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HomeMy WebLinkAbout18002 (17) r...._-,��...�- �� - _ �--� � 1� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ��, S�l (,,� � 21660 E.Copley Drive Suiu 190 •,l�l��• (909)864-3195 Faz(909)861-3117 _{� 1 PR ESS '�=�^�+ BUQ.DING PERMIT APPLICATION �j �� ��^4� �I�m FIRMLY � JOBSITE APPLICATION� PERMIT (I,(�,� �/C �i' ' o ADDRESS �� � DATE � � NUMBER a ��� � ISSUE TYPE OCC APN LOT_�� TRACT DATE ,GROU p OWNER � ~ � ADDRESS `JS�P.b-u.lc- P Lb--z.i..- S�t'rc J(:�6 ZONING SETBACKS �,��� 1 N 1 � � �W CRY inl'F` ZIP TEL4' ��� 7�I R�RT RW OO � APPUCANT TEL.�LZf�'�=Lt2Z SIDFJSIDE STREET RW O � CONTRACTOR SIDE ❑ � ADORESS PROPOSED USE �i��� CITY ZIP TEL � ARCH/ENG/ ' DESIGNER �S NO.DWEL NO. NO. ADDRESS �-h UNITS STORIES BEDROOMS � CITY�QaI�V�= � ZIP�L�- TEL � DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � p� ; OWNER-BUIlDEROECLARATION SFR/ADD/REM O Q 1 HEREBYAFFIRM UNDER tENALN OF VEIWRY THAT 1 M1 EXEMFT FROM h1E CONTMCTOiiS U• G829���R W CENSEUWfORTHEFOLLO'W�N�REAS�N(SEC.70.1�.6BUSINESSANDiROFE5510N5GODE:ANYdTYOR (n � COUNiYMhiCHREOURfSAPERAIRTOCANSTRUCT,ALiER�PNOYE.DEMOLIAI,ORRE�NRAN'I57RUG W patiol�eck � 7URE.VNpR TO RS 65UANCE.ALSO REOUIRES THE AFPLICAHT FOR SUCN VEPAIIT TO FILE A SIGNED -,� w � lTATEMENT THAT HE OR SHE IS LICENSEO W0.5UANT TO THE iROV1510N5 OF THE CONTMCTONS l4 � CEH4ELJIW(dUPTERY(COMMENCIN6WRHSECTIDN7o0a)OFDMSIDN�OFTH[BUSINESS/�NDPRb u' POOVSQB FESS�ONS COO�ORTHAT NE OR SME IS EXEMPT THEREFqpA AND TNE BIl5i5 FOR THE ALLEGED E7CfA�P• 710N.ANYVIOLATIONOFSECTION)07t.6BVMIVMPLICANTFORAPER/AITSUBJECTSiHEAPPLIGNTiO � Z Re-Roaf � ACMLFENALiYOFNOT►IOHETWJiIVEHUNDHEDDOUM5p5ao).): - � OlASOMMEROFTMEVROPERTI;ORMYEMPLOYEESWIiHWAGE5A5THEiR50lECOMPEN5A710N, 0 COf11RIBfCIdI SS WNl DO TME W`ORK AND TME SiRUCTURE IS NOT INTEI�DEO OR OFFEREO FDR SALE ISEC.7oH,BU54 J l/E54 AND VROFESSIONS LOOE 7NE CONiMCTORSIICENSE UW DOES NOT MPLY TO AN OWNER OF � � OROPERTYVAIOBUILOSdiMPROVE3THEREON.MlOYh10DOESSUCHWOHKHIA15ElFORHERSELFOq = � Q TNqOUfYi HIS OH HER ONM EMttOVEES,iROVI�ED TNATSUGI MvpOVEMENTS ARE NOT MENOED OR m . � � ,OFFEREDiORSALEIF.MDVYEVEI�iMEBUlD�N40RWPPOVEIAINT65dDN71HINONEVEAROFCdJRE Z 710N,TME CNNEFLBUR.DER YALL FfAVE TNE BUROEN OF PROV7NO TXAT HE OR SME DID NOT BUILD 01l � MVROYE FOR THE PURPOSE OF SALE� W ❑I,Il40MMEHOFTMEVFIOPERTT.I�ME%CLUSIVELYCONTMCTWOYATI�4CENSEDCONTMCTONS [t to corrsraucrtr�v�cr�sEa�ou,euswEss�wo rr+o�ssans ccce n�e corvrrucroas u• Valuetion ADJ.AREA IL CENSEUWDOESNOTMPLYiOANOMTIEROFAPROPEFITYWHOeURD50RWPROVE9TMERECN.AND � 1NfOCONTMCT3FOi15Ud1PR0.JECT5IMTHACONTRAGiORIS�UCENSCDPURSUIUlfTOTHECONTMG Q�JppJr�7y DESCRIPTION FEE � lOR�11GQ15E UW.) . . . . . O 1/W EXEYPT UNDER SEQ B.t V.C.FOR TMiS REASON Q r � U � u" DATE OVMER V . . . . 