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HomeMy WebLinkAbout16452 �� CITY OF DIAMOND BAR - DEPARTMENT OF COMMiJNITY 8r.DEVELOPMENT SERVICES 2i�o E.c���y nr;��s�c�i90 � PRESS (909)8643195 Fax(909)861-3117 . . '����� BUQ.DING PERMIT APPLICATION FIRMLY } JOBSITE ��p� ��S�};�.,,,5 Dr. APPLICATION O PERMR 6 o ADDRESS --� DATE NUMBER li � . ISSUE TYPE OCC APN ' LOT TRACT DATE CONST. GROUP p OWNER N N O � ADDRESS 4Q- �a 20NING SEBACKS LL' CITY ZI�P�0 �D TEL.1 � REART RW Oa � APPLICANT �tIJ WHN t'7tt TEL. -� SIDE/SIDESTREET RW O � CONTRACTOR SIDE ❑ g ADDRESS `• CITY ZIP TEL PROPOSED USE , ^ . ID � ARCH/ENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER DECLARATION SFRlADD/REM O Q 1 HEREBY AFFlRM UPDER VENALTY OF PEMJffY iHAT I Nd E%EMPT FROA/711E CONTMCTOfiS L4 .GarggB�C21yOK � W CEHSEUWPoHiHEFOLLOWWOREA50NISEG7IXi1.68U5WES5AHDVROFE5510N5CWEANYCRYOq (n l.� COUNtYwHCHREd11RESAGER►IR7000NSTRUCT.ALiFRMPROVE,DEAqUSN,ORREPA1R/vVYSTAUG W patiolDOCk� ZTUpE,VpqR TO RS ISSUANCE,ALSO REOUIRES THE 11F7Li('.AM FOR SUC11 PERMIT TO GIIE A SI(3NED . w � STATEMENT TINT HE OR SNE S LICENSEO VURSUANT TO THE PROVI510N5 OF TNE CONTMCTORS l4 � CENSE UW(GiAPiER 0(COMMENCQlO N'ITH SECTION 7D00)OF DNLSION 1 OF TME BUSMESS ANO OR0. � PooVSpa iE55qN5 CODEJ OH TNAT HE OR SHE IS D(EIAPi TMEREFROAI INO TNE BASIS FOR TNE ALLECED EXEMP- 710N.ANYVIOLATIONOFSECTION7W1.68Y/NYAPPLILNffFORAiERMIT5UB1ECT5THEMPLICINTTO Z qe�Roo1 �„_, ACMLPENAlTYOFNOTMORETHANFIVEHUNDREUDOIURS(15aa).r J � OlASOVMEROFTNEVR07ERTY,ORMYE�PL0YEE51MTHWAGESASTHEIR50lECOMPENSATK»I, � COmmBfClel - YAll00 THE WOWC,AND iHE STRUCTl1RE IS H0T INTENOED Oli OFFERED FOR SALE(SEC.701t,BUSI• J NESS AND VROFESSIONS COOE:TME COHTRACT00.4lICENSE LAW OOES NOTA7PLY TO AN OWNER OF N PROPERTYMT/OBV0.DSORIMPROVESiNEREd4/NDMh10DOE55UC1/WONKMIMSELFORHERSEIfOR � � (L 7HROU6HHISORHERONNEMPIOYEES,PROVIDEDTMATSUCHWPROVEMEMSMENOTMENDEDOR m � ,OFfEREDfORSALEW.NOWEVER7NE8ULDIN00FiMPROYEMINTI550lDYATHMONEYEAROFCOMPLE� Z TION.TME OWMER�BURDER YVILL MAVE 71�E BUi1DEN OF PNDVPIO h1AT HE OR SME OiD NOT BVttD OR � WPROVEFORTHEPURPOSEOFSALE� � OLASOWNEROfTHEPROPERTY.MIIXCLUSNELYCANTRACTP70WRHL10EN5mCONiMCTOR3 TO CDNSTIi1CT THE VRQIECT(SEG TOM.BUS�NESS AND PPOFESSIONS CODE THE OOflfMCTORS ll• �VdIU21I0f1 ADJ.AREA CENSf UW DOES NOT MPLY TOAN ONMER OF A PfiOPERTY WMO BUMS OR IMPpOVE51f1ERE0N.AND .Z NTfpCONTRACTSFORSUCHPRQIECTSWITHACOMiUCTOR(5)LMENSED�URSUANTTOMECONfMG QUANTITY DESCRIPTION FEE. �� 7t�fiS