Loading...
HomeMy WebLinkAbout16692 (19) CITY OF DIAMOND BAR EXPIRED � J� � DEPARTMENT OF COIvIIvIUNTI'Y&DEVELOPMENT SERVICES r ,��` ' 21825 E.Coplcy Drive JUN 171002 (909)860.3195 Fax(909)861-3117 PRESS ''-�� BUILDING PERMIT APPLICATION FIRMLY o ADDRESS�I� �3���k-'��1 {J��' � DATECATION �Z' O NUMB R !C � �!i � APN� LOT TRACT �SSUE n JI TYPE OCC DATE f�� CONST. GROUP p OWNER �E7f1_ l�'Q " ADDRESS `n/�S� °.r -+-.n ZONING SETBACKS gCITY O;�M I'�ncii J�ZIP ����TEL.�61'C�T� FRONT RW ❑ APPLICANT TEL. REAR ❑ SIDE/SIDESTREET RW ❑ � CONTRACTOR �C' " G� 1 _ SIDE ❑ ADDRESS 1 -i'Y� � CITY � t ZIP �i``�/ " EL. �id,f `i��L.'l„z�l PROPOSED USE -�o^ - ' .S lC ' J2�, -4:,,: ' � �'C.EU a � .I� �. .. = T: .0 wo ARCH/ENG/ BU a — ��� r OESIGNER fii N0.DWEL. . NO. n. ADDRESS � CITY Z�p 7EL UNITS STORIES BEDROOMS � u� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION o OWNER•BUILDER DECLARATION SFR/ADD/REM p 1 MEREBY�GFlRM UNDER iENALTY OF GERNRV THAT 1 M1 E%EMP7 FROA1 THE CON7MGTORS LI• G8f8gBlC8lpOlt W GENSEUWFOR7HEFOLLOVlINOREASON�SEG7a77.68U5MES5AN0iROFE55lON5COUE:ANYqTYOR (n V COVNTYWHICHREWIRESAPERMITTOCONSTRUCi,AITEH,lA17ROVE,DEMOLISH,ORREP�JRANYSTRUG W PatiolDeck � NRE,PRIOR TO RS ISSUANCE,ALSO REW IRES THE ADPLIGANT FOR SUCH PERMIi TO FILE A SICNE� w � STATEMEM THAT ME OR SHE IS LICENSE�PURSUANT TO TFIE PiiONSIONS OF TXE CONTRACTORS lb � � CENSE UW(CHAPTER Y(COMAIENCMO WITH SECTqN Ta00)OF DNISION]OF THE BUSINESS ilNO GRO� POOVSp3 fE5510NSCODE)ORiMATHEORSHEISE](EMGTTNEREFRpAANDTMEBASISFORTHEALLE6EDE%EMP- (� TqN.ANYVqUT10NOFSECT10N7071bBYANVACVLICANTFOR�PERMIT5U8JECT57NEMPLICM17T0 Z Re-Roof �� A CIVIL PENALTV OF NOT MOFE TfAN FNE HUNDRED DOILARS(f5oo).): ZOI��M/��EROFTHEPROPERTV,ORAIYEMPLOVEESYAhIWAGE5A5MEiR50LECOMVENSATION, O COf11rtIBfClel - WILL DO TME WORK�NO TME STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7o�1,BU51� J y NESSAN�iRDFE5510N5 COOE:THE CON7MCTORS LICENSE UW DOES NO7APPLY TO AN OWNER OF ? VHOPENTY Mh10 BU0.DS Oq IMPROVES THENEON,AND WHO DOES SUp/WOqN HIMSEIF OR MERSELF OR WiHROUGH HIS ORHEN OWN EAIPIOYEES,�HONDEO THAi SUCM IIAPROVEMENTSARE NOT WTENDEOOR m 0 OFFEREDFORSALEIF,IqWEVERTHEBULDIN60RIMPROVEAIENTIS50LDWR14NONEYEAROFC0IAPLE- Z T10N.TME OwNER-OUILDER WiLL HAVE TNE BURDEN OF PROVINO iHAT HE OR SHE DID NOT BUIID OR = IAIPROVEFORTHEPURCOSEOFSALEJ. 