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HomeMy WebLinkAbout12222 J� CITY OF DIAMOND B AR '� �' '• � DEPARTMENT OF COMMUNTfY&DEVELOPMENT SERVICES � � . � 21660E.CopleyDriveSuite190 . . . (909)860-3195 Fax(909)861-3117 PRESS � . '^�.� . , . BUILDING PERMIT APPLICATION � � .' FIRMLY v ADDRESS�� 17L' �`S�a��� APPLICATIO PERMIT �� �7P/C DATE ���Y"�I� NUMBER �'y1- ISSUE t�,.�� �a � TYPE OCC � APN LOT TRACT ' DATE ' � CONST. GROUP. g OWNER oNTc //�G ADDRESS — � "�� �«- 'ZONING SETBACKS � CITY �� ^� ZI TEL. FRONT RW p APPLICANT TEL. REAR ❑ � SIDElSIDESTREET RW O CONTRACTOR SIDE� ❑ g ADDRESS I,,,,,,I,.� CITY ZIP TE4 , PROPOSED USEs�`'`� ��✓ o ARCFUENG! , � DESIGNER NO.DWEL.� NO. NO. . ADDRESS UNITS STORIES BEDROOMS CITY ZIP TEL y DESCRIPTION Sa.Fi. ' FACTOR PSF ADJ.AREANALUATION � p� OWNER-BUILDER D�CLARATION SFR/ADDIREM O ' 1 NEREBYAFF6iI UNDER VENAITY OF VERAIRY THAT 1 MI E%EMPT FPOM THE CaNTMCTOH5l1• Gefe9fl�CefpOR � � ' ' �8 CENSELAWiORiNEFOLLdMN4REA50N15EC.70.'Ii.68USWE55ANOPiqFE5510N5CODE:ANYdiYDH (n _..� COU1fIYW/9G1RE0URE5APERA/RTOCONSTRUCLKTEiLIM�ROVE.DEMOLISKORREPAIRANY5�l7C- W Patie/Deck � . � _ �_ NNE,PRI�R TD fT3 65UANCE,KSO f1EIX11RE5 THE APPIICANi FOH SULl1 PENMIT TO FlLE A SIGNED W � BTA7EIAEM 1FMT HE Ofi SME IS UGENSED PVRSUMlT TO THE PRONSIONS OF THE OOHTN��CTORS LL , N � CEHSE UW(QIAVTER Y(COId1AENCPlO YATH SEGT�ON 7000)OF DIYISqN 1 OF TXE BUS�NESS M!D PRO � POOV$p9 FE6510NS COD�dt T11A7 NE Oit SME IS EXEUPT 1MEREFRd1 APID THE BASiS FOR THE ALLEOED EXE4P- TIDN./YlYVIOL�TIONOFSECTKK1T0.11.6BYAHYAPPLICANTFORAPERYITbUBJECT57MEMPLICINTTD � Z Re-Raot �„� ACML7ENILLTYOfNOTWHETWIFIVEXUNDREDOOlLMSpsW).Y. ' ! � 04�.40NNEROFTHEPHOPERTYORLMEAI7LOYEESVniHWACE5A57MEIRSOLECOM7ENSATION, O �COR7mBfCl01 YALL00 TME WORK AND TNE STRUCrUR[IS NOT NTENDED OR OFFERED FOR SAIE(SEC.7D,1,BUSF J N HE55 ANO iROFES510N4 COOE:THE COHTiiACTON9 UCENSE L11W DOES NOT APPLY TO IW OWNER OF . � ►pOPERiYVYF�OBU4DSORMPfpVESTIEREON,MIDWHODOE55VptWOHKM1I5ElFORMERSELFOq � _ Q TIROUGHIYSdiHENOMMEMPLOYEES.PROVDE0THA75UGMiMPROVEMEMSARENOTNTENOEDOR m � ,OFFENmfptSALE�F.NON'EVFRINEBULDa00RM7ROVE4EMISSdDN71HINONEYEAROFCOURE- � •TION,TNE OYlMER�UIIDER WH.L IUVE THE BURDEH OF VROYINO THAT NE Oq SHE D�D HOT BUILD Oq MVRONE Fpt iHE VURPOSE OF BALEl � W ❑41SOWHEROFTHEPROPERiY./1AE%QUS�VELYCOMRACf1NON71HLICENSEDCONTML70ii5 fL TO CONSTRULiTHE PRQIECf REG 7oN.BUSiNE55 AND PROFE5510N5 CODE:iT1E GGlTMCTOF45 U� V81U8110l1 ADJ.AREA l� CEH6EUWDOE4NOTMVLYTOANOWNEROFAPROPER7YVMOBl11lD50RMPROVESiHENEON./J�O wnowrrta�cTSFonsuwv�crswirH�eartw��cron�s���cer+seowasuurtron�eoorrtww OUANitTY DESCRIPTION FEE � 70ASUCEt+SEUw�. ..