UCQISE UW.j.', 1,� � O I MI E7(EMPT UNOER SEG B.i V.C.FOR THtS REASON U O _ M � � LL' DATE OWNER �"' � . � ,, W � f ' �1 ._. . UCENSED COMRACTOfiS DECLARATION -� � W � INEREBVAFi1RMUNDERPEWLLTYOFiER1URYi11AT1AMLICEN5E0UN0ERPROVISiONSOFCIMPTER Ur � s �(COMAENCwOYAMSECTIDN70oo)OFOMSION70FTHEBUSINESSANOVROFESSqNSCODE,AND Z X W LICENSE IS N FULL FOHCE AN�EFFECT. m llJ � � UCENSE CUSS IIC.NO. J V p�rE cor+rancroR a w � � � WOFKERS'COMPENSATION DECLAMTION -� U � IHEREBYAFVIRAIUTAERGENALTYOFVE0.1l1R'�ONEOFTHEFOLLOYlINCDECLARATIONS: � Z Q � �IINYEANDMALLMAINTNNACEfITIFICATEOFCON5E71TTO5ELF•INSUREFOHWORKERS' S COARENSATqN,ASPROVi�EDBYSEC710NT7WOFTNEUBOHLOOE.FORiHEPEHFORMMICE W OF THE NroP1C FOR WMltll THiS iER1AtT IS ISSUEO. .� 0 �I HAVEAND WILL MAMTMH WORKERS CO1dPEN5AT10N INSURANCE,AS NEOU�RED BV SECTION � Q �7000FTHE4BORCODE.FORTHEPERFORMMICEOFTMEWORKFORYhtIp1THI5VERMtT15 i 65UE�.WWORKEASCOAIPENSATIONINSURANCECARRIERIWDV0.iCYM1AIBENME: CONSTRUCTION . 11 j uwniEa PLAN REVIEW � � ra�er�ueEa ELECTRIC { � (TNsSEciqr�INEIDNotBE00�.RETEDOFTEPEWR16idtON[M�D�00.3A�6��1��s1 PLUMBING Z �CEqiIFY 7NAT RITHf GERFORMANCE OF THE WORK FOR VMICH TF115 PERIAR IS ISSUED,1 MECHANICAL � (,�' SHALLNDTFYPLOYANVVERSONNANVMANN[q50A5T08ECOMESUBJECTTOTHE N WORKERS'COM�VENuATqNUM50FCALIFORlLA�NDACREETUTIFISMOUItIBECOAIE INSPECTIONFEE • � 5'JB.1ECTiOTHEMIORKERS'COMPENSA710NPROVISqNSOFSECTION�70o0FMEUBOH ISSUANCE COOE.1 SM�il FOR71MA7N GOMPLY YATH h105E PROY510N5. O ' SMIP p DATE: �� APPLICANT: � � WMNIN�:FAILURE TO SECURE WORICERS'CAMPENSATION COVERADE IS VAUWFUL.AND S�ULLBE ENERGY P�C SUBJECfANEMPLOYERTOCR:MWKPENKTIESANOCMlFNESUPTOONENUNDREDT110U5AND ENERCaYPERMIT pOUAFiS(f t00,00D�,IN ADDITION TO7HE COST OF COMCENSATION,OMV�OES AS PFtOV1�ED FIXi IN J SECTqN]10EOFTHEU80RCOOE,INTEREST.AN�A7TORNEYSFEES. RETENTIONFEE: � � a , CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEPfBVAiFlRMUNDERVENALTYOfCEfiR1RYTHATTMERE15ACON5TRUCTIONIENDMOAGENCY FOR THE PERFOMIANCE OF TNE WORK FOfi WMICN TMiS VERMIT�5155UE0(SEC.70Y7.CIV.G1. � � � LENDER'S NM1E � LENDEH'SADDRE55 - ��r � ICERTIFVTHATIHAVEREADTHISMPLIGTIONANDST�TETHAT7HEABOVEINFORAIATIONISCORRECT. TOTAL FEES \ d IAGFiEETOCOMPLYN1THALLCITYANDCIXINT/ORDIwWCE5AND57ATEUwSPELA7x�OTO0U4D�N0 � ' � �, 1 �' CONSZRUCTION.AhOHEHEBYAUT}qRREREGRESEN7ATNE50i7MISCOVNTYTOENTERUPONTME 1 Aw AI nO. � S� ABOV�l.