HomeMy WebLinkAbout17755 (32) ---- _ --� __ _ _ _ . . �. . _. _
CITY OF DIAMOND BAR
J''� DEPARTMENT OF COIvWIUN1TY&DEVELOPMENT SERVICES
,
21825 E.Copley Drive '
(909)860-3195 Eax(909)861-3117 PRE$$
�`-:�' BUILDING PERMIT APPLICATION FIRMLY
� JOBSI7E Q�, r�1����� p 12. APPL�CATION 3 PERMIT �'7+�,�-�-+ P/C
o ADDRESS�U � / _ DATE �� cZ"" NUMBER •.(�j1L,t It
c� ISSUE TYPE OCC
APN LOT TRAC7 DATE 3� <<I �L CONST. GROUP
p OWNER
ADDRESS J[.v ZONING SEfBACKS
z CITY -- ZIP��.�TEL. REAA RW D
g APPUCAN • TEL. •r� SIDFJSIDE STREET RW O
� CONTRACTOR C SIDE O
ADDRESS PROPOSED USE — •V
� CIN ' ZIP TEL. --�' � �
w ARCH/ENG/ �
� DESIGNER
a ADDRESS N0.DWEL. N0. NO.
� CIN ZIP TEL. UNITS STORIES BE OOMS
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�
Q OWNEq-BU�LDER DECLAHATION SFR/ADD/REM
O
p 1 HEREBY AFFlRM UNDER VENALTY OF GE0.IURY THAT I AA1 EXEMPT FROA1 THE COIITMCTORS LF Garage/Carport
W CENSEUWFORIHEFOLLOWIN�RE�SONISEC.70.t1.6BU51NE55M1DPROFESSIONSWDE:ANVCRYDR (�
� COUNTYWHICHREWIRESAPEN.��TTOWNSTRUC[KTER�MPPOYE,OE4W9LORFIEPAIRANYSTRUG W PatiolDeck
NRE,PHIOR TO ITS ISSUANCE.ALSO REW�AES 7NE APPLIC/�M FOP SUCH FERMIT TO FILE A SiGNED W
� STATEMENT THAT NE OR SME IS UCENSED PUHSUANf TO THE PROVISIONS OF 7HE COMRACTORS lF
� CENSE LAW(CMAPTEA o(COMMENCNO WITH SECTqN 7000)OF DIYISqN�OF TNE BU5ME55 ANO PR0. u' PO�VSPB
^ FESSIONSCOOE�ORTIUTNEORSHEISE%EMPTTHGREFROMMIDTHEBAS�SFORTMEALLEOEDE%[MP-
� TION.ANYY�OLATIDNOFSECTION7007.6BYANVAPPUCANTFORAPERMITSUBJECT97MEAPP�ICANTTO Z Re-Roof
� ACM�VENALN OF NOT AqqE iHAN iNE HUNDRED DCIURS(5500).):
0 O�ASOWNEROFTIEPFlOPERTV.ORMYEMPLOYEESWITHWAGESASMEIRSOLECOMVENSATION, 0 COmm9fCf01 �
Z WILL DO TXE WORK,IWD iHE STRUCTURE IS HOT INTENDED OR OFFERED FOR SALE(SEG.70N.BU51- J
NESS AND GROFESSIONS CO�E TME COMMCTORS LICENSE UW DOES NOTAVPLV TO AN OWNER OF
� FIqPERiYVM110BU11.090RMVROVESTHEAEON,ANDWNODOESSUCHWONNHIMSELFORHERSELFOR m
Q 1HROUCHMSORNEROMMEMPLOYEES.�ROViDE0iMA75UCHIMPROVEMENTSARENOTINTENOEDOR
LL1 OFFFREO FORSAIE IF,IqWEVER 7ME BLMLA�N(i ORIAIPROVEIAENT LS SOID 1NRMIN ONE YEAR OF COM�LE-
� TqN,THE OriNER�BUiIDER N7LL MAVE THE BUROEN OF PRONN�TUT ME OR SHE DIO NOT BURD OR
Z MIDROVEiOR7HEPURPO5EOF5KE).
