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HomeMy WebLinkAbout14783 �� CITY OF DIAMOND BAR � , DEPARTMENT OF COMMUNITY 8c DEVELOPMENT SERVICES ._ '- � �� , 21660 E.Copley Drive Suice 190 , ' (909)860-3195 Fax(909)861-3117 . PR E$$ �'��'� BW.DING PERMIT APPLICATION FIRMLY � JOBSRE (] 1 APPLICATION � PERMIT 1(.� P!C o ADDRESS—1 �� C�IOI��1� �r QCII�S �� DATE NUMBER �, i r g ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER �'1 I LL' ADDRESS O U f� 1( � r. ZONING SETBACKS w CITY Q O �� �"�sIP �I I �S TE O�} '(3 FRONT RW ❑ � APPUCANT C Yl L,c7�TiYQCJIZTcSTEL =J'ib�,ti iS-13�� REAR ❑ SIDFJSIDESTREET RW O � CONTRACTOR \D �CS� SIDE p � ADDR S � `�• _ CITY r ZIP UZ T S �I PROPOSED USE � ARCH/ENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL ti v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFlRM U!lDER VENALTY OF VEfWRY iHAT I MI El(EMPT FRdA THG CONTMCiORS LF G818gB/C9ry0R CENSEUWF0IITFIEFOILOWWOREASON(SEG7071.68USINESSANDGfiOFE5510NSODDE:ANYCT'OR (n Cd1NiYMMIf11REQARESAOEiWrtTOCONSTRl1CT.ALTER�FROVE,DEMOIISH,OFiREPA:RANYSTRIIG W P8tI0/DBCI( ' ' 7UqE,VRqq TO RS BSUANCE ALSO NEIXI�RES 7NE A7VLIGUlf FOR SUCH VERMIi TO FILE A 610NED W 6TA7EMENT TU7 HE OR SHE IS 110EN5ED M10.5UM7T TO TME PROVISIONS OF TMC COHTR/ICTORS LL � CENSE Uw(CHAPTER�(COMMENq1�W MnTH SECi10N 7000)OF DIVISION i OF THE BUSINE55 AND PRO- V' POOVSpfl FESSqNSCODt70R7)UTHEORSMEISE%EMPTTIIEHEFiIOMANDiT1EBA515FORiHEALLEOEDE%EMP• (� TION.IINYVIOLAT%7NOFSEGTION7071.6BYMIYAPPlIC1WTfOF111VERMIT6U8JECfSiMEAPRICANTiO Z Pe-Raol � ACNRPEN4LTYOFNOTIAORETII/JlFNEHUNDREDDOIUNS�f5001.F � OI�O�MIEROFiHEPROPENTY.ORYYEYPLOYEESNATNWAGESA5THEINSOLECOYPENSATION, O COmmBfCl81 � MALL DO iHE WOFi1C M10 THE STRUCTURE t5 NOT INTENDED OR OFFERED FOR SALE(SEG 70u,BU54 J N NESS MO iFiDFE5510N4 COOE 7NE CONTMC'TORS LICENSE Uw OOES HOTMPLY TO AN OWHEH OF j P110PEMY N4q BUIDS ON MGROVE9 TM[REON,AND W110 DOES SUG1 WOfiK NIMSELF OR MERSELF OR Q T/WOUOMMISORMEHOYMEM�LOVEES,VROVIDEDT7ATSLCIIMPROVEMENi5/1REN0TIMENOEDOq m � OFFFRmFOHSKE.IF,HDWE'/ER7HEBULDIN00RMPROVEMINi135pDWfMNONEYEAROFCOMPLE- � •TION,TfE OWNEHAUttDER 1NLL H�VE iHE BURDEN OF PROVWO THAT HE Ofi 6ME DD NOT BVILD OR W FROVE FOH THE PURPOSE OF S+LLE7. W