- ... . . . . . . . O�FY E%EYPT UNDEA SEG B.�i.G.fOR TMIS RE�SON J 3 � . `� _ �i . pATE OWNER . W � UCENSED COMRACTORS DECLARAT N W �pK/�,/�, q�t, � � I HEREBYAFFGIM UNOEH PENALtt OF PERAIHY iYUT I M1 IICENSED UNDER GROV1510N5 0F tNAPTER Vr ' , . . � f(COMMENClI�WITH SECT�W17000)OF DMSqN�OF TNE 8U5iNES5AND VROFES5iON5 C00E,AN� Z X YYIICENSE 6 W iUl.IiORCE/WD E�FECT. m , LL! O . � F tICENSE CIASS LIC.NO. J . V pATE " � � � CONTRACTOR � a LL � WORKERS'COMPENSATION pECLARATION –r � U � N IHEREBY�FFIRMUNDEHPEN.LLTYOFPER1UItY0NE0FTHEfOLLOWiNGDEttAtUTqNS � �� � � � - � N Z 4 - G ��INAVEANDYALL4NN7AMACERTIFIGITEOFOONSEMTOSELF-INSUREFORWOiiKERS' 2 � CdJVEN5A7CN,ASViiOVIDEDBYSECiION]7000FTHElAWRCOOE,FORTHEVENFORAW�CE W OF ME 1M1GRK FOR WM1CH THIS PERUR IS ISSVED. � . � �I HINE AND W�LL W1MAP7 WOPo(ERS CdAPENSATqN INSUMNCE.AS REOVIRED BY SECTION� QYfooOFTHELABORCODE,FOiiTHEVERFOFUAMICE0F7HEWORKFOHNMIOfiHISPERMITIS � ISSUED.WNVPoCER3'COYFENSATqNPlSURANCEGRRIERIWDPOLICYNUTABERME: CONSTRUCTION > �qq�Eq PLAN REVIEW � DOLICYNUMBER ELECTRIC 0 (n65[cnoNFEmNo78ERbs1E7mOFTEPEA�isFOHotEHx�ORcnDdlljLSRtm)onlF55F LUMBW � Z ICERTIFY7HATNTHEPERFO{vAANCEOFTHENORKFORWMiCMi1n5PERMITI5155UE0.1 MECHAMCAL � ('} SHALLNOTEMPLOYIV7YPERSONNANYWNNERSO�ISTOBECOUESUBJECYT07HE �/j WORKER5COMiENSATqNUW50FCAL60fWIA,AND�GREETMATIFI5F10ULDBECOME INSPECTIONFEE S SUB.IECTTOTI1EWOpKERSLOMPENSAi1DNPRON510N50F5ECf10N770o0fTMEUBOR - ' ?r �� COOE I SNALL PoHTMYniM Cp.�PLY WITH 7T105E PROV�SIONS. ISSUANCE � SMIP p DATE: APPLICANi: . .. w ENERGY P/C WARMNa FAIIURE TO SECURE WORKERS'COMPENSATqN COVERAGE IS VNINNFUI.�ND 51ULLL 0E � SUaIECTANEMPLOVERTOC(iIMP1ALPEWILTIE5M9GMLFNE5UPi00NEHUNDREDiNW5M1p -� ENERGYPERMIT �(i1oo,000).N I1DOrttON TO TME CO57 OF COMPENSATION.DMu6E5 AS PRD�DED iOR W JOC SECTIDN770lOFTNELA00RCODE,NlEREST,ANOATTOiWEY5FEE5. ' RETENTIONFEE: � � a CONSTRUCTION LENDING AGENCY PFiE•ALT FEE: O � INEREHYAFFlRMUNUERFENKTYOFPERNMMATiNERE15ACON5TRUCT10NlENDW6AGENCY FOR 7NE VERFORUANCE OF TNE Y�'OfiK FOR NM1IICH iM15 PERMIi IS ISSUFD(SEG 70Y7,CIV.G�. � IEN�ER'S NAME . .. . / � C LEN�ERSIl00RE55 � ICERTIFYTUTINAVEREAOTHISMVLIGATN7NMJ�SiATETNiTHEA80VENFpRA1ATqNISGOfWECt TOTAL FEES , � � IAaREETOCO�APLYWIiHALICfTVANOCOUNiYOADNAMCES�NOSTATEUwSRELATINOTOBUILD�NG � CONSTHUCfI�N,ANDMEREBYAUi/qWZEREVpESENTAT1YE50FTH15COlR/iYTOFHfEHUPOH7HE . - S� ABOVEdAEHT10NEDVROVEHiYFORINSPECTIONVURPO5E5. COMMENTS � 9 �c7'� �}� `� l�L.d�e ti � - m PERIARTEENM�EfPNIHn . � a�� � �—..� - �a– � y NANRE OF VEFiM E DATE � RECPT.N0. PAID BY VALIDATION WHITE--Depenment Copy,YELLOW—Fhenee Copy,PINK�Assessor Copy.GOLDENROD—File Copy,GREEN—Applicant's Copy � . CITY OF DIAMOND BAR �,, _-:;-;�: ,,,: - ,,. - � . .. . . �. . .... :,::INSPECTION RECORD �� ... .