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HomeMy WebLinkAbout11251 .,.�."_'.�.����. ��_ ..-��__��'_._ _._._._..__�..._..__.�__"'._..�._'_""""_.....___'_'"' '.._ . . . . . . . . \ ---��- - CITY OF DIAMOND BAR � � COMMUNITY DEVELOPMENT DEPARTME �:.,.0 21660 E.Copley Drive Suite 190 PRESS (909)860-3195 Fax(909)861-3117 ; ""' B[7ILDING PERMIT APPLICATION FIRMLY ' � 'JOBSITE p�/� APPLICATION PERMIT P!C � o AD�RESS����D ��L-i�1Ck. �� DATE NUMBER I�z-S � p � � APN LOT TRACT ISSUE J TYPE OCC DATE CONST. GROUP p OWNER �1'�C'(Z/�.1� o ADDRESS 1a� ZONING SETESACKS , Z CITY � ZI�_ TEL $ FRONT RW p o APPLICAM TEL. SID SIDE STREEf RW ❑ � CONTRACTOR SIDE ❑ � ADDRESS� �� � CITY.I.l�,�rJt� ZIP^ TEL:a/�38E�-5S-II � ' PRaPOSEDUSE aARCH/ENG/ �r— W .DESIGNER �� NO.DWEL NO. NO. a ADDRESS UNITS STORIES BEDROOMS � � CIN ZIP TEL. cn - cn DESCRIPTION SO.FT. FACTOR PSF ADJ.AFIEANALUATION p� OV'MER-BI;ILD[R DECIAFiATION. SFF{/ADD/REM O 1 HERE9V�FFIRM UNDER�ENALTV OF OEfUURY iHAT IlUI EXEMPT FROM THE CON7RACTORS LI� Gy�ggBlCelpOrt - W CENSEUWFORTHEFOLLOW:NGRE0.50NISEG.7o71.6BU5�NE55M1DPROFE55qN5G00E:ANYCITYOR (n � • U. ,�qJNT'/WHIp/qE�UIRESAPERMITTOCONSTRUCT,/LLTER.MPROVE.DEMOl15N,pRqEPAIRANYSTPUG W Pd2i0/DBG( Z NRE.PR�OR 701T3 ISSUANCE.AL50 NEWIR[5 TME APPLICpNT FOR SUGH PENMiT TO Fl�E A SIGN[D W STATEMENT THAi HE OR SFIE IS UCENSED PURSUANT TO THE PROVISIONS OF TNE COHTRACTOIiS LI� W � � � CENSE UW(p1APTEH Y(��M[NCINO WfTH SELTqN 7000�OF DIVISION 7 OF THE BUSINCSSAND PRO � PxVSpa � -FESSiONSCODE)ORiHATHEORSHEtSEIIEMP7THEREFiiOMANDTNEBASiSFORTHEALLEGEOEXEMP- C7 ,. V TqN.l1NYVIOlAT10NOF5EC110N7071.50YM1YAPPLICANiFORAPERMITSU&IECTSTMEMPLIGA.Y7T0 � Z {�0•(�pp� ' F A CML PENALTY OF NOT AIORE TNAN FIVE HUNDFED DOLLAF35(f5o0�.): � ❑�ASOWNENOFTNEPHOPERTY.ORMVEM�LOYEESWITNWAGESASTHEIRSOIECOMPENSRTIDN, � COTTBfCIr]I . Z WIIL DO THE WOP.K�NO THE STRUCTURE IS NOT INTENOED OR OFFEREO FOR SAIE(SEC.70��.BU54 J � N NESS IWO CROFESSIONS COOE:TNE GONTRACTORS LICENSE lAW DOES NOT APP�V i0 AN OWNER OF. � . .. PROPEFRY WHO BUI�pS Ofl IMPROVES THEREON,AN�NM110 DOES SUCN WORN NIMSEIF OR HERSELF OR' ' Q THi7WCMHISOHNEROWNEAIPLOVEES,VRONOEDTHATSUpiIAAPROVEMEMSARENOTINTENDEDOR m W OFFEREOFORSALEIF,HOWEYERTMEWILDiNOORIMPflOYEMENTI55DLDWITwNON[YEMOFCOMPLE• � � ' � TION,THE OwNER�BUrtDER WILL HAVE 1HE BURDEN OF PROVINO TUT HE O�i SXE DID NOT BUIID pR Z pAPqOYE FOR 7ME WRPOSE OF SALE). � � _ ❑�ASOVNJEROfTHEDqOPERTV.MAF%CLUSNELVCOMRARINGNITHLICENSEUCONTMCTORS W (L TO LONSTRUCT TME PR0.IECT(SLG 70N.BUSINESS AND PROFESSIONS COOE:TN[CONiRACTORS U• V21t18110f1 ADJ.AREA � W CENSEUWDOESNOTAVVLYTOANO�MNEROFADqOPERTYW1q8UI�SORRAPqOVESTHEREON,ANO �� YRqGONTMCT5FOR5UCHOqpJEGfSWITNACONTMCTOR(SILICENSEDPURSUANfTOTMECONTMG QUANTITY DESCRIPTION � FEE Y TORSIiCENSEUw.