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HomeMy WebLinkAbout12296 (13) �� 1 CITY OF DIAMOND BAR - DEPARTMENT OF COMMUNITY&DEVELOPMENT SEFVICES �c . 21660 E Copley Drive Suite 790 . (909)8603195 Fax(909)861-3117 PRESS ' . • ����' BUII.DING PERMIT APPLICATION � FIRMLY , 0 ADDRESS ��3�7 �5�� �1 - . DATE CATION�Z,/ � �/ NU BE �Z p'C T i � APN - LOT CT 15SUE TYPE OCC , � DATE CONST. GROUP p OWNER �/1 1'Ll,°b!� 1^ "' ADDRESS �C � ' ZONING SETBACKS � CITY • IP.,�7G-�TEL. �,{/ —'�7(e�1- FRONT - • RW p APPLICANT TEL. REAR ❑ SIDFJSIDE STREET RW ❑ � CONTRACTOR f11.����„r—it �� . n .O SIDE ❑ ADDRESS � � � CITY ZIP TEL PROPOSED USE o ARCHIENG/ � , � DESIGNER ' NO.DWEL. NO. NO. ADDflESS UNITS STORIES 6EDROOMS � CfTY ZIP TEL � DESCRIPTION ` SO.Ff. FACTOR PSF ADJ.AFiEANALUATION � OWNER-BWLDER DECIAFiATION SFRIADD/REM ' '` ' ' O 1 HEREBY KFWM UNDER pEW4TY OF VERIURY TH�T I AM E%EMM FRpA TME CONiMCTORS tL G3f8QB/C81pOR � �8 CENSEUWWN7HEFOLLOWNK7REASON(SEC.70.71.6BUSINESSMIOiPOFESSIONSCOOE:ANYtlTYOR (n U COVHTYWHICHqEOUIRESAPEWaRTOCON57i1UCf,/LLTERMPROVEOEUOUSH,OPREPNRl�HVSTNUG W patio/Dack ' ' � iUf1E.PR10q TO RS ISSUANCE.AL50 REW IRES iHE APRICAM FOR SUCM PERAIIT TO flLE A SICNEO W STATEYEM T1U1T HE Oq SME IS IICFNSED pURSU�WT TO THE PROVISIONS OF TME CONTRACT00.5 LL , � GENSEUW�CMAPiFRY�fAMMENCv10W17N5ECf1DNTWoI�DM5iON70FTHEBUSINE55M1'JPRO � PooVSpa . fE55qN5COOElORM�TNEOHSHEISEXEMPTTHER£FR01IAh97HEBASISFOqTHEALLEGEDE%EMP• (7 T1p1.ANYVplAT10HOFSECf10N7W1.68YANYA7PLICANifORAVERMITSUBJ[CfSTHEMPLICANTTO Z RaRaof � AG7V�LVENALTYOFNOTIAOREIMANFIVEFM1INDNEDDOLUit51f5oo).Y � OI,ASONMENOFTHEPROaERiV,OiiMYEUPLOYfESYvi7MWAGE50.STHEiR50LECOA�vEN5A770N, O COrtiff�BfCi81 . . - � MALL DO TME WONC/ND TME STAVCiURL IS NOT IMENDED OR OFFENED FOR SALE(SEG 70�4 WSI- J � NE55 MD VROFESSIONS CaOE:iHE C�liMCTORS LICENSE UW OOES NOT 11PPLY TO Ml OWNER OF � , , � FROPEFiTVYNqBUIDSORMViOOVESTNEHEON,ANDYMODOfSSUCHM'ORKMIASELFORHERSELFOR m Q TWiOU('J1MiSORNEHOriNEM7LOTEES,GROYiDEOTlMLSUGI�APROVEMETrtSMENOTIMEN0E00R � OFFEREDFONSALEG,IDVlEVE0.71�EBULdN�ORIUPROVE4FMISSOlD1MfHNONEYEAROFCddRE• � �TION.7HE OW1�Eii-BViIDER N1LL/NVE THE BUPDEN OF OROVINO TNA7 NE Oit SNE DD NO7&11LD OA . _ . •IPR�VE FOfi THE R1flPO5E OF SALE7. ' �. W ❑�A40NMEROFiHEVROPERfV,AMf%CIUSNFLYCOMRACTNOWRXUCENSEDCOMiUCT00.S � Toca+srmictfHerWo,iecr(sEa.