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HomeMy WebLinkAbout10878 .____ __.--- �__.-----_.. ._ .__.. _ .__.. _. . _... --..--.-.---- r- - ----- ----...---.-•. - CITY OF DIAMOND BAR COMMUNTTY DEVELOPAtENT DEPARTMENT ,,.� . 21660 E.Copley Drive Suite 190 � PRESS (909)8643195 Fax(909)661-3117 " 4'""'� BUILDING PERMIT APPLICATION FI RM LY o AD Ri SS���5 I C1 tl��Qil ���►'19 S �r � DATE CATION � Z� �7.NUMB R o0� � N�� � APN LOT TRACT ISSUE TYPE OCC p OWNE�� �'Y S ' DATE CONST. GROUP wADDRESS 2 1 1 Ol C�/� �ir�'n r � ZONING SETBACKS � CITY�1�0�1 �� ZIP C� TEL FROPIT • � RW ❑ � APPLICANT TEL. REAR � ❑ SIDFJSIDE STREL-T RW O � CONTRACTOR i5 � S . SIDE ❑ ADDR�SS 0. � PROPOSEDUSE 00 " �O - � CITY I C V 0. ZIP TEL. o ARCH/ENG! z� DESIGNER NO.OWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCFi1PTION SO.FI: FACTOR PSF ADJ.AREANALUATION p� OWNER-B�ILDER DECLARATION SFR/A�D/FtEAA ' O p 1 NEREBV AFFlRAI IMDER PENALTV OF FERJURY THAT 1 MI EXEUPT FROIA iHE CONTMCTORS LI• GE�aQO/CdryOrt � � W CENSEUwFORTHEFOl10WttJCRE0.50N(SEGfa71.68USINE55ANDVPOFE55lON5CO0E:ANYtl7YOR (n U CpUNTyWH1p1qEOUqE511VENA?TOCONSTRUCf,ALTE0.�PiqVE.DfuOLISH,ORREVAIRANYSTRUG W P8Ii0IDBd( � � TURE,PH10R TO RS ISSUMlCE.ILLSO REWIRES 1HE APVLICN7T FOR SUC}1 PEPoAIT TO FILE A SIGNED W � STATEMENT T1AT HE Oil SHE t9 LICENSED PUHSUM7T TO iHE FROVISIONS OF THE CONTMCTOR4 L4 � . � GENSE Uw(CHAPTEH 9(LdAA1ENCH6 WITH SELTION 7000)OFpIVI510N]OF 7HE BUSiNE55 ANO PRO� POOVSpB Z. FESSIONS OOOE�OR T1U7 HE OR 511E IS EIIEMPT TIEREFfpM M10 Ti1E BA515 FOR TME ALlEGEO E7(EMP• � TION.ANYVIOLATIONOFSECTION70�1.6BYANYAPPLICMITFORAGERMITSU&lECTSTHE11PPlICANTTO Z Flg-R001 �� � A dVIL VENAITY OF NOT A10RE THAN FNE HUNDREO O011MS(f 500).k 0 Ol�C1AR.IEROFTHEPROPERTY.OiiWEMPLOVEESWITHWAGESASTMEIR50lECO/APENSA710N, O COf1�111BfC1.1I Z WILL DO THE WORK IWO iHE 6TRUCTURE IS NOT WiENDED OR OiFERED FOfi 6ALE(SEC.)Oat BU54 J N HESSAND PROFESSIONS CODE THE CONTAAGTOHS LICENSE UW DOES NOT APPLV TO AN OVMER OF ? . � PROiERTY W1q BUM1DS OR u1VROVESTMEREON,AND MAW DOES SUC11 WDRK H�MSELF OR HERSEIF OR � Q THROURMNISORHEROWNEMFLDYEES,VROVOEOiNA75U011MPROV[YEMSMLNOTNTENDEDOR m � OFfEREDfORSALE.IF.FIOWEVERIMEBUIDINGORUAGHDVEYENTI550lDN7THMONEYFAROFOdAiIE• � Z TION.THE OVMER�Bl11LDEN WILL HAVE THE BUROEN Oi PROVINO iwU ME OR SME DI�NOT BUtl-0 OF � WPROVEFOR711EVURVOSEOFSALE} �y,� OtA50NTlEHOFTHEVROPEitiY.M1E%CIUSNELYCONTMCTNOK'ITHIICENSEDCOffTMCTOHS � TO CONSiRUGT THE ORQIECT(SEC.70�t,BUSiNE55 ANO OROFESSIONS CODE THE CONTRACTORS LI• V8IU8IIOf1 A0.1.AREA - L11 GENSEUw00E5NOTMPIYTOANOYMEROFAPHOPERTYW1iOBU1LDSORUAPROVES111ERE0N.AN0 � YnqGOMMCTSfOHSUpIPR0.1ECT5WITHACONTRACTOR(5)LICENSE'JiUHSUANTTOiF1ECOHiMG OUANTITY DESCRIPTION FEE � TORS LICENSE UW.