HomeMy WebLinkAbout15554 (32) � I� CITY OF DIAMOND BAR
�!� �_
� DEPARTMENT OF COMMUMTY 8c DEVELOPMENT SERVICES �
21660 E.Copley Drive Suite 190
(909)860-3195 Fax(909)861-3117 PAESS
'���� BUII.DING PERMIT APPLICATION FIRMLY
o ADDRESS I � � I u��I�_�� APPLICATIO PERMIT �� P/C
DATE NUMBEFi N
c� ISSUE TYPE OCC
APN�aT��T�RACT DATE CONST. GROUP
� OWNER � _ . 1^F
" ADDRESS ZONING SEfBACKS
Z CITY ZIP TEL. A�R RW ❑
APPLICANT � T �ZZ�(
S ^ 51DE/SIDE STREET RW ❑
o� CONTRACTO �� � d SIDE
� ADDRESS pR POSED USE ` ���- J l� -�'J
o C �/'��,� ZIP�1(�jL, TE 2` i /�
ARCH/ENGJ • ` (�(.(/j��.
DESIGNER O.DWEL NO. NO.
ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
N DESCRIPTION SQ.FT. FACTOFi PSF ADJ.AREANALUATION
N
Q OWNER-BUILDER DECLARATION SFR/ADD/REM
O
p I HEREBY AFFlWA UNDER FENK7Y OF iE0.AJHY TMAi I M1 EXEUVT FROrI THE CON�MC70RS L4 GaragolCarport
W CENSEUWfORiHEiOLLOWNOREA50NISEG70]1.6BUSWESSANDPROFESSIONSCOOE:ANYGTYON (n
C� COUIITYM11Utl/pE0U1NE8ACERMrtTOCON5Tf1UCLALTERM7ROYEDEMOIISHORREFAIRIWVSTRUG W Patio/peck
Z7URE,VRqR TO RS KeVANCE,ALSO REW�AES 111E APPLICANT FOR SIKM iERYIT 70 LILE A SIGN[0 W
� STATE4ENT Tw�T HE Ofl SME 6 LICENSED PUiSW WT TO iNE PPOWSqNS OF THE CONTRAClORS ll
� CEN9E UW(CIIAPTER�(COMMENCNU YATN SECf10N 7Wa)OF DIVISqN f OF THE BUS:NE55 AN�PRO- � POOVSp3
FESS�DNS CODE)OR iMA7 NE OR 511E IS EXEMPT TNEREFROY AND THE BA515 fOR 711E ALLEGCD EX[A�P•
T10N.FNVVICIAiIONOFSECf70N7077.6B�ANYAPPLIGu1TfOR�VER/.UTSUBJEG75iMEAPPUf:ANrTO Z Re•Roof
F, ACMLVEIL1lTYOFNOTMOFlE7}UNFNENUNDREDDOLLMS(i5o01�Y
� O11�40MMEROFiHEPROPERiY.ORMYENPLOYEE5VATIW�CESAST�EIqSOtECOMVENSATqN, ❑ ('qTmerClal
YALL 00 THE WOR1C/WD 1HE STRUCiURE LS NOT INTEN�EO ON OFiEPEO FOR SALE ISEG 70u,BU56 J
� NESS A/�VROFESSIONS OOOE:TN[CONiMCTORS 110EN5f UW 00E5 NOT�l7VlY T0/JI OWNER OF ?
