HomeMy WebLinkAbout17054 (40) r . _ - - - - -_ _ _ _ -- - - -_ .. _ _ . _ _ — CITY OF DIAMOND BAR � � DEPARTMENT OF COIvIIvIUNTTY 8c DEVELOPMENT SERVICES 21825 E.Copley Drive '� (909)860-3L95 Fax(909)861-3117 PRESS "'-�� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE � ,e APPLICATION ,.,, ��1 PERMIT �",n` P/C o ADDRESS � DATE � NUMBER_I_Iw q � ISSUE TYPE OCC APN LO TRACT DATE CONST. GROUP °C OWNE - � '-/L oADDR � L " / � L ZONING SETBACKS gCITY� /7 /'✓ / ZIP�f�f�STEL.% �' � � � FRONT RW ❑ APPLI �✓/J ' ✓L TEL. ,/-�'� REAR ❑ � • SIDEJSIDE STREET RW O � CON RAC 0 SIDE ❑ o ADDRE S / � -� pROPOSED USE � S�E� CIN � ZIP ELy ' (,[T ALG d- / 'yL w ARCH/ENG/ �F��'y/n?y,v I T� ��/l-�/_ � 0 � ADDRESS NO.DWEL. NO. � NO. = CITY 21P TEL. UNITS STORIES BEDROOMS r�n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADDlREM O p 1 HEREBY AFGIRM UNDER PENALTY OF PERJUM THAT I1lM f%EMPT FROA1 THE CONiMCTORS L4 Garage/Carport W CENSEU�MFONTHEF0.LOWIN�RE650N(SEQ7a71.68U51NE55ANDPROFE55KKJSC00E:ANYCIT/OR (n U COIRiTYMMICHqEOUIRESAPEHtA1T7000N57HUCT,ALTER��PR�VE.DEA/OUSH.ORREPAIRANYS7RUG W pgti0/DBdc � NRE PRIOR TO ITS ISSU/WCE,AL50 REIXJIRES TME AVPUGN7 FOR SUp1 PERMIT TO flLE A SIGNEO � STA7EMENT THAT NE OR SHE�5 UCENSED PURSUMJT TD TME PROVISIONS OF TME CON7MCTOR3 Ll� � CENSE UW(p1APTER Y(COMMENqNa WITM SECTIDN 7W0)OF DIVIS�ON 3 0F 1ME BUSINESS AND VR0. LL PooVSpa FESSqNS COOE)OR THAi HG OR SME IS EXEMPi TMEREFpOAI AND THE BASIS FOH THE ALLE6ED E%E�P� � TION.ANYVIOLATIONOFSELTION7071.68YANYAPVLICANTFORAPERMITSUBJECTSTHEAPPLICANTTD Z Re-Raof ACML PEN�LTY OF NOT MORE T WN FNE HUNORED OOLURS(f5ao�.Y ZO4ASOVINEROFTHEPROPERTY.ORMYEM7LOYEESWITHWAGESA57MEIFSOLECOMPENSAiION. � COrtlmBftl3� NnLL DO 1ME WORK,ANO iHE STRUCTURE IS NOT IN7ENDED OR OFFERED FOiI SALE(SEC.70�1,BU51- J � NE55 MID PROFESSIONS COOE:T/1E CONTMCTOflS UCENSE UW DOES NOT AVPLY TO AN OWNER OF ? PROPERTV WNO BU0.D5 OR IMPROVES TMEREON,AND YMO DOES SUCH WORK HIAASELF ON HERSEIF OR Q THROU6HHISOf1NEROWNENPLOYEES.FROV10EDiHNTSUCNMPROVEMEMS�RENOTMENDEOOR m 0 OFFEilE0FOq5ALE.IF,FIOWEVERTMEBULDINGORIA/PROVEMENTI550LDWRMNONEYEMOFCpAOLE� Z TION.THE OWNER�BUILDER 1MLL iUYE TME BURDEN OF VROVINO THAT ME OR SHE UID NOT BUILD OR = IIAPROVEFORTHEPURP0.SEOFSALE}. �y,� O4ASOWNEROFTHEPROPEHTY.AAIEX0.VSNElVCAN7MCTINOWITMUCENSEDCOf7�RACTORS Q TO CANS7RUCT THE PR0.IECT 15EC 7aN,BUSINE55 ANO CROFESSIONS CODE:TME CONTMCTORS LI� V81U0110f1 ADJ.AREA W CENSEUWDOESNOTMPLYTOANOWNEROFAPROPERTYWHOBUIlD50RIMPROVESTHEREON.AND � YM1qCONiMCfSFORSUCHPRQIECTSWITHACONTMCTOR(S�IICENS'cDPURSUANTTOTF7ECONTMG OUANTITY DESCR�PTION FEE Y TDqSLICENSEUW.7. �j�{ � O I AM E%EMPT UNOER SEG B.d V.C.FOR iHIS REASON Q �� � �� 1 �/� � � � C"/ a-If;� DD'T S � OATE OWNER V � �Q UCENSED CONTRACTORSDECLARA710N W [L IMEREBYAFFIRMUNDERPENALTYOfVERJURYTMATIAMLIGEN5E0UN0ERGROV1510N50FCMAPTER � p„ Y(COAIMENCINfIWITHSECTION7o0o)OFDINSqN30FTNEBUSINESS�N�VFOfE5S10NSCODE,AND Z X A/Y LICENSE IS IN Ml FORCE AND EFFECT. m LL � � UCENSE CUSS LIC.NO. � V OATE CONTRACfOR d W � WORKERS'COMPENSATION DECLAflATION � NINEREBYAFFIHAIUNOERPENAL7YOFiERNRYONEOFTHEFOLLOWWGOECUMTqNS � '�/'� / � .,._,_. _� _IM7IVEIW�WILLMAR7TAINACERTIFICATEOF�pNSEMTOSELF�NSUREFORN'ORKERS' COMPENSATpN,ASPROVIDEDBYSEC710NJ7ooOFTMELABOfiCOOE,FOHTMEPERFORMANCE