Loading...
HomeMy WebLinkAbout17413 (19) C1TY OF DIAMOND BAR �•p � ! '13?S f�' • DEPARTMENT OF CO1v4viUI�11TY&DEVEIAPMENT SERVICES EXPIRED 21825 E.Copley Drive "'� (909)860-3195 Fax(909)861-3117 JUN 18 y002 PRESS `'<��` BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE APPLICATION -�/,,�' PERMIT P/C ADDRESS .� I��O G�aTCW�T c:nGD_C_Fn�toF DATE /J� NUMBER/?'S�/.3 # � ISSUE � TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER "' ADDRESS ZONING SETBACKS z CIN ZIP TEL. FRONT RW ❑ g APPLICANT TEL. REAR ❑ � SIDFJSI�E STREET RW p � CONTRACTOR �Q/�' Cp��:�e L S�g;�ir�g lw��_ SIDE ❑ o ADDRESS /9a I /�nNc�rA ci.rcGs pROPOSED USE_l�A.�1 /JeY.E _�./��/� �F�r FA✓ o CITY �/7Lw.•�s rnb ZIP.�Zp TEL.7r.i S'fa•6s�,10 ����,� � A�� v o ARCHlENG/ � DESIGNER�,���g NO.DWEL. NO. NO. ADDRESS /�'j'7C?.2 ��t_AQTfiU�P (3Lt�D. UNITS STORIES BEDAOOMS = CITY %�P U1ti1�C ZIP�,�G/A T�L.44y '7�_4 l4S� � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER�ECLARATION SFR/ADD/HEM O � 1 HEREBV AFFIRM UNDER OENALTY OF PERJUiIY THAT I MI E%EMFT FpOM 1HE CONTMCTORS LI• GBfHQB/COfpOR W CENSEUWFORTNEFOLLOWINOREASON(SEC.70.11.48USINESSANDPROFE9SIONSCOOE:iUJYGTYOH (n U COUNTYriMIp/REOUIRESAGERMITTOCANSTRUCT,ALTER�MPROVE,DEA101J5M.ORREPNR�NVS7AUC• W patiolDeck � 7URE.PflIOH TO RS ISSUANCE.ALSO REWIRES THE APPUCIWT FOR SUCH VENMIT Tp FILE A SIGNEO W STATEMEM THAT HE OR SHE IS LICENSEO PUNSUANT TO THE PROViSIONS OF iHE CONTMCTORS LI• � CENSE UW ICHAPiER Y(CDMMENC1Na WITH SECTION 7a00)OF DIVISqN�OF THE BUSWE55 AND PRO� � Pool/Spa GESSIONS�E)OR THAT HE OH SHE IS E%EA/PT THEREFROIA AND THE BA515 FOR THE/iLLEGED EXEYP• TbN.ANYVIOLATqNOFSECTION7071.68YANYAPFLIGWTFORAPERIAITSU&lECTSTNEA7PLICANTTO Z Re-Root A CMl PENILiY OF NOT MO{iE THAN FIVE NUNORED DOLURS(f Soo)J: 0 OI.ASOWNEROFTNEPROPERTY,Of7MYEMVLOYEESW1T/1WACESASTHEIR50lECOMPENSATqN, � �mmero(al - Z WIlLDO TNE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BU51• J � NESS AND 7POFESSIONS COOE:TME CONTMCTORS UCENSE UW DOES NOT APP�Y TO�N OWNER OF � PROPEHTY NT10 BUILDS OR MPROVES THEREOf7,ANO N'MO DOES SUCH WOHK H�MSEIFOR HEqSEIF OR Q 7HROl76HHI50RHEROWNEMPLOVEES,PROVIDEDTHAT5Ud/1MPROVEAlEMSARENOTMTENOEDOR m W OFFEREDFORSALEIF.FIDWFVE0.TMEBU0.DWODRIMPqOYEMEHTISSOIDWITHINdJEYEAROFCOMPIE 0 iION.THE OWNER�BUILDER N7LL HAVE THE BURDEN OF PROVWG TFIAT HE OR SHE DID