Loading...
HomeMy WebLinkAbout17705 (19) fi�� . . . ___ w ._ . ..._�.�___...... . " '_ ._. . . __.... . . . , � CITY OF DIAMOND BAR EXPIR�� DEPAR7'1v�NT OF COMMUNTTY&DEVELOPMENT SERVICES • �s- 21825 E.Copley Drive JUt� 1� ���� (909)860-3195 Fax(909)861-3117 PRESS ��'%�' BUILDING PERMIT APPLICATION FIRM�Y � JOBSITE .,/� APPLICATIO PERMIT P!C o ADDRESS�Ih3 ���T Q�.. DATE G �L NUMBER/7�oS k � issue TYPE occ APN LOT TRACT DATE CONST. GROUP p OWNER p ADDRESS ZONING SETBACKS z CITI��ZPL ZIP� TEL. — R�RT RW O g APPLICANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTO SIDE ❑ � ADDRES ' p C�l, ` Z� TEL PROPOSED USE oARCH/ENG � DESIGNER NO.DWEL. N . NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNEFi•BUILDER DECLARATION SFR/ADDlREM O I MEREBY AFFIRM UNOER VENALTY OF VERIUHY THAT 1 AM El(EMiT FROM TME CONTMCTORS L4 G3f8gB/C81pOR W CENSEUWFORTMEFOLLOWIN(iREA50N(SEC.70.71.6BUSINESSFNOPROFESSIONSLODE:ANVCITYOR (n U COUNTYWHICNREOUIRESAGERAIITiOCONSTRUCT,ALTE0.��PR�YE,DEAlOLISH,ORREPAIFANYSTRUG �1J PdtIOIDBCk � IURE GRIOR TO ITS ISSUANCE.AL50 REOUIRES TME APPIICAlR FOR SUCH PEfWIT TO FILE A SIGNED W STATEA/EM 7HAT HE OR SHE IS LICENSE�MIRSUANi Ttl THE PFOVISIONS OF THE CONTRACTORS L6 � CENSE UW(CiIAPTER Y(COIAA1ENpN�WITH SECTION 70oa)OF DIVISION 7 OF THE BUSINESS AND PR0. �- PooUSpa FESSqNSCO�E)ORTHATHEORSHEISE%EA1PTiHEREFR0A1AND7NEBA515FORTNEALLE�EDE%EMP� (� � iqN./NVVIOLATqNOFSECTION70.71.68VANVMPL�CANTFORAPERHiTSUBJECTSTHEAPPLICANTTO Z Re-Roof A CML VENALTY OF NpT MORE TW�FNE HUNORED DOLURS(f5oo).): 0 ❑�,ASOYMEROFTMEPROPERTY,OFMYEMP�OYEESNATMWAGESASTMEIRSOIECOMPENSATqN, � `(Amm0fCI8I - Z WILLOO TME WORK,ANO TF1E STRUCTURE IS HOT IN7ENDED OR OFFERED FOfl SALE(SEC.70N,BUS�� J N NESS AND VROFESSIONS CODE:THE CONTMCTOqS UCENSE UW DOES NOT APVLV TO AN OWNER OF ? PROPER7Y YM110 BUIlD3 OR IMPROVES MEREON.AND WHD DOES SUCH Wt�RK MIMSEIF OR HERSELF OH 2 7HROUCHHISORNERONMEMPLOVEES,PRON�EDTHATSUq/WPROVEMEMSARENO7INTENOEDOR CO QOFFEREUFORS/LEIF,FIOWEVE0.TMEBUL�INGORIMPqOVEA1EMI550LOW17HINONEYEAROF�pMPLE Z iqN,THE OWNER�BUILDER MALL HAVE iNE BURDEN OF PROVWC THAT NE OR SHE D�D NOT BURD OR � IMPROVEFORiHEPUflPOSEOF6ILLE). w ❑4�OWNEROFh1E7ROPERTY,AAIE%CLUSNELYCANTflACTWOWITHUCENSEDCONfMCTORS � TO GONSTRUCT THE GROJECT(SEG 70N,BUSINES511N0 PROFESSIONS CODE:TME CONTMCTORS L4 V8N8�IOf1 AQI.AREA L11 CENSEUWDOESNOTAPPLI'TOMIOWNEROFIIPROPERTYWNOBUILDSORIMFROVESTMEREON.MlD F_ WHOCONTRACTSFORSUCMVRPIECTSWITHAGONTMCTOR�S�LICENSEOPURSWWTTOTFIECON7RAG OUANTITY DESCRIPTION FEE Y TOflSLICENSEUW.