iROPEHTY YN10 BUIDS O(1 MPROVES TXEREOH./ND WVq DOES SUG1 NORK NIMSELF OR NERSELF OR
(L TTWOINiHW50RMEROMf1E#NLOYEES.iROV10EDiHATSUp11MPROVEAICM9ARENOTWTENDE00�1 m
� OFFEREDWRSALEIF.110WEHER7HEBULdN00i1MPqOVEIAINTI350lDWITMNONEYEAROfCOMPLE•
TION.THE O'WNER-0UILDER WILL MAYE TNE BUPDEN OF iROVP10 T1U7 ME OR SNE DD NOT BU1LD Oft
W PiqVE FOi11T/E PURPOSE OF SALE}
� ❑1A40NNEROFiHEPROPERTY.AME%CLUSNELYCONiRACTWONrtTHLIGENSEDCONTMCTORS
TO[ONSiRUCT TME PRQIECT(SEC.)Da1,BUSIHE55 A!A VROFESSIONS COOE.T11E CONTMCTOfti Lb V01u91i0f1 ADJ.AREA
CENSE UW DOES NOT Il7PLY TOAN OWN[R OF A VROPERTY YAIO BUILDS OR 4PpOYES 711EREON.hND
� YAqWNTRACTSFORSUCFiPRQ7ECT4W1iHACONTRRCTON(S)LICENSEDOURSUAHTTOINECONTMG pUANTIN DESCRIPTION � FEE
� TOli3 UCENSE UW}
O IMI EXEMPT UNOEH SEG B.1 P.C.FORTHIS R[ASON Q
3 �
¢
LL' DATE OWNER V
� J
� LICENSED CONTRACTORS DECLAitATION W
� INEREBYAFTIRNUNOERVENKTYOFVEtWRVT1IATIAIALICENSEDUND[RPROV�SqN50FC1v�vTER Vr
(� �(OOEMENCYIU MAiN SECTIDN 7000�OF OMSION 7 DF THE 9V51NE55 NrJ PFOFESSIONS COOE,ANO Z
W LICENSE 6 N FULL iOHCE AND EFFECL m
Q �ri i
� LICFJiSE CUSS LIC.NO. � � � �
v p,ve��y�i�l corrrancro :.� � a
W / T�� � ��
� WORKERS'COMPENSATION DECLARATION ,�,�/�b/�/ U �': (;���d'
� IHEREBYAFFIRUUlAERPENALTYOFPE0.IURYONEOfTHEfOLIAwINGDECURATS�s_ Z
a
� �IHAVEANDW�LLMNNTANACEifTIFICIITEOFCON5EM705ELFN5UREFORWORKENS' 2 �FP '' �1 n�^
� OOYPENSA710H,/S iROVIDED BYSECTION 970o OFTNE LABOR COO[.FOR iHE PERFORMANCE �U . `���
OF THE MIOqK FOR WNiCH T1n4 CERIAIT IS ISSUEO. � ��i'T'���-- .
� il
�I MIWE AND W1L MAMAIN YARK[RS'COMFENSATION wSVRANCE,AS REWIRED BY SECTION `�1����•1 lJ:V U U AR
O 77000F7NE LA80R CODE FOR THE iERFORMMKE OF THE WOFK FOR WMi(al THIS PEFUIIT IS �3 UILDIN� ��T�i A�,'L"T-��
ISSUED. RKEA5 Cq1VEN5A�G ISUM�ICE CARRIERAND POIICYMIYBERAAE: CONSTflUCTION T�$.
jeu�iea� 1 i(�� � �� ��f� PLAN REVIEW
� POLICYIM6ER������ ELECTRIC
0 (IYGSECfqNNCmNOTB[OOI.iLETE'�OF71EPEfi.(T6FD(iUE1tl�OfIEDOQ1AftSR�a`l�1E55} PLUMBING
Z ICCRTIiY7MAiNTHfPERFORA�ANCEOFTNEWOFKFORWHICHTItl5PER1�?LSISSl1ED,1 MECHANICAL
(�' SHNINOT EMPLOYANY GERSCN W M�Y NANNER SOAS TO BECO�.�E SVBJEtt TO TNE
� YWPo(ENSCOMiENSATqNtAW50FCAL�FORMAIWD�GFEETINTIFISHOULDB[COME INSPECTIONFEE
S SU9JECTT0T/1EMlORKERS'CO�.�vEN5AT10NP VI iON50FSEt ION77ooOFTHEUBOR ISSUANCE �
COO .1 SHALL iOfi11NVITM COMPLY� V AVIS 5.
� , � ��n1L1 sM��
p DATE: APPLICA
� ENEHGY P!C
WARNIIq:FA4URETOSECUFlENRIRKERS'COM NS�710NCOYER�GEtSUMAwFULANDSWLLLBE
� SUBJEGTANEMPLOYfRTOCRnAPULPENAL71E5ANOCMLFNESUPTOONEMUNOREDiHW5AN0 ENERGYPERMIT
DOLU0.5(f�m.000),N AODITIOH TO iHE L0.5T OF COMPENSATqN,D�GES AS PROVIOED FOR M
� SECTION f70!OF iNE UBOR COOE,N7ERE5T,IJA1�T70RNEY5 FEES. R[TENTION FEE:
pw_, CONSTRUCTION LENDING AGENCY PRE•ALT FEE:
O
� INEREBVAFFIRAIUNOERDEN/�1TYOFVERJURYilUTT11EREI5ACON5TRUCTIONLEND�NaAGENCY
2 iOR iME FER�ORUMiCE OF TME WORIf FOR WNldi iM15 VERMITIS ISSUED ISEG 7ov7.qV.4�.
