Loading...
HomeMy WebLinkAbout10827 (5) _ _.,,._.._.._.___ .�._.._,_.IT___m__,....... . ,_..__..__._ . .. _._.._..----�----_____-- -- -.___ . _ .. _. �. .�......,, ..�,..�,�_:..- - CITY OF DIAMOND BAR COMMUNTfY DEVELOPMENT DEPAR'1'MENT -:,.c . zi�o E.cop�Gy D��e s�;u�vo . � � PRESS (909)860-3195 Fax(909)861-3117 ^��° BUILDIIVG FERMITAPPLICATION FIRMLY / U' l % / NUMBER (/'CJ�� N JOBSITE �..+ b f APPUCAT'ION '� PERMIT • !C o ADDRESS��' ��f-,,L /�j�'�. LGI�t�_ J� UATE � � , (SSUE TYPE OCC ; .- APN LOT TRACT pATE CONST. GROUP ' SOWNER /'�1R� �'t/S/�� �� p ADDRE$S � I.ZONING SETBAGK5 � CITY /�. ZIP_,_, T , FRONT FlW L3 APPUCANT '�l:(�b�X�f^�-a`� S DE/SIDE STREET RW C7 ¢ CONTRACTOR � �G/ '� SIDH � � ADDRESS'� '7"3 S:� ~' ' • _ CITY �•sfl� .tf>i ZIP,� E� a�,�j���� PRpPOSED USE w ARCH/ENG/ � : z DESIGNER ., .' - , v i, � ADDRESS NO.DWEL. NCS. ' NO. . � �UNITS � ���� STORIES� .�-� ' BEDROOMS� � CITY ZIP TEL: 1',' , N . ' DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATiON � �, � OWNER•BCILpER DECLARATION . ° SFWADOIREM O p 1 MEREBY AFFIRM UNOER PENA�N OF PERJVRY THAt 1 AM 1fEMPT FPOM'�'HE CbNTRAC70R5 LI '�, ' �:. Ga�9�C8I�Ort - - � � � � � L�J CENSEtAWFOATHEFOLLOWINOREA50N�SEG703i.68U61NE55��PROFE551pNSGODE:ANYqiYOR � ,(� V COUNTYWHICHREDUIRESAPERMITTOCONSTRUCT,ALTER,IIAPpQVf,DEMOLISH,QRREPAIRANY9TR41U I �.�jJ PetIQ/DBCJC W RIRE,PRIOH TO ITS�SSUANCE.AL50 REOUIRES THE MPIICANT'.FOR SUCH PERMtT TO i1LE+19tONE0 � LL� � � � TION,ANVVIOLA710NOFSEC710N7031.6BVANYAPPL��qp17THEPNOYISION50FtHECON7M(i7�R&U � , fE35lON5CODEJOR7HATNEOHSNE15E7(EMVTTHE9EF��OFdIVIS10N3.OFTNEB�SINESSµDPP10 �i..� PQOVSp9. . ' � S7ATEMENT THAT HE OR SHE IS UCENSEO PURSUANT T (� CEHSE LAW(CHMTER i(COMMENGINO W1TH SECTIOM 7 � � OMPN�]THEBA915KlRTHEALLE0EDE7(EMP �. � , � Re-Root �,. _ � fOp,RPERMIT$UBJEC'f9 THE APR4�CANT TO � ACMLPEWLLriOFNOTMURETHANFNEHUNbpE6�011':Af9S(f5po1J: ' ' � � �� � , . A ❑LASOWNEROFTHEPRCPERTY.ORMYEM?LOYEESw',TH AGE6ASTHEIR&OIECOMPENSATtON, �i , L7�� COTRIBfCi81 � �r WILL pp TNE WORK,AND THE 9TRUCTURE IS NOx HITENWEQI OR pFFERE�FOR BALE(fiEG.iOM,6U51• ��� .,J � NE6S AND PROFESSIONS CODE:THE CONTMCTORS UCEN9E UW OOES NOT�PPL�TO AN OWNER t7F �� ..^'� ' . . 