1� W � UCENSED CONTRACTORS DECIARATION � � w IHEREBYAFFY7MUNOERPENKTVOf0E0.JUMTIATIAIILICENSEDUNOERDROV1510NSOFCHAPTER Vr � �(COAWENCYIOVATHSECT10N7000)OFDMSION]OFTIIEBUSINESSANDPROFESSiONSCODE,AND �� MY LICEMSE 45 N FULL FOf7CE N�0 EFFECT. m � " 0 UCENSECUSS ' F LIC.NO. ��y � / � j �-j �� — � "' corrrrucroaC�t�rs�f C�ti�s;r::lh� a w �� i�� � � WORKERS'COMPENSATION DECLARATICN -� N � a I HEREBY AiFlRAI UlOER iENALTY OF CENVitt ONE OF iHE FOLLOWiNG DECl/WATpNS U (/� Z � _IWWE/.NDWiLL�7rTNHACEHTIFIGTEOFO�NSENTTOSELFaNSUHEFORWORKERS' _ � • � . � . • � ' � • - CpIpEN5AT10N,A9 PFWVIDED BY SECTIOH 77W OF THE UBOR CODE,FOR THE PERFORAIANCE W OFINEMlOWCFORWHICM7Hi5VEHMRISI55UEU. � �� . _ � �IHAVEANDNILLIAA�NTADIM�DNCERS'COMPENSATIONWSURANCE,ASREOUIREDBYSECTION � O Q i7000fTHElABOFiCOOE.FOFTMEFERFORMANCEOFIHEWORKfORWHICHTH15FEFMITIS 1 �L� � ISSUED.MY�MORKFAS'COMPENSATIONWSURANCECARR:ERAI�DOIICYNUMOERARE CONSTRUCTION � � c,wwER�.�i�•T� j'�+�� PLANREVIEW � � -- � POLICYM1MbEN �)�L^"f�-1� V/V 17 O�!/`�ol�.� ELECTRIC . . o �Ssccnuirx�r,prgEpu,aErepoFnEvcp.�rsaoaa��oott�s6+m)a�tFSI PLUMBING w MECHANICAL Z ICERTIFYhUTNiHL7ERFORMMlCEOFTMEWONKiORWM�CHTH15CEfiMITI3I5SUED,I ('} SHALLNOTEMPLOYANYPERSONIN►NYMANNERSOASTOBEC0IAESV&IECTTOTNE uj WORKERSCOMPENSATIONUWSOFCAUFORNiA.ANOAGREETMATIiI51qULDB[COME INSPECTIONFEE - S SUBJECTTOTHEWORKER,'LOMPENSATIONPROVi510NSOF5ECT �N77000FTHELIBON �SSUANCE COOF,ISH,LLLFORTMW77NCOMPI-YNn1H �5£VROVISION� o �=j3_e�,z. ,i�, SMIP DATF: APPLICANT 1 , I �W WARNIN�:FA�IURE TO SECUFE Wd7KE7' PENSATIDN COVERAGE I U! WFUL.�NO SW�LLBE ENEFiGY C/C � � • SUBJECiANEMPLOYERiOCAIMWALOENALTIESANOCMLiMESUPTOd NUNDREDTfOUSANO ENERGYPERMIT pOUARS(f 100,000�.IN IDDITION TO THE C0.5T OF COMPQ75ATqN.DM/AGES AS VPOVIDED FOfl W � SECTION770eOF7MELABORCODE,IMEREST,ANDATfORNEY'SFEES. qE7ENTI0NFEE: a ' CONSTRl1CTION LEN�ING AGENCY pRE-ALT FEE: O ' � IHEREBYAFFlN.fUNDERPENAL7YOFPfR7URVTMATTHEREISACONSTRULTIONLFNDWdAGENCY FOR THE iERFORMANCE OFTHE WORK FOR WHICH TNIS PEiWiT IS ISSUED�SES 70Y7.dV.C.). � ` � IENDERS NAME I� � LENDER'SA�DR[55 �( � ICERTIF/THATIMAVERFI�DTHISAGPLICATIONWJO3TATETUTTMEABOVE�NFORMATqNISCOpRECi TOTAL FEES � _� � r`� t � IAGRFETOCCMVLYYdMAtLCRY�PIDCWMYONDINANCESMIDSTAiEUWSRELAT�NfiTO8U0.DIN0 . ^ ��ji � CONSiRUC'fION,ANDMEREBYAUT/10RIZEREPPESEMATNESOFiHISCOUNNTOEMERUPoNIHE ^ \ ��� ABOVE-MENTIDNEO PROPER FOR MSPECTION PURPOSE3. ��« � �: � � ..Y"� � • - - aVE EE E(ORIHn . �' )�� �^^1 � CA _.