04�ONMEROFTMEPROPERTY,MIEXCLUSNELYCANTMCTIN6WfTF1LICENSEOCONTMCTORS y- , � V� � i0 CONSTiiUCT THE PR0.JECT(SEG 7M�,BUSINE55 AND PROFESSIONS COOE:THE CONTMCTORS U� VBIUaI1011 R' ADJ.AREA W CENSEU�MOOESNOTMP�YTOIWOVrtJEROFAPROVERTYNTqBU1LD50RMPROYESTNEREON,ANO � W11000NTMCTSiORSUCMPROJECTSVATHACONTMCTOR(5)LICENSEDVURSU/JlTTOTHECON�MG pUANTITY . DESCRIPT�ON �E, Y TORSIJGENSEUW). � O I MI D(EMPT UNOER SEG B.6 P.C.FOR TM�S NEASON Q • 3 U ti.. � DATE OwNER f- O W � LICENSED CONTRACTORS DECLARATION w IHEREBYAFFlRMUNOERPENAITYOFPERIURYiHATI�MIICENSEDUNDERPflOV1510N50FCMAPTER � p., 9�COMMENQN6 WITX SECfION 7000j OF pIVI510N]OF TME BUSINESS MJO PROFESSIONS CODE,AND Z `L MY UCENSE IS N NLL FORCE AND EFFECT. m � � � � � LICENSE CUSS� l�C.NO. ` � V DATE C� GO cTOR� d � �A—^wL J— ` � 4 � WORKEFiS'COMPENSAT�ONDECLA TION � IHEREBYAiflfUAUNDERPEN�LiYDFVEiWRYONEOFTMEFOLLOWIN00ECURATIONS: z � �IIUVEANDWI�LMAINTNNALERTIFICATEOFCONSENTTOSElFdNSUREFORWOPHERS' $ �� COMPENSATION,ASPROVIDEDBYSECTION]7000FTMEUBORLOOE,FORTMEiERFORMANCE W OF i11�WORK FORNM1/ICH THIS PERMI7IS ISSUED. � � � 4 ��VEANDWILLYAINT.4NWORKERS'COIAPENSATIDNINSURANCE,ASREWIREDBYSECTICN � � �. �JU �7000FTHElABORCODE,FORTHEPERFORMMICEOFMEWORKFORWMICH7HISPERMITIS » � ISSUED.MYWOPoCERS'COMPENSALt_o�lINS.UMNC�GARRIERANOPOLICYNUMBEflARE: CONSTRUCTION �� j GARIER� �'�. \1�1C — PLANREVIEW i I 0 FOIICYNUMBER �L �-J' ELECTRIC � � ' ♦ 0 (fICSSECfriJNEmN0T8ECCl.�LEfEDOFTE7EiiMTISiORONEIIll�EDDOLIARS�T100�OfiLESS). PLUMBING Z 1 CERiIFY MAT N THE PERFOfUAANCE OF THE WORIf FOR WHlql iH13 P ISSUED,I MECHANICAL U' SIULLNOTEMGIOYANYPER50NWANYMANNER50A5TO8ECOME JECTT THE �/j WORKEfiS'GOMPENSATqNUW50FG1C1FOiVCfA,-11NDAGREETMAT IS/KJl1LU ECOME INSPECT�ONFEE SUBJECT TO THE MIORKERS'CGA1 ENSATION PRONSIONS OFJE ON 7700 E U�BOR �1 CO/UE.I ALLi RTHYAiNCOMVI 7MOSEPROVISIONS.� ISSUANCE �✓ � p DATE: `�� � � APPLICUJF. . SMIP .� J _� � ENERGY P/C � WAqNIN�: AILURETOSEWREWOfiKEFS'COMF TIONCOVERAGEISUNUwR1L.,ANOSHALLBE � SU&IECTANEMPLWENTOCRIMIWLLPENALTIESANDCMLFWESUPTOONENUNOREDTHOUSAND ENERGYPERMIT � �" OOILAfiS(f 700.000).N ADDIiION TO TNE COST OF COMPENSA710N,DAM�GE511S PROVIDED FOR IN � SECTION�70BOFTNEIABORCODE,wTfHEST,ANDA7TORNEV'SFEES. RETENTIONFEE: OCANSTRUCTION LENDING AGENCY PREALT FEE: � � IHEHEBYAFFIRMUNpERPENALT/OFPERIURVTMA7TMEREISACONS7RUCT10NLENDWOAGENCV FOR THE 7ERFORAIANCE OF THE WORK fOR NMICH T111S PEHMIT IS ISSUED(SE0.0077,GV.G�. Z w �� LEN�ERS NAME - � IENOER'SADDRESS � TOTAL FEES � 30.