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HomeMy WebLinkAbout13019 '] . l 1� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DE I �c 2166oE.copley�ivesu�cel90 PRESS • (909)860-3195 Fa�c(909)861-3117 • ��'��� BUQ.DING PERMIT APPLICATION FIRMLY � JOBSffE APPLICATION PERMR �(��� P/C o ADDRESS �,�Z7 �r��..r+/�L i+'• DATE NUMBER���1�. * ISSUE r, TYPE OCC � APN LOT T T DATE�,�V CONST. GROUP p OWNER /%� p ADDRESS � u - ZONING SETBACKS Z CITY - � ZIP�'��TEI�/ � EAR RW ❑ � APPLICANT T�lj,Q��'jg=GOC SIDE/SIDESTREET RW ❑ CONTRACTOR SIDE O � ADDRESS PROPOSED USE��[=.,�..►u.0/L�/c�l) CfTY ZIP TEL o ARCH/ENG/ • � DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � �ESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION � Q OWNER•BUILDER OECLARATION SFR/ADDIFIEM O � . I HEREBI/AFFiW UNDER iENALiY OF PERIURY THA71 MI E%EMPT FT10M THE CONTMCiORS LI� .G8f9Q9/CdIpOR CENSEUNIFONTMEF0.LOWINONEA.ON(SEC.10.71.6BUSINE59MIDiROFE55qN5WDE:ANYCITYOR (n COIhRYWIqIREOUNESADERMRTOCONSTAUCT,KTERM1�PROVEDEMOUSMOFtREPluRM1Y51AUC• � W Pg��p/p�k 7URE GRiDR TO R9 69UANCE ALSO REOUIRES THE APPLICJ�NT FOR SUp1 iERM1T TO flLE A SICNED W � BTA7FMENT TIAT ME OR SHE IS LICENSED W0.5UANT TO THE VROVISIONS OF THE CONTMCTORS LI• � CENSE UW(Q�APTER 0(COMAIENCINU YATH SECTqN 7000)OF DINSION�OFTNE BUSINE5511ND PRO- �- PooliSDe FE6S�OHS OODE)DR lfUT ME OR SME IS E7(EMPT T1IEREFROM AND iHE BASiS FOR TNE AILf 6ED E%EMP• 7qN.11NYV10L�TIONOF5EGT10N70.71.6BYIHYA7GLIGANTFORIIPEAMRSUBJECT5IHEAPP�ICANTTO Z Re-Roof �„_ A CNIL PEN�ITY OF NO7 MORE T1UN FNE MRlDRED DOLURS If5o01.1: J . � O1A50'MIEROFTHEPROPERTY,ORMYEMPLOYEESW17HWAGESASTHEIRSOLECOUPEN5A710H, 0 Commereial . WILL DO T1E WOHK.ANO 7ME STRUC7URE IS NOT INTENOED Olt OFFEFED FOR SALE(SEG 70M.BUSI- J NE6S AND ViqFF5510M4 OOOE:TIIE CONTMCTOR9 UCENSE LAw DOES NOTAPPLY TO AN OWNER OF N piqPE11TYV/1qBUlDSOHMPipVE57MEREON.ANDWMODOESSUCHYpRN/auSELFORHE0.5ELFOfi m � 1HRdJOHWSORNEHOWHEMPLOYEES,VROVIDEDTFIAiSUC1/MPNOVEMEMSARFNOTMENDE00R � OFFEREDFONS�LEIF,lIONEYEi�7HEBULDNOORMPROVENEMIS50lD`MT}�INONEYFMOFCOMPL6 TION,THE OYMER�BUIIDEH WILLlUVE TME BUROLN OF PROVINO 7/uT ME OR SME DID NOT BUIID Oq MViqVE FOR 7HE PURPOSE OF SALEl