HomeMy WebLinkAbout113510 _ ----�-- -. ----� _�___. . . -�__.___ ____.__._--- .__.�- --
�
-----J��---�� CITY OF DIAh40ND BAR
COMMUNITY DEVELOPNIENT DEPARTh7ENT
.x:.•C 2I660 E.Copley Drive Suite 190 � PRESS
(909)8643t95 Fax(909)661-3117
'"" BUILDINGPLRMITAPPLIC � FIRMLY
Q DDRESS_ �Ov /V I/%r�N401Pd F�Y !1 U APPLICATI N PERMIT �?� P/C ���D?
p r DATE � NUMf3ER�� tl
� ISSUE E OCC
APN LOT TRACT DATE C�J�F�� GROUP
°C OWNER _1��U1 e� C.
O
o ADDRESS z�n �AI ��)F.IcJN� hAv � . ZONING SETBACKS
z CITY �►,�nt�r,cl j�1r ZIP q/�LS TE���d�-89Y.Y FRONT 0(.'T n � R}� ❑
a LICAN S ' TEI�SLtI Of-Q'+i 3 REAF1 �UU� p
a � SIDE/SIDE STREEf RW O
� CONTRACTOR �S% �t SIDE ❑
ADDR SS,��y � �
� CIT�� � ZIP�L T �or_Q��3 PROPOSED USE ,�_lr � G�� C
o ARCH/ENG/
�z DESIGNER ' NO.DWEL. ��0. NO.
= CDDfiESS ZIP TEL _ UNITS STORIES BEDROOMS
cr�
cn �ESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER•BL'ILDER DECLAFiATION SFR/ADD,'fiEM
O
I H[REBY AFFlRM UNDER PENRLTV OF PERJURV THAT I AM FJfEMOT FROA1 iHE CONTMCTORS ll- GOfB J0/CB�OR
W CENSELAWFOqTHEFOLLOW�NGREA50N(SEC.7071.SBUSINESSFNDPROFESSIONSCODE:ANYCITYOR (n
U �OUNTYWNICHPEOVIRESAPERMIiTOfANSTRUCT,ALTERMFROVE,DEMOLISM,ORREPAIRANYSTfl:JC• W
- '- W TURC.PRIOR TO RS ISSUANCE.KSO RCOU�RCS T1E APDIICMT FOft SUCH VERMIT TO FILE A SiGNfD_ w Patio/Dock
� STATEIAENT TW1T NE ON SME IS LICENSED PURSUANT TO THE PpOVI51IX:5 OF 1HE LON7MCfORS L6
� CENSE UW ICMAPTER Y ICOAAMENCWG WITH SELTION 700010F DIVISION]OF iHE BUSINESS A�D PRG u- Poo�Spa
FESSIONSCO�E)ORTHATHEORSMEISE%EAIPTTHEREiROMAN'�THEBASISFOH7HEALLEGE�E%EUP• (�
VTION.ANVVqLAT1CNOF5ECTION7071.5BYANY�PPUCAN7FOFAVERMiTSU0.1ECT5TME�PPLIGINTTO Z �p-Rpp} .
ACIVIL PENALTY OF NOT MORE iNAN FNE HUNDRED OOlLARS(fSDD)):
OI.AS OWNEfl OF THE GROPERTY,OH MV EMPLOYEES WITH WAGES AS iHEtR SOLE COMPCNSATION,
Z � Commercial
N'ILL DO 7ME WORK,IW�THE S7RUG7URE IS NO7 INTENDED OH OFFERED F01i SALE(SEC.7oN,BUSI• J
N NE55 ANO PFOFESSIDNS CODE:7HE CONTFRC70R5 UCENSE UW DOES N07 APVLY TO AN OWNER OF =
PROPERTY Yrt10 BUMS OR IWVROVES THEREON,AND NMO DOES SUqI WORN HiIASEIF OR HERSELF OR
� THRIXIG//HISORNERONTlEMPLOYEE5,7RDVIDEOTNATSUtl/1MPROVEMENiSARENOTNTEN�EDOF CO
QW OFFEREDiORSDLE.IF,FIOWEVER7NE8ULDINGORIMPROVEUENTISSOIDWiTHINONEVEIAOFCOAI7LE� � '
Z TKKJ.THE OwNER�BUtLDER W'LL HAVE hIE BUROEN OF PROVINQ TMAT HE OR SHE DID NOT BViID OFl
= IMPROVE FOR THE GURPOSE OF SALE�.
