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HomeMy WebLinkAbout15506 (20) 3 ' •' �.. �' CITY OF DIAMOND BAR ' � -J� -- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E.Coplcy Drive Suitc 190 ' (909)8603195 Fau(909)861-3117 - . . ' . PRE$S �'A�'� BUQ.DING PERMIT APPLTCATION � FIRMLY � J08SITE 7 � � APPUCATION PERMR � P/C OG�� /') o AODRESS t-�U IQ Gl(7Lp� $��'kC,�;�j�a�h DATE � NUMBER� �1 � g iSSUE Q TYPE OCC APN LOT TRACT DATE � 1 � CONST. GROUP �r �� 8 A DRESS�T��E,�GP��� !7�- ' ZONING FRONTCKS RW ❑ � CITY �fnu+�y,l�,Rd2 ZIP,��f� TEL.����Iq REAR ❑ APPLICANT _•aNMI'��— Y�WI TEL.2L2-�_ ��1-I_41�- SIDE/SIDESTREET RW ❑ � CONTRACTOR �' �' "` �� O ' SIDE p � ADDRESS / C-, 1 G�i - (,, yr✓ CfiY E�', G-� _ ZIP��3TEL �� PROPOSEDUSE '"f'1 11nhh 1'ct^rtL7 �012 rS;.a� �� ARCH/ENG/ t 'S��T-�� �' `' � DESIGNER ArL��ti� . NO.DWEL ��0. ` ,�� NO. ADDRESS_?+�n�?P.4f�{�1],�.yy�� .el� S�f17£-/�5—.— UNITS STORIES 6EDROOMS � � cmr }iw�laei� Rep zta r�c� rE�.r���„c�l �n DESCRIPTION S�.'FT. FACTORPSF ADJ.AREANALUATIDN p� OWNER-BU�LDERDECLARATION SFFi/ADD/REM �;' '.' O • p 1 HEREBV AFFMiLI UNOER VEIULTY OF PE0.AlRY THAT 1 AM EXEAIPT FROM iHE CONTMCTORS L4 Garage/Carport lL CEX9EUWFORiHEFOtLOM'1HOREA90N(SEC.7o71.6BUSMESSANDP110FESS10N3CO0EANYGI7YOR (n ZCOUNTYWI#CIIREOUIHESAGERMRTOCONSTRUCLALTE0.M7ROVE,DEMOU91,qiREPA1RANVSTAUG W Patio/�ecic ��� NRE.PRqR TO RS 159UANCE.ALSO REW WES TFIE MPLICAN7 FOR SUq1 PERMIT TO fILE A SIGNED W � ETATEMENT THAT HE Oii SNE IS LICENSED PURSUM1NT TO THE PROV1510NS OF TNE CaNTRACTORS l4 CEN9E UW(CMA7TER Y(COMMENGINO WRH SECTION T000)OF OtVISqN]OF THE BUSNESS 1WD PR0. LL" POOVSpB iFSSIONS COOE)OR i1UTHE OFi SHE IS E%EMPT iHEREFROM AND TiE BASIS FOR 7HE ALLEOED EXEMP- TION.ANYVqU7qNOF5EGT10N7W1.6BYANYA7PLM.+WTFORAPERMI75UBJECTSTHEMVLIC/�NTTO z Re�poot � A CIVIL PEIULT'OF NOT YOHE iNAN FNE HUNDRED DOLUAS(f600l,r � O OLASOVYNEROF711EpROPERTY,ORMYEMVLOYEESWITMWAGE5l15iHE1N50lECOM�EN5A7101J, O �mmerela - � YALL DO THE VIORK,IWO THE STRUCTURE IS NOT MTENOED OR OFFEHED fOR SALE(SEG 701�,BU51• J � NESS AND VHOFESSIONS OODE:TME OONTMC70fi5lICENSE LAW DOES NOiADPLV 70 IW OWNEq OF j —�. ,l. PIYDOERiY VMO BUIlD3OR IMVROVESTHEREON.