� . . .. . � OIAl1FXEYPTUNDERSEG B.tP.C.FORTHISREASdJ Q l'. U � ¢ i ✓O , 1 DATE OWNER V . Z W � LICENSEDCONTRACTORSDECLAAATION " W • � INEHEBYAFFIitlAUNDERPENALTYOFPE0.RIRYTMATIA4LICENSEDUNOfRPROVISIONSOFCHMTFR Vr ...� d 0�COMMENCN6 WRH SECTqN)000�OF ONISION]OF THE BUSINE53 Ah9 iROFES510NS COOE,AfA Z X IAY LIGENSE IS W FULL FORGE AND EFFEGL m � S , � � UCENSE SS LIC.NO. 2' �� U j p. / V DATE Z 6 CONTRACTOR �S$i 0 I% S a �`�— W � � �WORKERS'COMPENSATIONDECLAFiAT10N 1Z�` � 4 � INEREBVAFFliWWDEROENALTYOFPERRIRYONEOGTHEiOUAVANGDECU{UT�ONS: Z �f/ �(� �/ ./D �v � _INAVE/�NON'iLLAIAINTAINACERTIFlCATEOFCONSEHTTOSElHNSUREFORWORNERS' � 2 � Z) �/,� �. IO CpAGENSATqN,ASPROYIDEDBVSECTqN770aOFTHELA80RC00E,FORiHEPEf1FOM1ANCE W Q OF TlIE WORK FOR WHICII7NI5 GERMIT IS ISSUED. � � _IIUVEANDWILLYAWTNNWORKER5COMPENSATIONtNSURANCE,A3RE0U1RED8Y5ECTI0N 0 J7000F THE IABOR CODE.FOH THE VERFORMANCE OF THE YYOIiK fOR NR1IR1 THIS GERIAITIS �1 LSSUED.MYVK]RKERS'fJ,�/I0 N ATIONINSl1RANCEGRRIEIiANDVOLICYNUMBENARE: CONSTRUCTION J� •3� . j CARRIER ���� LAN REVIE � vaicruuueca ELECTRIC � fl• ?S ¢ ^ � (ntSSECt�oNlEmwTBE00AftE'tmoFnEP6MtsinRa+EtllloREDoa1�luR+oclaqtF55� PLUMBING Z�_`ir Z I CERTIFYTHAT W 7HE 7FRFORMMICE OF TNE WORK FOR WHidI TMS VERMIT IS ISSUED,l MECHANICAL {- .CY C7 S�uILNOTEMPLOYANNiER50NWANYAMNNERSOASTOBECOAIESUBJECTTOTME � WORKERS'GpApENSATqNUW50FCALIFORNiA+�NCrA(iREETMA7IFI5MOULDBECOML � INSPECTIONFEE � � SUBJECT TO TME M10R1(ERS'COMPENSATION PROVISIONS OF SECTION�700OF TH[IPBOR �, / � .O� O �cop isryuvoannnn�couttr�+nnrT sevarnnsaws. 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ROUGH HEATING - -'-� -' - -�' - ` BENCHING . . . , ..,; ' ROUGH ELECTRiC - - ��-�� ROUGH GRADING . . , : ... . .. . . . ... � : ROUGH PLUMBING - FINISH GRADING , . , i SHOWEFirTUB TEST •�;� c . . - �- - - POOL ELECTRIC ' ' , . ; EXT.LATH/SIDING � - ..1, . , --- - PO�L FENCING �Cry�..� Z �' f� : _ ' WALL INSULATION POOL FINAL �3,d��� I^ CEILING INSULATION OFF SITE Ir.1PS. f . � "-. DRYWALL NAILING DEDICATIONS . . ' • . . 1 SEWER . _ ' FINAL ENG. ' �- � , SEPTICTANK ' � " , ' LANDSCAPEIIRRIG. � SEEP PITlL.L_ ' __ - - . ON SITE IPr1PS. � ---- FINALZONING '"` ' GAS AIR TEST - � ; � __ ' � � FINF.GGbfV�T.- -�'';•�' ` '. � �1 -�»� ,'''- - FIRE DEPT. FINAL •,: � FINAL-HEAT'ING . . _. _ --- . HEALTH DEPT. FIP�AL - . __.. ..:.... _. -. . ._. . - � , FINAI�E4ECTRIC - .. � �� � DEV. FEES PAID: ., �., , , � FINAL-R UM ING �,� , � �� ''� � ENER.GY . � . ' . � �t� =�;.��1. \ �'Z•• i..T;��.� :?.��-5�-..e� � r _ � - -' . I _l.�_ �I'! C��'.�Jti��__ -• �--•• - � -- ._... .. _ _ .. - . . 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