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HomeMy WebLinkAbout12027 (11) � , � . ,�,, p a2��� CITY OF DIAMOND BAR � • �!'Vt�' � � -- -- DEPARTMENT OF COMMUMTY&.DEVELOPMENT SERVICES 21660 E.Coplcy Drive Suitc 190 ' ' ' ' ' ' (909)8603195 Faz(909)861-3117 PRE$$ : � �'%*"� BUII.DING PERMIT APPLICATION FIRMLY N JOBSfTE !�3 ���Id / _�nd • APPUCATION `l �j�i PERMIT �/)Z P/C o ADDRESS q DATE �•/ NUMBE�.�N � APN LOT�� TRACT - �SSUE 'fYPE •� OCC " DATE CONST. GROUP g OWNER ��6{rd � ' p ADDRESS r-�' it ZONING SETBACKS � • "' pIT( ' 1Q q •ZIP Q2b�i TEL. � 6 . FRONT - RW p . � APPLICANT TEL. � . REAR p � � SIDE/SIDE STREET ' RW O CONTRACTOR N� Y�1Pn C. SIDE ❑ � ADDRESS � , PROPOSED USE ' . � CITY ,��zs•iari �%�n ZIP� TEL - D . � ARCFUENG/ • ' � DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDROOMS CITY ZIP TEL. c�n _ . . DESCRIPTION ' SQ.FT. FACTOR PSF ADJ.AREANALUATION O - - - OWNER-BU�IDER D�CLAMTION ' SFRJADD/REM 8 I MEPEBY AFFlPM UlDEq PENALh'OF iE0.R1RY THAT 1 AA1 E%EIAPT iROM 1HE CONTMCTOqS LI- GefeQBlCBfpOR . � ' . . � CENSEUWFORTMEFOLIOWMXiREA.AN(SEG70.71.6BUSINESSJINOPROFESSIONSCOOLANYqTYOR ,. (n COI.MYNfApIREOURESAPEAMRTOGONSTRUC'i,ALTER�MPROVE,DEMOl15H.ORREPAIRM(YSiiWC- W patiolDeck IURE,PRIOR i�RS ISBUANCE.AL50 REOUNiES iXE 11PPLICAMi fOR SUQ1 PENMIT TO FILE A SIONEU W STATEMENT T/UT NE Oq SHE t5 UCENSW PURSUANT TO TME PfWVISiONS OF 1HE CONTFlACTORS U• .� CEMSE UM�(CHAPTEF Y�CCM�MENCNO WfTN SECT�ON 7000)OF OMSION]OF T1E BlI51NE5S AhV Dilb � PooUSpa � . fEB510M3 COOE)ORTiNT XE OR SNE IS IXEMPTTFIEREiFlpA AND T1E BASIS FOR hIE KIEGED E%EMP- TION.ANVVqIAipNOFSfCTION7W1.6BYMIVAVVLICANTFORADEH1A175UB.lECTSiHEAP7l1ClW�TO Z Re-Root '� AGVILVENKTI'OFNOTMORETMANFNEMINDREDDOLtIfL51i6oD1.):. . � O 01�80WNEROFTHEPROPERTY,ORMVEMPLDYEESMATMWAGfSASTHEIRSOLECOMPENSATION, � � COrtIf1lBfClal � , ' ' ' Z M/ll OO TME WONIC AHO 7ME STIR/CN11E IS HOT INTENDED OR OFFERED FOR SALE(SEG 7W/.B1156 . J . N NESSMO iiqFE5510N5 OOOE iHE CONiRACTOR3 LICENSE UW DOES NOT APPLY TO AH pNNER OF ? � VND7Efif'I MAIO BUlD4OH MPi10VE3 iNEREON,AN�MA1D OOES SUCN WORK MIYSELFOq HERSEIF OR Q 1Yi10UGHWSORHEROMMEMPLOYEES,iROVIDEOhWTSUCHIMPROYEMENTSMENOTMENUEDOR m �� OFFEREDPDRSM.E�F.FION'EVER7MEBULdN00RIM�qOVE/AENTIS5dDW1T1aNONEYFAROFCOMPtE. Z TION,TME dWNER-0ULDER YALL MAVE iT�E BURDEN OF PROVMQ iHAi HE OR 6HE O�D NOT BUItD OA � M7RDVE PDR iNE PURPOSE OF SALE} � . . . � � Ol/150WNEROFTIIEPROVEHTY.NAE7(CWSNELtCOMMCTINOWRHLICENSEDCONTMCTORS .. . .. . .. . . . . . . M COHSTRUCT THE PROJECT(SEC)Ou.BUSINfSS J�NO GROFESS�S CODE:THE CON7RACTORS LI- VelUetiOn ADJ.AREA CFNSE UW DOE9 HOT APVLY TOIW OwNER OF A PROPEHTYN'Fq BURDS OR MCROVES THEHEON.IV�U � wNocormucrsFansua+orw.