= pI,ASONMEROFTHEiROPERTY,AMEXCLUSNEIVtOMMCTINOWI7HLICENSEDCONTRIICTORS n .. �
� TO LONSTRUCT TIE YRQIECT(SEG 70H,BUS�NE55 AND PROfE55lON5 COOE:THE CONTMC10H5 Lb V0IU8lI0f1 h GT�D ADJ.AREA �� p I' •
W CENSEUWDOESNOTAVPLYTOANOWNEROFAPROVERTYWNOBUILDSOHMPROVESTNEREON.MIO
� W/1000NTMCTSFORSUCM7ROJECTSVATMACONiMCTOR(57L�CENSEDPURSUANTTOTHECANTiUO QUANTITY DESCRIPTION FEE
Y TORSUCENSEUW.).
� O 1 AM EXEMPT UNOER SEG B.t P.G FOR THIS REASON a
� U
u' UATE OWNER �
Z W
� UCENSED CONTRACTORS DECLARATION �y
� IHEREBY/FFIRMUNOERPENALTYOFPEiWRY7NATIAMLICENSEDUNOERPROV1510NSOFCIUPTEF �
d i(COMMENCMaNTiHSECTqN70D0)OFDN�SION70FTHEBUSINESSANDPROFESSIONSCODE,I�ND Z
4V IICENSE LS IN iUl FORCE AND EFiECT. m
�
0 UCENSE CUSS �• LIC.NO. � J
V DATE � CONTRACTOfi � d
.. _._W . - . . -
� WORKERS'COMPENSATION DECLARAT�ON Q
� U
� IH q�BYAFFIRMUNDERPEWLLTVOFPERIUMONEOFTHEFOLLOWINOCECLAMTIONS:
� �'�{��/r' Z
0 y��HAVEANONALLMAINTNNACERTIFlCA7EOFCONSEMTOSELF-INSUREFORIMORKE115 2
� � Z�OMPENS�TION.ASFROVIOEDBYSECTION7IOOOFTHELABORCODE.FORTHEFERf-0RMANCE W
OF 1HE WORK FOR WH1CH TMIS VEAMIT IB ISSUED. �
�
IHM/EANDVJ�LLMAIN7AMWORKERS'CAIAPENSMIONINSURANCE,ASREWIREDBYSECTION /�(�^DO
Q J7000FiHEtABORCODE,FORTMEFERFORMANCEOFTHEWORKFORNMICHTMISiERMR15 �
ISSUED.MYWORIfERS'�PE�N°TIONWS 10ECMRi NJDPOLICVNUMBERME: CONSTRUCTION 6J
� CARRIER �Yi'—'�'^ PLAN FEVIEW
Z POLMV NUMBER ��'�� ELECTRIC
� (fWssEcm�rEEDeaiBE0.Y.RFfEooFTfPERMi16inROh£Hl�AiiEDDOl1MSK+00I0RLE551 PLUM8ING
G
Z ICERTIFYTHATNTHEPERFORMANCEOFTHEWORKFORWHIpITN15PERA1ITISISSVED,1 MECHANICAL
C7 SH�I.LNOiEMPLOYANYPER50NINANYMANNERSOA5TO8ECOME3U8JECTTO7FIE
N WORKERS•COAIPENSAiIONUWSaFCALIFORN10.�N0/�fiREfTHATIF15110ULDBECOME INSPECTIONFEE �J �
SU&IECTTO7MEMlORNERS'COMPENSATqNPROVI510N50FSECT�ON�7000FTHElABON �SSUANCE +�'�-+' ^r
CODE, OHTIMATH COMVLY WITH TNOSE ROVISIONS. )�
p DATE: ' � ��APPLICANT. I��CJ C�U� SMIP
� WARNINo: MURETOSELUREWORKER5COMPENSATqNCOVERAGEISUNUWFUI,AN�9WLLLBE ENERGYP/C •SD_
� SU&IECTANEUPLOYERTOCRIMNALPENALTIESANOCMLFWESUPTOONEMJNDRE0THW51WU ENERGYPERMI7
DOLLARS(St W.DoO).IN AOOI710N TO THE C0.5T OF COAIPENSATION.DAM�GES AS PRO�OED FOR IN Q
J SECTION 770t OFTHE UBOR CODE,NTEHEST,ANO ATTORNE'!5 FEES. RETENTION FEE:
�
