNOFSECT�ON7001.6BYANVMPLIGNTFORAVENAITStAJECTSTMEAVFLICANTTO Z qe•Roof � ACIVaPENALiTOFNO7IAORETWWFNEIM1INDNEDDOlLAH51=�I.Y l O p4h4CM�NEROFiHEPROPER7Y,ORYVEYPLOYEESWI7HWACESASTHEIRSOIFCOMVENSAiqN, O (`,pmmBfd21 �. WRL DO THE WORK AND THE STRUCNRE IS NOT IMENOEO OR OFiEAE�FOR SALE�SEG T01t.BU51• _1 �ESS ANO YROFESSIONS COOE:iME GONTMCTO0.5 LIGENSE Uri DOES NO7 AVPLY TO/N VNNER OF N pRDiERTYYIHOBUlD90fl�MvqDVESTMEREON,ANDNM1lOD0E55Ud/WORNHII.ISELFIXiXERSELFOR = Q TNROVOHHISOFIHEROMRIEMPl.OYEES.VRDVDED7HAT5IlO1�IPqOVEYENTSARENOTMENOEDIXI m l�1 ,OFFEf1E�FORSA�EIF.110WEVERTHEBURDPHIOfiIMPROVEMENT650lDYAT19NONEYEAROFCOMPIE- ', TqN,THE OMn1EA�UILDEfl NnLL FIAVE TNE BUHDEN OF PROVINO iHA7 ME OR SHE DiD NOT BUtID 0{i $ rAPiqYEFqiTHEVIIPDO5EOF3ALE). W p1.A40YYNEROFTHEPAOVERiY.AMEXCLUSNLLYCOMMCTINON7iT1UCEN5EDCdRMCTORS � TO COHSTRUCT iME PFIOJECT(SEG 7041,BUSINESS M!O PROFESSWNS COOE:7NE COMMCTOIIS U- V0�U8liIX1 ADJ.AREA CEHSELAWOOESNOTMVLYTOANCJ/NEROFAPROCEqTYWiqBl1lD50RMPROVESTMEREON,AN� NM1OWNTMGTSfORSUCNVROJECTSWITMACONTMCfORIS�LIGENSEDPURSWWTTOTMECONTMG Q�JA ITY DESCRIPTION FEE � � TqtS UCflSE UW.). . O I IUA ExE4Pi UNDER SEC. B.�P.C.FOR THIS RE^ U r 5 LL' OATE OWNER V . . . � W UCENSED CONTRACTORS DECUIMTION W � IHEREBYI1FFIiN1UNDEH7EWLTYOF7ERIURYTNAiI.WLICENS[DUN�ERPRONSIONSOFdUMER �. � � �(CpMAENLINOWITH5ECT10N7000�OFDIVISqN]OFTMEBUSINESSN10iROFE5510N5CO0E,AVD Z W LICENSE�3 N NLL iOqCEAND EFFECL m � LICENSE SS �� UC.N0. v��� J V �ATE_ CONTMCTOR a W � WOpKERS'COMPENSATIONDECLAFiATION � Q � � U � IHEHEBYAFF61uUnIDFRVENAL7YOFPERIURYONEOFTHEiOLLOW�NGCELLARAilONS: Z Q � __IIIAVEANON'RLWVNTNHACERTIFICATEOFCONSENTTOSELFaNSUREFOpWONKERS' S COMPENSATpN,ASPROV��fOBYSECTiON77000FTXEUBONC00E.FOqTMEPERFORAIANCE �U OF 1ME M�1f iOR M711G1 TNIS VERAIIT IS ISSUE�. � � O �IlUVE IWD WILL IMINfNN MR�NKERS'CO�dFENSATpN INSUMNCE.AS REWIRED BY SECTqN i7ooOFiMELABORCODE.FOHTHEiERiORMANCEOFTHEWOf+�fFORVMIp/7HISPER`AiTIS � {SSUm.IAY RKEAS'CpAPENSATqNINSUiWdCELARRi RMIOVOLICVNUAADERApE: CONSTRUCTION � uaR1ER � Ar1A� Y'IS� Pth4REVIEW � POLICY MJMBER y � ELECTRIC 0 (M65ECAo1+N[�PaTBEap.(tE7IDOFT1EaEn.RSPoRONEFILwPIDoat�nsR�rolrntES51 PLUMBING w MECHANICAL ��'� Z ICER71FYTIATN7HEPERFORAVwCEDFTHEIMORKFORWMICHTMISPERM�715155UED.1 (J SH�LLNOTEIA7LOYANYYERSONNANYMANNERSOASTOBECW.