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HomeMy WebLinkAbout14104 (24) l� �� CITY OF DIAMOND BAR� '/ � DEPARTMENT OF COMMUNITY 8c�� DEVELOPMENT S RVICES , . - ,,,�a 21660 E.Copicy Drive Suite 190 (909)860-3195 Fax(909)861-3117 PR ESS '^" BUII.DING PERMIT APPLICATION FIRMLY � � ���� J DATEICATIO .. PERMff I - � O /C �.. JOBSITE 7 � o ADDRESS ��D�J� 7�� n � S � NUMBERt �u APN LOT TRACT ISSUE 7ypE OCC � OWNER �p�'�) DATE CONST. GROUP o AODRESS � -p � � ' ZONING SEfBACKS �"' CITY ZIP TEL. FRONT RW ❑ APPLICANT TEL.� REAR p � SIDFJSIDE STREET qVy ❑ CONTRACTOR U - M n. SIDE p A�DRESS 2 g CITY �'�' Cn�1 F� ZIP DO(�TEL PROPOSED USE �++ ARCWENG/ • � DESIGNER NO.DWEL NO. NO. ADDRESS � CITY ZIP TEL UNITS STORIES BEDROOMS � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLAHATION SFRlADD/REM O p I MEREBY AFFlRM UNDER PENALT'OF PEiWRY THJR 1 AM EXEMPT FROM THE CONiMCTORS U• GefBQBIC01pOR � CFNSEUWFORT/1EFOLLONnNOREASON�5EG70.71.6BUSINE55ANDVROFESSqNSCODE:ANYCITYOH (n . 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O I/UA EXEI.IPT UNOEq SEG 8.{P.G FOR iH15 REl150N U LLZZ DATE OWNER � � W UCENSED COI,ITRACTORS DECLARATION � 4 w ¢ IMEHEBYIIFFIRMUNOERPENAITYOFPERNRYTHATIAAIIICENSEDUNOCNPFiOVISqNSOFCHAPTER V. r/` ,� S t(CO��MENCYq IHITM SECTqN 7000)OF DIVISqN]OFTHE B1151NE55 ANO PROFESSIONS CODE,AND Z `7 ' X YY UCENSE l5 N iUl1 FORCE AND EiFEC7. 2O . � C'. %4 E O c7 i � uc�sE�uss e,'3� ��c.No. d� J � � �"j o�h `i �O ^ `��_corn�ucro� ��C• c a w � WORKERS'COMAENSATION OECLARATION Q � IHER�'/l�FFlRMUNOERiENA1TYOFiE0.NMONEOF7HEiOLLOWING0E0.AMT10N5: Z � / O �� �NAVEANDNIILLIMM7ANlACEHT1flGTfOFCONSENTTOSELF-INSUREFORWOi1KEfi3' a � COu9EN5ATqN,AS PROVIDED BY SEGTION�70o OF iHE lIB0f1 CODE,FOR THE PERFORMANCE w Q OFTIEWORKFOHYrF11CHhIi3VENAIT15135UED. ` � _IHAVE/WDNnLLMAMiAL4WORKERS'COMPENSATIONWSIIRANC[,ASREOUIRED6YSECTqN Q ]7ooOFTHEU80RCO0E,FPfIT11EpERFORNANCEOFiHE HV�iCHTHISPERMITIS ISSUFA.MVM/OHK fE�(SAT NWSU R:ERAN OLICVNUMDERARE: CONSTRUCT�ON � WRRIER ���/� �F �""�•"��i , c.. - P��E��EW � . � POLICYM7MBER_y;LJ,� Z � Z ELECTRIC d � (M6sECfiONN�NOTBE�1.iiE7EDOFhEFCFi.ff6fona+EM1�DKDDot1A16d+oc)plLFSs). PLUMBING _ � Z �C£RT�F`/THIR Wd TME iERFORMANCE OF THE YANK FON NMK]1 TMS VERMIT IS ISSUCD,1 ANICAL SNALI NOf EMP�OY/NY PEHSON N ANY YANNCH 50 AS TO BEGOME SU0.IECT TO THF �p WOPo(ERS'COMPENSAlqNUW50FGLIFORNIA,ANDAGREETHATIF15110ULD9ECONE �NSPECTIONFEE S 6U&IECTTOIHEY.VRI(ERSCOMVEN51��5' SOFSECT ]7000FTHElABOR E,i swu.�vom n+ca.�a�r vrT nase s. ISSUANC[ � o _3p,. � 'p DATE: RICANT. �SM�P � WARNINQFAILUR[TOSECUREV10RICERS'COAIPENSATIONCOVEMCEISUNUN'FUL,ANOSHALLBE ENERGYPIC � 6UBJECTANEMPLOYERTOCN1AwALCENALTiESANOCMLFNESUPTOONEHUNDREUTMOU5AN0 ENERGYPERMIT ¢ DOILM.a q700.000),IN AODITION TO iHE COST OF COMPENSATION,DAIAAGES AS PROVIDED FOR IN SEC7qN77oeOFTHEU80HCO0E,PITEREST,AnDA770RNEY5FEE5. RETENTIONFEE: OCON5TRUCTION LENDINC�AGENCY PFiE•ALT FEE: � IHEREBYAFF�RMUNOERPENALTIOFFE0.JUFYTNATTIIEREISACONSTRUCTIONLFNDw6AGENCY Z iOR iME VERFORAAANCE OF iHE WORK fOR NmiCH iMiS 7ERMR IS ISSUED(SEC.3oW,CIV.C.