�EMIONEOVHOVERTYf-0RINSVECTION7URPOSES. COM NTS v�,t�v�, _ � Hw oH m PERM�,EE NAME(CRt lr�� D 4 v—/ � � �� �� y NA7UREOFPERM EE �TE RECPLNO. PAIOBY VALIDATION ~ , WHITE—Oepartment Copy,YELLOW��ence Copy,PINK—Aasessa Copy,GOLDENRO�FIe Copy,GREEN—Applicant's Copy .. , , - . � . , � + . . . � . . . . . • . �.•. . . .. . . � . ,. ._ . -. .. . � CITY OF DIAMOND BAR ; �,�:.:��. , ,.:INSPECTIO(� RECORD '; .� � -. . . .; � � i�'i1���1:��.��:R'1��� '.oJ'�9�` �l►`��;��:�":F�e�� ���1►�.�:�.��ilsCe�"�g+ - :e�'��?=� �(►`�-`��►�c��`ol;:� ;SET BACK �i - -�� � � �`•, ';-� , , . � FLOOR J015T ...,_._......�.�I - (,u,��...�,;;__�.._.,..�:.._.... i i . . ,, ... , , , _. ;FTGS/FORMS/STEEL - - '` :„ , - � FHA REQMTS _ _. _ _ _ � ' • ' ;ELECTRIC GROtJND_ _ _ .. � - . -._ _ UNDER FLOOR DUCT , � , ! ; ' ' ,'GROUND PLUMBING UNDER FLOOR dP�l0U1T �;� � :'�' � _. ' • " ' _ ' _..._-- �SLAB GRADE - ' - - -- --- - - ' FIREPLACE F�UNQATION �_r- ,-:�• � : .. ;•.1,:'� � � ----- 'TEMPPOWER - -.;� - : .. FIREPLA�EBO�lO�BEAh7 �� ' ' '`'. ", ��,�-= . ,� ; �WATER SERVICE - - - - - - MID HT. BOND BEAM � :ROOF.SHEATHING I � � ` �� � � - -- - � ' � - � � 8 FT. BOND BEAM i FRAMiNGiVENTILIATION ' ' -- �' ' • �` � FINAL'BOND BEAM ! ' iROOF COVER , "� PRE-GRADING ,ROtJGH HEATING -: - - - " - � BENCHING • ROUGN'EL�CTRIC _ _._ / D _ ', _ AOUGH GRADING -- --'. !R�UGH PLUMBlNG - - - �� - - - - - -� - FINISH GRADING ! � SH��"JER,TUB TEST ' -- - • -- - -� POOL ELECTRIC : ;E�.'T. LF,TH!SID(NG - — ----- = -- -- - ; - - POOLFENCING , ` ! 'WALL tNSULATiON- -- - - - - - - -- - POOL FINAL � �CEILiNG itdSULATI�N - - �FF SITE IMPS. DRYWALL NA1LIPdG - - � -- ' " DEDICATIONS , ; ;SEWER - - - _ FINAL'ENG. !.SEPTIC TANK � LANDSCAPE/IRRIG. ' iSEEP PiT/LL. _ ON SITE IMPS. � MCAS F�IR TEST FINAL'ZONING � � �FINAL CQNST... __ ��� `�- 1 .��..�'.1 '�!I FIRE DEPT. FINAL ' �. F1NF�.L HEATWG_ _ �"• �-��.' i:; %_ c.+'� HEALTH DEPT. FINAL f - ,:"=l+Jt.�ELECTRIC - ���j� . - - DEV. FEES PAiD _ ;�i="•ln.L PLUMBING - ENERGY � , . � _ ��-T- _----� -- I - - � - --- -- - - ----�._..y�.------------ -�-�------ � �,c,-�RI'•�'I.r �'�r;�t: I � �:L_ . _ �. .. .. , - -- - -._ - - - !1COt�1MENTS : -- - , , -- - - , � �-- _ -- - , � . , ; , ; .. - . � � - . � . _ - -- - -- -- _ - -� , _"! _ �� i , . � -- : , , i � � . � ._ - � _ . '�. ' ; - ; . + .; �SEPTIC TANK SIZE. �`._.. �.�.���� ' ; ; 'SEEP PIT/U SIZE _ ��N j ; , i - ; - , ! ,,rAr�. . I��- - - - - _ _ I I, ; \� , y _� �) � , • i . . , I ` -__._- I ' ' I ' y � i - _ ' � ' ' .. . '' • I r. ,. ' . �I '�.��..+.. �.�r�.r� • - Y \. 1 - - - `� � .� _ - , , � ` '