HomeMy WebLinkAbout13791 (52) C[TY OF DIAMOND BAR
� _ -� ( ��
DEPARTMENT OF COMMUMTY&DEVELOP SERVICES
�� 21660 E.CopleyDrive Suite 190
(909)860-3195 Fax(909)861-3117 PRESS
�`'��'�� BUII.DING PERMIT APPLICATION FiRMLY
o DDRIESS ZO '�'� 3� �AR-Lr C�/S+TE S I • DATECATION � � �"� NUMBER ' `'�� (N/C
� ISSUE TYPE OCC
APN c�oG U 2 M Ac2 g L(-' DATE CONST. GROUP
p OWNER
o ADDRESS_ 20 S 30 �A F=�—f� G—A'1 G i f. ZONING SEfBACKS
� CITY�I A Mr�N�-i/�/r11P ��J��'TEL. c, FR�� RW �
'*'�`7 ����/ REAR p
APPLICANT .r✓,�T�G Ti � � �� � TL'
� °'*y'- �'''�►'Gh'�. , SIDE/SIDE STREET RW ❑
CONTRACTOR {tC MEG(�y/aN�L'/-►� C1� /NG� SIDE ❑
ADDRESS 2�/ 5 • 5'�'� /4 vE
� 1 PROPOSED USE
CfTY�� PV E�►i E ZIP�'���TELi1�I -��+
� ARCH/ENG/ �
DESIGNER NO.DWEL NO. N0.
ADDRESS UNITS STORIES BEDAOOMS
� CRY ZIP TEL
cn DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
Q OVYNER•BUILDER OECLARATION I SFR/ApDlREM
O
Q I HER�V AFFlRM UNDER PEwLLN OF iERA1NY THAT i AA1 E%EUPT iRCM TH[CONTMC70R5 U� G2f8g0/C8(pOR
� W CENSEUWFORT11EiOLLpM:NOREASON(SEC.7W7.6BVSINESSANOPROF[S510fJ5LO�E:ANYCIT'OR (f�
� COUHTI'YRAOIREOUIflESAPERMRTOCONSTAULT,ALTERIMPROVE,�EF10LI5H2ORREPAIRANYSTFtUC• W Patio/Deck
TURE,VRqR TO RS tSSVANCE,AL50 R[W IRES THE APPl1CANT FOR SUCM PEfl4IT TO FlLE A SIGNED w
� STATFMENT h1AT HE DR SME IS LICENSED VURSUMIT TO TNE PRONSIONS OF TME CONTMCTOFtS LI•
CENSE lAW(dUDTER Y(COAIMENCINO YAM SECTICN 7000)OF DIVISION]OF THE BUSINESS AND 7R0• V" PoaUSpa
FESSpNSWO�ORTHATHEOR5HE15E%EA�PTTIIEREFROI.�M7DTMEBASISFORTHEALLfdEOE%E1AP- C7
TION.ANYVIOLATIONOFSECT10N70]1.68VANVAPP�ICANTFORAVERMIiSU&IECTSTHEAPPLIGWTTO Z Re•Root
� ACML7ENALTYOFNOTMOfiETWWFfVEHUNOREDDttURs�fsoel):
� 04ASON'NEROFTHEPROPERTY,ORMVEMP�OYEESWITHWAG[SASiHEIF50lECOMPEN5AT10N, ❑ Commerdal �
NMLL DO iHE WOWC,M!D TME STFUCTURE IS NOT INTENDEO OR OFFEREO FOF SALE ISEL.70N.BU51• J
N NESS IINO VROFESSqNS CODE:7HE CONTMCTOFS UCEHSE UW OOES NOT APPLY TO AN OWNER OF =
VROPERTY 1M10 BUIL.D9 OR IMPROVES THEREON.M10 MAiO OOES SUpi WOi1K HIMSELF Oq HERSELF OR
� TMROUGNHISOfiHERO'V�RJEAIPLDYEES.CNOVIOE�T/ATSl1tl/UAPROVEAlEYTSARENOTMENOEDOR LI�
OiFEREO FOR SAI.E IF,/qVlEVE0.N�BUILDWOOR IMMdOVEUENT t5 SOID V.'ITHtN ONE YEAA OF COM0.F-
TqN,TNE CWNER-BUIIDER WILL HAYE THE BUfiOEN OF PROVINO TMAT HE OR SHE DID NOT BUIID OR
PIVROVE FOR ME NRPOSE OF SALF7.
