HomeMy WebLinkAbout16722 (19) C1TY OF DIAMOND BAR
� -�� � DEPARTMENT OF CONIIvIUNIlY&DEVELAPMENT SERVICES EXP I R��
� �,r� 21825 E.Copley Drive
'i � ��,"i'�' (909)860.3195 Fa�c(9U9)861-3117 �t� PRESS
� BUILDINGtER1tilITAPtLICATION JUN 1; �styL FIRMLY
o ADDRESS ZZ�Z ? G'S �c�r�- �• � DATECATION l _ �"��' NUMBER.J�r`k/C
�p
� APN LO ACT ISSUE TYPE OCC
p OWNER
� ��/�AhL DATE CONST. GROUP
"" ADDRE S '¢� ZONING SETBACKS
0
OCITY���'�'�t � � ZIP /7 J TEL.� E �/�{St� FRONT RW O
APPLICANT TEL. REAR ❑
� SIDE/SIDE STREET RW ❑
� CONTRACTO . �'4 �� • SIDE p
Q ADDRESS �l.4 ST ..�1 pROPOSED USE r
� Cill(/V• CLt/ ZIP�TEL. � -
oARCH/ENG/
z� DESIGNER NO.DWEI. NO. NO.
n. ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
�
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER•BU�IDER OECLARATION SFR/ADD/REM
O
� I MEFEBYAFFIRM UNDEF PENALTY OF FEiWflY THAT I JUI E%EMCT iROM h1E CANTMCTORS U• Gdf8g2/C0fp0A
W CENSEUWFOqTHEFOl10WiNGREASON(SEC.7031.68USMESSANOPROFESSIONSCODE:�NYCITYOR (n
U �1NTyWMIp1REOVIRESAPERMITTOCONSTRUCi,ALTEN,IMVROVE,OEMOLISM,OflREPA1RANY5TRUC• W PatiaDeck
� NHE,PRIOR TO RS ISSUANCE,ALSO itE0U1RE5 THE APDLICANT FOR SUCH CERMIT TO FILE A SIGN[D w
STATEMEM THAT HE OR SHE IS LICENSEO PUqSUAM TO THE PROVISIONS OF iME CANTMCTORS U•
� CENSE lAW(O/APTER Y(CDMMENCINO WITH SECTION 7000)OF OIVISION]OF THE BUSINESS MD PR6 � PooVSpa
FESSIONS�E)OR THAT HE OR SHE IS E%E61PT THEREFROA/AND THE BASIS iOR TME ALLEGEO EXENP•
� TION.INVVIOLATIONOFSECTION70.71.68YANVMPLICANTFORADERUIT5U8JECT5THEAPFLICANTiO Z Re-Roof
A CML FENAL7Y OF NOT MORE iH/Vl FIVE MUNORED DOLURS(f 5oo1.y.
❑I,�S OriNER OF THE PROPERTY,OF MY EM7�OYEES WITM WAGES AS TNEIR SOLE COMPENSATqN,
Z 0 Commerciai
WILL DO TNE WORK,AND TME STRUCTURE IS NOT INTEND[D OR OFFERED FOR SALE(SEC.)OIa,BU56 J
� NE55 AND VROFESSIONS CODE:THE CONTRACTORS LILENSE UW DOES NOT A7PLY TO AN OWNER OF �
PROVERN NM11O BUIIDS OR IMPROVES THEREON.AND WHD�OES SUCH WDRK MIMSEIF OF MEHSELF ON
Q 7MROUGHHISORHEROWNEMPLOVEES,PPANOEDTHATSUd7IMPROVEMENTSARENOTINTENOEDOR m
W OFFEREDiORS/LEIF.MOWEVERTHEBUILDIYOOHIMPqOVEMEM1550(�WITMYONEYEAROFCOMPLE�
� TION,TNE OwNER�BURDER N1LL HAVE THE BUADEN OF PROVINO THAT HE OR SHE DID NOT BUIID OR
Z IUPROYEFORTNEPURPOSEOFSALEI.
(=j� ❑4�OWNEROFiHEPROPERTY,AME%CIUSNELVCONTMCTINGW�THLICEN5E000NTMCTORS
[[ TO CANSTRUCT iHE PR0.IECT(SEG 70��,BUSMC55 ANO PROiESSIONS CODE:THE C011TMCTORS U- V0IU3�1Of1 A0.1.AREA
W GENSEUWDOESNOTAPPLVTOANOW4EROFAPROPERTYWHOBUROSORIMPROVESh1EREON,A4D
� WHOCONTMCTSFORSUGHGROJELTSWITHACONTMGTOP(S�LICENSEOPURSUMITTOTHECONTRAG QUANTITY DESCRIPTION FEE
Y TORSLICENSELAW.}
� O IAA1 D(EMPT UNDER SEC. 8.l V.C.FOR iHIS REASON �
�
IL ¢
DATE OIVNEH �
� LICENSED CONTRACTORS DECLARATION W
� IMEfl[BYAFFIRMUNDERVENµTYOfPERIUMTMATIM�UCENSEDVNDERiROY�5�ON50FCHAPTEq � �y� � � ' ��
p. i(COMMLNqNa WRH SECTION 7000)OF DMSION�OF TXE Bt151NE55 AND PRO�ESS:ONS CODE,�ND Z ���
)•C NY LICENSE IS M FULL iORCE AND FECT.