�. J� � O�NA E%EMPT UNDER SEC. B.a P.C.FOR THIS REASON x � � �� � � . . ... .. .. LL � OATE OYlNER � . Z � UCENSED CONTRACTORS�ECLARATION ' � IHEREBYPFFUUAUNDERPENALTYOFGERIURYTHATIAMLICENSEDUNDERPROV15lON50FCHAPTER Vr ` f� C � I � , d 0(COu�ENCWGWRHSECT�ON7000)OFDNISION�OFTXEBUSINESSANOCPOFESSIONSCWE,AN� Z X MY LICENSE IS N FULL FORCE ANO EFFECL : m . __ � . L1J � LICENSE RCLA55 �' LIC.NO. Z � ' V pATE :L2 CONTRACTOR r _ OJ- W., � WORKERS'COMPENSATION DECLARATION � � IHENEBYAFFIRMUNDERPENAITYOFPERNRYONEOFTNEFOLLOWiNGDECLAMTIONS: - N � �IHAVEINDWILL4AINTAINACERTIFlCATEOF�ONSEMTOSELF-INSUREFORWORKERS � � COAIPENSA710N,�SP{iOYIDEDBv5ECT10N�7ooOFTHELAeORCOOEFORTHEiERFORMANCE W � Q OFTHE WORN FOR WHICHTHIS PERMIT IS ISSUED. � �� � _IMAVEANDWILLAUMTNNV70RKER5'COMPENSATqNINSURANCE,ASREWIRE08Y5EGTION � Q ]700 0F 7HE IABOIi CODE,FOR THE PERFORMMICE OF THE WORK FOR NR11CH TH15 PEN.iiT 15 �SSUED.MYNqRKERSCAMPENSA^TION�IN,(S�UR/ANCnEGIRRIERAN�DPOL'ICrYNUMBfE�q�AR'E 1 CONSTRUCTION � CARRIER CAG C`�-CJ,C.N�(!�`-��G+�� !C"��l PUW REVIEW z raicrr+u�+[jea �����^r-��Z ELECTRIC Q � � � (h�L55ECilONNC�rqTBE001.�;ETEDOF1fEVERMtSFOl10NEHlIi%ifDDOl1M.R�7C10it1F551 PIUMBING. Z ICERTiFYTMATPI7XEPERFORMMlCEOFTNEWOFiKFORWHICHTi19PEMi1715155UED,l MECHANICAL _- �(} . SHAII NOT EIAPLOY ANY VErtSON IN ANY 1AANNER 50 AS TO BECA1dE SU&IECT TO TH[ � (n WORKERS'GOMPENSATIONUWSOFCALIFORMtilWDAGNEETIATIFISHOUL�BECOME INSPECTIONFEE '� � � SU[iIECT TO iHE WORNERS'CAMnENSATqN PROV1510N5 OF SEMION�70o OF TNE UBOR /� � " _ -rj COOE.ISHALLfORTMWIiHCOMP� 'ITMTM�SETFC saNs. .. ISSUANCE ���t • � ' l7O v 'p OATE: �Z APPLICANT: SMIP + • . � ENEHGY P/C - . WMNINQ;FAILURF TO SECURE WORHERS'COMPENSATION CAYERAGE IS UNUWFUL�NO SHALLBE �• •SUOJECTANEAAPLOYE0.TOCRIAIINALPENALTIESANDdYIIiWESIIPTOONEHUNDREOTFqUSANO ENERGYPERMIT ' DOLLARS(f taD.oOo),W ADOfTION TO THE COST OF CDM�ENSATION,OAMAGES AS PROViDED FO(11N ¢ SECTION�7oeOFT1EU80RCODE,NTEREST,ANDATTORN[YSFEES. � RETENTIONFEE: � � �� � ' � � _ O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: - � � � IMEREBVAFFlRMUNDERVENILLTYOFPE�LRIHYTHATTHEREISAGONSTRUCTIONLENDWCAGENCY � � FORiH�PERFORAIANCE OFTHE wORK FOR WNIp17MI5 7ERulTIS ISSUED REC.90V�.CN.C.). -Z .. . . . . . . W . � LENOERS NAME � � f-- LENDER'SAJDRE35 � � W IGERTIFYTHATIHAVEREADTMSAPP�ICATIONANOSTATETHAT7HEABOVE�NFO�W�nON15COFRECL TOTAL FEES /l • �S � I�GREETOGOMV�YYATMKLCITYANOLOUNTI'OFlDINANCESINDSTATEUY/SP[LATINGTOBUI�p;NG . � CONSTqUClION,ANOHEREBVAUT/10R12EREPRESENTATNFSOFTHISCOUNNTDENTERUPONTXE ' Z ABOVE�MENf10NEDPROPERTVFORINS�ECTqNPURPO5E5. COMMENTS ' ' � ti�A�M�-�ti � � m PERMITTEE NAME(PRINT {� � ' ' ' ¢ 1.