W Ot�OWNEROFMEPqOPEftTY,AMIXCLU5IVELYCONTRACTIN�WITHUCENSCDCONTMLTOR4
� TO CONSTRt1CT TME PHQIEGT(SEC.1aM,BUSINL55 AND PROFESSIONS CCJE:7HE CO`1TfUCTORS U- V31U8IIOf1 A0.1.AREA
� CENSEUWDOESNOTA➢PLYTOANCWNEROFAFROPENT`/Y�'HOBUM1DSORWVROYESTHERLON,Ni�
MhqCAfdTMCTSFORSUpf�ROUECT5WITIACMlTMttOHI51UCEN5EDPURSUANTTOTHECONTMG OUANTITY DESCRIPTION FEE
� TORS LICENSE UW�. I
O I AM IXEIAPT UNDER SEC. B.1 V C.FOR THIS RE�SON J
�, U
Q
LLZ' OATE OWNER � V
F LICENSED CONTRACTORS DECLARATION , w L�!O y`' O`�+
J
� `
I HEREBY�FFIRY UNOER iENN.TY OF GE0.A1Rv MAT I A1A LKENSED UNDER PFOV14�oNS Of CNAPiER �
S ��COMAIENGNOVnhISECTION7000)OFDNISq�7J THfBUSINC55M'DPRJFESSIONSCODE,M10 Z ' �
X MY LICENSE IS N iULL FORCE MJD EiFECT. ! 3 I_ i m -,p Q A '����r •
/�/ ►� � (J '\�
o u��sE�uss G'� ��.No. G 3 �o� 'S �
�
V DA o �a���o� K�M�cKa.�/c�t a
� WORKERS'COMPENSATION DECLARATION �I � Q / � C C'L.. Y�� O CL�w �,
� I NEREBYAiFlPM UNOEH PENALTY Of FENUiiY C4aE OF TME FOLLOYnNG DECLAiLl1�ON5. Z �N d � � �
O �IHAVE/NDWILLAUMTAINACERTIi1CAiEOFODNSEHTTOSFIF�INSMEGORWORKERS' $ � (� � ��
a COMPENSATION,/S PROVIDED Bv SECTION�700 OF TIE UDOR COOE.FOiI iHE VERfORM/WCE �U r • '�^� J � r, •�
Of TME WORK FORNMIGI THIS VEFMR IS ISSUED. .2
,�„ / I
_I HAVE AND W!LL 4AP.IAIN WORKERS'COMPENSATION INSURANCE.AS RCIXJ'R'cD BY SECTION
4Q 770o OFT1E 1A00R COOE.iOR THE GER W 0.UANCf OF THE WORK FOR WHICH THIS 0ERu1T 15 ,
ISSUED.WWORKERS'COMPENSATI IN ANC�A IERMIDVOLICYNUM9ERM". CONSTRUCTION
jCARRIER v~ � `-�2`�'��n � PLANREVIEW
2 va�crNu�eEA � ELECTRIC
Q
� (iY7ss[cnwn£�NoiBEa�s�ErEoocncvEn.RstortoHE��r.DRFDoaluLs�t'roloqt[ss) PLUMBING
J Z I CERtif'/THAT N THE PERFOHM/WCE OF iMF N'ORK FOR WHIG1 TMIS PERIniT IS ISSUED,1 MECHANI �
• (7 WLLLNOTEMPl0YM1VPEf3SONINANYMANNERSOASTOBECOMESUWECTTOTME
� RKERS'CpAPEN5AT10NUW50FCALIFOqNIA,ANOAGREETHATIF15VqUlDBECOA�E INSPECTIONFEE
SUBJECT f0 THE W00.KFR5'CpAPEN5AT10N VMJNS10N5 OF SECT10t177a10i THE UBOH �
.is coAtr+vnnicor.�a�rwm�nasEoao�nsar+s. ISSUANCE
i
� DATE:� 1' �APPLICAM: �G /V)�CH�MI E�C C-� SMIP
� ' ENERGY P/C
WAiW INQ fAILURE TO SECUNE WORKERS'CAMPENSATbN COVERAGE IS UNUWFUL.Ml0 SHALL BE
�y SU&IECTMlEMPLOYERTOCRIM'.NALOEtU1TIESANOCNILFWESUPTOONEMIXJDR[DTHOUSAND ENERGYPERMIT
DOIURS(f100,000�,M!ADDITION TO THE COST OF COIAPENSATION,OAMAGES�S DHOYIOED FOR IN
¢ secrnNa�oeoFn�eueoacoo[.wrEAEsr.u+o�norwErssEEs. RETENTIONFEE:
pW_. CONSTRUCTIDN LENOING AGENCY �', • PR6ALT FEE:
O
Q IHEREBVAFFIRMUNDERPE�ALMOFPE0.IUHVTHATTNEREISACONSTRVCTIONIENDINGACENCY
a- iOfl TMC VCRFORMANCE OF THE WORN iOR WM�CH TMS PEp�R IS ISSUED(SEC.�DY�,CIV.C.).
