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HomeMy WebLinkAbout13094 (14) J� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES• � . 21660 E.Copley Drive Suite 190 (909)860-3195 Fex(909)861-3117 PRE$$ ���^� BUQ.DING PERMIT APPLICATION FIRMLY v� JOBSITE APPUCATION PERMIT P/C o ADDRESS 6 cwa DATE NUMBER � �f � ISSUG� TYPE OCC APN LOT TRACT DATE�� ��_CONST. GROUP � OWNER p ADDRESS-�-��,L W1� ZaNING SEfBACKS �u' CITY �u� ZIP TEL�.�{���y REAR RW �p APPLICA T TEL� SIDE/SIOE STREET RW ❑ � CONTRACTO /Ll SIDE O � CfTY E S ZIP TEL. PROPOSED USE� W o W�,' � ARC G/ • DESIGNER N0.DWEL N0. NO. ADORESS UNITS STORIES BEDROOMS � CffY 21P TEL. y DESCRIPTION SQ.FT FACTOR PSF ADJ.AREANALUATION � Q OWNER-BUILDER DECLARATION SFR/ADDlREM O p 1 HEREBY AFFlRN UHDER PENALTY OF VE0.AIRY TF4�T 1 AM E%EMFT FRdA 1HE CONTMCTORS lF Garega/Carport W CENSEU'MWRTMEFOI.LOWMORE1150N(SEC.70J1.66USiNESSWOPAOFESS10N5CODE.�M'GfTVOR (n � COIXlTYWIUR/REQUIRESAPEAMRTOLONSTRUCT,AL7ERIMPROVE.OEMOt15H2Oi1RE7NRANYSiRUG W Patiolpedc TURE W7qli TO RS b9UMILE.AL50 PEOUIFE!TME APVLIGNT FOR SUCN VEPM�T TO FILE A SIONED � � ST�7ENENT iHA7 NE OR SME 5 UCENSEU VUilSUAHT TO T1�E FROYISIONg OF iH[COMTMCTORS L4 � CETISE Uw(GUPTER O(CpAMENCWG WfT/15ECTqN 7000)OF DMSION]OF THE BUSINESS AND CR6 � PDDUSpd .FESSqNS COOE)ORTWU ME OR SME IS EXEMPT TNEPEFIiOM AND THE BA515 FON TME ALLEOCD E%FMP• TION.ANYV�OLA710NOFSECTION7Wt.6BYANYMPLICANiiORAPEHAI�TSUBJECTSTNEA➢VLICANTTO Z �jg-{�pp( � ACML7EWLLTYOFNOTMOFiETHANi1VEMUNDFED00LLAN5(t5o0).} � O4�"�ENOFTHEPHOPERT:ORIAVEA�7LOYEESWIT1wACESASiNEIRSOLECOMPENSAT�ON, ❑ CpmmBId31 - WILL DD 1HE NIORK/W�iHE STRUCiURE IS NOT INiENDED OR OFFEREO FOR SALE(SEG 7at,BUSI• _! NESS IY�PqOFE5510N5 COpE:TNE CON7MCTORS UCENSE UW DOES NOTMPIY TO IW OwNER OF ? � PpDPEHTYMAtlBUlD40i1MPROVE5INEREON,MIDYYHODO[SS11C/1Y/OHKHIMSELFORMERSELFOR m Q TIROUONMSOfiHERCMIEMPLOVEES.PRDVIDEDTHATSUCHIUPROYE4ENT5�NENOTNTENOEDOR W OFFEREOFORSILE�F,NOWEVERIHEBUS2IN�ORMVROVEMLNT650lDYATNMONEYEAHOFCOMPLE• Z �TIDN,771E OWNER�BURD[N WM1L HAVE 7NE BUROEN OF pROW�O TwIT NE OR SME DID NOT BURD OR � MOHOVEFORTHEPUfiPOSEOFSALE� � O�h40riNENOFTHEPROPERTY,AME7f0.U5NELYCOMMCTIN�N7TFIlICENSEOCONTMCTOR3 TO CONSTPoICT Tt�E VRO,lEC7(SEG 7ou.BUS�NESS IwD DHOFESS�ONS COOE:7HE CONTMC70RS LI- ValU8ti0f1 ADJ.AREA CENSE U�M DOES NOTMPLY TO AN OWNER OFA PROPERTY YAq BUMS Ofl MPROVES THER[ON,IND � YAqCONTRACfSFORSUCl1VR0.1ECTSYNT1A00NTfUCTOH(5)LICENSEDPUPSUANTTOTNECONTMG OUANTITY DESCRIPTION FEE � TONS LICENSE Uw.). O IAM El(EMF7 UNDER SE4 B.L 7Q FOH THIS REASON U tL �.