O 4 AS OWNEfl Of TME iROPERTY,AM EXLIUSNELY LOMMCT�NG WITM LICENSED CO4TRAGTORS `,��/�
Q 70 WNSTPUCT TT7E PRO.IECT(SEG 70��.BUSINE55 AND PROFESSIONS COOE:ME CONTRACTORS LI� V.71U8;10f1 �'J('A !I / �� AQI.AREA �
W CENSEUWDOESNOTAVPLYTOANONTJEROFAPROPER7Y1N10BUILDSOR11.1PHOVE57HEREON,IiNO
' � N17000NTMCTSFORSUCHPRQIECTSNATHACONTfUCTOR(S)LICENSEDPl1RSVANTTOTHECONTMG QUANTITY �ESCRIPTIOM � � FEE
�Y TORS LICENSE UW).
� O I AM E%EMPT UN�ER SEC. B.t V.C.FOR THIS REASON Q � � I"'► .Z�s'� ,
� V .
LL �
OATE OWNER V
Z
�-¢ UCENSED CONTFlACTORS DECLARATION W
CC IHER[BYAFFIRMUNOERGENALTYOF7EFtM11RYTHA7IAMLICENSEDUNDEACROVI510NSOFCHAPTEH � . �
� i(LOMMENCWGWffTISECTpN7000�OFOMSION]OFTHEBUSINESSAN�PROFE5510NSCODE,AND Z
X W LICENSE IS N FUL�FOHCE AN�EFFEGL ' m
o c -Yr LIC.NO. SLL" o �
� LICENSE SS �
V DATE__����� CONTRACTOR . � ��_ a
W
� � WOFiKERS'COMP[NSATION DECLARATION a
. N IHEREOY/IFFIRAIUNDERVENAL7YOFPEiLR1RYONEOFTHEfOLLOW:NCDECIARAT10N5: Z , ,
. � _IHAVEANDYYILLMAINTAMIICERTIFlCATEOFCONSENTTOSElFaNSUflFFORYIOFKEflS' _ '
COMPENSATION.�SPROVIDEDBYSECTION770oOFiHELABORCO�E,FORTHEGERFONAANCE �U
OF THE WORK FOR VJ111CH TMS GERIIIT IS ISSUED.
� 2
' ¢W _IXRYEANOWILLMAINTNNYYORKERS'CAMPENSATIONINSUflANCE,ASREWIFED8Y5ECilON
�7000F THE IABOR CODE.FOR THE PEfiFORMANCE OF THE WOH1C FOR WHIp17HIS PEWnIT IS / �,o
� ISSUED.MY WORKERS'C0IAPENSATION INSURANCE CARRIER AND PIXICV NUA��EN ARE. CONSTRUCTION p �/�
'- ' ' j uwRtER PLAN REVIEV'J . s�7�.r
�, Z Paarr+un+eEA EIECTRIC _ 3j•�
d
� (IH6SECf10NNEmNDTBE00M'LEIEDOFTEPEW.RBGOHONEHfl]PFDDOLUAS(ft00�CALFSS) PLUMBING
Z 1 CERTIFY TNAT W THE PEHFORMANCE OF THE ri�ORH FOR WHlp7 TNIS PEflMIT IS ISSUED,I M[CHANICAL
(7 SHALLNOTENPLOYANYVERSONWANYMANNERSOASTOBECOMESU&IEC7TOTME
(/� WORKERS'C0IAPENSATqN�AW50FCAlIFORNiti�1qDAGREETMA NSHOULDBECOM[ INSPECTIONFEE� �
: � SU&IECTTO WORNERS'LOMPENSATION PR SIO�:S OF SEC.ON'77000F iHE UBOR
cooe,i oar�+wrtN couc�r vnn�nas �ao isaus. ISSUANCE ��•p�
O �/ �-�r-�
p DATE: A qPPLIWNT. C �I✓ SMIP •�'✓
� WARNIN�: AIL ETOSECUREwORNERS'COMPENSATION VERAGEISUNUwFUL,AI:DSHALL9E C-NC-RGYP/C —�y��►-��y��,���,
} SU0.1ECfANEMP�OVERTOCRl1.1!N:ILPENALTIESANDCIVILFINESUPTOOf:EHUNDREDTNOUSAND ENERGYPERMIT ��1�\ Y��1
DOU.AfYS(f100,000�P!/AIDITION TO THE GOST OF COMPENSATION,DAMACES AS PROVIDED FOR IN
� SECiION�7oa OFTME LABOR OJDE,NTEREST,ANO ATfOANEYS FEES. RETEHTION FEE: � �
� O CONSTRUCTION LENDING AGENCY PR6ALT FEE: /►�. ' - ' -
� 1 MEREBV AFFIRM UNOER PENA�Ty OF FERIURY THAT iHERE IS AfANSTRUCTION LENDINC ACENCY � . '
FOR THE PERFORMqNGE OF THE Y/ORK FOR WMlpl TMIS PERMIT IS ISSUED(SEC.J091,CIY.CJ. ��
Z
W
� LENDER'S NAME .