7ROPERiYWMQBU0.DSOPIMPROVESTryERCON,ANOWHO ESBUCMWpRKHIMSEIFONHERSELFOq �, [L MI�U6HNISORMEA�WNEMPLOYEES,PROVIDE07HRT�HIMPHOVEMENTSApfiNOTINTENOWOF I �m . � OFFEREDFOR9AlEIFHOWEVERTMEBUIl01NdORIMPROVEMEN'YSSOIDWITNINONEYFAHOFCOA1Plf��'. ' TION,TNE'OWNER�BURDER WILL HAVE TWE BUf1DEN OF PRpVINq TH�T H�'OR�iE DID NOT BUILp OR,-i, � IMPROVE FOR THE PURP05E fJF 9ALE�. ' � '� I, � W CI.ASOYMER�FTHEPROVEATY,AMEXCLUSIYELYC�NTRAC71N0WijNL1GENSE'1LONTMCTORS Os . . . . , . � Tp CANSTRUCT THE PRO.IECT(&EC.70��,BUSMESS AND'�PROFE$310N3 OppE:YME CONTRRC7aRS LM �: V9WfltiOfl ADJ.AREA W CENSEUW�OESNOiMPLV70ANOWNEROFAPROPER'IYIWHo��,BUIIOSORIMP(�WES�THEREON,AND - YhiOCONTRAGTbFORSUCMPROJEC7SWiTMACONTRACTpR�&�UCENSEDRURSUFNTTQTMEG,ONTAAG, �, ,i OUANTITY ���ESCRIPT10N - � ' FEE TORSUGENSELAW.�. . ' . 4�,�� j ':� � ,., � .. .. . . . . : . � _ ,. �� .. . ❑1 AM EXEMPT UNDEH SEC. B.a P,F fOR 7HI8 REA80l1 . �. � ' IJ' �ATE � OWNER �, , . , � . ..r �. a . . , . Z .. . . � . .. . . . _ � �IGENSED CONT�iAGTOR$I�EG�ARATIpN � ;::. r. � 1 HEREBYAFFIRM UNOER PENAL7Y OF PERJURY THAT I AM UCENSED UNDER PR�N&iON3 OF OHhPTEq � W LICENSE lS Ml FUIL FOfiCEM7D EFfECT. : SSION9 CODE.WJD I�. .'�'7 .... � 9(COMMENCWOWITHSECTION7000}OFOIVISION90FTH�BU81Nff39YWDPROfE LLL � � LICENSE CLASS �~ L�C.NO ����/ � ,; DnrF I v-(�.��� coNrancrpA i,��ti;f/�i;Y 5^'I &" "�Ty,, ai WORKERS'COMPENSATION DEGLARA710N a ' � U � tMEREBYAFFIPMUNDERPENALTVOFPERIURVONEOFTNEPoLLOWM�pECtARA?I�NS: � � � . y Z � �IHAVEANDWILIMAINTAIN�CEflT�FICATEOFWNSENiTO�l9ELi•INSUREfOF�WONKERB' 2 � COMPENSATI�N.A9 PROVIDED BY 9EGTION J70o OFTHE U1fiOR COOE,FqR THE PEHFORMANCE W� . OFTHE WORK fOR WHICFI.THIS PERMIT IS ISSUED.�, � .�r 0 . . . . . ._ _ . , . .. . W �_I HAVE AND WIL�MAINTAIN WORKERS'COMPENSATN]N INSURANCE.A9 REaVIRED BY BEGTION - /� q Q l70o OF 7HE LABOR COOE.FOR THE PERFORMMlCE OF 7Hfc WORN FOR WHICM TWIS PERMIT IS T'7� Li� ISSUED.MYYYORKERS'COMPENSATIONINSUNWC$CARRIk`pANDPDUCYNUMBERARE� " CONSTFIUC � -�' � cuaaiEA"��G ..!r��.'�' P UMBINf3EW ¢ v PI,AN REV L� POLICYlAJM9ER '�.�G�? ELECTRIC . . . . .. . . . . , . .. � . o �nussEcnor+�mriareeaaw.EtmoFn�vEw�xtswaCr+ErKr�ooau.�sg+mloa�ssl L Z I CERTIFYTHAT IN THE PERFORMANCE DF THE WORK fOFl WHiCH THI3 PERMiT 161SSUED,l MECHANICAI (7 SHAtl NOi EMPLOY ANY PERSON W ANV MAN�ER S4AS.TQ BECOME SUB„ECT.�Q.TME . . , Vj WORKERS'COMPENSATK)NUWSOFCAIIFORNIA,AND�QREE7MATIFISFpUL�BEGOME (NSPECTIONFEE � " S 6U&IECiTOTHEWORKER3'COMPENSATqNPROVISIONBQFSECTION37000FTWELA80fl � ����� CODE.I SHALL FORTMVYI7H GOMPLY W�TH THOSE VROVISIOMS. � � WAHIV�INa:FAIL�CUH�N'ORKEHS`COMPENSAT iCIJVERA6EISUNUWFl1t,AND�'SM1�L�0E ! SMI � p ^d "�,�APOLICANT. w ENEROY P!G -- n rT A �7 �A�}� � SUBJEC7AIVEMPLOYERTOCRIMINALPENALTIESANDCINIFIHESUPTOONEHUNDRED7HDU3AN0� ENERQYPERMIT pOlUqS(i100,000�,IN ADDI770N