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HomeMy WebLinkAbout16424 (23) __ ,..�. ._ __ . . .. . _._.._._...... . . .. .. __ �$ � . 3°t b- SG �� �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICE �I i �c , 21660 E.Coplcy Drive Suite 190 C.� (909)860.3195 Fax(909)861-3117 PRES$ �, " ���^� BUQ.DING PERMIT APPLICATION , FIRMLY y JOBSITE A APPLICATION � O I PERMIT I�L1 L P/C o ADDRESS 2-OyO�j FLJI�TGL�tT� ��• DATE �� NUM6ER � x ` � ISSUE . --- 'TYPE ' '�� OCC APN LOT TFACT DATE � CONST. GROUP p OWNER wAu,.ACE + DO R�S B,Q��a wADDRESS,� d�lC b �t1 NTC=i47'� DR• ZONING SETBACKS CfTY�IAMeAI� Bl�e ZIP 4�isr�i TEL L FRONT RW ❑ � APPLICANT ,��1JIN1 t-�ZStkSA1�yA1A TELS�.j -�1�-0 y p REAR � p � SIDEJSIDE STREET FW ❑ CONTRACTOR SIDE ❑ g ADDRESS -- ' � � ' pROPOSED USE �N�O�'�'� �Fv�� CITY ��.� ZIP�Q�,� TEL����3 � �--- ' . � ARCFVENG/ . . ; .� . . . DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL y �ESCRIPTION SO.Ff. � FACTOR PSF ADJ.AFiEANALUATION p� OWNEFi•BUILDER DEGLARATION :SFR/ADDlREM O p I MEREBYAFFlfM1 UNDER VENALTY OF PEM1AJRV TNAT I AM E%EM�f FR011 iHE COMMCTORS LF Ga���rt W CEHSEUwFq1TXEfOUAWwCiPEll50NI5EG70.71.68U5MESSA�iOFROFE5510N9CO0EANYCRYOR (n 5.2 COUNiYM/ACMNEOIMES�VERYRTO00N57HI1GT,ALTE0.�PHOVE.DEMOLISH.ORREiA1R11NYSiFttlG ' W Patio/peck Z TVRE,PRqR TO IT9 159UANCE,AI.A REWIRES TI+E MPt�Ni FOR SUCH PERMIT TO F4E A SiONED �� ETATEMEM TMA7 HE OR SHE IS LICENSE�VURSUANT TO TME PROVISIONS OF iHE COHTRACTOH9 l4 W - -.._ __.... . - . � � CEHBE lAW(QUPTER C�COMMENCINO VATII SECT�ON M00)OFOMSION 7 OF iHE BUSiNESSAND P{q � PooUSpa� FESSiONS OODE�OR iNAT ME OR SHE IS E%EMP7 i1fEREFRO►1 AND TME BASiS fOR THE ALLE�ED E%EMP• TqN.AHYVqIATIDNOF5ECT10N7Cn.68YANVAPPLICANTFORApEHMITSUBIECiSTHEAPPLICANiiO z Re-Rool�_� ��� � A CNC VENALTY OF NOi MORE TFW!FIVE FNNDAED OOLIAAS�l500�.�: � ❑tASOWNEROFTMEPROPEf1f1:ORMYEMPLOVEESY+iMWAGESASTHE1RSOtECOMPENSATqN, 0 �mmerclat � �- - YA.L DO ME WOPI(AND TME STRUCTURE IS NOT INTENDED OR DFGEAED FOR SALE ISEG 7D��,BU51- J NESS AND iROFE5510N5 COOE TME GONIMLTORS LIGENSE Uw DOES NOT AVVLV i0 AN OVINER OF � VNOPEIifYYN�OBUNDSORMOROVES7HEREON.AN�1M1000ESSUCHWDRKHIMSEIFORHE0.5ElFOR = � a TYi0UCW1450qHEROMRIEMPLOYEES,VROVIDEDiHA75UCMIYPROVEYENTSARENO7NTEN0EDOR m �Lr OFFEREDPoRS/LEF,NOWEVER7HE&1LDWGORM7fiWEMEMRuOlD1M7MINONEYEAflOFCOMPLE• � T1]N,TME OVMER�BNIDER WILL HAVE TME BUFiDEN OF GROVN6 THA7 NE ON SHE WD N0T BUILD OR MP�1yE FORTXEVURPOSEOFSAI,�. W J�t1440WNEROFTHEVPOPER'TV.AIJE%CLUSIVEIYCOHTMCIWOWITHLICENSLDCOHTfiACTOR3 