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Home My WebLink About12212 (13) CITY OF DIAMOND BAR � � ---�� --- DEPARTMENT OF COMMUNITY&DEVELOPM SERVICES �� 21660E.CopleyDriveSuiu190 . (909)860-3195Fax(909)861-3117 � �� PRESS ^�*�� BUII.D�iG PERMIT APPLICATION FIRMLY JOBSITE / /��/� APPLICATION G � / PERMR �}� �/C o ADDRESS (n�S Gd��/Gl�'/J/�S � DATE � ` � �NUMBE� '� " I" N c� ISSUE TYPE OCC APN � � LOT TFlACT ' DATE ' "" " CONST. GROUP g OWNER "' ADDRE / — ZONING SETBACKS . � CITY ZIP TEL. • REAR RW ❑ APPLICANT TEL.�[7ri-S -/ . SIDFJSIDESTREET RW ❑ � CONTRACTO C ' SIDE ❑ � ADDRES PROPOSED USE '�J� - � o CITY � L ZIP /��' TEL -�> '�S . . � ARCWENG/ • ; , DESIGNER NO.DWEL NO. NO. ADDRESS UNRS STORIES BEDFi�OMS � CfTY ZIP TEL c�i� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� ONMER�BUILDER D�CLARATION � SFR/ADWREM O , - p I MEHEBY AFFWM UNDER VENALTY OF VERRIRY TNT I M1 El(EMPT iROM THE CONIMCTORS LI• G8f9Q0/C81pOR _ '"� lL CENSEUWFOflTNEFd1dMNOREA.�ON(SEG7071.6BUSINESSANOPROFESSIONSCODE:ANYpTYOR (n I C_�7 COIMTYNRACMREOURESAVEAMRTOCONSTRUCT,ALTERIAIFROVE,DEY0U51i3ORREPA;RANYSTRUC• W Pgtb/D6Ck �j' Z 7URE.VRIOR TO ffS RSUhHCE.1150 REd1WE4 T11E AVVLICAHT fOR SUdI PENYIT 70 FlLE A SIONED �l� STATEUENT THAT HE OR SNE IS LKENSED PU0.5W WT TO TNE DROVISIONS OF THE tONTMCTOit3 LI• w � CFNSE UW(dUP7ER Y(COMMENqNO WITH SECTpN 7000)OF DMSqN 7 OF T11E BUSINESS AND PRO- � PDOVSpa ' � . FESSqNS CODE)OR TW�7 NE OR SNE 19 E%EMPT iNEREFiqY/WD THE BA919 FGI THE ILLlEOED EufuP• TqN.IW�'VIOLAT%7110FSECTION70]1.68YANYAPPLICJWTFIXiAiERMIiSU&IECTSTMEMPLICNlTTO Z Re•Roof F A 4lVIL fENFLT`!OF ND7 MORE TWN i1VE NUNUREO�QURS�fsao)j: O OlA4d1N1EROFTHEPROPERTY.ORMYEMPLOYEESWITHWAGESASTHEIRSOIECOM7ENSATqN, ❑ �mmerclal - Z WLL DO iHE WOfIK,AND TNE STRUCNFE IS NOT WTEFDED OR OFiEREO iOR SALE(SEG 7a�,BUSb J N NFSSIUDOROiES510N5CO0E7HECONTRACT00.SLICENSEUwpOESNOTADVLVTOANOWNEROF ? V1i00ERTY WHO BUR.OS OR MPi1WE5 TIEAEON.AND M1110 DOES SUCH WORK MIMSFLF OR HEHSELF OR � (� 711ROUGHHSORHEROIMiEMPLOYEES.VROVIDEDTIAT5Up11uPROVEAIENTSM[NOTMEHOEDOR m OOFiEREDiORSJLE�110W€VER7NEBULDINOORMVIqVEMEMI55qDWITHNONEYEAROFWLIPLE- Z �TqN,THE OMMEN�UILDER YIILL HI1YE THE BURDEN OF VROVNO THA7 ME OR SME DO NOi BUIID OR = MIPROVE FOR THE PURPOSE OF SALE). W ❑L/�SOMMEROFiHEVROPEHTV,AME%CLUSNElVCOHTMCTN0YRRIUCEN5E000NTMCfORS , � TO CONSTR.ICT TNG PROJECT(SEC.7a�.BUSiNESS M10 VROFESSIONS CODE:THE CONiRACTORS L4 VelU9liq1 ADJ.AREA � CFNSE UW OOE9 NOTMPIY TOAN OWNER OF A PROPERT/Wlp BULDS OR 11APpOVE4 THEREON,AND � � YNqCONTMCTSF0115Ud/VNOJECTSMnT1ACONTRACTOA(5)LICENSEDPURSUANTTOTHECONiM0. pUANTITY DESCRIPTIO� FEE � 70R9 UCFNSE UW.). . �J . . . . . O I M1 IXEMPT UNOER SEG B.