� � ❑IAMIXEMPTUNDfRSEG B.iP.GFOHTHISREASON a � U l� ¢ OATE OWNER U Z W �Q UCENSED CONTRACTORS DECLARATION w CC IHEREBYAFFlRMUNDERPENALTVOFPEFJUFYTMATIAMLICENSEDUNOEHVROVISKKJSOFCMAPTER Vr � 9(COMMENpNON7THSECTION700oIOFDIV15qN�OFTHEBU51NE55ANDPROfE55qN5CODE.AND Z �� MV LICENSE i51N iULL FORCEAND EfFECL - / m � uc�r+se cuss uc.No.���/�D � j V DATE ��" � COMRACTOR _ �- W � WORKERS'COMPENSATION DECLARATION Q = U � IHEREBVAFFIRAIUNDERDENALTYOFGf0.NRYONEOFT11EfOLLOWINODEd.AfUT10N5: z � _IHAYEANDWILLMNNTAINACERTIFIGITEOFGONSENTTOSEIF-INSUREFORM/OR1(ER5 =, COMPENSATION,ASPHOVIDEDBYSECTION�7o00F7HEU80RCO0E.FORTMEPERFORMANCE W Q OFTHEWON(fORWHICHTHISCERMITISI55UED. � w �IMAYEANDWILLMNMAINWORKERS'COMPENSATIONINSUiUNCE.ASREWiREDBY5ECT10N Q 770oOFTMELABORCODE.FORTMEPERFORMANCEOFTMEWORKFORWHICHiN13PERMRIS ��;��� 65UEU.MYIN7RNERS'LOMPENSATIONINSU CARRIERANUPOLIGYNUMBERARE: CONSTRUCTION � CARRIEN ��Ts�'�r' �� PLAN HEVIEW 0 POLICYNUMBET��� 7f'L� �O/ ELECTRIC � i'� -- ' I . 0 (fHSSECfIOHNEmNOTBECp.S'LE7FDOFhfPEPoMSi01i0NEFIlR,OiIEDDQIARSKfmJOqLE55} PLUMBING � . . Z I CERTIFY iHAT NTME FERFOqMANCE OF THE N'ORK FOR WHlp/TNIS PERMIT IS ISSUED,I MECHANICAL � ! � ����'� (} SHALLNOTEMPLOYMlVPERSONWANYMANNERSOA5T00ECOMESUBJECTTOTHE � WORKEN5 LOMPENSATION UWS OF CALIFORM0.�ND�GREE T//�T IF 1 SHOULD BECOAIE INSPECT�ON FEE S SUBJECTTOTMEWORKERS'COMPENSATbN7flOVI510N50FSECTION]7000FTHEUBOR .._ „ �' CAOE,1 SWLLL FORTHIMT/COM7LY VAIH T110SE PROVISIONS. ISSUANCE � SMIP — ,.J U p DATE: APPLICANT: W � WARNINQ:GAIWHETOSEWREWOIiKERS'COMPENSATIONCOVERAGEISUNUWFULANDSH�ILBE ENERGYPIC �y SUFfJECfANErAPLOVERTOCR1611NALDENALTIESANDdNLFWESUPTOONEHUNOREDiF10USAN0 ENERGYPERMIT DOLLARS R��.