TO7HE CAST OF ODMPENSAT�ON,bAlAAC3E5 AS PROVIDED FOR IN ¢ SECTION37080FTHEU80ACOOE,INTEREST,ANDATfORNfY'9FEES. � ' � � � REYENTIQNFEE: � a CONSTRUCTION 1EN01NG AG�NCY PREALT FEE: ` �C IHEREBVAFFIRMUNDERPENAL7YOFPERJURY7HATTHEHB � � � ISACdN3TRUC710NLENDINqAGENCV ' � FOH TNE PERWRMANCE OF THE WORK FUR WNICH THS PERM�71S ISSUF��SEC.9oW,CIY.C.j. , _ . . , . Z. . . . . . .. , �� ". W � IENDER'S NAME � � � �� � F ICERTIFYTNATEHVEpEAPTH�SAPPI,ICATpNANDSTATETFU7'l1iEABOVEMFORMATIONISCORRE � �T TOTAL FEES � 1 AGNEE TO COYPLV WITH ALL CITV AND COUNTY OROWANCES ANO STA7E LAWS flELATINO TCI BUIl01NG ��� �� � �'- � � i ���•/ , � CONSTRUCTION,ANDHEREBVAUT/qRIZEREPRESENTATIVE50FTNISfAUN7Y70EMERUPONTHE - . . ABOVE-MENTqNED PROPERTY FOR INSPECTION PURPOSE5. � COMMENTS o ,�.""c��� � Y1' _ , m PERMITTEE NAME(PRINn . .. .. . . . . . . . ..� .�. . � /O•-o7^�`� ,�. cn . y SIGNA7UREOFPERMITI' ��� OAT - - '� � = RECPT.NO. PAID BY VALIDAT{tlN ~ � � � WHITE-DepartmenE GOpy,VELLOW-FinotFce Copy.PINK-qeaessa Copy.GOLRENROD-FUe Gopy.�flEEN-Applicant'A Copy�. � - � � .� �� " .,, .. „ ,.�.,.�. . „�. ..: � : . . ., ; - << .. .,.fi_ . ..:.� ... .. „-, .,,. ,. , .. „ . . , ... ,. , , , , ,:. �., ;;� , r crrv oF a�Anno�Q Baa INSPECTION REGt)RD} . � � � . � . . � i � • � ' SET BACK � ELQOR JOfST � ' FfGS/FORMS/STEEL FHA RE(�MTS , , � , , , ELEC7I�IC GROUND UNDER FLOOR DUCT � � � GRUUND PLUMBING UNDER`FI�O��1 COt�dUIT ' � . SLABGRADE FI{�EPLAC�`FOUNL7A710N - ' ' TEMP POWER - FIREPLACE BONDBEAMY.,' ' - ; � WATER S�RVICE MID Ht;BUND BEA�A � ` - ' � ' ROOF SHEATHING -9~9'7 8 FT:BONp BEAM FRAIVIINGNENTILIATION . '� FINAL BOND BEAM RODF COVER - c7 7 1�7 PRE-GRADING ROUGH NEAT4N� ' BENCHING R13llGH E�ECTRIC RaUGH GRADlNG ROUGH PLUMBING FINISH GRADING � SHOWER/TUB TEST POOL ELECTRIC EX'�.:LATN/SIDWG."•;' -w POOLFENCING WALL INSULAtIf�N POOL FiNAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS' SEWER . FINAL ENG. SEPTIC TANK � 'C LANDSCAPE/IRRIG. SEEP PIT/L.L, ON SITE IMPS. GAS AIR TEST• - ° 'A � � FINRL ZONiNG FINAL CONS7. y - FIRE DEPT. FINAL � FINAL HERTfNG � ��� ` � HEALTH pEP7,F��1AL, , � �-_� FiNAL ELECTRIC " �= QEV.FEES PAI� .• _ FINAL PLUMBING � ' � � ENERGY ' •- �. . . � f;� � ' . . . . . . i . . ... " �._ , . COMMENTS- � , :_ , .. ... . . . L . .� .� 6 . � '�. .,._.._ � , r,. � �° ... . . � . • . - v, i • _�,_.9. , . � ., � .. � �� � . . '. . . . . ......_- ..,r.... „� . ; . �,,� ��. , �+M N . . . . . . ' . SEPTIC TANK SIZE SEEP PIT/U SIZE r � � , ��.' , , ' ,-, _. �, '�`' _