-�--�__ � L/�°i� � NA OF PENMiTTEE DA7E � , RECPL NO. PAID BY VALIDATION , I —Department Copy,YELLOW�inence Copy.PINK—Assessa Copy.GOLDENROD—File Copy,GREEN—Appl��cant's Copy `—___...__-- -_.- -- - ____ _. �'� CITY OF DIAM�ND BAR . . , .> ,r,-. ? •:: � �� Ih�SPECTIOt�! REC�RD . _ . - �\'�, i { i r,�l � . , , . � - '�11��t-�;,��'f'"���. o.�'�''�1�= '����-�� sa�f = .�+'1►��.'�l�I�}��T��C� :s������'���-�_ .:����-����;��r��„k� - .�.,..� S�T BACF:. i�1;���� i � �: ��. � . FLOOR JOlST. , , � - -- � .�� ': . ,-- - ., `FTGSIFOR��1S/STEEL -'- . , : I _-. � - �-� . _ FHA REQP.1TS i,' ' • -• ._ _ _:. _ . _ = ----__ ELECTRIC GROUND_ ._. . .., � 1' . . : ' ..-; UNDEC��FLOO�i DUG7 i ..� � ---> _ .. ____,__r_._•;� _ ._ _.. GROUND PLUMBING ; ' � • UNDER FLO R C.U;�'DUIT �" `. � ;-'� „ , _ , . , .... !SLAB GRADE ' _._ _ ' - ---- -- - � ' " FIREPLA�E'F�UNDATION :.'� ,.l _;_; , , ., , 1 - TEMP POWER_ --- ; ..__ -. . _ - , - FIREPLACE'��"JD B�AM ✓r.�, -, , .,� �, . ,;.s�_— ,...; ,.. j ; : 'WATER SEFiVICE-_ -.___ _ I _. _ MID HT.BOND BEA�1 _ ` 'ROOF,SHEATHfNC(is.f.s _=; __' - ,.,:. r-;��'c.�-'-`=' 8 FT. BOND BEAh1 _ ___. .. . I ; - _. _ i FRAMIf�G,NENTILIATION __. _ _ __ . _. _ FINAL BOND BEAM _ - I ` ,- .:•=. �-- . , � � I ROUF COVFR � �` PRE-G�3�1DIG. , _ - 'ROUGH H�ATING __ , , _ _ . _. BENCHING?..s;�.,`. j:�� ' ',.� _,.,•,. ; . _� i . .. ,,. �ROl1G!� ELECTRIC .. __' ._ _:-..-' _ _ . ` ROUGH GRADWG - _._ -- -__ ___ _- -- -� RpUSH !'LUMBING . :-- __ _- ; _._ -__ _ ._ FINISH GRADING i �SHC'•�Jr�rfUBTEST _ _ _ -� POOL�ELECTRIC . '; ; ;�7�'T. Lr,7'Hr'SIDING --' -- - - POOL�FENCING • ' 't^lALL tNSULATfON - ; . - - POOL'FINAL • . E,� ^�ILING Il�:SULATfON`-- - �" .;� " �FF SITE IMPS. � _ . , .. DRl'�VAL.L"NAILING DEDICATIONS ! ...`. _ � , � �r!S�VJEFi -- - -,-- - _ _ _ FINALENG. , }:StP?fC7ANK ; LANDSCAPE/IRRIG. ' j`Sti::p_P�T/LL. <_��� ,�:�=';' ON SITE IMPS. � G,'�.`_,f�(?i�ST - FINAL ZONING ��.__:�-._,__- i r "_<';'._'=ONST...:_ ._._._ . .�� FIRE DEPT. FINAL �� ..;`_NEATING_ _ HEr�LTH DEPT. FINAL - -- - DEV. FEES PAID ' . _; _CLECTRIC - _ _ _ _ _ ;: . ��.-PLUM6tNG - . - ENERGY � i � '�.-cv� �oL ��4�i � - __ _ -- -- - _ - � �.-■-�•�- 1_- � a�l: �,j c�ti. � �,.. ._.._. ...r_____ _ _ ,.._ � . _._. _.__._ _. !�- .__ _._ . _ . _ . _ . - - __ _ _ � � - ' _. _ _ _ _ _ ' . , • , - �. � '�����/I�,�ENTS , . : . _ ___ --- - ---_� _ .--- ---- �,;-�-o�- pt��..�.� �'�-�—rz�s--t33:�/ . , � -- -_- ___ ��=s .�� ,� ,� ,,��� . _ , i ;;;_ �a.� • ; � _ _ _ . . -i . .. � _ _ _ __ _ . _ _ . . _ _ _ � �. . � _ _ .' 'ti �;. i �- . _ . . _ . . _.. . . ,SEPTt�G TANK�!�� _ . ISEEP PIT/lJ'SiZE - - _ I . _ .. ��...-.�.-.�r.. ..._.."^� .._ . __.�.. J/I �/ .' �' ., � . .�. 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