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HomeMy WebLinkAbout18358 �� CITY OF DIAMOND BAR - � ,� DEPARTN�NT OF COMMUNITY 8c DEVELAPMENT SERVICES 21825 E.Copley Drive PRESS ~ (909)860-3195 Fax(909)861-3117 ��`�� Bun.nnvcrE�rra�P�CA�oN FIRMLY o ADDRESS�� ��.Gc� Q� � � APPLICATION 2 3 DZ PERMIT It/�S�'('� P/C � � �,� DATE 7 NUMBER � M c� ISSUE TYPE OCC APN ' LOT TRACT DATE � 23 �Z� CONST. GROUP °C OWNER �' O o ADDRESS � �-( �t � 2.5�- pri�/e ZONING SEfBACKS �"' CITY � � c� � ZIP TEL.G04��G1�00� REART � p APPUCANT TELCt�i''/�—00�� SIDE/SIDE STREET RW O � CONTRACTOR ' SIDE O Q ADDRESS � CITY ZIP TEL PROPOSED USE w ARCWENG/ � DESIGNER NO.DWEL NO. NO. , ' a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADO/REM O p I HEREBY AFGIRAI UNDER CENAL7Y OF PE0.AlRY THAT 1 MI El(EMM FROA1 THE CONTMCTORS LF GAfB�B/C8fp0A W CENSEUWfORiHEFOLLOWtlJaREASON(SEG7W1.6BUSINE54ANDii10FES510N4CODE:IHJYCRYOR (n (.7 COUNT`/WHICHREWIF3ESAPERMRTOCONSTRUCT,ALTE0.MPiiOVE.DEMOLISN,ORREDA1qANYSTRUG W �Z 7URE,PH10R TO RS ISSUANCE,K50 REWIRES THE MPLICANT FOR SUp1 PEPoAI7T0 FILE A SICNED W PaliolDeck ETATEMENT iHAi ME OR SME IS IICENSED iURSUANT TO THE PitOVISION3 OF THE CONiMCTORS lF � C£NSEUN�(CMAPiER�(COMMENCWOW(THSECTIDN70D0)OFDM510NiOFTMEBU51NE55ANDGRP V" POOVSPe FESSqNS COO�ON THATl1E Oi15NE IS EJIEMPT THEREFROMAND iHE&4515 FOR TYIE ALLEOED EXEMP• TION.MIYVIOlAT10NOfSECT10N)W1.6BYANYAGVLICANTFORAPERAIITSUBJECTSTHEAVVLICMlTTO Z RB-R00} �„_ ACMLPfE1N.7YOFNOTMOREIT1ANiNEHUNOREDDOLLMS(5600),I: � 11L�OMMEROFTHEOROVERiV.ORWEIADLOVEESMATHWAGESASTHEIqSOIECOAIPENSATbN, � �mmerolal - WILLDO THE WOiit,IND THE STRIICTURE IS NOT IMENOE�OR OFFERED FOR S/LE(SEC.70u,BU51- J N NE54 AND DROFESSIONS CODE THE COMRACTORS LICENSE UW DOES NOTAPPLV TO AN OWNER OF � iROPEiRY VRIO BUIlD30R IMPIqVE3 THEREON.M70 WHO DOES SUp/VKMK HIMSELF OR HERSELF 011 2 THROU(7HMISORNENOWNEGiLOYEES,FROVIDEOTHATSUC11MGqOVEMENTSARENOTMEt�EDOR m 6 OFFEREOiORSALEIF110WEVERTMEBULpNOORiMPROVEMINT650LDWfTHINONEYEAROFCOMPLE- Z TION,THE O'M1ER8U0.DER YALL IUVE iHE BURDEN OF pROVINU THAT HE OR SME DID NOT 6UILD ON = MVfiDYEfOR TME WRPOSE OF SALEI. W �1,ASOWNEROFTHEDROPERTY,AMEllCLUSNELYCONTMCT410NTiTILICENSEDCOHfMCTORS � � M tONSTRUCTT/1E GNOJECT(SEG 7aI,BUSINES4AND ViqFE5510N5 CODE iHE COHTRACTORS U• Ve1U011W1 ADJ.AREA CENSE UW DOES NOTMPLY TO AN OWNER OFA PROPEHTY Ynq BU0.D5 OR MPROVES THEREON,M1D � wracoHra�crs�onsucNvr+aEcrsvnn��cartrucroRls�ucer+seovur�suurrron�ewrrrrua pUANTITY DESCRIPTION FEE � Toas ucer+se uw.�. , � O I AM EXEMPT UNDER SEC. B.l P.C.FOR THIS REASON � � U � �=' DATE OWNER U F UCENSED CONTRACTORS DECLARAT�ON W � IMEREBYAFFIRMUNOERPENALTYOFPERURYTMATIAMLIGENSEOUNDERiROVISIONSOFCHAPTER � � f(COA1MENqNO WITN SECTION700o)OF DMSION�Of THE BUSINE55 ANO FROFESSIONS COOE,AND Z �� MY LICENSE IS N ML FORCE AND EFFECT. m � UCENSE CLASS � LIC.NO. � V ppTE ' CONTMCTOR d W � •WORKERS'COMPENSATION DECLARATION 4 � IHE0.EBVAFFIRMUNOENPEWLLTYOFPER1URYdJEOFiHEFOLLOWiN60EC1ARATIONS U � 2 0 _IHAVEAND'MLLMNNTAR/ACERTIFlGITEOFCONSEMTDSELF-INSUREFOHWORKERS' � '�d- COMPENSATION,AS PRONOED BY SECTION J700 OF TNE UIBOR CODE FOR THE PER�ORMM7CE w Of THE WORN FOR NM1aCM iHIS OER/AIT IS ISSUED. � � Q _I MAVE IND NALL MAIMAW WOfiKER3'COMPENSATION INSUW WCE,AS RE WIRED BY SECTION J7000F7HELABORCODE,FORTHEVERWRMANCEOFIMEM/ON(FOHWHiOtTM�SiEHMR15 J���r � ISSUED.I.fYWORKERSCOMPENSAT10F1W5URANCECARRIERINDPOLICYNUMBERME: CONSTRUCTION � GRqIER PUW REVIEW o DOLICVNUMBER ELECTRIC �¢ 0 (iYCSgECI1Cry1i��p7pEW�FLETEppF71EpERwr6FOqprlEM.rpfiEppOlWtsgloojOqlE55} PLUMBING Z t CERTIFV7HAT N THE PERFORIMNCE OF iHE WOPoC FOR WMCH iH15 VERMR 61SSUE0,I MECHANICAL Ly 5/uLLNOTEMPLOYMIYGER50NWANYYINNEHSOASTOBECOME9UBJECTTOTHE N W'ORKERS'COMPENSATIONUw50FGWFORNiA.ANDAGREETHATIFIStIq1lDBEC011E INSPECTIONFEE S SUBJECTTOTHEWORNERSOaAPENSATIONVRON510N50F5ECTqN�70oOFTHEUBOR �SSUANCE - COOE,1 SWLLL FORi11W17H COMPLV VlIiM THOSE PROYISIONS. � p WTE: � APPLICANT: SMIP � . � ENERGY P/C WARNINO:iM.URETO SEWRE WOiiKERS'COMPENSATION COVEMGE IS UNUIWFU4 AND SIULLBE � 6U&7EGT/iNEMPIOYERTOCRIMINN.PENFITIESANOGIVItfiNESUPTOONEHUNDFEDiHWS�WD ENERGYPERMIT OOLLARS(1100,000�.W i1DDITION T07ME COSTOF GOMPENSATION,DAMA6E3 AS PROVIDE�FOR IH � SECTION]70lOFTHELA80RCODE,RffEREST.ANDA7TORNEYSFEES. RETENTIONFEE: � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE O � IHEFEBYAFFlPHUNOERVENKT/OFPERtt1RYiMATiHEREISACONSTRUCTqNLENDINOAOENCY 0Z- FOR 7HE GERFOFMANCE OF THE WOFlK iOR NT71CN T1115 VERM�T IS ISSUED(SEG JOY7,qV.C.} W � lEN0ER5 WVAE gIENOER'SADDNES4 � ICEHTIFYTMATINMEREADTNISMPIICATKX1IwD5TATETW�TTMEABOVENFORMA7qNISCORRECT. TOTAL FEES �� � �� W I AGREE TO WMPIY WITH A�L GIfY ANU COUNTY ORDPUNCES ANO 5TA7E UwS REUTN6 TO BUILDING � CONSTRUCTION.ANDHEREBYAUTlIOH12EREFRESEMATNESOFTHISCOlR7TYTOENTENVPONTHE Z ABOVE•4EHTIONED VROPERTY FOR INSCECT�ON PURPOSES. COMMENTS �' = I�QCf"�'[.i � �rYtGlvl d-C.Z. m oEaMrrrEe wwe ivar+r� a '�'dl�1 f/l.f-� �� � y SIGWUUREOFFERIAITTEE DATE � RECPT.NO. 3 pAID BY e VALIDATION � VYHITE—Depertment Copy,YELLOW--Fhence Copy.PINK—Aasessor Copy.GOLDENROO—Ffle Copy,GiiEEN—ApplicanCs Copy . . , . . , , .-.� , . , . � .'., , . - - . ,. , . . . . , .�-. . . . .. _. .. , . ._ CITY OF DIAMOND BAR INSPECTION RECORD ' i(��-J��c�,�ii (a`l�� �.��fi=� !I�F=�������� �f►���������I ��;�r�.. . . il►��=��1��I�I� SET BACK FLOOR JOIST • FTGS(FORMSlSTEEL FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR COMDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE � MID HT.BOND BEAM ROOF SHEATHING � 8 Fl:BOND BEAM FRAMINGNENTILIATION � • ' ' FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT:LATH/SIDING � 3! pZ R��Z POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK � LANDSCAPE/IRRIG. SEEP PIT/l..L. ' ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. �bz.. FIRE DEPT.FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV.FEES PAID FINAL PLUMBING ENERGY ltti��n--� � SiluL � n�z7 ,c �; P�!��:„c�Xe�,t� � COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE i�� . � j - �■ i 41��� 'I�; � � ;