OI,,l40NMEROFTHEPROPEffiY,/UIEXClUSNELYCONfRACTWOWRHLMENSEDCONTMCTOit4 a 70 CONSTMICT TNE P0.0JECT(SEC.70N.BUSINESS/ND PROFESSbNS CODG TH[CONTMCTORS U- VdIu8f10f1 ADJ.AREA � CENSEtAW00ESNOTAPPLYTOIWOVINEROFAPROPERTYWHOBUILDSORMPi10YESTHEREON,ANO ��� NkpCONTRACTSFONSUCMPHO.IEGTSYATIACOMRACTOF(S)LtCENSEDPURSUAMTOTHECONTRAG pUANTITY DESCRIPTICN FEE � TORSLICENSEUW} O IAM EXEMPT UNDER SEG 8.l P.C.FORTHIS REASON U u' OATE ONNEN � � LICENSED CONTRACTORS DECLARATION � � w , IHEREBYAFFIWAUI�AEAPENJLLTYOFVEiWRYTHATIAMLICENSEDUNDERVROV151QV50FCHAPTER V. �� s ��OOA�YENCNOWrtHSECTqN)0oo)OFDMSION]OfTHEBUS:NESSANDPRDFESSqNSCODE,IwO Z X W LICENSE 6 N FUIl FO(iCE AND EFFECL m 0 LICENSECUSS �Y LIC.NO. �(� S � H �j DATE CON7MCTOFi � W � WORKERS'COMPENSATIONDECLAFiA N n . . , , . N IHEREBYAFFlRAILNDEHFENALTYOFPERNRYONEOFiHEFOLLOWR OEGURAi ✓ N L� _I MAVE AN�W!LL►UMAlNA CEpi1FICATE OF OONSEM TO SEl�INSURE FOR NURKERS' _ Q CpAPEHSATqN,ASPHDVIDWBVSECT10N77o00FTHEUBOq E,FORTHEpERiO C OF iNE Y/ORK FOq N771C/1 TNIS fE W.��i t4ISSUED. � _IHAVEMIDWRLAUMAe1Wd71cERS'CdAVEN5AT10fJIN5URANCE,ASREdnRE �CTION 4Q 0700OF iHE LA8011 COOE,FOR THE PERFOiW�NCE OF THE WORN FOR ' THIS PERMI � 155UEO.IAYWO EASCOMVENSAT INSURAN CARRIERANDPOI hUuBERM STRUCTION ? GMIER � O EVIEIN � va�cr�+eEa - L RIC - � (MSSECIIONNLIDNOTBEOp.iIETmOFMPEfi.lT6FLRONE Tt0010R F LUMEiING Z ICERTIFYiHATNTHEPERFORFl.ANCEOFiNEMOPoCFOFWHICHTHISVERMRI5155UED,1 MECHANICAL __ (i 51uL1 NOT E7A�LOY AN'/VE0.SON Ml ANY YANNER SO AS TO BECOME SUOJECT TO THE N WORKERSCOMPENSATqNUw50FCALIFORNIA�NDAGREETMA71F151101A08ECOUE INSPECTIONFEE � • S SU&IEGTTOTHEWORKERSCO�APENSATIONVROVIS10N50FSECTqN77000FTNEV�BOR .GODE,ISMALLFORTHwrtMCOMPLYWI TMOSEiROV15lON5„ ISSUANCE � • � � � M},�.��/� �/y. SMIP ■1 � ' p DATE: APPLICANT: ��� �Jl�ll Vti(�1[� C�� . � ENERGY P/C WARNINQ:F/ULURC TO SE WRE WORKERS'C�PENSATiON COVEMCE IS t1NUWFlA,AN�SIULL BE � SUBJECTANEMPLOYERTOCFIYItU1GENALTIESFNDGVILFINESUPTOCNEMUNDflEOTiqUSAND � pOLURS(f10a.0oal.INl1�D1ilONTOTNECASTOFGOM7EN5AT10N.DAMAGE5A5PROVI�EDFORIN ENERGVPERMIT �_'} C � SECTIDN7t0lOFTHEUBORCODE.M7ERESLMID�TTORNEYSFEES. RETErJTIONFEE: ��J.