�:• � �: :, ; . �` , _ ., . , . ,. . . .. ,. ..,; . , � ` � � . � . . � � , . + . 'SET BACK .... • � . , �� ' . _,,: � ��� FLOORJOIST ..' �' .,t':.-_� - _ � r ;.�. I = . iFTGS/FORP�IS/STEEL " ,' . , ,, _t:: FHAREQMTS -- ---- - -- - . . { : �ELECTRIC GROUND_- �;. . ' _. . - _ - -: - UNDER FLOOR DUCT " � � - " ' --„ � - � ' � - �GROUND PLUMBING � - UNDER FL'OOR CO�IDUIT = �• ' - • � - - - ISLAB GRADE' - �-- ---._.... _ . _ , FIREPL'ACE-FOUNDATION _. •.. .... , .,.::. '.�.:�'r�,:� � °- . �TEMP PdWER-- ` ' - `� " : .�• � � FIREPLACE BOND BEAM..__: �WATER SERVICE ___-_ __: _--.-._..:�-.-_ - :.:� _.. .-.:_. _. ..__.- = MID HT.BOND BEAM -- - - - � .. : � . . . .. •.":.:. �; •., -.. _ . ,ROOF SHEATHING - . __ • `=-• :. ._'_' .: .._ _ . 8 FT.BOND BEAM � ••,,., ! 'FRAMINGNENTILIATION . FINAL BOND BEAM � � " . • _ . . _ _ . --- - - .: i .,. ROOF COVER, �.. ' r. PRE-GRADING - - -ROUGH HEATING ---- _ .-- -- -, . . - - BENCHING - - ' '' �` ! S, �ROUGH ELECTRIC -� - - � � , � -`.-��� RDUGH GRADING ' � � - - � I ROUGH PLUMBING '--- -- �- -- - - . " . -:-.- �FINISH GRADING . . i . , 'SHOWERITUBTEST ,� Z2 � - : POOL'ELECTRIC ' ' .EXT.LATHISIDING � � POOL'FENCING � - WALL INSUlAT10N ' � POOL FINAL . � ' CEILING INSULATION OFF SITE IMPS. • � I -_' DRYWALL NAILING DEDICATIONS , . : � - SEWER. . .__... - ---..:--- • : ._. .. .. FINAL ENG. �. . SEPTlCTANK . --. '._....- ---.__ _... _ . . ...- --. LANDSCAPE/IRRIG. . � SEEP PITlL.L. --- --- ' _ -- ; - = - � �N SITE IMPS. : " -- � ---. . . . . : . � GAS AIR TEST . .. - _ -. - --- -- FINAL ZONING � � ; FINAL•CONST.- - - -- - � - - - �: - ----� FIRE DEPT. FINAL ' ' �' - . . � : . . FINALHEATING -��-� - - � -- "` ; - HEALTH DEPL FINAL '• . . - � , _,_ , ;FINALEL:ECTRIC---- . _ ... '� : .. _ �. . _..._... . : DEV.FEES PAID . . :. . - - : . - -- . .. --- � , FINAL PLUMBING 2 � ENERGY � • ; � � . �- � -�. , . � : � ; -- - - - - -- ' . ------:...... _----...... . :. .. _. _. . �.. � •-. • . :::. I : 'GOMMENTS -�- .. __ __ _ . . . ... ._.. .. , . , . . � � --- - -- - - -- - - , - ; . _ , _ ,. . . - , . . � - - --_ _ -- - ' _ . __ . . i . . _. ; _ . ...-�-- . _ � . ' , . -. i _._. . _ . _ . . . • . _ _ . . . ; . -�_� � _ ___ _ _ , � - - . ; . .. . ; � ' -- - -- . . , � • . . � _�- -- , •- . . _ _ . . - - � .. , ---- - - _ .. . � ; ; . . _ , SEPTIC TANK SIZE � � ` ` ' - � i `- SEEP PIT/U SIZE ,,,,, , , • � '' ;� t x� � ', .. � ; ...: __ ;� : i . _. ' � ; - � ... , � - . -. � _ _ � } • .. . . . � .. , . ' . . .. : ' , _ - -- - - . _ , � , ; . . , . . . .... • � - _ - : , � _ , j �.' � ;i - ; � . , _ . _. -; , - .