oW.. CONSTRUCTION LFNDING AGENCY PRE•ALT FEE
Q IHEREBVAFFIRMUNDENVENALTYDFVERJURYTHAT7HEREISACONSTRUCT�ONLENDiN6AGENCY
a FORTMEVERFOWAANCEOFTHEWORKFORW111CMTHISPERAIITISI55UED(SEG00C7.qV.G). �
�
� LENDER'SN�E
� LENDERSADORESS
WICERTIFYiNAi1H�VEREADTHISAPPLICA110NM7D5TATEiHATT7EABWEINFORMATqNISCORRECT. TOTALFEES I� �
� IA6REETOCOMVLYN7THALLCT'ANDCOUNiYOROWANCE5AND5TATEUNSREUTWOTOBURAINO
CONSTRUCTION,AND NEREBV AUTHORI2E AEPRESEMATNES OF THIS COVNTY TO EIRER UPON TNE �
ZABOVE�I.�ENTqNEOVROVEFTYFORINSPECTqNFUNVO5E5. COMMENTS
o � � n�
miER1AITTE N E(ORINT�
� 0'-z1
� SiON U �OFPERMITf TE
� RECPT.N0. PAID BY VALIDATION
WHITE—Dapartment Copy.YELLOW—Fnanee Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy
tj.. ..... .._ . , .' .�: Ylti: '�i.—.._.v�R- .. -.'�):.zo:.,s P✓�;Y,�,`tPiJ. .-:.C4.L"-7.�I.i.'��ry'..J'���•8Y�'4���r-,P" �. ��r;.r-.�._�'.w.T.a•w�w.>n.•erM":_.yd>.. - .. .��^ ... .
'b. " � ,
CiTV OF DIAMOND BAR
� INSPECTiOfs REC06;D
�
-
� i1��-����:�c���. . i�'��� �"��-���.��o�r� � . lf►,�����`.�I��� :��`��r=� .�. ����.�'�� �'�� :
SET BACK � , _ --:�._.. .... � _ FLOOR JOIST .._._..� ..__I:� .J ., -
FTGS/FORMS/STEEL �� � . FHA REQM7S
ELECTRIC GROUND UNDER FLaOR DUCT .
GROUND PLUMBING UNDER FLOOR CUI�IDUIT -` - ' '
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MIO HT, BOND BEAM
ROOF SHEATHING I' /Ll 8 FT. BdND BEAti1
FRAMINGNENTILIATION � FINAL BOND BEAM
ROOF COVER . � ��(�i PRE-GRADING ':
RODUH HEATING BENCHING i
ROUGH ELECTRIC R�UGH GRADING �
ROUGH PLUMBING � FINISH GRADING
SHOWERlTUB TEST � I POOL ELECTRIC
EXT.LATH/51DING POOL FENCING
WALL IPJSULATION � ' POOL FINAL �
CEILING INSULATION � ! � OFF SITE IMPS. �
DRYWALL NAILING I � DEDICATIONS
SEWER. _ ; FINAL ENG.
SEPTIC TANK . ; LANDSCAPE/IRRIG.
SEEP PIT/L.L. "�� � ON SITE IMPS.
GAS AIR TEST ; FWAL ZONING
� FINAL CONST. J ! FlRE DEPT. FINA!
FINAL HEATiNG � ; HEALTH DEPT. FINAL
FINAL ELECTRIC� � 1 - I ' DEV. FEES PAID
FINAL PLUMBING � i ENERGY '
� I • I
; � �,"c9 �,�p.�c��1 a c e. . �
. �
� - - - -- --- -_ ___ - - -- •----- .--- - - --— -
COMMENTS
_ . . _ . . . . . 11
�' fy. .
.. `.
SEPTIC TANK SIZE
SEEP PIT/U 51ZE .
_�� . .
, .... I
?���� .�. • .��r
li
M
_ ::� _, � . . . . �
. �
_..,.�..�_._........_� - �� , i ;: . . . .