�1•�N ADDITION TO THE COST OF COMVENSATqN,DAAIACES AS PHOVIDEO iOR IN � SECilON7�0eOFTiELADORCOOE,INtEREST,MIDATiORNEY'SFEES. RETENTIONFEE: n` aw.. CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBVAGFWIlUNOERPENiILTYOFPE0.1t1HVTHATTHEREISACONSTHUCTIONLEN�INGAGENCY FORTME VERFORMANCE OF ME WOi1K FOR WNICH THIS 7ERAIITIS 1554E0(SEC.]097,CIV.G). Z W � LENOEfYSNAME F_— LENDERSM�RE55 � ICERTIFYTHATIHAVEREADTHISAPFLICATIONAN�STATETHATTHE�BOVEWiORMATqNISCARRECT. TOTALFEES �/ 3• " W IAGREETOCOMPLVWITHALICRYIWOCWMYOR0INANC[SANDSTATEIAWSREUTINOTOBU1L01NG 1 � CONSTRUC'TION,ANDHEREBYAUT/10PIIEREGRESENTATNESOFTHISCWNTVTOEMERUPONTME Z �BOVEdAENTIONEDOROPERTVFORIN57ECTqNPURPO5E5. COMMENTS 0 � m ¢ PENMITtEENA E�P � `� �-(2-�1-�=�i-�I'?� � SIGNANREOFVER EE �TE � RECPT.N0. PAID 8Y VALIDATION WHITE—Department Copy.YELLOW—Finence Capy,PINK—Assessor Copy,GO ENROD—Fite Copy,GREEN—Applican['s Gopy . _ .. -- -_ „ ,..., .. ...,. .. . , - , . . . . . .. " �.e . �..:•.. . .i•'1�,'•Y t:i.�.,.. , . .� �.:Y� . i... :.T'1 '. ��1 .,. .�. :'�. .. r . R'i'.. t �i( �. . . • !�5�4.\ �i i lr c�� �a�,rror�� 6,�� i�����E�����ur� �:�co�� �..._..__.___.T ��.�_�_ e' Y . �' �l R -i --_-�._.-_....-.....___ �.< ___ .-.�.-_ �... _ ,I►r�,j'i=rc`;�(C��►�;' c,u ie .: ��� a-�.� rr�)�� i►�c-��'..1�`��l[c���r �trti�[1�. �►�k-��l�c��e;�*� i .._..�._____.:-- --__..__ �. -� . '- -- _ __ .- _ . - •- : ._..___..___ ..__. _._.._�_..-�___.__.�.��.._.._, . SET BACY, ! I � � FLOQR JO1ST I FfGS/FORP�IS/STEEL i FHA REQ'�iTS � ELECTRIC GROUND � fj � �U�dDER FLOOR DUCT I I GROUND PLUMBING I _�_ _ i Ui�DER FLOOR CU�IDUIT � SLAB GR�1DE i I FIREPL'F�CE FOUNDATION� I� TEP�1P POWER � � FIREP�ACE BOND 6EAP,4 I I WATER SERVICE _ _l MID HT. BOND BEAP.1 _ I ROOF SHEATHING • �__�� s FT. �OND BEt,r�1 ; � FRAPJIING/VENTILIATIOi�I I FINAL EiONO BEA'�� ROOF COVER PRE-GRF.DING i ROUGH HEATIfJG BEt•JCHING � ROUGH ELECTRIC ROUGH GRADING ROUGH PLUti1BING FINISH GRADING I SH�WER�TUB TEST j POOL ELECTRIC EXT. LATH/5101NG �POOL FENCING � bVALL INSULATION POOL FINAL i CEILING INSULATI�tJ OFF SITE IMPS. DRYWALL NAILING DEDICATIOf�S j SEWER FINAL ENG. SEPTIC TANK , ,�� • LANDSCAPE/IRRIG. SEEP PITlL_L. � � ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. � F!RE DEPT, FINA!. FINAL HEATING � � HEALTH DEPT. FINAL F1NAL ELECTRIC � i � DEV. FEES PAID FINAL PLUMBING Et•JERGY ( �. C,O���r,T�.���i,".jE{[�,' � ' _...r....__. ��.� ----------� CUMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE i��G � ���� ,` � ��, \ . �