7 � m
� LICENSE CLAS� �� LIC.NO. • �!��� j '
V DATE ��� CONTRACTOA n-
W
� WORKERS'COMPENSATION DECLARATION Q
� IHEREBYAFFIRIAUNDERPENALTYOFPERNRVONEOF7HEFOLLOWINGDECLAMTIONS: Z
Q
� _INAVEANDWILLIM�NTAINACERTIFlCATEOFCONSENTTOS[LF-INSUREFORWORNEi35' _ �
� CqAP AS iROV10ED BY SELTION T0o OF THE LABOR CODE,FOR TNE GERiORMANCE �U
�c WOi1K FOR WHIp7 7HI5 PERMiT IS ISSUED. �
O
W _IHAVEMIDWILLMAINTAINWORNERS'COAIPENSATi(lNINSURANC REWIREDBVSECTION
Q ]7000FTHELAB �.FORTHEPERFpRM .. T !O :ORWHId/TH15GERM1T15
455UED.M'IWO RERS' MPENSATIONINSU �NC�CAR _R .�PS1lICYNUMBERARE: CONSTRUCTION
� �/,pq�Eq � PLAN REVIEW
� GOLICYNUMB[R���/�.�t..�� ELECTRIC
o �n+¢sEcroaNEmr+oreFm.r�Fr[oocncaEa.rrs�or+ _ c ,vis�s�m�or��ssF PLUMBING +1�
Z ICERTIFYTMATWTMEiERFORMANCEOFTHEWOW(FO WNICHT :P � iTI51S5UED,1 MECHANICAL
C'J SMALLNOTEMPLOYANYPERSONINANYMA"' S0 O -^ SU ��CTTOTHE
(n WORKERS'COMPENSATIONUIWSOFCAU .1WI11 ���-E .l IF1. 7l1LDBECOM[ INSPECTIONFEE
S SU6IECT TO THE WORKER$'COMPENSAT�N V .. _,. �OF TME UeOR
COOE.ISN LFORTNNAMCOMPLYWIT T . �' 'ISI�� ISSUANCE �•�l�_
O
p DATE:�'� � _ APPLICANT: SMIP —_ ..
� , ENERGY P/C -� '� �
J WARNINO:FNLURETOSECUREYK)RKERS'GOMPEfi YEMGEISUNUWFVLANDSNALLBE . , __.. . � �
�y SU[iJECTANEMPLOYERTOCR11AttULPENALTIESAN�qWLFMESUPTOONEMUNOREDiMW5AN0 ENERGYPERMIT
DOLLARS(Sl W.000),IN AODITION TO iNE COST OF LOMPENSATqN,OAMAG[S AS FROYIDEO FOR IN
� SECTIDN710BOFTHEU90RC0'�E,INTEREST,ANDATTORNEY5FEE5. RETENTIONFEE: ��
� CONSTRUCTION LENDING AGENCY PRE•AL7 FEE:
O
¢ IHE(iCBYAFFIRMUNDERVENALTVOFPER1URYiHATTHEAEISACONSTRUCT10NlENDINGAGENCY
nZ- FOR iHE PERFORMANCE OF TME WORK f-0R WNiCN 7M15 VEAMIT IS ISSUED(SEC.7097,CIV C.).
W
� IENDER'SNAAAE
F- IENDER'SIDDRESS
� TOTAL FEES �,5�
¢ ICERTIFYTHATIMAYEREADTMISAPPLICATqNA (11TETNATME�BOVEINFORMATqNISCARflECT.
W IAGREE TOCOMP RH LLCITYAND COUP T O :INANGESAND ST�TE UWS REUT�NCTO BULLDING
� CONSTHUCTI .AND�E _BYA � ES V7ATIVESOFTHISfAUMYiOEN7ERUPON7HE
Z ABOVE�MLN NEO ER oaiN .C7 �viavOSES. COMMENTS
_ ,�
¢ CEHMiTTEE �E(P / ���A�
� Y ���
N Si6NATUREOFP '�MITfEE DAIE
� RECPL NO. PAID BY _ VALIDATION
WHITE—Department Copy,YELLOW—Finanee Copy,PINK—Assossor Copy,GOL�ENROD--File Copy,GREEN—Applican['s Copy
� ' . ..-.i:. . , , .. .r.p��, , a .r' . , ,. �...,��;•r�. rd.�+!"'�'C.�'v.i�,,.Fi.i�r. . ti ,�;T"^'"f�:'r+�q'' ,i . . :�1w�i�.•�.,rC ,oL" . _ -..r.,�, _.. � — : .....' �
ciz�� or- �ir�..nror�!r� 8�,�
ir�s��c�►or,� �cco€�o �
'Irl-�:l=c;'I'C��1►,�M -��}��,Ei='�� (►��-7F��� 6'�1�{ ^ I►��.'�.:� .�E,`��'tc�►��i c)��.�!: ��(���I�c>>�o):� i
_ _. . . �_ - -
_ _ ._._.____.....___.___..� ._ __._-------.__ �__.___.----____�_____. . _ ___
_______._____._.._------�._.__ .__---- -__ _ ..._._____..._ _ ._.. _
SET BACY � i � � FLOOR JO(ST � �
FTGS/FORMSlSTEEL ; I FHA REQMTS
ELECTRIC GROUND � � UN�ER FLOOR DUCT �
GROUND PLUMBING UNDER FLOOR CUi�IDUIT
SLAB GRADE FIREPLACE FOUNDATION I
TEMP POWER I FIREPLACE BOND 6EAM
WATER SERVICE PJ11D HT. BOND BEAh1
ROOF SHEATHING 8 FT.BOND BEAM `
FRAMINGNENTILIATION FINAL BOND BEAM
ROOF COVER PRE-GRADING �
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL I
CEILING INSULATION OFF SITE IMPS. j
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING �� ENERGY
sl�,�r! t�;. �rl��:f� ___.__ �
COMMENTS
SEPTIC TANK SIZE �
SEEP PIT/U SIZE
--------,
,'��.1 �
h�r� _
,
e� '