�
� LEMJERS NAF.�E
C LEN�ERSADORE55
� ICEHTIFYTUTIIUVEREADTHISMPLICATIONANDSTATET/UTTNEABOVEINFOi74ATqNISCORRECt TOTf1L FEES �
� IAGREET0001A7LYN7THALlCITYANDCOUNTYORDINANCE5AND5TAiEUWSRMTU�6TOBUILDIN6
� Q�NSTRUCTION.ANOMEREBYAUTHORIZEREPR[SENUTNESOFTMISCOUNTYTOENTERUPONTIIE
Z A80VE#/ENTIONE�VfiOVERTY FDR MSPECTqN PURP05[5. ' COMMENTS
� • ��-/SR� (( vM
�
m PERMfTTEENAMEI7 N '
Q A — � /��
V] i /��•� � �
� SIONANHEO vERM DAiE �
� ! RECPT.N0. P1UD BY __ VALIDATION
WHITE-0epertmenl Copy,YELLOW—Fuiance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Appliagnnt's Copy
, . . . . . , . ., - . . , ,, , ; . .. , .. � ,.' , , , . . . . , �
, ' ci�-i% oF �ianror�D st��
�raspEczior� ��co��
r. .. . � .�_._. _______ �_� --._____._.�___________ __-------_-__ �_._._.
° i�,s,`�:�_':r is�i^���o`�_,.__.� -��``,'�_ )►r�`1::t�c,;'f��,1�,��'ji` 'j�.it c-M��}�i• ls.,e'Cv�aE'= R��f..�1'l=1�'-:rt�),��
� - T - . . -. . . . ... . . _. ... . _ ... . . _. . . ..
I SET���Ct: .�.. - •�•• . FLO�R JOIST I � �_
�_�TGS/F�f�"�:S;STEEL � FHF�REQMTS � � _
I �LECTRIC GROUND , UN�ER FLOOR DUCT �
� �rOUP�:D r LUiA�?I�JG j U�lDFR ELOUR CU�,�DUIT i
I�:!._�B GR�1_�� j FIF3EPLAC�•FOUNDATIOl1 I �V J `__
� T(=':iP FOWEn � I FIREPLACE BOND 6E11h^ -- —
� '�"J��ER SER��ICE � P,�ID HT:60ND BEA�r �
r. __ �' G ��' 8 FL BOND BEF,P,�
'77F�H_rtTHl�l,� � � ___
I Fr�r1i,"idG'VENTf�IATION I � FIPJAL BOND BEAP�1 _ � _
1 �;��OF�COVER I 4 �' PRE-GRA�ING _�
I :�;:1G�1 ��'P,TIN; �v ' �� ��= y?_`-- � 6ENCHING
�-'-_—=--- -}- -
i :-i�U�!, E_�-•CTRIC j0 7�1 I ,1�y� � ROUGN GRADING _
j ^��:J_al_1 PLl_l"fBI�JG ; J i FINISH GRADING � `— —
i =I{O',;J��t!TU5 TEST j I POOL ELEGTRIC ��
I �;:�. 1�1THiSiD{NG � POOLFEPJCING i
;�'^lf��L fi,�SUI�TlO"� POOL FINAL a —� —
�-- — ---- --
j �;�ILC�G It•]��ULF+TIO^J OFF SITE IPJIPS. �
� i��Y�:Ii�LL i•!F,1�(�dG � DCDI�ATIONS ; �_,_____
; S'4��ER � I I FINF,L EtdG. j
i :�'.�=i�I�IC'f��f.l'�: � LANDSCAFE/IRRIu- I ��
i_:-_=P F'IT/L.L. � i � ON 51TE I�J�PS. j-- i ---- J_------
�",S Ai;�i ES i _ j FI��1tiL ZO"d!NG _ I_
:';l;',','.r;��'1:�T � FIRE DEPT. FINP,L � 1
�- ---- -- --
i"i:.��,!;-c,11I!:dG I HEALTH DFPT. FIN�+L I I
- ---- ------- r---------------
: _,. '--- ;_E::Tfi;: ! � � � DEV. FcES PnI�� ---- — -- —�
_ ___ � _
,.'.' P�U�.i��`:^ ' � � E(`dERGY �
• , „
. , ,
- -- — - I r —� -- --—- -------- ---...---------
y, 1�/� � I
, t � t ;
�"
�� (� ��..<<_ _N�S.--I , � �i� � � � - " ' _'_"'____ ---____-__-_._____--______
� ---- - . � I r I F. ,_ , .,. ��'!� -.�-' . ., ' -------�"----'-----
� ;� �r�-_ i�-r� ,
, .!I:i,'1 _�V ! .� — —�
i
�
�---------------� ,' ---------_-- —---
� -----------
` ------- ,. . — ---- --— --�
�-------- — -- — — ---------
,
-- - --- -------I
,
•-- ----- -------- - — -
� �.=i-i I.r'.i I�,t�!h S I Z G ---------- ------
; `;��� p��il� S I Z t= _ — ----- -- ----—
; - .._ ... . ._.., ..
� ' b,� — -- ----- - — --
� " - — --------
' ; i J, ' ---
� � � -----------------------
i
� I
� --- _ _
� . . .. ' ... .., ,. "� `\ ` __-__ -' '