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�� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SER\'ICES ,,� . 21660 E.Copley Drive Suite 190 ' (909)860-3195 Fax(909)861-3117 PRE$$ '���^' BUII.DING PERMIT APPLICATION • . FIRMLY } JOBSRE �1 O �S' �'D��Q+1 S�jie� � APPLICATION/'�'`I /�C, n PERMIT (� P/C �j'� o ADDRESS 1 �'� � DATE "% 6 1 NUMBER L U / ��� � APN LOT TRA T , ISSUE TYPE OCC DATE CONST.�� GROUP � OWNER �C aN41,0� ` V ' ! "�' AODRESS i � ►.� c5 ZONING SETE3ACKS �u' CITY ZIP TEL. R�RT RW ❑� APPUCANT �1.^—� '!� TEL���� SIDFJSIDE STREET Rw p � CONTRACT P+ �. SIDE ❑ � ADDR SS '��"� �� PROPOSED USE S�rJST11 Ll... J Fee.e�.�.� �r�_, CITY ►� � ZIP� TE � � � ARCH/ENG! DESIGNEFI N0.DWEL �l0. NO. ? CQDRESS ZIP TEL. UNITS STORIES BEDROOMS N rn DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION I SFRIADDhiEM O � I HEREBYAFFlRM UNDER iEN1LL1Y OF PERAIRY TIUT 1 MI E7(EAIPT FqOM 7HE GONTMCiORSIY GBf8190IC81p011 C£NSEUWFOqiHEFOLLOWlI�RE1lSON(SEC.70.71.68USMEYSANDP(ixES510NSCODE:ANVCITYOR (n OOUHTYWH�OIREWINESAiEHMRTOGONSTRUGLALTERMPROVE.DEAqUSM.ORREPAIRMlYSTRUP W P81101DBCk 7UAE,VRIDR TO RS ISSUANCE,A150 R[OUIP[S THE MttiCAtlT FOR SUCH VERMIT TO fllE 11 SICNE� � ETAiEMENT TTWT HE OFi 5ME LS UC£NSEO PURSUANT TO THE PROVISIONS OF TIE CONTMCTORS LL � CENSE UW�CFU7TER Y(COMMENCNO YIITH SECTqN 70oa)Of'DMSION]OF THE BUSINESSl1ND PHO- LL POOUSpe iESSIONS COOE�OR TIUT NE OR SHE IS E%E4PT THEREfROM AND iNE BA515 FOH 7HEALLEOED E%EA1P- T10N.ANYViOIATqNOf5EGT10N7o71.60YANVA7PLIGMlTFOR�PERMITSUBJECTSiHEl1PPUGWTTO Z pe-Raol � ACMLVENALTYOFNOiMOqEiHANiNEHUNOREDDOLLAR5�f500).)� i � OlIlS01M1EROFiNEPROPERTY,OiiMVEMPIOVEESWITHWACESAS7NEIqSOLECOMPENSATpN, � COtI1rtIBfCWI . � WILL DO THE M'ORIC AN�iME STRUCTURE IS NDT MlTENDED Oii OFFERE�FOH SALE(SEC.loN,BU51• J NE531UlD VROFESSIONS COOE:TNE CONTiUCTOR4 LICENSE LAW DOES NOT APVLY TO AN OWNER OF ? � VHOiERT'fWfbBUKDSORMPROYESTIEREON.ANDMA1000E5SUCHWORKHIMSELFORNEfiSELFOR Q 7Nq0UGH1ASORHEHOWNFlAPLOYEES,VR�N�E�THATSl1(]IWPHOVEAIEMSARENOTWTENDEDOH m � ,OF'FEREDiORS�LE6,lIOWEVER�BU�ID�NGORMPi10VEMEMIS'YLIWITHINONEYEAROFCOMPLE- � TqN,h1E OYMER�UIIDEq YALL MAVE TitE BUNDEN OF PROVPlO THAT ME Oq SME DIO NOT BUILp OH W PW�VE FOp THE VURPOSE OF SALE1. w OI.A90WNEROFTIEGROPEHfY,AME%CLUSNELVCONiMCTINON1THUCENSEACONTitACTORS � TO CONSiilUCf TME PfiOJECT(SEC.7D41,BUSINE55 MO PPAF[SSIONS COOE:!NE COlRMCTORS LI• V81U91IIX1 ADJ.AREA � CENSEUWDOESNOTADPLYTOANOVMEROFAPROPERTYNMOBUILDSORMPROKSTHEREON,AND