�w,ousu+essu+ovao�ssia+seooe.tHEeartrueroruu• Valuation ADJ.AREA CENSE UW DOES NOTAD0.Y TO AN OVMEH OF A PHOPENTY 1rip BULDS Oq IMPROYES THEREON.AND � 1NpCONTMCTSFORSUqiVRQ1ECTSYVIiHACONfMCTOH(S�LICENSFDPURSUAMNTFIECON7MG p�qNiITY- DESCRIPTION FEE 70R5 UCENSE Uw.�. � OIAAIEXEYPTUNDERSEG B.LV.GFORTHtSRFA.ON Q � SW � � ` � ' 3 � � ¢ . � `.•. LL' OATE � � OWNE '�� _ V . F UCENSED CONTRACTORS DECLAAATION W � INEHCBYAiFIRNIM�ERPENAIttOFPEM1AIRYTNAT1AMlICENSEDUN�EAPROVI5WN50FCHAPTER � � � p. Y(COW�ENCtllON7T115EC710N70ooI�FUM5iON70FTMEBU51NE55AN�VROFE5510N5CODE,MrD Z �L W UCENSE IS N iIA.L FOi10EAND EFFECL m � LICENSE CLA55 UC.NO. j V DATE �� CONTiUCTOR � � a � WORKERS'COMPENSATION DECIARATION Q _ � IHEREBY11fFIRUUNDERGENILL7YOFGERAIRYDNEOFiHEFOLIAWIN(iDEQAMTIONS: U - � Z Q � _INAVE7�lANALLAWNTANACERTIFlCATEOFCONSENTTOSELHNSUR[FORYA(LCERS' 2 COMPENSATION,ASGROVDEDBYSECTIONJ7ooOFTHEU00HCODE,FOR7HE7ERFORMANCE U � OF TNE WORK FOR WN�Q1 TMS PERMIT IS ISSUED. � C _I XAVE IUID 1NLLhWMAP7 YYOPo(ERSCOMVENSM1nON INSUfi/NCE,115 REOUIRED BY SEGTION Q 57000FiNEUBORO00E.FORTHEPERFOAMANCEOFIHEWORNFORNMICHTHISPERMITIS ISSUm.L1YWORKERS'GOWPENS�TIONINSURANCECARWERM�D70LIC�NUMBERANE: CONSTRUCTION � CAHRIER ' . . . . . . � . . Z vaicruuua[n - CTRIC ' ¢ ' � (�S[CTIONI�E�NOTBEOC�.RE1FDOf71EGERMt6roRWElu,Oi€DOCUA0.SIt+m)MLFSsI . ING . Z ICERTIFVTMATNiHEPERFORMANCEOFTMEWORKFORN77tl/TNISPERMITlSLSSUEO.I MECHAh�CAL� (J SHALLNOTEMPLOYANYPEIiSONW�NYMANNEP50A5TOBLCOM[SU&1ECTTOTHE � y WORKER5COM7ENSATIONLAWSOFGLLIFOHNI�ANDAGREE1MA71FISHOUIDBECOME INSPECTIONFEE ' � SUBJECTTOTNEWORKfRSCpAPENSATIONPRDV�510NSOF5ECT10N�7000fTNElABOR ' cooe,i sw�u coRTrwmi ca+c�r win+rHosE vArnnsarrs. SUANCE O -p DATE: APPLICANT: . .. -. � WARN�N¢FA0.URETOSECUPEN'ORKERS'Cd.�PENSATIONCOVERAGEI3UNUwFUI.ANOSMALLBE ENERCIYP/C �y SlA1ECTANEAAPLOVERTOCRIAANALGEtuLTIE5/�lIDCMLFWESU7TOONEHUNOHEDTHOUSANO ENERGYPERMIT pp1M5(f 1oo,00Gy IN/�DDI710N TO THE COST OF COMPENSATION,DMUGES AS PROVIDEO FOR W �' � £ECTION�70eOFTHEU00RCODE,NTEREST,ANDAiTONN[l'SFEES. RETENTIONFEE: r � �" a CONSTRUCiION LENDING AGENCY pRE-ALT FEE: O - -� ' � IMEREBYAFFlRMUNOEflPENALTlOFPER7URYT4ITTMER[ISACONSTRUCTIONLENDNKi�GENCY FORiHE DERiORWNCE OF TME WORK FOa WHK71 iH15 PERA�IT IS ISSUEO(SEG�oV7,CN.G). � � LENDER'SN.wE � � � � � LENOEH'SMORE55 W ��pTIFYTUTIHAVEREIIDTMSAiVLIGT10NM1DSTATETMIITTHEABOVENFORMA7)ONISCORRECL TOTAL FEES � f p� IAGHEETOCOIAPLYN7iHIiLCT'/U+DCOUNTYORDPIANCESN+OSTATEUwSREtAT1N�TOBU�tD�NC , � CONSTRtlGTpN,M1DMEREBYAUT/10RIZEREiR[SENTATI�[SOFiXISCOVl17YTOENiERUPONTME . . . . ABOVEJAE EDVROVERTYfOf11N5PECTIONGUR 51 COMMENTS � v a� r m /� , PERN EN EIPWMJ - _� —�� ♦� .Q ._ � �.