�ctsvntH�ca+rrucroA(s�ucer+sEo�uasuurtron�Eoxrnua OUANTITY DESCRIPTION - �E � 101iS UCENSE UW} ' . . .. . .. OI/JAD(EMPTMDERSEC� B.IP.C.FORTHISRFASON Q 3 . � u. � - - DATE OMMER U . � J UCENSED CONTRACTORS DECLARATION W � IHEREBY�FFIRMUNDERPENALTYOFiER1URYT1ATIAMUCENSEDUNCERPROVI5lON50FC11APTER V. „- . s O�COWENCNqW1THSECT10N70oo10FOMSION]OFTIIEBUS:NESSMIDPROFESSIONSCODE,AND Z �L MY LICENSE IS N FULL FORCE AND EFFECT. m ,,,� l � UCENSECUSS�_LIC.NO. � j � WDATE ���„r—�O� CONTMCTOR 1 EN C � WORKERS'COMPENSATIONDECLMATION �� a NIHEREBVACiIRYUNDERGEN.LLTYOC7E0.N�7VONE0FTNEFOLLON11NG0EClAMT1ONS: Z �� � ` � � � ' O _�IHAVEANDWILLMAMTAtNACERTIFICATEOFOONSENTTOSELFdN5UR6FORriOPI(ERS' S � COAIVENSATqN,ASDROVDE�BYSECi70N]'/ooOFTNEUDORCOOE.FONTHEVER�ORAIANCE - W OF TME V�RK FOR WHICl1 T11I9 PERMR IS ISSUEO. � 0 �1 HAVE ANO YALL WNTMI WOfifERS COMvf NSATON MSUMNCE,AS REOUIRED BV SECTqN • Q 7MOOFTH�(ABORCODEiOqTHEPERFORNANCEDFTHEN+OPICFORWHICH1HISiERAl1715 � ISSUED.MY WORKERS COMPENSATIOTN M�SUfUNCE CARRiFR MID POIICVMJMBEN ME: CONSTRUCTION ] GIARIEN �-�q I�kl Gsl C- PLAN REVIEW Z vaicrr�uueEA 8"�00 ELECTFIC . _. �� 0 {fId65ECilONt�E�NOTBEW�fIEfIDOFM�EPMf6fORONE14faf€DO(]LLA0.S{ftOC10RlES5�. PLUMBING — � ' Z I CEATIFY TiAT IN THE PERFOfUW�CE OF 1HE WORK FORNMICH 1HIS DEHIAR IS ISSUE�,I � MECHANICAL - - ('} 511ALLNOTEA�7WNANYVERSONNANYYANNERSO�ST09ECOMESUAIECf70TNE , (q WOi1KERS'COMPFj15�T10NUW50FG1LIFORNI�MlDAGREETHAT615HOU B[C06�E INSPECTIONFEE SUBJECTi07HEY10ilKERS'COMDENSIITIONDROVISIONSOF3[CT10N77oo TMELAOOR � rj cooe,i s psomHvnrn Caav�r wi se vRovisia+s ISSUMJCE � p DA7E�+�1�APPL�cANT: � SMIP. � WMNiNa:FA0.URCTOSEGVREWdiKERS'COUPEN5ATI0NCOVERAGEISUNUwFULMlOSMALLB[ ENERGYP/C � � � 6U&IECTANEYPLOYERTOCR�APIALOENALTtESANDGMLFWESUPTOONEHJNDREDTF10U5AN0 ENERGYPERMIT DOl1AR5�f 100.000),N dDD1ilON TO THE COST OF COMPENSATIDN,DMIACES AS VROVIDEO fOR IN ¢ SECT10N77a�OFTNELAAORCODE,NTERESLANDATTORNEY5FEE5. RETENTIONFEE: � � a CONSTRUCTION LENDING AGENCY PqE•ALT FEE: s+�+ •� � O � IHEfiCBYAFFIRMUNOERGEN�LTYOFVERNHYTYUTTXEREU^IICONETRUCTqNLEN�PIOAGENGY , _�� A � �� ' FOR THE PERFORMANCE OF TME WORK FOR WHICH TNIS PEHMIT IS ISSVED(SEC.i0Y7.CIV.C.). � � - �� �ENDER'S NAME . ' ' � IEIAER'SADORE55 _/ � � ICERTIFYTHATINAVEflEADT115APPl1UT10NANU5TATE711ATTHEAEfOVEMFONAAT10NI5WMECT. TOTALFEES . ,J�� d IAONEETOCOYVIYVrtM�L1CffYIWDO]UNTYORDWANCESANOSTATELAWSRELATNOTOBIIL�INO � �Y I,. CONSTRUCTION.ANOHER�BYAUT1fORQEREPqESENTATIYESOFiN15COVN7'l70EMERUPONhfE . . . . . . � ABOVE�YEHf10NE�PROPERTYiORINSPELT10NiUR005E5. COMMENTS 9 i (1!i ,Q, Qit'1 � m � � �w������� � ^�F�� y 8101U HEDFPERWTTEE DATE � . RECPT.N0. PA1D BY VALIDATION � WHITE-0epertment CApy,YELLOW--FfnenCa Copy,PINK—Asseasor Copy,GOLDENROD—Fib Copy,GREEN�ApplicenYs Copy ��� � � � � . ....� . .. ..� . .. . .�. . w . . , 1 ' � ' � . . . . . ' • . . �. .. w4.. 1.,� �-.�, :'+.� . � � � � , . . ' � � w. .^I�. . .