�3 �,� ,q(� � ICERTIFYiHATIMAVEREADTHISAVCLICATIONANDSTATETMATTMEABOVEINFORMATKKiISCOHRECL W MGREETOCOMPLYWRHALLCfTYANDCOUNTVORDINMICESANDSTA7EUWSREUTINaTOBU1LDIN6 � CONSTRUCTION,ANOHEREBYAUf1qRIZEREPRESENTA7IVESOFTHISCOUNTYTOENTERUPONTME � Z � NTqN D PROPERTY FOq INSFECTION PURPOSES. � COMMENTS \ � ` � P WIT�EE� 4E�R � aNA7 �� FPCRMI EE OATE � RECPT.N0. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROP—Fite Copy,GREEN—Applicant's Copy �..�wr ..�,...-�ui:,.,.. - >,.��y�a�,.a .,..r...,.:-: n�n��.:... .��..-..,..._. ._,,,,.,i•.. •�:.��,.�.r;- "'M.'� . ,T�.t.4' � . , -_ _ - .. « ��. ...r.�r.a".. .. __ �.. . .. ., . ci�ti' C�F �IAP�f(?��G BA,R ii�fSi'�C i Iflt'd f�ECC)E�t7 '---_. �...._._..�.__.�.._ _.._..__._.____ .�____._,.___._........_.____ _.� ..____ il►�k-�:���;���I�Ji'k C.�_�G=. 1i`E-`� {..(�'`.�e1�i 1���=�:�aE ,:�(sy�`I �r��1��.; I►�I-`i����^F'o � __..._._..�.._ ___.._..---___.____ _. _..___. .._._______._..___ ._ _. - -.-----__ _.� _._..__ .._._.,��_._. __.._---- ____-------.___.._.r___ � SET BACY. _ �. _��_FLOOR J�IST I � _ FTGS/FORMS/STEEL � • FHA REQ�.1TS ELECTRICGROUND _ I • j � U�JDER FL�OR DUCT } � GROUND PLUMBING I UNDFR FLOOR CUI�IDUIT , � SLAB GRADE I • FIREPLAC� FOUNDATION ' I _ . TEPAP POWER I FIREPLACE 60ND B�AM ( WATER S�RVICE ( MID HT. �OND BEAF�1 ROOF SHEATHING ����-o\ �T _ 8 FT. BO�JD.BEAh.1 _ " FRAMINGNENTILIATION FINAL aOND BEAM ROOF COVER I PRE-GRADING ROUGH HEATING BEP�CHING ROUGH ELECTRIC ROUuH GRADING ROUGH PLUMBING � FiNISH GRADING SHOWERITUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL IfJSULATIOfJ POOL FINAL CEILING IN�ULATION OFF SITE IPJIPS. DRYWALL NAILING �EDICATIOi�S SEWER FINAL EPJG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IN1PS. GAS AIR TEST FINAL ZONIPJG FINAL CONST. � FIRE DEPT. FItJAL FINAL HEATING HEALTH DEPT. FINAL FINAI ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY �.,�_ c,�:�„s,I,:°j)i.. , _ ,- - — e — — , . _ COMMENTS � � SEPTIC TANK SIZE SEEP PIT/U SIZE ,`�M i ��f� �� . � � �