W
� LENDER'SNAUE �
� LENDER'S/iDORE55 /�/�(�/
� ICERTIFYTNATIHAVEREADTMISAPPLIUTiONANDSTA1ET11ATTNEABOVEWFORIAATIONISCORRECL TOTAL FEES S �/ � �
� IAGREET00061PlYN7THILLlCI7YMIDCOUNTYOR0INANCESANOSTATEllINSREUTWf1TOBU4DIN0
CpN37RUCfION,AND MEREBY AUTiqRIZE REPRESENTATIVES OF THIS COVNTY TO ENTER UOON THE .
Z A80vE�MENT10 EOiHOVERTYFOflWSPELTqNPVRP0.5E5. COMMENTS
/
o • - �,u,-fP �-�
_ � �
m v �� E(PRIhT)
� ��
Uj f OF GE iTT �
� RECPL NO. PAI�BY ' VALIDATION
WHITE-0epertment Copy.YELLOW—Flnance Copy.PINK—Assessa Copy.G LDENROD--File Copy,GREEN—Appicantb Copy
. . , , ..
�. ....... . .. . . •..,-..,..:. ti. �..•.,, ... _. . ,. . .. . .. . . .. .�. , � -
', - CITY OF DiF�1UfOND BAR . .
-.ItdSPECTtON R�CORD �
�'�:�,:��'��s1,�,E��;��1:.��=��1.►�r.�i��ck .e i .. , �yF-�.:�?.�.�1�_�.-.,....._ . .._°1���.=�. _..�!�F-��'=;¢�'�;cli�:,._..
SET BACK y . - ' � � � � I FLOOR JOIST . .�. ., ,. �-��- LL -
FTGS/FORR"S/STEEL � � � FHA REQP11T5 ' " ' ' �` •
ELECTRIC GROUPdD � ��� UNDER FLOOR DUCT _ �
� � - -
GROUND PLUMBlNG ' UNDER FLOOR Cb�,iDUIT , ' ' � � ' � __ :
SLAB GRADE FIREPLACE FOUNDATION �_
TEDAP POWER FIREPLACE'BOND 6EAP�1 I ' '
WATER SERVICE h"ID HT.BOND BEP,P�1 � ' � � �
ROOF SHEATHING ' ' 8 FT. BOND BEA��1 - '
FRAMI�dGNcNTILIATION I - �FINAL BOND BEAhA I
ROOF COVER I PRE-GRADING I
ROWGH HEATING BENCHItJG
ROUGH ELECTRIC I ROUGH GRADING
ROUGH PLUMBING � FINISH GRADING
SHOV'JER,rT'UB TEST POOL ELECTRIC —(�!. ..�..,,��
E�T.LATH/SIDING POOL FEPdCING I ( �–o� t
V'JALL INSULATION POOL FINAL ���_o ^ i_.__
CEILWG INSULATION OFF SITE I�APS. / • •
DRY11'JALL NAILI�dG � � �� DEDICATIO�JS
-�_=�=- -=-1
SEWER FIPJF.L ENG. �_
SEPTIC TANK L.Ah:DSCAPE/IRRIG, � �
SEEP PlT/L.L. � ' O�J SITE IPI�PS. �
GAS AIR?EST l���OQ� � FINr,L ZOPdIPIu � � ._
FIi�,4�..CO"JST.. t' �— ( FIR�DEPT. FINFsL � (
F1�1AL HEATING i HEALTH DEPT. FINAL � �
PiNF,�ELECTRIC � � � DEV. FEES PAID
F!"JA,L PLUMBI�lG Eh:ERGY ,-----------
— , --i--- -------------
i
, _ — � _ � � ,.- .."�:.•ix .;���,""�.�.,�..,T� . ....._ — ---�----- ---------�
COMMENTS o�� !'c�u. .6c�jc - exs�s�ty_c,,�'-�y—,�.Y �,If�� �7 13-�' -- I
- , , - . ' I
SEPTiC TANK SIZE
SEEP PIT/U SIZE ---- –
:� :���:� _.�' ---- ---
`#. .�_ .
,
!'.,....:,: . .. . I — -----
' ----
r��..
,,,� '�R
I�r.w• �. . . ". 1 ' . -. - ----' _-
+ 'i. �
��, �_.�.�'w..4�.....�.......�..�... ' _ ____"_'�__