gro WR�'TPUCT THE iROJECf(SEG 70a1,BUSMESS AND VROiFSSIONS COOE:TH[CONTMCTOHS LI- ip11 ADJ.AREA CENSE UW DOES NOTIIPPLY70AN OwNER OFA PROPEfliI'Ym0 BU0.0S OR NIPHOVE9 TMER[ON,ANO � NMOCONTRAttSFORSUG1VpO.lECTSVnTHAWHTMCTON(S)LICENSEOPURSUINTTOTMECOKTMG pUANTI DESCRIPTIOV FEE � � 1GR5 UCENSE LAW.j. OIIMf%EMPTUNDERSEG. B.iP.C.FORTH15REASON U � �=' DA7E � �O WrNER V . � W -., .� LICENSED CONTRACTORS DECLAFtAT10N -� � 1 HEREBYPFFYMI UNDCR iEWLL7Y OF FEfUURY TMT IM1 UCENSED UNDER CROVi510NS OF CHAPTER Ur � � �(COYYENCNOYniNSECTqN7aoo)OFDMSqN70FTMEBU51NE55AN�VROFESSiON5CO0E,AND Z LL� WLICENSEBP7FUlFOACEANOEFFFCT. O f � � �.,_. LlCENSE CIASS LIC.NO. J � pA� ' �O CONTMCTOR d � WORKERS'COMPENSATION DECLAFlATION a = U N 1 NEIIEBYAFF�W UNDEH PENKTV OF VF0.NNV ONE OF iNE id1MNNG DECIARATqNS: N Z Q � __IHAVEAHDWiLL1AAMINNACERTIFICATEOFGONSEMTOSELFaNSUREFORNqfUCERS' 2 � - � COY7ENSA7qN.A5Pf10VIDNBVSFCitONJmoOFTMELABONCODE,FOHTMEGERFORA/ANCE �U OFTHE WORK FOrtNM111CM THIS CERMR IS ISSUED. � O 1 HAVEAND 1MLL w1HTAM WON(ER5OD67PENSATION INSUiUNCE.AS REa1iRED BY SfCT10N Q ]1000FTHEUBOHCOOEFOR7MEPERFORMANCEOFTHEWOAKFORNT11pITHISPERMIT�S L� ISSUED.WWORKERSCOMPF�NSAT ,;Jt�SURANCECARRIER/JIDPOLICYNUTABERMG CONSTRUCTION � � . C.4ISRIER ����.� . .__. - � ^ PLAN REVIEW � POIIGYMA�OER�� � ELECTRIC � �'I� � (Ii65ECfICNNLIDNOTBEW�itEfFJOfMPEW.R6PoHONEHUH�im00.1JJiSRtO�ORlE55} PLUMDING Z �CERTIFYhuTN1MEPERFOfWMlCEOFiHEWORKFOHWHIp7hIi5iERMIT1565UED,l MECHANICAL � SMALLNOTCMPLOYANYVENSONNANVMANNERSOASTODLCOAI[SUBIECTTOTIE . � WORNERS'COMPENSA7iONUw50FC�L�FORNtAµDACREETMATIF15HDUlDeECONE INSPECTIONFEE SlA1ELTTO7MEWORKERS'COMPENSATIONV ONSOFSEC7qN77ooOFiHELABOR woE, F i1M1NTHGOMPLYWITM r Ns. ISSUANCE,. � p DATE: ` OI APRICANt �' SMIP 1T � � w ENERGY P!C WAflMMO:FALURE TO SECURE LWRKERS'COIAPENS�TION COVERACE IS UNUWFU4 AND SWLLL BE ��y, SL61EC7AN E4IPLAYEN 10 CRIMNUL VENALTIES AND CMl FINES UP TOON[NUN�RED TFIOUS�ND ENERGY PERMI7 DOLURS(f IOD.D00),IN ADDRWN TO THE COST O�COMVENSATqN,OMUCES AS VROV:DEO fOA IN ¢ SECTiON770lOF7MEU�RCOOE,MTEREST,AND�7TORNEYSFEE3. RETENTIONFEE: � pw_, CONSTFiUCTION LENOINGAGENCY PRE•ALT FEE: � � IHEREBYAFFiNMUNOERVENKNOFpEiUURVTFIATTNEREISACONSTRUCTqNLENDINOAGENCV -- - FOR iNE VER�ORW WCE OF 7N[WOfiK FOR WHlpl TIAS VERM�715ISSUEO ISEC.7DV7,GV.G). � � LEHDE1t5NAME _ C LENOER'S1IDDRE55 � � WICERTIFYTHATIHIaEREADTIIISAPPLIGTIONANDSTATETHAT7HEA6�VEINFORMATqNISCDRRECf. TOTAL FEES I ACREE TO COMPLY WRII I11CT'AND COUNTY ORDINANCES�4q STATE UN5 REUTNU TO BU0.DIN0 � � OONSTRUCTION.ANON[NEBY/IUfHONRERE7qESENTATIVE50FTHi5COUNTYTOEMERUPONiHE G/� 2 S� ABOVE�YFMIONEDOR07EFTYFORWSPECTqNM1NPOSES. COMMENTS � J _ �� Y1. W /V m GEi1MRi c(P YT) a 3 `/S-O � N I�UTU VEHMITIEE D�TE � RECPT.NO. _PA'DBY . VALIDATION WHITE—DeDertmenl Copy,YELLOW�inence Capy,PINK—Aasesaa Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy , . 1 `' 1`' ',, . . . • , • _ �ITY�OF�DI�MOND;BAR , . . , � . ,�. . . , . .. , �, . :,�;�... .::.�,-:.�IfvSP�CTlOP�I RECORD ':� :�:,:.. :.; ..�. : r _ r `;�. I � ' _ . . . .,.... , . . .. � .. .. . ; ' . ti,,.: . . =�.r...:.,.. ''�i��-����'.�'1����.� .:j�;��� �.1�.�-������m�.� .:� ._1���'��.i��lF����'+ ��.�u�����,;. � _.��ev �::1���'��� jsE,fsncr,- :�P�" : • !.~I! : i~ � '�ti � I , 'FLOORJOIST �%��,r:,^,1..�}1tr;_ . � ;�,���,('_ .' - -- �FTGS/FORP�ISIST�EL ' !/.. � i ^+. _ FHA REQ�ATS ' - � __ , .`- l _. 1 ;ELECTRIC GROUND.. ._ . . . • _ _ - UNDER FLOO DUCT � •� - �' �' � -- iCROUND PLUP.4BING , .�,:�.� :. UNDER FLOO�f 0 a�t1'�T �����'. `,T s� .".::-�_ .'. � ':' , ^ ;'-L-.�; . I.IAB GRADE- ,`' - - FIREPLACE FOUNDATION ��i!u • .�fru Q�.t^.f.1 �.�' i - — 4T�MP POWER---- - - , .. _ ._ FIR�� AC�'6C-`J�V��1M �at.�,,��.�1�;.::1� C�t:v;;.� ; ---- �V�lATER SERVICE . - - - . -- - � � �.P,AID HL BOND'BEAFJ� .; - , � ' ', �•j 1 ; ".;'=' ,. - iR00FSHEATHIFJG: ;%__ _ 'I ; ��;-. -- -. .,. � I s Fr..�oNo BE�r�1, :���.-�;'.-�.�- -_ � . . . _ + �FRAhdING.NENTiLIATION Ij�j-04�(i���—� _ -FINAUBOND'�EAM�... .. .:„ ' ...._��, :,_ :�:.. ' , � - C__ - ; - iROUF COVFR .�•' . � PRE-GRA�ING - - - - - - ' ' � ' � �ROtJGN HEATING - -- . __ _ BENCHING - - . - - � � - � �RJUGH ELECTAIC ' _. �40`t-�sl ' '` '- • ' 'ROUGH GRADING _.. .. .....-- � ;, •.ROUGFi PLUI�1BING � - � --- - -- -' - �INISH GRADING i ;. ,SH�VJER.rfUB-TEST .:.._._ _. __,...-.- .-- - .... .._ .: . ._. POOL ELECTRIC , . ; .. , • � � ; : jEXT.LF,TH!SIDING -- _ (.� _....... I I pOL FENCING � . ' �� — --- i�PJALL-INSULATION -; � _ _ :- � POOL'FINAL . . , , , _ �(b_( I. ;CEiLiilG 1�dSULATION � � - OFF SITE IMPS. . • • f DRYI"JALL PJAlL1NG / b ? � � DEDICATIONS • � �. " .. . . ... ;.... FINAL�ENG. .-, iS�4h'ER - . i �SEPTIG Tn^dK ;. . •;� 1•' LANDSCAPE/1RRIG. �� . j ; !SEE?.PiTlL.L. - � �'� „ - 'ON SITE MAPS. • . %G:,S A!F3 TEST _ . I � F.INAL:ZONi"dG � ; _� -- _ .. . _ !r!`l;l:��i.Otd�T.._ .... --.. . �-��- • • -.._.,, I- . .. FIRE DErT. FINAL .. . I � . , _ � . . . � �i-1!1!':!t-f�A?1NG _._..._.._ . : _j -.. �FiEALTH DEPT. 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