�. � �6 NnEOFYEw.u77EE . DA7E � . _ RECPT.NO. PAID 0Y VALIDATION WHITE rtment Copy,YELLOW—Fnenee Copy,PINK—Aseeasor Copy,GOLDENROD—File Copy.GREEN—Applicant'a Copy • . ,�.. ..�,. . : '.. ' ' . �. .� . , � , ..... .. . . '.'�, .. �• ' . � � . . . A�.; .� '� -+ ' . ' CITY OF DIAMOND BAR .r:, .;,. ; . ' ` :: .' .� = INSPECTION RECORD -, ' ' �.�;' ,. , � . . . -- ;: � • o � • • - • � � • - SET BACK ' '-:,1, '• '�. ' �t �. . ',_s �.�' 'FLOOR JOIST . ��'� r�, ,�,�:.,-�_'; ' \<-��:. � FTGS/FORMSlSTEEL' '' FHA REQMTS -� ` . ... i . ELECTRIC GROUND�. - �_. UNDER FLaOR DUCT �., •, . , „-, .,��,'� GROUND PLUMBING ' ' '- UNDER FLOOR CO�IDU�T, .. - - `...,r.tf: _ . -SLAB GRADE _ _ . -- . _ FIREPLACE FOUNDATION�� ` >;, ' J _`. .� ,.c � - :. . TEMP P�WER - �" - --- r ' - � FIREPLACE BOND BEAPd -- � VUATER SERVICE.- . - . ��. : - _ :: _ - .-. MID HT.BOND BE�AM •.: :t .� +.���' � �, �' , ' , _ , . _ �.:. t . ; _.. ,..., •,�., :;. . _.. . ROOF SHEATHING � • - - -' 8 FT'.BOND BEAM � ; ; FRAMINGNENTILIATION � FINAL BOND BEAM � ' ROOF COVER. ' " PRE-GRADING - - ROUGH HEATING - � - - - - - - BENCHING ' � � _. ._ .. ... � �' ROUGH ELECTRIC ; - LI' �� � �ROUGH GRADING ROUGH PLUMBING "" - ' FINISH GRADING • . : ' SHOWERIfUB TEST. � � � � POOL ELECTRIC . EXT.LATH/SIDING POOL FENCING ; ' WALL INSULATION • POOL FINAL � CEILING INSULATION OFF SITE IMPS. � ' DRYWALL NAILING ' p / � ' � DEDICATIONS ; . ' SEWER _ _ ' -- . _. _ . ' __ FINAL ENG. �• : SEPTIC TANK - -- - LANDSCAPE/IRRIG. . � - ; . SEEP PIT/L.L. - - � - ' ON SITE IMPS. . GAS AIR TEST� - -- -- � � - -- . - � FINAL ZONING . FINALCONS� ;i -- - � y _ - `� FIRE DEPT. FINAI • � FINAC�HEATING ' '' � � ' HEALTH-DEPTJF,I�JA4'_��:;,;'; t_.• � �r �• ;� \•. i - FINAL ELECTRIC p� - DEV. FEES PAID • ; � FINAI PLUMBING ENERGY • , . . . , . �w Y Qr s;, � _ - . .. ... . _..... .------- - .. - - COMMENTS - - � ' : - i: , . `�.� . . _:;\1 _ . _ _ .: _._.� , � � ; _ _ � . . . . � , � r;, . SEPTIC TANK SIZE' i' �_� 1 r 1 � ' ' ' SEEP PIT/U SfZE`�--`--=�-�—' _ , - . . . . _ � . -1 � � -, , _ . .. . � � --1 'f''_- _. . .. 1 '-d. � � - ; - - ._ � ' - ' , , . . • . ..- - - , � � t i • � __ - � . . . ,� #: , `� \� ,, ` • ,� �. .i� � � � ' •. t r, + • � - � �- '� 1 . . `�•. 1\