�l11_ �( � `' :O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: V � IHCRCBYAFFIR4UNDERFENALTYOFPEMIFYTHATTMEREISACONSTRUCTIONLENDMOAaCNCY n�] � Z FOR THE VERFORMIV7CE OF iME WORI(fON WM�CMTMiS PERMIT IS ISSUED�SEC.70i7,Crv.F�. ClJ ,.� LENDER'S NAME � LENDERSAD�RE55 � ICER7IFYTNATINAVEREADiHI5A7PUCATqNANOSTATETUTTHEABOVENFOR/1ATI0NI50DRRECT. TOTAL FEES d IAGREEfOCCA1PLYWI7H/�LLGTYANDCOUNTYOFD�NANCE5AND6TATEUWSRELATRMTOBUlDINO � � � CONS1Rl1CTION,/WDMEREBVAUfNDRIZEREPFE5EMA7NE50FTMSCOUNTYTOEMERUPON7ME Z ADOVE�MEMiqNED PROPERTY FOR WSPECTqN PURP0.SE5. COMMENTS � .� U s o . v m � P iMtTiE AME �Nn �, l���l.(r-� .�l6rJ . y NA E iT7EE OAT � � RECPT.N0. PAID BY VALIDATION WHITE-0epaNnent Copy.YELLOW—Finenn Copy.PINK—Asseseor Copy,GOLDENROD—File Capy,GREEN—Applicant'a Copy � CITY OF DIAMOND,BAR , , , . - - -•_ . �. � .� 1�JSPECTIOf�l�RECOP.D : . . •, , . � ,,;, - . :i►+�:sr'~C���,'rt�1�J � �� �= "�������J= ;t� �:��:;�a�[�.�►'� R�� :��'= = !I+' ��►.�.�-�'��.��� �. � ..� !� .�. � ri t- �.�._ �-� ��- 'SET BACK � �'� ' • w �FLOOR JOIST ^~�� ��� TM� }�R.�~�... 'FTGS!FORPY S'STEEL - - : , . ' . FHA REQIATS�. ' � ._ � � -• ELECTRIC GROJND. � �� � _ ' _ '. � UNDER FLOOR DUCT . � � �GROUND PLU�;IBING I UNDER FLOOR CU�iDUIT' � � - � � ' � • • �SLF,E GRADE - - i - - FIREPZACE FOUiJDATION : � ' • �TEt."P PO�'VER � � � FIREPLACE-BOPJD 6EAM - � � ' - - ' � � � VtiP,i Fn SERVICE- - P�11D HT. BOND BEAP,1 ' '' : '� � • • • ' " '� 'ROOF SHEATHING - � 8 Ff. BOND BEAM . • ' - -- ' - ' '�' - - � FH/1F"ING:NENTILIATIOv FINAL'BOND BEAM � ;ROOF COVER � PRE-GRADING - � �RO�GH HE�,TiNu^ - - - � " - BENCHIfJG � 'ROUGH E�ECTRIC ' � ' ROUGH GRADING - FiO;1G�-i PLUP1�81NG I - .-. .. - • - FINISH GRADING ' SHOWER.rFUf3 TEST - - - - --•- - POOL'ELECTRIC ; .•� .FXT.LF�TH/SIDf�G � � - �-- - - -� POOL FENCING I ' '„ !^lF,LL tNSULATION - - - � POOL FINAL � ; .., �C�i!I�JG INSULATiON � -- - " OFF SITE Ih1PS. ^ �•.�,. DRYb^Yn�.t�ra�,iL1�JG- - - DEDICATIOidS � ' � SEI;VER FINAL�ENG. - SEPTIC'1'APdtC LANDSCAPE/IRRIG. � . ��EEP PITi�.L. � � ON SITE 1��1PS. j ':��5 f.IR TEST ' ' , ' FINAL ZO�vING ' . - �__. �-�l;d�'�L CO�JST. _ � FIRE DEPT.FINP,L � I ''�i�:AL HEF,TlNG � HEALTH DEPT. FINAL j --- � �'Fi:.AL f�l.ECTRl� - � - �_ � DEV. 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