MAqCOMRACTSFORSUqIFROJEL?SWITIACONiiUCTOR(S)UCENSEDPUFtSUMfiTOTMECUliRAG pUANTITY� DESCRIPTION FEE � TORS UCENSEUW�. . . . . . , ' ❑IAMIXE4PTUNDEASEG B.iG.GFORTHISPEA50N U ; �� l a n1 f' �,r LL' DATE OVMEA � � ^� � � UCENSEO CONTRACTORS DECLARATION , W � IHEREBYAFFIitlAUN�ERPENALTYOFPE0.IURYTNATIMILICCNSEDUNDERPROVI510NSOFCHAPTER �, , . , s �ICOMMENCNOVATHSEMqN7ooa)OFOMSION90FTHEBUSINESSANOPROFESSIONSCOOE.AND Z W LICENSE 4"W Rll iORCE NA EFFECL � � �{' i � � LICENSE CLASS � J UC.NO. �� �+ � - � � � �j DATE p CONTMCTOR� ' d W � WORKERS'CAMPENSATION DECLARAT N Q � IHEREBY�FFWMUNDERPEWILNOFPERNNVCM[OFTHEFOLLOW1N60ECLMATIONS�, � .1 Z �� _ � ; r�. � ,� , �. . .. � . . . . .��. ;, . . 4 � �INAVEMIDWILLMAINTAINACEHTIFlCA7EOFGONSENTTOSELFaNSUREFORYARICERS" � _ ' , ' � � � � � � , , �� .• . � � OOMPEN3AT10N.ASPROVIDEDBYSECTION77DOOFiNEUDORLOOE.FORTHEiERFORYUJCE W p OFTHEWOAKFOpWMICHTMSPERMITI5155UE0. ' � "` ,� '. � (Fy� �_I NAVE AND WILLMAINTAPI WORKERi'COMPENSATION INSURu1tE,AS REOUIRED BY SECTION \( Q 77oo0FTNEL/�BORCODE.FORfHEVERiOq11ANCEOFTHEWON(fORWNid/TNtSPERA11T15 , �' . ... � . , � ,' ISSUED.MYWOFlKEAS'COh��ENSATIONINSUMNCECARR1�IlNOPOLICYNUMBERME�. CONSTRUCTION • � CMRIEII� -t-���t. �-� PLANREVIEW � 7QICYMIMBER �p����_ /J ELECTRIC , � pp (tt�sSEcrcxN[�NoiBEm.sl£�IDOF71[FEaMi6cnAa2H..lDi1���Ju��tE55} PLUMDING Y•• � ICEHT1fYTU7MITHEiFRFORIAANCEOfTHEWORKfORVMItl1THI57ERMRlSIS5llE41 MECHANICAL .� 6�ULLNOT EMPLOYIM'pER50N W AN'I MANNER SO AS TO BECOME SUBJECT TO THE rr ,J J � NOPo(EHS'LOMPENS�TqNUW50iGLLIFORNII�ANpAOREETNATIFISNOULOBECOME INSPECTIONFEE ��y,}� 6UOJECTTOTHEWORKERS'COIAPENSAT FPAVISq OFSEMqN]1000FTHEUDOq J1�' � - �at•��`� � cooe, sruu onrnwimca�r�rwm+ asevaa s. ISSUANC[ ��?'•� o �� � SMIP � �: L`r9„_- 'i�� • � lJ� OAiE: APPLICANT: � w � ENEFGY P!C t r�` . " ��" � WIUWiNO:FNLURETOSEGUREWORI(ERSGOIAO ATIONCOVEMGEISUNLAWFl1L,AND3HAlLBE �y 6UBJECTIWEAIPLOVERTOCRtuIN11PENAL71E5AN�CMLFWESl1VTO0NEHUNDREOTFIDUSANO ENEFGYPERMIT DOLURS(i to0,0ao�,M ADDITION 70 T1E COST OF COMPENS�TqN,OAYAGES AS PRWIDED FOR IN � SECTION J70!OF THE UBOR WOE,WTERE57,M1D A7TORNEY'S FEES. � RETENTION FEE: � a CONSTRUCTION LENDING AGENCY �' �� � PRE-ALT FEE: o r � INER[BYAFFlREIUNDEHPENALTYOFVEfiNNYTW�TTNEHEISACONSTNUCTIONLENDINOAOENCY � � FOHTHE i[RfONMANCE OF THE WOiU(iOR N71N71 iN15 VERMIT IS ISSUED(SEG�oY7,CN C.). . � � LENOERSNAME � - C IENDER5A00RE35 � IAOREETocb�iivwn aiu�m"'�ooTur1DN+NORDST�NMlCESANDSTA�T UWSRREIATWa'TOBVILDIN6 TOTAL FEES �-���-- � CONSTflUCfION.ANO MEREBY 11UTIqHRE REPRESENTATNES OF THIS COUNtt 10 ENTEfl UPON TME Z �BOVE�AIENTIONEDVHO�ERTYFORINSOERIONPURPOSfS. , ,,,�,,,,E„�„ . �Y Q �;M IV}J '' �./� ' �.