OF THE WORK LOR WHlpl TMIS DERMIT IS�SSUED. G �I HAVE AND N1LL MIVMAP!WOtU(ERS'COMPENSATqN INSUMNCE,AS RE WIRFD 8Y SELTqN � 97000FTHELA90RCO�E.FOH7HEPERFORlAANCEOFIHEWOHKfORWMICHTHISVERMRIS ISSUEO.MYYYORKERS'COMPENSATIONINSUHANCECARRIERANDPOLICYNUMBERARE: CONSTRUC7ION j CAHRIER Puw aEviEw � OOLICYNUMBER ELECTRIC S, i p (rfa55ECItoNrdEmwTBEW1.itEiIDOFhEPEPo.fisPoRonEIU�DiimDotWY',(f�ro)OatESS} PIUMBING Z ICER7IFYTHATNTXEPERFORMANCEOFiHEriORKFORWMICHTNiSPERMIT6155UED,1 MECHANICAL C�} SHN.LNOTE�APLOYIWYPERSONWMI'/MANNERSOASTOBECOUESUBJECTTOTME y WORKERS'GOMVENSATIONUWSOFCA�IFORNIA,ANDAGREETNATIFISMOULDBECOME INSPECTIONFEE � S SUOJECTTO TME WOiiNERS'COMPENSATION PROVtS�ONS OF SECTqN�fa00f iHE LA80R D� CODE,1 SIWl FORTHWITH COMPLY WITM THOSE PROVISIONS. ISSUANCE l � SMIP p DATE: APVLICANT: W ENEFGY P/C � WARNINQ:FNLURETOSECUREWORKfP5COMPENSATqNCOVEM6EISUNLAWFULMIOSHALLBE �y SUB.IECTANEMPLOYERTOCRIMwALPEW�LTIESANOCMLFWESUPTOONEMUNDREDTHOUSAND ENERGYPERMIT OOLUAS(f 100.000),W fDDITION TO THE C0.STOF COAIPENSATION,DM7ACE5 AS VROVIOED FOR IN � SELTIONl70tOFTNEUHORCOOE,NTEREST,MIDATTOflNEYSFEES. RETENTIONFEE: a CONSTRUCTION 1EN01NG AGENCY pRE-ALT FEE: O — � IHEREBVAFFIRMUNUEAPENALTYOFPERNqYT1UTTHERE�SACONSTRUCTION�ENOWCA6ENCY �Z- FOR THE PERFORMANCE OF T11E WORK FOR WHICM 7H15 VEPMiT IS ISSUED(SEC,]097,CIK C.). W �Z LENOEqSNAME y � LENDERSADONE55 � ICERTIFYTHATIHAVEREADTHISAPVIIC�TKKJANOSTATETHATTHEA00VEINFONMATIqJISCORREGL TOTAL FEES IAGREETOCDIICIY ALLCRYANDCOUNTYORDINANCESANOSTATEUWSHEUTINGIOBVIl�IN6 ^ � CONSTHVCi O N REBY flRE REPRESEN7AiIVES OF iH15 COUNTV TO FNTEHUPON THE �2�I�O ZABOV EN EOV PERTYF INSPECTKKJVURPOSES. COMMENTS ��► � ' r ' ��-�����L'-� m � NAM[(CRI � Q �' '.�f� �/S � CJ � SIONATVqE OF PERMITTEE DATE � J RECPT.NO. PAID 8Y VALIDATION WHITE—Oepartmenl Copy,YELLOW—Finance Copy,PINK—Assessor Capy,GOLDENROD—Fila Copy,GREEN—AppliwnCs Copy � -.- ���:.i.:-. ., � �,. ;...., . • k .1..::ta,"r,t�;-,Fy. -•;;::.k.".�.;.�-� ..., ,... . . -.. . . , i; . . � . .�t,.� �.j: ! i,..,._fa�. '.:?:"��i . . 't -i�.�„ r`, .� i.:J'e:�,.+�,'�'.rw:'.�,�! ' � � . ,. . , .. - � CITY' OF DIAPJ��t�D BAR . I�v�SP�CTlOi�4 RECORD � ._ _.._., ._ _ .. . _ __ �li��-�;a��:'��I��k imr��t�R. .1��-�����"�a:� �.C��F-y� �`�������:� (���i��. �_1►!������ SET BACK '— --�� – –/� -LL;f_��� FLOOR JOIST.- `� . � - . FTGSIFORMSlSTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT - GROUND PLUMBING UNDER FLOOR CUPdDUiT . _•. SLAB GRADE FIREPLACE FOUNDATION �� TEMP POWEA FIREPL'ACE�BOND BEAM - � – � WATER SERVICE MID HT. BOND BEAM - ROOF SHEATHING ` 8 FT. 80ND BEAM. FAAMINGNENTILIATION FINAL 60ND BEAM ' ROOF COVER PRE-GRAD�NG ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING � FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATHJSIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PITlLL ON SITE IMPS. GAS AIR TEST_ _ . FINAL ZONING FINAL CONST. q_� �d . FIRE DEPT.FINA� FINAL• HEATING 1 HEALTH DEPT. FINAL FINAL ELECTRIC ' ' DEV.FEES PAID FINAL PLUMBING ENERGY c,_.��itc�l.�,ca�c c•; COMMENTS � �--:�- -- _ . � `� " . � � SEPTIC TANK SIZE � ! SEEP PIT/U SIZE . I��� ��' . ,��r,� .,y, �:� . � . _ :� - ��� _ �