� .. , ' �. . �� ; ' ; CITY �F DIAMOND.BAR, ,, ; :;�,•��;;-. ,. .;.,.... ... _. ._. . _ . .. . . .. . .,. . - �. " ' � '' '' �INSPECTION'RECORD `_ � .;� � ��� _. r ; . . . , . . .. . _ .. _ , ._.. , . _ , . . . • � � � - • � � � - SET BACK " ` � • . ` ' � 'FLO�R JOIST .:�,i�,;�� 1•' ; i .'�,.-; \� r \ - ' - FTGS/FORMS/STEEL � FHAREQMTS - - - — --� -- -- - -----�--�- ' • • , � . .._. ._ _. . ELECTRiC.GROUND - -:' _ .":�. -_ .- . _ - � -... � : UNDER FLOOR DUCT , �•, �, , ; ' ; , i , ,., � . • GROUND PLUMBING � •• UNDER FLOOR CO�IDUIT� ' •• >'�t �! � " - '-,•, ; �' _ ._ . . SLABGRADE __. .. . ---- -. .. _. . . _.. .--- - ,. � FIRE�'LACE'FOUNDATION '�' . ,. ,, .;�� �.•. •. ;... '� : � � , . _ ._ TEMP POWER -�--- �:. . - . ...... . : . :. : �.-� . � , FIREPLACE�OND BEAM - - . ..- -� - � � .�-�.- _. . _ . , ,_ -WATERSERVICE_ .-__--_ -_--.-:._-: _ . ._: :. .. _..:..- -= MIDHT.BONDBEAM ..r•; �„• :�.��. -__'. �. � ... , , , _ ROOF SHEATHING -- - --- -- �- -- --- - ._ ._.::. :.. ; 8 FT.SOND BEAM :,�: , -� , : : c, :; , ...' �.:� i�..:'�_ .,'ji� : -- ... ..� FRAMINGNENTIUATION . FINAL BOND BEAM � � - ' ROOF COVER ='� � PRE-GRADING�� � � -- - � - � , . ROUGH HEATING --;.. _ . . . _ . - .-- -- - BENCHING.._...... .. ; _ �- .. .. . _. .. _ , .; , : .�. ROUGH ELECTRIC--;� - --- � � - ' '�; -' = -ROUGH GRADING -• � "= ROUGH PLUMBING-� -- - - _... -- - --.--...__._... .. ... - FINISH GRADING � - . . , . i • , -SHOWER/TUB TEST � �� -- � - �- � - - POOL ELECTRIC - ' " � EXT.LATH/SIDING� � ; ; ., POOL FENCING ` - � � WALL INSULATION � POOL FINAL . • .. CEILING INSULATION � � OFF SITE IMPS.� • DRYWALL NAILING , DEDICATIONS ' ' ; , •� SEWER.- ---- -.. _---'-..... � _.�. . _.._... . FINAL ENG. �. � . .. ; SEP.TIC TANK . _ -.-. ..--. ' - ........ . LANDSCAPE/IRRIG. � � � � -SEEP PIT/LL. =---------- - .. ON SITE IMPS. .. . ' GAS AIR TEST;----•'------ -- - - -FINAL ZONING � � i . FINAI-CONST.; -- - - ._ _. .. .-------.... ._. .. _.. ... FIRE DEPT. FINAL' _ I `_ FiNAL�HEATING - - �� �- -- -��- � - � HEALTH DEPT.FINAL ' �� FINAL ELECTRIC- - -"- - - _ . .. .. __.. ..._.__ . _ � DEV..FEES PAID - � -- � . • FINAL PLUMBING l�� ENERGY ' • - -'�' .1 � . ,, . .". ,. • • . v � � � . . ... , _ . ._ _ _ , . .. . ... _ , . , _ _..... _. . __. .. - - - -- — . _ .. _. ., _ . . ., ..... , — , , : _.' , . ,, -�. : _ . , . ... . ..,: ...;.. . .. � . -COMMENTS -- -_ ._.. . _.._ _ _ � , . ; _ ___...._ _..__.... _.. _ _ . ._. _ .. . __._ , . ; ; _ _. _. __ , , . ._. . __ . _.. .._. - - - -.._... _ . .. .. ; �, -... .__ ... . •�� . .,i :� ,. .r . , ' � 'i �� � ,�'1`•_ r � . � -� -� - 1� --- -......_.._. . ... . . � ' � . . . � . � . • ' - . . � � . . . I ._..... ..... . .... .. .. . . - . . . � ' - . . , , . , i , ' - _ . ----- .. .- -- - � � - - - � _ , . � � � . . . � i _. . _ _ _. _. __ . . • �., , ` . �;- � ...� `, .. __- • , --, _.. , : _ .. . ._ _ . j SEPTIC TANK SIZE _ _ � i , . . .; , —- ... — —.. . SEEP PITlU SIZE��� r,: ... 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