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HomeMy WebLinkAbout10850 i��- � --- -"-- .._ .._---- .. .._ . _ ---- -�-�------ -� - '- . � . ., -- - ---. . ._. _--.. .-'----.—"._ _ --- �. � - , ! ---��� --. CITY OF DIAMOND BAR� � � � . � � COMMUNITY DEVELOPMENT DEPARTMENT � � !.,.w 21660 E.Copicy Drive Suitc 190� :•r ��••- - _ �- PRESS (909)860-3195 Fax(909)861-3117 '� ' ' ' ' � ''�' BL)ILDING PERhiIT APPLiCATION FIRMLY � JOBSITE ��2 g ! ` _t_ — � � APPLICATION r� (" PERMIT !C o ADDRESS �r�Ql_(,J.�Q. � DATE • � ! NUMBER # ���� c� ISSUE , TYPE OCC . APN LOT TfiACT DATE ' CONST. GROUP - p OWNER � " ADDRESS ZONING SETBACKS z CITY n • R- ZIP EL. FRONT ' - � - - RW � ❑ o APPLICANT TEL. S DEISIDE STREET RW ❑ z ¢ CONTRACTOR � J ' SIDE ❑ � AD�RESS ' PROPOSED IJSE� C� ` � � o CITY ZIP TEL R�� r w ARCWENG/ ' �� .r s iz DESIGNER ' "- ' � " . NO.DWEL. NO. � , NO. n. ADDRESS UNITS STORIES BEDROOMS ' � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATIOY � OWNER-BI:ILDER DECIAAATION - - SFRlADO/REM � O ' ' p 1 HEREBY AFFIRIA UN�ER PENALTY OF 7EfilURY iHAT I AM EXEMPT FFOM TMC CONiMC70R5 ll• G2f2ge1C3ryOR ' W CENSEUWFORTMEFOLLOWINGREASON�SEC.70.71.6BUSINESSANOVROFESSIONSCODE:ANYCITYOR . (n U CWNiYYMICHREOIJIRESAPERMITTOCANSTPUCT,ALTER��7ROVE.DEIAOLISH.ORREG�IRANYSTAUC- W Py;I0/DOCK�� Z TU0.E.PPIOR TO RS ISSUANCE.AL50 PE�UiRES THE APPLIGM FOR SUCM OERMIi TO FILE�SiGNCD � � STATEMENT THAT HE OR SHE IS LICENSED PVRSUANT 70 THE PFiOY1510N5 OF TNE CONTRAC10qS LI• � � � LENSE LAW(CHAPTER i(OOAIMENqNC WITN SECTION 70a0)OF DIN510N 7 OF THE BUSINE55 AND PRO- POOVSP3 � FESSiONSCADE)OHTIMTMEORSMEISE%EMPTTMER[FROMANOTHEBFSISFORTNEILLlEGEOE%EMP• C7 V TION.AN'/VqLATIONOFSECTION7071.58YAYYAPPLIGNTfOA�PERMITSU61ECT57HEAPPLICANT70 � Z Re-Raof ,'Q ' - �'j, A CIVIL VENALTY Of NOT MORE THMI FNE HUNDRED DOLURS(f5W11: � -� , OLASOWNEROFTHEVROPER7Y.ORMVEMPLOVEESWITHWAGESASTHEINSOLECAMPENSATION, 0 COmmBfCiOI N'�LL DO THE WORN,A4D THE STRUCTURE IS NOT INTENDED OR OFFERED fOR SALE(SEC.70�a,BUSI- � NESS AND PfiOFE55lON5 O�OE:THE COqTHACTORS LICENSE UW DOES NOTAPP�Y TO AN OWNER OF ? PROPERiY WHO BURDS OR IMPROVES THEREON,AND WIiO DOES SUCH WOFK HIMSEIF OR HERSELF OR Q iMROUCHMISORMEROWNEMPLOYEES,PROVI0E0TXAT5UGMIMPROVEMENT5MEN0'fWTENDEDOR m ' W OFFERE�FOFSAlEIF,HO`NEVEF�IHEBUI�DINGORIMPROVEMEMISSqDWITNINONEYEAROFCOMV�E. - ' ' � � TpN,THE OWNER�BUILDER WILL HAVE THE BURDEN OF VROY:NO THAT ME OR SME�i�NOT BUILp OR Z UAPNOVE FOR TME VURPOSE OF SALE4 � = OIUOwNEFOFTHEPPOVERiY,M.1E7(CLUSIVELYCONlMCTa1GWRNLICENSEDCONTMCTONS W . Q TO CONSTRUCT THE PFlOJECT�SEC.70�a,9USINE55 AND VqOFESSIONS CODE:TMG