�r•'-5 � i . .. � � PERMITf .NMIE(PRl A i � � � s EE oe � , RECPL NO. F�AID BY � VAU�ATION � WMITE—Departmenl Gopy,YELLOW--Flnence Copy,PINK—Assessor Copy,GOLDENHOD—File Copy,GREEN—/1pplicanCs Copy '.r. , . . �... .+ ,.+�� 't' . y r..'t� f: ��`v� . . , �d)�� �. "-4�.�nr"r.�a�r���.•r. � .�. •�.r„�,_:..�• :.. ,�i..�,,.w�•, � . . . � .. . !'S�� ti ,..1 , . . � . .. . .��t.,f.. :r ... . . .� . . � CITY OF DIAfInOND BAR % �'�. it�lSPECTION REC(7RD . . �. *�.������' o t'� 11 ' ° �1►��-.�..�..�:•..l.e '' ._� � :, �� I�►!��y�4F?1���� � ,SET BACK� �• � � � �� FLOOR J015T - ;•,.- �, �� '�_ 'FTGS/FORMS/STEEL, ", `j ' /1 ` ' � FHA REQMTS � ' - " �' _ ,ELECTRIC GROUNQ'_-'' � UNDER FLOOR DUCT � ' • • • 'GROUND PLUMBING � UNDER FLOQB,COhIDUIT' �� ', -. . �- � � - SLAB GRADE ' ' ' FIREPLACE FOUNDATION ' �,�^ �TEMP POWER FIRERLF�G�E'BOND'BEAM •-�'�' ' -' � a - ' WATER SERVICE MID HT. BdND B�At�f =. �' �" � " " ;�= '-�`� ,:�'. : ; i ; R�OF SHEATHING •,,`i� � _ �� r. � t;_. 8 FT.80ND BEAM' ' �.,`•' . • ' ' �FRAI�IINGNEN7ILIATION FINALgONDBEAM � ��� � ' � � ROOF COVF_R PRE-GRADING ' ' ROUGH HEATiNG BENCNING �ROUGH ELECTRIC ROUGH GRADING � - - �` --` '�ROUGH PWMBING FINISH GRADING �SHOWERli'UB TEST ' - POOL ELECTRIC ;EXT:LATN/SIDING � -- POOL FENCING WALL INSULATION ' PO�L FINAL CEiLING INSUL"ATION � OFF SITE IMPS. ' �DRYII'JALL NAILING - DEDICATIONS SEWER � _ - FINAL ENG. , lSEPTIC TANK ! LANDSCAPEIIARIG. • SEEP PIT/L.L. , ";��i ON SITE IMPS. • GF�S AIR TEST : FINAL ZOPJING ' ' 'FINAL.CONST. `� 3 .�2 FIRE DEPT. FINAL � ; �FI�IAL'NEATING . _'. � _ : � _' : HEAL7H DEPT. FINAL FINAL'EL•ECTRIC ' '. • � � � DEV. FEES PAID - 'Flh1At PLUMBING ENERGY �:— . -- ':.il.�xl:C •'y2��.Qot'es':. ��....:i ' '�� '-' --- "'' — } _ .. ._...._ . _... .. , _ .._.------»__._.. _ . . _ _._. .-- .: � ' -` -- - - - i � � ,COMP,�ENTS � �� � .i ����g <5g : l% . �' �,'�..l��fa/`'n �.—��nl��,� •� ��, � � � �� o � � ��.-��-�o���-�-��-a/�� —1-�n��.o -%—,/-�.^��-c�=�l� .� , , �' t G / ��. ' (- �: �. �� � � .��„�\ � 'l <i � � .`.' 1 • �`' , .- , , i` . . � , tJ�:`111.. 1 ' ti 1, . . . . '. � { � '�� ��. � � , . � _ �, 1 � +i .. , � ; �1` ._-_ 'SEPTIC TANK SIZE . ., � � , . , •.SEEP,PIT/U SIZE , , ,������ . i� �' ;t' �R ;j 1 � • i, :'ti ,y, a . , � ��.�I�� :�.c,I � . .. �� : %��.�` �=�.; ' _ ',�� � ,�I , . , . - � _ � i ';� � j `� . � . . , , . . �� . � .�.:.,�' ...,..�...... _�....� , � ���. .�' ,�'\. � � � , �