�P.G fOq TMIS REIISON Q 3 � _ . . � � DATE ONn:ER � V � LICENSED CONTRACTORS DECLARATION W � IMEREBYIlFF6M1UN0ERPEWLLTYOfVER1URYTHATIMILICENSEDUNDERFROV1510NSOFCHAFiER Vr �- jrK C � ��COYYENCHO NrtTM 5ECf10N 70oo)OF DMSION]OFTNE BUSINESS AND VROFESSIONS CODE,ANO z X W LICENSE IS MI FU1 FORCE M1D EFFECL m � IICENSE CUSS C(�� LIC.NO. _lO�/��b j V DATE ��Q=-! CONT{UCTOit �� W � WORKEFlS'COMPENSATION DECLARATION -� ¢ N IMEREBYAFfIRMUNOERPENALTIOFVERNRYONEOF7MEFOLLOwW6DEClAMTqNS: ' V - ' "' a , � �IMAVEANDMnLLMARlTAMACEHTIFICATEOFODNSENTTOSEIFdNSUREFOAWORKERS' _ { CpADENSATION,AS�ROVIDEDBYSECT10N77ooOFTMELMOfICOOE,FORTHEPERFORMIWCE U Q OF iHENORK FOR WH�G17Ni5 PERMIT B ISSUED. � � ,.,�IHAVEANDWILLYANTA:NW01iKE0.5'C0IAPENSATqNINSURANCE,A5RE0UIRE�9Y5ECilON ' ' ' , 4Q 970o OF 7HE tAl30R CODE,FOR 1HE PERFORMNJCE OF THE WOHN FOR Nn11p1 MIS PERMIT IS � ISSUED.WWORKERSCOMVE SATqNiNSURANCECARRIERANDPOLICYNUMBERME: CONSTRUCTION > CMRIER "L � P PLAN REVIEW � POIJCYNUMBER,� �7 �� ELECTFlIC p (M55Ect1oNN[mNoiBLaoM'IETmOfTEPEaMisPoRor+E�lUnt�EDOatAiLSR�m)Ca�E551 UMB . Z �CERTIFYTHATMTHEPERFORA4INCEOFTHEWOFiKFORWHIpITHISPERAlI7bI55UED,l MECHANICAL (7 SHALLNOTfMPIAYAN'fVER50NW11NY4AHNERSOASTOBECOMESUBJECTTOTXE � � VNORKERS'COAIPENSATqNUW50FC�L�FORNI,�IWOAGREE7MATIFISMIXADBECOME INSPECTIONFEE S �SU0.IECTTO THE WORKERS C01.IPENSATION VRONSIONS OF SECT�ON 77000F 1HE UBOR - ' ea7oe,i swui vponnpewm+caa�r winr nase vnowswr+s. ISSUANCE � pOATE: /�/�'7 0 APPLIGNT:� .SMIP � . � ENERGY P/C WARNINQ:FALUR[TO SECURE M�OFiKEPS'COMPENSA7IDN COVERAGE IS UNLAWFUL,IIND SMALL BE • �y SUBJECTAN EMPLOYER TO CR9AINAL iENKTIE9 AND CNIL i1NE5 UP TOONE HUNDRE�THOUSAND ENERC,Y PERh9T OOIURS(S70o,0001.��DITION TO TME CAST OF GOMPENSATpN.DIUAAGES AS VROViDED FOR IN J 6ECTION�70e OF TFIE UBOR CODE,MREREST,AND ATTOPNEY'S FEES. RETENTION FEE: � CONSiRUCT10N LENDING AGENCY PHE-ALT FEE: O � IHEREBVAFFlMIUt�DERPENALlYOFPERNRYiHAiTMEREISACON5TRt1CTIONIFNDIrq�GENCY Z FOR THE 7ERFORMANCE OF iHE WORK FOR N'N�CII iH�S YE RlAR IS ISSUCD�SEG 7077,GV.G�. C17 � lEN0ER5 NMIE � � tFN0ER5ADDRE55 � IGERTIFYTMATINAVERFJDTHISAPPl1CAT10NAlIDSTATETNATTHEABOVENFORAIATqNISCORRECT. TOTAL FEES W IAGREETOCOGOLYWRHALLC/fYMACOUMYORDINANCESMIDST�TEUWSREUTNqTOBVlDINO t � COH^TRUCTION,ANDMfREBVAUT1qRRERE7RE5ENT�TNE50FTW5COUNTYTOEMERUPONTHE. � /BOVEiIEtfiqNED OROOERTV iOR MlSPECTION PURPOSES. � COMMENTS � � � GZn ts' - _ m �l (J�[ --o 6 VER1AiT7EE NnME(PiUI(n I(/�S(J r � 1�-- `?'