W OL�OMNEROFTHEVRDPEHfY,/WIXCLUSNELYCOHTMCTWON�IM��CENSEDCONTMCfOH7 Z TO pONSTqUCT T1E VR0.IECT�4EG 70a,.BUStNE55 AND GROFESSIONS CODE:THE CONTRACTORS LI- Ve1118CW11 ADJ.AREA � CENSEUWDOESNOTMPLVTOANONMEROFAGRODERiYYN10&1LDSORWPRWESTNEREON.AND �_ Nnoc«+rn�asca�sua+Pna,�crswmi�carirucror�cs���ccr+sevruasuu+rronrEcor+r�uo pUANTITY DESCRIPTION FEE � ia�s ucEt+sE uw.} ~ O IAM D(EIAPT U1OER SEG &�P.G FORTHIS REASON � Q LL' pATE OriNER ~ � U J LICENSED CONTRACTORS DECLARATION W � IMEFEBYAFFINYUlOERPEWLLNOFFEFWRYTUTIAMLICENSEDUNDERPROVISIONSOFCMAPTEfl � s �(OpYENCPM3MniH5ECTIJN70oolOFDMS�ON70FiHE9U9HES5�NDPROFESSIONSCODE.AND Z X I,IY LK;ENSE IS N FUIL FORCE ANO EFFECL m L1J � 0F UCENSE CUSS LIC.NO. J -z] DATE eONTRACTOn a .. .._' . lTl _... . ....... .. . _ � WORKERS'COMPENSATION DECLARATION a � U � IHEREBYAFFGWUlWERiENALTYOFVEfWRYONEOFTHEfOLlO'MNOOECLAMilONS: � 4 O �11UVEANDWILLMAINTANACEfRIFlCATEOFCONSEMiOSELFJNSl1REFORKORKERS' 2 Q CCNPENSATIOH,ASPROVIOE�BYSECTtON�7o00FTHEW30RCODE,FORTHEVERFORMANCE W pf 7}IE M/ORK FOR WMQ1 TTIIS PERMIT 19155UED. � � _I/WVEAND WHIIMMAIN WOi1NER5•COYVEN5AT10N WSURANCE,AS REWIf1ED8Y SECTION QO J70oOFiHELABORCODEFORTHEPERFORMANCEOFTNEWORKFORMn1IdiTHI5PEM11T15 /� 65UED.MYWOfU(ERSCOMPENSATqNWSUiIANGECAANERANDiOLICYM/MBERARE: ONSTRUCTIO �I�n�•UlJ - - -- -- ------ - - -- _ _ _ . . _ _.. --� ----euaei¢n - -- -- PLAN REYIEW � P0.1CYlK1A1BER ELECTAIC 0 RH55E�YNt+E�wTBEOU�s;FrtDOCTEPEadiswnONEH1l7f�DaluasR+�IORLE5S7 PLUMBING � (�A \�J Z I CEHTiiFYiHAT NTHE PERFORMANCE OF T�E WOfUC FOR YMICHTHIS PENAIT IS ISSUE0.1 MECHANICAL (J SHALLNDT EuvLOYAM'7E0.50N w AN'I MAMIER SOAS TO B[COME SU8IECT TO 7HE � WORKERSCW.�PENSATqNUW50FCALiFORNIRMID�CREET1U11FISV10ULD0EfAME INSPECTIONFEE ' � SVBJECTTOTMEMIOPoCEN5COMVEN5A710NPROVISIONSOF5EC710N77o00FiNELABOR 1SSUANCE � � CO�E,I SnALL FORTlMn71�GdAPIY M'IlH THOSE Pi10VI51ON5. �� � SMIP �'� � r�� p OATE: AP7LIG!!T: l. . � W ENERGYP/C ' r. � WAAN�Na:i�LURE TO SECURE WORNERS'CO�.