��� (/J (n SIGMATURLOFPE E�—� � DAfE . � V`� � R[CPT.NO. � PAID BY VALIDATION � � � WHiTE—Department Copy.YELLOW—Finance Copy.PINK—Assessor Copy,GOLOENROD—File Copy,GREEN—ApplicanCs Copy . � f ..; ,. ..,..,- �- .� . ,. . - . , , � ,�..�'... . ...�r.tr:�'. �'�.,........� . . ,..... .4- . _ .. YY✓. � . . . . . ../.,,.. .�..�. .. .��:., .-.��.n.a.:.ti,.,,-I...T.'� � ' __ ,....� .. .:. ... ...'.. t ' �• � . . s .. � . ..1',.. , a ' ' 1 . . ... � ... . .. -' .�. / ' „ �� CITY:OF.DIAMOND BAR; '`" �,,�, ',�;'�� ' . I' ..,� _ � � ... . .. �:.;r: , � . . �. = `� ; � �iINSPECTION RECORD` � . � : ,' . -.•: .. - . _�� - . :i � ��. . . . . ,.. �. � � � ' • " 9 � � • - SET BACK ' - � � �: ' ' I .�'� � FLOOR JOIST ' • ' FfGS/FORMSlSTEEL _ ' ' - FHA REQMTS � ' ' � ELECTRIC GROUND � UNDER FLOOR DUCT . GROUND PLUMBING UNDER FLObR•CO�IDUIT - . -'' :� ` • ' �- • � -�• SLAB GRADE � - - - FIREPLACE FOUNDATION � TEMP POWER -- .- :- - _ -_- -- - - � - :: FIREPLACE BOND BEAM�� � .° , = � ; ;. . -- � • . , . _ . - . - . . . . WATER SERVICE --- -- - ' MID HT. BOND.BEAM � . ' - ROOF SHEATHING B FT.BOND BEAM � . FRAMINGNENTILIATION ' ' FINAL BOND BEAM - -- � ' ROOFCOVER- - - - � -� � � • 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 � • , ' . ' CEILING INSULATION OFF SITE IMPS. • DRYWALL NAILING DEDICATIONS . � SEWER- - - .... .. .. . .. . . _ _._. . _. _ FINAL ENG.. . SEPTIC TANK.-_ . . . _' '. LANDSCAPE/IRRIG. "' " SEEP PIT/LL'-:- - -. -. .. _ _. _. . ' ON SITE IMPS. ' -� GAS AIR TEST - -- - - - �- - - - FtNAL ZONING • ,.. FINAL CONST.-, - - - - ---- - ----= FIAE DEPT.FINAL � FINAL�HEATING - - ; - H�ALTH DEPT.FINAL -.. � - ---- - --- � � FINAL�ELE�TRIG ' ) OEV. FEES PAID : FINAL PLUMBING �p�� � _____. ENERGY Lr � �,.�. ,� . . � _ . . . . -• � - c s - ._ . i � � . --- -- -- - .: .. , --- .. . . _ . . _... � , COMMENTS � � . .. ; '., - , , , - - -. _ . . . . ; , � =� _ _ � � �.. ',._ . .,. -; . . . . , _ _ . '�' � i � . -- ' - =- , �.., �► . � . � , . _ . . : � � . , - j ,. : � hr ��_} ; . . .. u..' •� ' . , . � , _ , � i , , - . � - _ �. SEPTIC TANK SIZE ' ' ' - - - - - - - - � SEEP PIT/U SIZE � - � ' , ; - , � 1 . � • � -, �;- , ' , �. _ . , I � � �: ; , . _ : . �, � � .