- y 610NATUREOFDERWTTEE DAiE i � . RECPT.NO. PAID BY VALIDATION WHITE—Oapanment Copy,YELLOW—Flnanee Copy,PINK—Assesaa Copy,GOLDENROD--Filo Copy,GREEN—App�canYs Copy - . . • �. . .. .. -.. . , ., .�. : ,.... ... ... . , ... .. � . � , . . . � , r^. . . , • . . • - �• .'+ . �� . i "�,. ' , � �. �. . . .� ...�. . CITY OF DIAMOND BAR� � �.; � ��,�. _ .. .,-_ ,,.. .-,_ .;. .. . ;. ,,..,,. -��• ' � PECTION RECORD '. �� . �. . � .. ., .': `, . . -. " , ." . . ► �� . e f ' ' � � ' • ' SEi'BACK ., ._. , � � • •� ,�_ , FLOORJOIST� ' • . �, � � , , : - FTGS/FORMS/STEEL :� FHA REQMTS� - - - - -- - � • � ELECTRIC GROUND - ' - - -'- � UNDER FLOOR DUCT - - - ��- ' - '• , � GROUND PLUMBING UNDER FLOOR CONDt11T � � .' , • �, . ,-: � - • - SLAB GRADE - - � .. � - --- -. _ FIREPLACE FOUNDATI�N .' , . . _ ,� � ,'�- TEMP POWER � `' - -- � - � � � ; FIREPL'ACE BOND BEAM .� ' ' ' � '' �� ` � WATER SERVICE -=-; - - - :- - MID HT.BOND BEAM � ` � ' ��•� � ' ' ROOF SHEATHING '— • ' ' - - • -- 8 FL BOND BEAM �- � � � . � FRAMING/VENTILIATION FINAL BOND BEAM � ROOF COVER � ' PRE-GRADING � - - - - - - - -� ' ROUGH HEATING - � - BENCHING ' ` -� - '' � R�UGH ELECTRIC -:- -� ` ' --- ;--- �� -ROUGH GRADING , -. . . ROUGH PLUFIIBING � �-- " - - � " ' �� •- - � - FINISH GRADING , . , . . : .. SHOWER/TUB TEST �� --- -� - �-- POOL ELECTRIC ' � ' EXT.LATH/SIDING- �� • POOL FENCING " WALL INSULf1TION POOL FINAL • � , ,.. CEILING INSULATION OFF SITE IMPS.� " � � DRYWALL NAILING ; I DEDICATIONS . . . . ' � � SEWER ' FINAL ENG. - � • � , � • - -- - � -- - - SEF.TIC TANK . ._.... _!.._. .. .. � -- ----'-.. �'�- LANDSCAPE/IRRIG. � SEEP PIT/L.L.. �_ - ---- ' ON SITE IMPS. GAS AIR TEST - --- � -� - FINAL ZONING • -� -- FINAL-CONST- -- -- - -- - - � FIRE DEPT.FINAL - - ' ' ' � � FINAL HEATING �� - - � - HEALTH DEPT. FINAL FINAL ELECTRIC - �-- -� - DEV. FEES PAID " . � - -- FINAL'P,LUMBING -. , • - - ,� .� EPJERGY • •� . ; i =�e �� e � - � , . _ . ... ; �.. .......... . �- - - -- -- - - - , . .. � COMMENTS - - - - � - - - , _ `. . ,. . , . ,. . ' • " `. _ _ . . � . , - � .. _ . .. , . -- ' � - - - . .. _ • . , ; � SEPTIC TANK SIZE � � � . , , ; :� SEEP PIT/U SIZE ' _ , , , , , � - - '� � '� .t ; � � , • • - . . .. . � ---- - - _ ' - - - - � - . ;1�P � _, , ; - , , • . � � ' _. ` - _ _ � .. , - f : � �,. . �`- ,' . _ , • ._ . .