CONTMC70RS U- V01U3�1 ADJ.AREA � W CENSEUWDOESNOTAPPLYTOIWOWNEROFAPROPERTVNA70BU4DSORIMPROVESTMEREON.AND � W/pCONTMCTSFORSUd1DRO.lECTSYATHACONTMGTOR(5)UCENSEDPURSUM7TTOTHECONTMG OUANTITY DESCRIPTiCN � � � FEE . � . Y TORS UGENSE Uw). ' � O I AM EXEIAPT UNOEfl SEC. B.A P.C.iOR iHIS HEASON U � _ ' ' . . . . . . . . .. LL , Q OA7E OWr:ER U � QW .. .. . . . _ .. . , . . � _ _ LICENSEO CONTRACTORS DECLARATION. ' ', W � I NERE9V AFFIRM UNDER PENAITY Of GERIUNY T1UT I M1 IICENSED UNDER VNOVISIONS OF CHAPiEA V, ' , . � . p„ 9�COMA1ENpNCMnTH5ECT10N7Doo)OFDIVISION70FTHEBVSINESS�NDVROFESSqN5CO0E,AND Z ' X Mv UCENSE IS W FULL FORCE AND EFFECT. , , m . . LU � LICENSE CLASS LIC.NO. � V DATE CONTRACTOA� d W � �o� - WORKERS'COMPENSATION DECL4RATION . -� . Q NI HEREBY�FFlRM UNOER GENALTY OF VERJURY ONE OF THE iOLLOWING OECLANAT10N5: ' Z , � _IHAVE�VlDWILLGUINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFOf1VIOliNEHS' � _ ' COI.IPENSATION,ASVROYIDEDBYSECTONY7000FTHELADORCODE,FOR7HEPERFORMqNCE `U , p OF 1HE WORK FOR WHICH THIS PENMIT IS ISSUED. � w �I HAVE M!D 1MLL MAiNTAIN WORKERS'COIAPENSATION IhSURANCE,A$REOUIRED BV SECTION Q 77000FTHEUBORCODE,FORTHEPERFORMANCEOF7HEWOHKFORWMICMTHIS7ERMITIS /7� �s� ISSUED.MYWORKERS'COM7ENSATIONINSURANCECARRIEHMIDPOIICYNUMOERARE: CONSTRUCTION /71�_�! � a --r /�, IL � CAHRIER PLAN REVIEW ��_� , Z vaicrr�uuOER ELECTRIC - ' ¢ � (fFtlSSECTIONNEFDNOTBEWF�LFfmOFTHEPEPo�7f6fORONEHUU7EDDOl1?1L5(5100�ORLE55} PLUMBING r1 rd., Z I CERTIFY TFUT IN TME VERFORAAANCE OF 7NE WORK FDR WHICN THIS PERMIT LS ISSUEtl.l MECHANICAL C7 SNJLLI NOi EMPLOV ANY PERSON W ANV MMINER SO AS TO BECOMG SUBJECT TO TME —�.� �.aeC . !Y✓ � WORKEAS'COMPENS�TIONUWSOFCALIFOFiNI�ANDAGREETHATIFI5F10ULDBECOME INSPECTIONFEE ' SU&IECT TO THE WORNERS'COMPENSATION PROVISIONS OF gECiqN J700 OF THE U60R rj COOE,I SHAII iORTMYI7H GOMPLY WI7M TFqSE PfiOVI510N5. �SSUANCE ���� � SMIP. .... n^T `� ' �I�� - . S'O • p DATE: APPLICANT: --�{{—}-}� �yur v V 1 1 •�.,�:7 ,_�j WARNING:FNIURETOSEWREVYORKERS'OD��PENSATpNCOVERAGE15UNUWNLANDSHILLLBE' ENERGYP/C - - �y SUBJECTANEMPLOYEFTOCR:MMALPENALTIESAhDGINLFWESUPTOONENUNDREDTHOUSAND ENERGYPERMIT DOLURS If100.000),IN ADDITION TO TME COST OF COMPENSATqN.�AMAGES AS CROVIOED FOfi IN y - � SECTqN77o80FTHEUBOfiCOOE,INTEREST.ANOATTORVEY'SFEES. ' ' ' � �RETENTIONFEE: � � �� � � - C..O� ' ' O .. CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � � � ' ' � 1 HEREBV AFFIRM UNOER CENALTY OF GERJURV THAT THER[IS ACOHSTRUCiION LENOWC AGENCV '' - FOR TME GERFORAIANCE OF TH[WORN FOR KNICH iNlS PERA�IT IS ISSUED(SEC.7097,dV.C.). Z - ' _ ' _ ' ' ' ' � . . �w ` .. ' . . ' �y. �LENDER'SNIVAE• , • , � LENDER'SADDRE55 � � � � � �� �� TOTAL FEES ' /'�L_ �S � ,I CERTIFY TMAT I HAVE READ 7HISAPPLICATqN AND STATE THAT THE ABOVE MFORMATqN IS CARflECT. w 'IAGREETOGOI.