H LENDEiFSADDRE55 � � �
� TOTAL FEES
-' W I CERTIFYTHA71 HAVE READ THIS APFIICATqNAND STA7E TMAT THE ABOVE?1FOiWATION IS CARRECT. '
p. I AGREE TO COMPLY YATM ALL CITY M70 CAUN7Y OROINMICES AND STATE UWS REUTI�G TO BURDING
� CONSTHUCTION,AND HERE6YAlfTHORIZE R[7RESENTATIVES OF THIS COUNTY TO ENTER UPON THE ,
Z ABOVE�4EM E DR07ERT'FORINS CTIONPURv SES.
o COAIMENTS
J �
� �
� m PERMITfEE E(P I ' � ' ' �
� ' > �
N SIGNAil1REOFPERMI T Op �
� R[CPT.N0. � �PAIJ 6Y _ VALIDATION _
� � / � WHITE—Depanmenl Copy.YELLOW—Fnance Copy,PINK—Assessor Copy,GOLDEhROD—Fite Copy,GREEN—ApplicanPs Copy .
� 4 ' � . � 'S ..w • .� '. ,I�.�—� �. ' lR^_. ' R.�• �✓�- �ti^'—_"`�'f." '.—.�.w— �CG'-�'� ' �4 � .��T�'�'�'�� [.���ti�.����ar..�.,.Iw-
�4• _ � . � . .r �. . .. . . . � " . " -
�
OF DIAMOND BAR � �
� ` PECTION RECORD � � �
�,.. - ,; �
' � � ' ' � " • r � � -
SET BACK � � FLOOR JOIST _ .
FTGS/FORMS/STEEL (��,r-:1''�%`-•' FHA REQMTS ,
ELECTRIC GROUND ,;� UNDER FLOOR DUCT.�� .. � - •.,� - ,,.;_
GROUND PLUMBING S,';,;�� ��� �'"��' UNDER FLOOR COMDUIT ' �. � � • �
SLAB GRADE FIREPLACE F�UNDATION -' � - � ' . '
TEMP POWER -- FIREPLACE BOND BEAM �-` ':� • '
WATER SERVICE� .'• •— � � MID HT. BOND BEAM ': -- ' - • ' � '
ROOF SHEATHING 8 Ff:BOND BEAM �
FRAMINGNENTILIATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGN HEATING - BENCNING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING � FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC �
EXT.LATH/SIDING POOL FENCING ,
WALL INSULATION POOL FINAL � . .
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWEf� .. . FINAL ENG, _
SEPTIC TANK _ `-" - - '=- LANDSCAPFJIRAIG. ,
SEEP PIT/L.L: ON SITE IMPS.
GASAIRTEST f ' '••� .�'� ' ' �' �: `` '. FINALZONING
FINAL CONST. - FIRE DEPT.FINAL
FINAL HEATING - - HEALTH DEPT.FINAL
FINAL ELECTRIC " - DEV. FEES PAID
FINAL PLUMBING ENERGY • �
_ . �.•. _,
• • .
COMMENTS . .
, .
�� ..' '
, -�, �` _ ,
, ,�
�: , .,,� . .
., ,
,, �. �
. .:� , . . . . . . . . . : .•: �
i��� � � �� . .
� ,
SEPTIC TANK SIZE _.
�SEEP PIT/U SIZE�•�;_.� '): is�r .
�
- ' . .. .
� ., .
:�l.�•� ._`,l� `,1./ k1 � ,
1 1 . . . .. . . . .. ....... .. . . . . . _ . . _ . ..