�PEN511770N COVER�GE IS UNUwFUI,M1D SHALL BE SUBJEGfANEMPL01'ERTOCHMiPULPENAL71E511NOCMLFNESUPTOONENUNDREDT10U5IWD ENERGYPERMIT _`� �� ' GOLLARSIf100.OW�NI�DDIiIONTOiMEC0.5TOFCOMPEN5A710N,DNMGLSASiROVDEDiOitW ¢ 6ECTIDN]7oaOFiHELABORCODE.NTEREST,M1�AifORNEYSFEEi � FiETENTIONFEE: �� a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IN[REBVAiFtiWUNOERGENALTYOFVER1UqYTHJ1TTHEREISACONSTitUCTKKiIENDWOAGENCY Z FOR iHE PERFORMIWCE Of 7ME WOflK FOR WMICH iHIS�ERMIT IS ISSUED(SEC.iuY7.GV.CJ. W � LENDER'SNAYE � LENDER'SFDORE55 l'.1}-L�{�-�/\) ¢ ICERTIFYTMATIXAVEREA�THISAPPLICATIONANDSTA7E7W�TTHEABOVENFORIAATIONISCOFlRECT. TOTAL FEES � 1 11 l`-'� d I/�REEMW►�ttYWITHILLGiY/�NDCOUNTYOROWINGESANDSTATEUWSREU7�NOTOBUQOWO CONSTRUCTION.AND NEREBY AUTFIOiLZE REVRESENTATIVES OF THIS COUNTY 70 ENiER UPON iHE S�. ABOVE-►IENTIONE�VHO�ERTYFORwSPECiqNPURPO5E5. COMMENTS � _ �� � � m 2-/�--9 Vj SICtUTUREO EE OATE � RECPL NO. PAID BY VALtDAT10 WHITE—Oepartment Copy,YELLOW—F4+enoa Copy.PINK—Aseeseor Copy.GOLDENH P-Fik�Copy.GREEN—ApplicanCs Copy . . . .. . .. , . � . . � . � , :, . , . ... . .. .�..�+.-r. ..r�.•,.,..t�� ., .. . �a-� . , _ . . � , . F DlA111fOND BAR . . . r S • CTION RECOF�D � : . � ,�. o p .: ,� ...o=� 0 1 ..■ .. .� -; , � � �!►'�-���=_:�t'�C..���E °���1� `1����� �..�� i�.�=1,��a'm �)►.. � ''�.� . :f►f- �a�,: . _ . __ _ _ �:__... ��•�,_..(.���i�.j_.p` �.._.�.:..,`����,��'�: .SET BACK ., . ; • -r ... ! 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FINAL ENG. + ;- SEPTICTANK LANDSCAPE/IRRIG. � ' ScEP PIT/L.L. � ON SITE I�v9PS_ G.AS AIR TEST � � FINAL ZONING ' � . � . : r(N.S�CONST. FIRE DEPT. FINAL . � � � FiP�AL HEATING _ _... HEALTH DEPT. FINAL -- - --- - � � FINfiL ELECTAIC - - - ❑EV. FEES ?AID � -- - � i=1^:�.L PLU"�191NG - - '"` Ef`lERGY � _ . �. _. . . . �.��+�.��..€�Lr:!<�..4zis��W�.. -..�. _ I • " . _. _. . ._ ...., � - . . . - . . � . .'.. _._' '. :..: _ .. .. . 'GOi�ii��1Lr—�UTS � ----. .--- ___.__._.---------- _.��__,-_._. ._._._..... ____...._ _ . . . , ,, - i _ �', ..,, �� � ;,�, ' ,.; . - , . :i_ .�, �_ :. . . - -- • . ,` SEPTIC TAMK SIZE � � i � SEEP PIT/U SIZE �_ .. _-- � ' ... . ....�m. � ; �. :� . _'rt .. . . : _ ,_i - -- : �� ` ��_ . _ . - , �.. . < : ; . .. - . - -- -... --._. ... _ ; �,�t}t. � , _ � ._ . _ ; , - _ � ! . . , ..� �� - . .. �t . i . E. ._. .._.''1� 1�'..,_._..,,_.. ... _'i .� .}r ,� �� �� ; �.� � �v . _- ._ •� -- . : -� �J