�PLYWITNALLC17YN1DCOUNTYORDINANCESAN�STATEUWSREUTMGTOBUILDING ' " ' " ' � CONSTRUCTION,AN�MEREBY AUTMORRE H[PR[SENTATNES OF THIS COUNTY i0 ENTER UPON THE ' � ' : Z ABOVE�MENTIONEDVROPENiYFORINSPECTIONVURPOSES. ' _ � �`� � . �• ,�� � GOMMENTS � o , .", ' � p . J ����`'�L— � �. .. � m 7ER41TTE NA/AE I�fUNTJ • ..... . . .. .. •�� .'.. � . . N � �- ' �� 1�1-q1 ,'(n SIGNATUHc PERMITIEE DATE - � � � RECPT.NO. Pn�DBY �� VALIDA710 � � -- � ��� - � �WHITE—Department Capy.YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENROD—File Copy,GRE N—ApD���aM's Copy � . � . . . . r � " � ' . . � ... . .. . .. . t . . . . . . :, � , � . .. . , I � � CITY OF DIAMOND BAR � " � � � � �� . - .. :�_ f:. . _ : . . � � � ..� , � � .. ' • • - INSPECTION RECORD ' ' - � � � _ , . . . „ � . . ( � � � • - � � � • - SET BACK FLOOR JOIST T � � � � � ' FTGSlFORMSlSTEEL :Z y FHA REQMTS , , , , . . , ELECTRIC GROUND UNDER FLOOA QUCT:.,:__::=•- ,�, .�-..i •.; ; - � ,' GROUND PLUMBING - - � UNDER�FL�OR-GONDUIT� -�-• i: - : ••; �'•:.� � `: SLAB GRADE 7 �— FIREPI:,ACE FOUNDATION . _ - '. TEMP POWER.• � , - - FIREPLACE BOND BEAM����.' -= - •• - - ' � • WATER SERVICE �� '�. •`-•'-'�•� — �"• `:� MID•HT.BOND BEAM � ' ROOF SHEATHING ::�.':�I .� � 8 Ff.BOND BEAM ' FRAMINGNENTILIATION FINAL BOND BEAM '� "- ' ' ROOF COVER - PRE-GRADING • ROUGH HEATING BENCHING � � -• FiOUGH ELECTRIC - " -' ROUGH GRADING � ROUGH PLUMBING � FINISH GRADING � • • • SHOWERlTUB TEST �• � � POOL ELECTRIC � � • EXT:LATHISI�ING /e � ,� ' . �,•;• POOL FENCING . , WALL INSULATION ` POOL FINAL � CEILING INSULATION �� OFF SITE IMPS. � DRYWALL NAILING �, � DEDICATIONS . . . • SEWER _ _ L.' {�. '� FINAL ENG. • SEPTIC TANK �•=-= ==�• �` L;4NDSCAPE/IRRIG. SEEP PITIL.L. - - - �N SITE IMPS. GAS AIR TEST •FlNAL ZQNING � FINAL CONST. - (p � </ - FIRE DEPT.FINAI. ' _ '. FINAL HEATING � HEALTH DEPT.'FINAL �- - FINAL ELECTRIC (p � ' � � ' � DEV.FEES PA1D� ; i . FINAL PLUMBING ' � ENERGY - ; � • • : � - - -- --- — --- .. . .. . . . . __. ... .------ , -�• ...s_�_...__ _ . .,. ___ . ._ . ._._. . . .. .. . ..- - --- COMMENTS � �� �_ � -- � �� �. ''� , - _, - .� �. � .. , , � � - _ � �, ; ', , ' ,`, � . � � .. _ - -�-,; ,- . �,� .-�� � � � h ,• �J ' � `UJi .� � I .j C' - • . SEPTIC TANK SIZE ; , � - -� - . - - . SEEP PITN SIZE , . /7" � /N � �f pZ h ; -- � � r � �i� S�� �o� G 6�2 2� , , � +� - ,!_: T:t�.1.� ; .i . - � , . � 1!' I�� '11 � -1 -- ---,_•i. - - �