►ND WND OOES St1p1 wqiK MIMSELF qi HEHSELF OR Q T1IROUGH11130FiXEROMRIEYPLOYFE3,VROVDEDTHA75UCHWDROVEYE/1TSAi1ENOTNTENOEDOR m 0 OFFEREDFOqSALE1FNOWEYER�&14.DNOOqMPiqVEMEMISSOIDYATMNONEYEAFOFCOMPLf• � � 'T�OM.TME OYMER-BUItDEF WILL/I�VE T11E BURDEN OF PROVNO iF1AT HE OR SME OD NOT BUttD OR MPROVE FOR iHE PUHPOSE OF SALE). w O�ASOVMEqOFT1EPROPERTY,AIAE%CLUSNELYCOHTqACiflOVrtTHLICENSEDCONTMCTOqS Z TO CONSTpUCf TNE PR0.IECT(SEC.70K BUSINESS Nr0►f1OFE551DNS LODE:TME CONTRAGTORS LI• VHIt18li0n ADJ.AREA G3 CENSEUWDOESNOTAPVIVTOANOMMEHOFAVROPER7VVAiOBUILD50RMP{pVESh1EREON,/�ND �: NhqOONTHACTSFOR5UCH7ROJEGTSWIMACONTMCiOR(5)LIGENSEDPUPSUNITTOTMECONTMG p TITY DESCRIPTION �E � TORSl10ENSEUW} D IMA EXEIAPTUNDE0.SEC. B.t V.C,FOR 7HIS REASON a '�j� O I� , U V"' DATE OWNER � � �C��. :^�CC� � U UCENSED CONTRACTORS OECUIRATION w I � ,- � 1 HEFEBYAFTIiMI tMOER PENILTY OF GENUM TNAT IAAI IICENSED UNDER PRpN510NS OF CHAFTER � ' � . � f(COMAIENCMIO MrtfH 5ECf10N 70ooJ OF D�NSION 70F THE BUSIN[SS AN�VROFESSIONS COOE,AND Z W UCEHSE 6 W FULL FORCE MA EFFECT. ly 1��^ � IICENSE�jCUSS � UC.NO. O �� L � � � DATE,LS' �'T'O � CONTMCTOR � � � d WORKERS'COMPENSATIONDECLAF7ATION �p1� OI 4 yIMCFEBY►FiWMUNDERPENALTYOFPEMJRYONEOFTHEFOLLON1NGDEGLAMTqNS: � Z . ' _ . ,� 1 . � �, r, ¢ � _INAVEANDM/ILLWJNTAINACERT�FlG7EOFCONSENfTOSELFINSUREiORWOqKERS' _ " � " , � r . COYPEN9ATION,AS iROY1DE0 BY EECTqN 170o OF TNE U�BOR CODE.FOR iHE PERFOflMANCE W Q Of i11E NfORK FOli WHlpl TMS PERMIT 191SSVE0. , , � 4 �IMAVEANDYALLMAR(TIIMWORKERS'COMPENSATpNMSURANCE,ASREOVIREDBVSECTqN �J� ' ^ ^ f70oOF iHE UBOR COOE,FOp TME PEBFORAIANCE OF THE WOFi`C FOq MMICH iHIS PENAIT I$ . ' � ' ' � ' . �C ' J-`� � 65UEU.W WORNE0.S'COAIVENS�TIOH WS11R11NCE CARRIEN.W�VOIICY NUY�ERAqE: CONSTRUCTION �� o � C.NRIER � � i= < <V pL/1N REVIEW � pOIICYNIAaBER � — � � "�'G � ELECTRIC ' � (IYL45ECIIONILIDNOTBEOCY.RE7mOFhEPEWATSPJRON[IAI�ORF��oAl�.ts} PLUMBING �� z ICERiIFYTWTINTHEPERfOf1MANCEOFTHEWOHKFOf1WNICHTHISPERMITI51S5UED,1 MECHANICAL SHAIl NOT EMPLOY ANY PEFSON N IINY YMJNEN 50 AS TO BECO/AE SU9IECT TO THE (n WOPo(ERS'COMPENSATIONUWSOFCAIIFORNIA,/JIDAOREEiNATIFISHOUIDBECOME INSPECTIONFEE S SU67ECf TO THE MKXiK[IIS'COUPENSATiON ifmVISIONS OF SECTIDN�70o Oi iXE UBOR • J ` ' 070E 15/ULL FOHT11Y�nM COIAPLY WIT7 THOSE PROVISIDNS. ISSVANCE ' O p o�7E: �;C -4"�'�PR�c�rar. � SMIP C.l�l' `�- W ENERGY P!C 1 1 V} -/ � 1 . � • � WARNIN@FMURETOSEWFEN+ON(ERSCOMVENSATIONCOVERA0EI5UNUWFUL,IWDSNALLBE r' }�-�� � SUBJECTIWEMPLOYERTOCRIMINALPENALTIESANDCMLFNESUPi00NEMUNDREDT110U5MN OLiLIJiI 1 DOlUp3(f 100.000�,W AD�ITION TO THE COST OF COM7ENSATIDN,DAI.IACES AS PROVIDED FOR M! ENERGY PERMIT ' � BECTION770eOFTMELABORCOOE.RfTFRESLANDATTOqNEYSFEES RETENTIONFEE: Q CONS7RUCTION LENDING AGENCY � pREAL FEE/:�'�/,� 1/ � IHEi1E8VAFFIRMUlOERGENAITYOFPERR/FVTHATTHEFEIS�CONSTRUCTIONLENDWOACENCY TT�/ ! _ �� � � � Z FORTME GERiORMANCE OF7HE YlORK FOR WMIp17N15 YERMIT IS ISSUEO(SEF JOG7,CIV.C.). ��' . W � LENOE1i5 NMIE , , � LENDFf75ADORE55 _ `� W IGENTIFlTHATIHAVENEADTHISINPLICATqN�NDSTATEiIUTTME+IBOVENFORGAT10NI5CDRFiECT. TOTAL FEES 3 �"� /r Z 1 MiREE TO C0IAPLY VATH ALL CfT`IMD COUNTy ORD WANLES ANO SiATE lAWS REUTIN6 TO BUILDIN6 /� � CONSTPUCTION.MIDHEREBYAUTMOflIZEREVRESENTATIVE50FTWSCOVHiYTOENTENUPON711E y� ' � S �,��-�//'/�j �_ � ABOVFJAENTIONED P110PERTY FOA INSPECTION PURPOSES. COMME�`ITS /��• � " ��� � `2—.�.--c ��—�'. �L.�J � m PERMI7TEENAME�PWNn /� , • N .'_'`� /�"L—� �—�c—�'"' y 816NATURGOFPERW D TE � RECPT.NO._ • PAID BY ' VAtJDATION WHITE—Department Copy,YELLOW—Finence Copy,PINK—Aesesaor Copy,GOLDENROD—File Copy,GREEN—Applicant's Capy ... ,. 9. . . p, ..,� „ � ... .. ,f�. , . . . , .. : . . • � .i � �. , �...f ,�•n� , -.. ... �i.rt.. , . r :.... . � . , . . .,.. .., . . .... . .., ` �+ CITY OF DIAMOIrfD BAR , � , . r .' . . . . - ...�� .. . It�DSPECTlON RECORQ �. : � : , y, � �,��.t�i�.�;�� ���.���� ���1� � �` .l`,,.�-,`�. ��� : � ' i,1►v��R���`�����_..,. � ";� •�` �SET.BACK , • � ... _ � ` ' ., � FLOOR JOIST " ;FfGS/FORM5/STEEt � FHA REQMTS � ' -' _ . ' �ELEC7RIC GROUND . . ' :_� � :-=•i , . UNDER FLOOR DUCT - _. ! -• iGROUND PLUM�ING UNDER FLOOR CUt�IQUIT ' '-' ' ' � `'' "� . i `�� . , ,. ---- . SLAB GRADE . '' - - . . : FIREPLACE FOUNDATION -, : �,� , , � ' ��-� � � i ,-.� 'TEMP POWER - - FIREPLACE BOND BEAM � ' , • � '• ,-, . , ; ' 'WATER SERVICE - -- ' MID HT.BOND BEAM - � �- �` �� ` � • I � ' :ROOF SHEATHING . , '�...;; �,�� S F� BOND BEAM ' • � = �.' ' : ' � , ;FRAMINGNENTILIATIOlV �' � � t• � FINAL'BOND BEAM ' �' � � � ` '' ROOF COVER �' �� PRE-GRADINCa � • -"` ` � , —� . . . . . . ROUGH HEATiNG � ' BENCHING.. , �� ' ' ' • ' � �� ,� �.- , ,ROUGH PLUMB NG I, / �. I .� ' - ' - -. FION SH G AD�I QG . _. .. . _ --- -- .-. -- i � � � .' �SHOWEFi�I'UB TEST ' -- � - s POOL'ELECTRIC �EXT.IATH/SIDING � - --- - - - POOL'�FENCING ' ` , ; • !WALL INSULATION � -- - - � , �POOL FINAL , !CEILING INSULATION � � -', ; OFF SITE IMPS. , -- :DRYWALL NAILING- i � � " _. __ ' DEDICATIONS � ;SEWER. , � I... • . .�INAL ENG. ,. , � . - �SEPTICTANK . ` U4NDSCAPEIIRRIG. " . SEEP PITlLL . � ' ` . ' •ON SITE IMPS. • - . �GAS AIR TEST ' �INAL ZONING , ! �-, ;FINAL CONST. •• --' ���� � FIRE DEPT. FINAL . � � ;. 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