¢.. DATE OWNEft V � LICENSED CONTRACTORS DECIAAATION w J � W IIEREBYAFFlRMUNOERPENJLL7YOFPERNfiY7NAi1MILICENSEDUfdDERVRO'�SIONSOFGMPTEq � s �(COI,�AENCINO M711M SECTION 7000)OF DIViSqN 7 OF THE BUSINESS/�D VROFE5510N5 COOE,IIVD Z ��L W UCENSE LS N Ml FORCE M7�EFFECL m /� � � UCENSE CLASS ` � UC•NO• � J �'�'j OATE � oGCiLP d W ``� � WORKEFiS'COMPENSATION DECLARATION l � � -� 4 � IHEREBYAFFlPAIUNDERPENALTYOFOERNMONEOF7HEFDLLOVYPIGDECUMT`S: U � Z 4 L1 �IHAVENAIMLLMAIN7Ad1ACEiiTIFIGTfOFCONSENTTOSELFdNSUREFOqW7i1NER5' S Z OOY7ENS�nON.IISVRDVI�EDBV5EC710H77000FTMELADOf1CO0EFORTMEPEFFOfWMlCE U � OF7NEWORKFORWHiQ1TM57ERM1TI5�55UED. � VE AND W�LL 4ARRAIN WORKERS'COMPENSATION WSURANCE.AS RCOUINED BY SECTION Q �70o OFTHE UBOR COOE,FOR TY�E iERFORYANCE OF iHE WONf FOF YMiCH THIS PENMiT IS � 455UED.WMOiLCER'COIAPENSATION WSUMNCEC�RIERANDP .I NUAI�EHML CONSTRUCTION � CARPoER__ PLA eview � FOUCYtuueEa O � _ ECTRIC � (TV�SEC1ri�tE�raT8EO71.RE7C10FTEPERMRSiai70NEHJ�EDDCLLNtSIt��I LFSS} PLUMBING Z ICERTiFYTMATNTMEPERFO(iMANLEOFTMEK'ORKFORri511p1THI5PEAM�715I5SUED,I MECHANICAL �} S�ULLNDT E4?LOY M7Y VERSON 71 AM'U�NNER SOAS 70 BECOVE SU&IECT TO7ME � YYORKEHSCOMPENSATqNUW50FCALIFORNiA,ANDAGREEi11ATiFIS�KKILDBECOAIF INSPE ONFEE SUBJECTTOTNEWORKER5COMDENSATIONDROVIS�ONSOFSECTqN7700 THE s caoe.isw�uconrrrvnn�caavirwm� v iSSUANC � K pDRTE:�_ APPLIC . SMIP �� � W ENERGY P/C WARNINO:fMtXiETO SEGURE M'ORKEPS'COMPENSATION COVEMGE IS U D Sw�ll BE (—y SU&IECTM1EM7lOYEHTOCWMWALPEWLL71E5ANOCMLFNESUVTOONEMUNDR[DTnWS�ND ENERGYPERMIT DOILAFiS(t 10o,00D),N/�OITON TO THE C0.5T OF COYPENSA7qN,DAM�CES AS PROVIOE�FOR IN J SECTION]l0lOFTNELABORLODE,NTENEST,INOATTORNEY'SfEES. ' RETENT�ONFEE: ��, � � ' OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: ���� Q INEREBVAFFlRAIUNOERPENKTYOFPEIWRYTHAThIEREU^ACONSTRUCTIONLENDWCAGENCY � -` __ � FOR TNE PERfOM1ANCE OF TME WORK FOR WHK71 TMIS PE WAIT IS ISSUED(SEG 70W.CN.C.� � •��� � � �.�t.`�� � LEHDERS NAUE �tJ � � lENOER'SADORE55 � ICERTIiVTUTIHAVERFADTMSAPOLIGTpNAlASTATE7HATTHEIIBOVENFONAATI0NI5COMEGT. TOTAL F�ES W IAGREETOCOMPLVN1TMAlLGNANDCOUNTYOF70�N�NCE5AND5TATEUwSREUnNOTOBU4DIN0 � CONSTRUCTION,AN[1HEREBVAIIfNOHIZERE7RESEHIATIVE50FTN15COl1NT1'TOENTERUPONTNE S� ABOVE� qHED7fqGER7YFONl ECfqNVUR� COMMENTS � � � � < <� m P NAME P Q � , PENMI E� � , RECPT.N0. PAID BY VALIDATION WHITE—Depertmant Copy,YELLOW—Fner�Copy.PINK—Aesesaor Copy,GOLDENROD—Fiie Copy,GFiEEN—ApprcanPs Copy ' . _ . ..... .. ..� , . .r .. .. .. �.. •`t. �. y. •��`ra r��'' �t',.N.: .-N.. +4.n. � . .. . . . ' . '�'Y" . . . :f � ' - • .. . .. '.Y4�.t CITY OF DIA��ND BWR , � . . INSPECTIOt�! RECORD � . _ -.�-_-,,_ .,-_...�..-.._. :_�1'�=t.�aa6;r �`1�.E �r,1��i�= ' �l.R��.:� !u'J�.a '� _,�!■'1►`�= ��e'���'�i`R�*..�..'..a"'�'.� .. r" ....._ � `�.�.��'�;° �' �'' � ( � .�__.._ ..._,_.__:,.._�-fi:J*.;..,. ��:..��.-�_:.�_:.. ..�,� l.�E- F ,L� .a r� SEf E3l,CK .. .^� � FLOOR JOIST �.� _��.. � i � �� _ FTGS/FOR��SS,'STEEL � y� FHA R�Qt,4TS `' ' '- �� ' ' ' � ELECTRIC GROUPdD ' ' i � � UNDER FLOOR DUCT . • GROUND F'LUP�4BIWG � UNDER FLOOR CU��!DUIT �.,�: " ' � ' - SLAB GRADE�_I FIREPL�1d�FG)UP1qqT:ION +; :���_ • i EP.1P POl^JCR ����i FIREPLA���BON��6cAh4� " `' VV.�TER SERVICE ' �_ MID HT. �OND BERhs� '�� . -; :�,- -: �� •� �� ;'• ' •��;OF'$f�EATHIt1G ; ,j . _;1�� I El FT. 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