NOT BUILD OR Z WVPOVEFORTIIEPURPO5EOF5ALE4 �= O�ASONTJEROF7HEGRO�ERTY.AMEXCLUSNELYCOMRACTWOWITM�ICENSEDCOMRACTORS TO CONSTRVCT THE PROJECT(SEG 7011,BUSINFSS M!D PROFESSIqJS CODE:TME CONTMCTOPS U- ValllallOfl ADJ.AREA W CENSEUWOOESNOTAPPLYTO.WOWNEROF�PROPERTVWMOBUILDSORIAIPROVESTNER[ON.AND � W/WCONTMCTSFORSUp/7RQ1ECT5WiTHACANTMCTOR�S�UCENSEDPURSUNRTOTHEGONTMG QUANTITY DESCRIPTION FEE Y TORSLICENSEIAw.). � OIAME7(EMPTUNOERSEC. B.iV.GFORTHISREASON � � U lt� ¢ DATE OWNER V Z W ¢ LICENSED CONTRACTORS DECLAFlATION W Ct IHEREBYAFflRMUNDEHGENALTYOFFERJURYTHATIAMLICENSEDUNDERPROVI510N50FCHAPTER �r p„ 9(COMMENC�NOWITMSECTION7ooa)OFOIVISqN]OFT1iEBU51NE55AN0VROFE55qN5CODE,AND Z X MV IICENSE IS IN FULL FOFCEAND EFFECL m t1J � UCENSECUSS ��G .�O LIC.NO. ��'�j�A� j V DATE ����-O� CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION U � , , �+p N IHEREBYAFFIHMUNDERPENALTYOF�ERNRYONEOFTHEFOLIOWIN(iDECLAMTIONS: Z ._Q �TG � _IHAVEANDWILLMNNTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORYVORI(ERS = f D�Q � YO �O LOMPENSATIDN,ASPROVIDEDBYSECTION�7000FTHEUBORCODE.FORTHEPERFORMANCE W �l � OFTMEWORKFORWNICHTHISPERMITISISSUED. � .1��.,r e �,.,L . �O � /v W �IHAVEANDNALLNAIMAINWORKERS'C0IACENSAiIONINSURANCE.ASNEOIIIRE�BY5ECT10N Q �7ooOFT11EU�BORCOOE.FORTHEPERFORIAANCEOFTNEWORKFORwNICH7M15VERM1T14 ISSUED.MY WORKERS'COMPENSATION INSUHANCE CAFIRIER AND POLICY NUM�ERARE: CONSTRUCTION j CARRIER„z'N�P mal IT51 /A?S, A F N p� m fs )L!a PLAN REVIEW � POLICV NUAIBER���!Q 3Q_�;�^'O(y ELECTRIC (RESSECf10NNEmNOTBE�'LEfIDOFhEVERIXf6inRONEFIlD{IEDDd1ARSR10q0{I1E55} PLUMBING r=-_------_.�--- ,-- rj'1 Z I CERIIFV THAT INTHE PERFORMANCE OF THE WORK FOH WHICH THIS PERMI7151SSU�p 1 MECHANICAL � -" '- --' � � U' SHALL NDT EMPLOYANY PERSON P!M1Y MANNER SOAS TO BECOME SUBJECT TO�y�' ! � riURKENS'GOMPENSATIONUWSOFGLIFORN1IANDAGREETN�TIF1 NOUIDeEco INSPECT�ONFEE S SUBJECTTOTHEWORKENS'COA1vENSA7tONPROVI510N50F5ECT 700pFTNE R I 7S� CAOE,1 SHN.L FORTMMTH COMP�V VA1H TF10SE PROVISION� ISSUANCE i� � �f SMIP � OATE:I I%'��O� APPLICANT: •`` � WARNIN6:i�ILUREiOSE(.11HEYVORNERS' PENS�TIONCOVERAGEISUNUWFUl.M1D5HALLBE ENERGYPlC I��'�• � SUOJECTANEMP�OYERTOCRIMINALPE ALTIESANOCMLFWESUV700NEMUNOREOiN0U5iWO ENERGYPERMIT � � ' OOLLARS(f I00.0001.W�DDITION TO iHE COST OF COMPENSATION,�MIAGES AS PROVIDED FOR IN � SECTION�7oeOF7HEUBORCODE,INTERESLANDAT70RNEV'SFEES. RETENTIONFEE: I. ow., CONSTRUCTION LENDINGAGENCY PRE-AlT FEE: O � INEREBVAFFIRA/UNOERPENALTYOFPERJURYTMATTMEfiE1511CON5TRUCTION�ENDINOAGENCY d FORTHEPERFOqMANCEOFTNEWORKFORWNIpITHISVERMITI5155UEO�SEC.]OY7,CIV.C.). Z W � IENDER'SNAME � �LENDERSADORE55 ¢ I CEHTIFYTHAT I NAYE RE11D iMISAPFLICATqNAN�STATE TMATTHE ABOVE INiORMATpN IS CORRECT. TOTAL FEES �I• n V W IAGREETOGOMPLYWRMALLCfTY/J1000UNTYDRDINANCESMlOSTATEUWSRELA7Wc70BUILDIN6 � CONSTRUCTION,ANDMEREBYAUiMORIZENEPRESENTATIYE50FTH15COUNTYTOEMEflUPONiHE Z ABOVE�MENTIONEDPROPERTVFORINSPELTIONPURPOSES. COMMENTS O � r m CERMITTEENAAIE(CRINn Q � � SIG U tOFPERMITfEE DATE � 2 ` � RECPT.NO. PAID BY � 7 VALIDATION WHITE—Department Copy,YELLOW—Finanee Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applieant's Copy �1 . ..... .. ..�..... . .... . ....:..�,�. .��,,.�.,�.. ,4 . ...'2 t: . .� -�j.a��� . , . � .� ', �. •• � ... . , . - . . , � . � ' .. . . .. . :�, �4i'," �F Dl�f���'t�D EAR i1ilS�=-�C�'i�f� R�GC3i�? ______�.___�_.__...._._.______.. ___-__ ___�.�__._.,___ ^ _ _ __ � _ .._ _ . �_ ,I,�-�:?�c'.C!��,1►��, ���'Cf.� ,li+f'� �.=±�;t'e,l�i �I��-`�:a-lr .�'lci��E �y�1��1:: �►��-7���'"�c1�� ' -- ---.____..._�__...__. ... . . .__.. . ___.__--__...._. : __... __... _.__._.._.___: _--: _. -� . _--..-,---.__ _.__. _..______,._--._� ..______�....�-- 5ET BACK � _ � I FLO�R JOIST _�__I_ FfGSIFORP�15/STEEL � � FHA REQ�ATS ( ELECTRIC GROUND �U�dDER FLOOR DUCT � GROUND PLUMBING I U;JDER FLOOR CUMDUIT f � SLAB GRADE I FIREPLACE FOUNDATIO�d 1 i TEMP POWER � FIREPLACE 60ND BEAP�1 I WATER SEflViCE ti11D HT. E30h�D BEAF.1 ROOF SHEATHING 8 FT. BOUD BEAM , FRAMINGNENTILIATION FITJAL f30ND BEAM I ROOF COVER PRE-GRADING. . i ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGN GRADING ROUGH PLUP�IBING � FINISH GRADING SHO�"JER/TUB TEST 1 POQL ELECTRIC EXT. LATH/SIDWG � POOL FENCINu I WALL INSULATION POOL FINAL ! CEILING INSULATION � OFF SITE IMPS. i DRYWALL NAIUNG DEDICATIOtJS SEVv'ER FWAL ENG. SEPTIC TANK . LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE Ih1PS. GAS AIR TEST � FINAL ZONING FINAL CONST. � ! FIRE DEPT. FINAL FIPJAL HEATING HEALTH DEPT. FIFdAL FINAL ELECTRIC � � DEV. FEES PAID FINAL PLUMBING � ENERGY � � �,�s��w�,`,: �,��.��ei^-____----- COPJIMENTS SEPTIC TANK SIZE SEEP PITIU SIZE ��� r�`� � � ••,