�ESUBJECTTOTH[ —� � NOIiKERS'COL�PENSATqNUW50FCALIFORNU�MJDACREETMATFISNOUlL16ECOME INSPECTIONFEE S SUBJECTT0771EWORNERS'CO�APENSATIONiROV1510N50F5ECTqN1700 FTNEUBO ISSUANCE � � [DOE.I51iALLFORTMMTNGOMPLYWITN SEP 410NS �/� I � 3o OD�P�����j SMIP ��� .. �nnfl i o w�: ,, W ENERGY PfC J �'� WMNINQ:F/JLUNETOSECUREWOfiNERS'�MPENSATqNCOVEMOEISUNLAWFUL�NDSHALLBE r �� ` � SUBJ[CfANEMPLOYERTOGRIYIIULPENALTIESANDCNIlFWESUPTOONEMIHDREDTMOVSMA ENERGYPERMIT DOLLARS(i100.00�).N ADDITION TO iME COST OF COMPENSATqN,OAA/ACES AS VROVIDED FOi11N ¢ SECTqN770eOFiHELA00RWOE,INTERESL�NDATTORNEY5FEE5. RETENT�ONFEE: �,���G Q�D S , d CONS7RUCTION LENOIND AGENCY PRE•ALT FEE: O �I � IMEREBYAFi1RAlUNDERPENALTYOFpfR1UHYiHATTHEREISALONSTRUCTIONLENOWGAGENCY FORTHE vENFORMANGE OF iME YVOfU(FOR VMIl71 TNiS VERM�T IS ISSUED(SEG Mo7.CN.G). � � � � LENDEN'SNAAIE � IEN�EHSADONE55 . � ICERTIFY7NATIWIVEPEADTMISAPPL�G�TION�N�STATETHAiT1EA80VENfOR1AATqNISCORREC2 TOTAL FEES �� d IA6REETOCOMPLYWfi11ALLCfiYANDCOI.MYONDINANCE5AND5TATEUNSPEUTNOTOBUlOINO . CONSTRUCTI�N.IND HEAEB�AUiNORIZE REPRESENTATIVES OF 7H�5 GOUNTY TO EMEfl UPON THE , SL dBOVE•MENTIONEOPflOPER7YFORINSPECfI�NWNPO5E5. COMMENTS � '� � �,�s���p �("a1 P r►�4-�tn 2 m FE M U'Pw� O J O � � .��P Yc�l�o�}�Q � .� D y SN'. flEOFiE�ITTEE OATE �� RECPT.NO. PAID BY VAUDAiION � WHITE—Depertment Copy.YELLOW—Fnence Capy,PINN—Assessa CoOy,GOLDENROD--File Copy.GREEN—Applicanl'e Copy � ,.. .. . ... . ,._ . ... _. .. _ . : :.. :. ....:.. . �,,.. _ . , ,. .�.. ..:� ,.. � •.. CITY OF DIAMOND.BAR ., ... . � . -. - .. . :� It�SPECTION RECORD �-. � . . , , . . .��t�.�l'• �i� "� � �_��.� � _ s r E.l� e ��b � � �`� � � � .�...a..�. ��:=. - x�' �.►. l�.1=�' � n r� f►.�-�_:?�,.t,��'a:.�_.__ j SET BACK . .' �� . � � �,• . . FLOOR JOIST�� �• �i ' 1 ! !• i .: ��r•.� !FTGS/FORMS/STEEL � � :. . , ; ,, FHA REQMTS'' •�v :_: ; .. ...'.: . . , ELECTRIC'GROUND •� UNDER FLOOR DUCT - � - 'GROUND PLUt�A81NG - UNDER FLOOR CU�!DUIT�� `"' �J'" ` ' �'`�' - `' - ' � !SLABGRADE --. - . . . _ _ FIREF �f`AG�FOlJNC1A'fION �; ` 1i` .-•��.`i.,,:�1 � � ITEMP POV1lER -�-- �• � FIREPLACE BOND BEAM � � • � ' �WATER SERVICE _ � - MID HTi•BOND'B�At�i�-i,_� � i �,•_:� .� �.�• , .��� - _ � �ROOF SHEATHIPJG 8 FT.BOND�bEA�4 ,-�.'_' ='�='' -' '�'� • -=� `-� � ' i FRAFAINGNENTILIATION - FWAL BOND�E M �� � � -'� - �—".'-- - • ! i ROOF COVER •�-. PRE-GRADING - � - I ROUGH HEATING BENCHING � � • �R�UGH ELECTRIC ` ' . R�UGH GRADING - .-- -- . .f ':ROUGH PLUUlBING - - - -' -- ( FINISH GRADING �SHOWER,rfUB TEST ' - - POOL ELECTRIC � . 'EXT.L.EITH;SIDING �-- POOL�FENCING � 'WALLINSULATION - - POOL'FINAL • CEICING 1t3SULATION - - OFF SITE IMPS. , .. i DRYWALL NAILING - DEDICATIONS ; -• �SEWER . - _ - FINAL ENG. � -, ;SEPTICTANK � LANDSCAPE/IRRIG. �SEEP PIT/L.L. ON SITE IMPS. 'G�SAIRTEST � FINALZONIPIG �.FI"J,4L.C�iJSL..:. . ��'`•i •�-; , •: •,1 t'' FIRE DEPT. FINAL _... - . ._ ... �, .F1hAL NEATIt`G ._ . HEALTH DEPT. FINAL -- � - aU . ; _ !FI�Jfi,L ELECTRIC._. . . � � DEV. FEES PAID - - _ . - -- . . .' . 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