�. W � LENDER'S WwE � LFNOERSADDRE55 � ICEHTIFTTXATIHAVEREADIWSAVPLICA7qNANDS7ATEiHA7T1E1180VEINFORIAAT10N�5WqRECT. TOTAL FEES d IAORCETOCOMPLYWRHALLCITY/JlOWIRlTYOR�INANCESIWOSTATEU'NSREUTRN;TOBUL�IN6 ��� CONSTRUCTION.AND MEREBY AUiHORIZE REPRESENTATIVES OF THIS COUNTY TD EMER UPON iHE J � A�OVE�4ENTIDNEDGROGE FORINSCECTIONVURPOSES. 0 � �O �— COMMENTS " J ' � m PEPoAITT NAME wtln ^�Q `�� 4 � 1 y Srt3NATUREOFVERMITTE DATE � FECPT.NO. PAID BY VILLIDATION VYFiITE—OepeRment Copy.YELLOW—Finance Copy,PINK�llisesea Copy,GOLDENRO�File Copy,GREEN—Applicant'a Copy - . .... , : � . � . , . ,... . :.` ...s . ...` .��.�•F�•�..�:..�.r . 4,�.+.. f:ti" �.:Y., . :n'`���'tl��:�. �•4q....�,c,': . . . ... , �..� , � , _ . . . . ;. �+: Jw:T.. .A.�ND BAR. . . ... . . , • ti��..� . � . -:.• :, .':��• ItJSPE TION RECORD �1�. -: . :== � � . . . , .,. . �, . , . . . . .. �(��.�;��o;;j������ iDt►���'=� ���-�:���'�c.�r.�. 'I�i.E-7;���sle���� �� :�'��� �ir � e� o j ;SET BACY. . �� � , . : I ' •� . 1 � . •� FLOOR J�15T. � . M� ,� • � , IFTGSIFORP,".S,'STEEL� �- - . ,• ' - FHAREQMTS'. ' � - jELECTRIC GROUPdD__. . _ .__ " _.__ UNDER FLOOR DUCT " '' 'GRDUND PLUN;BING UNDER FLOOR CU�IDUIT - ' • , ' " �SI.ABGRADE- -- -- `�'� -- - - - - � FIREPLACE FOUNDATION' , • � . ; . . : . �TEP:1P POWER- - --.�: - I - � ; ' FIREPLACE�BOND F3EA�1 ' � �VVATER SERVICE - - - - ' MID HT.BOND BEAM � � � ��� � ;RQOF SHEATHING 8 FT. BOND,BEAh1 - � � - - �FRAP,4I�JG��ENTILIATION --- -- � - - FINAL�BOf�D�BEAM ' - , iROOF COVF_R .'' . � ' PRE-GRADING - • �R�UGN NE��TING -- - - - BENCHIh�G � � • - � , �ROUGH E�ECTRIC . �_ -_ % -�." __ ' __ �� • � �ROUGH GRADING - - - �ROUGH P�UPJ;8ING --- —, - - � . FINISH GRADING ,' Sh10WEFalTUB TEST ' �- � - � -- POOL�ELECTRIC . _ ' 'E�T:LATH/SIDING -� - POOL�FENCING 'WALL INSULATION - - - - � •POOL FIPJAL CEtLING�iJSULATION - - � OFF 51TE IMPS. DRY1"lAL:L NAILIPdG � -� '� � DE�ICATIONS • - SEWER � -- . . . _ . . FINAL'EPJG. � . �SEPTIC TANh � (1aNDSCAPEJIRRIG. �SEEP P1T/L.L. �_ • ON SITE Iti1PS. � ;GASAIRTEST . � • ' FiN�,L'ZONING ;FINAL.CONST. _ .__.. _! _ _ ... _ . FIRE DEPT. FWAL � : ;FfidAL HEATING .... __ HEALTH DEPT. FINAL � 'FINA�[LECTRIC -- �- -- . .. . . DEV. �EES PAID - � � Ff�1/1L PLUFA9ING - - - • EhERGY • , ,. � - - I, , , ....-- � - . . �..I-....,,..�....-... -- . .Jf�.��''f,��"_e�iF .it+,. .......�,..._. I • � ;.•�. .. — I _. . - - -�- - -- -- . ,)i`• . �.� . ' , _ . ' �cov�r�nErvrs --- - - � . : : - - -- _ . . , � . ; . i � ._ � ; ; . . � . �. , . � � � , _. . . .. . . , , . SEPTIC TANK SIZE � ' , i � 'SEEP PIT/U SIZE - , _ _. _ . . . . � . , � ��..�. __ _..._ ____�.__._._. : ' : � 'E�4 ' . . ; � _ _ . . . . . - , � ;���� ,�� , , - , - . . I : . . .... � � I . , � . . � � . :-� ;� • - . � . . . � . .`...�._,..... .__.._: : ` � -