Loading...
HomeMy WebLinkAbout17728 (39) T �� C1TY OF DIAMOND BAR � � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERV[CES ,��y 21825 E.Copley Drive (909)860-3I95 Fax(909)861-3117 PRESS "%�� BUILDINGPERhiITAPPLICATION FIRMLY � JOBSITE APPLICATION � PERMIT �J P/C o ADDRESS 7 n]�'7 �-��- rL ` DATE � � �� NUMBER� I� (i # � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER L " ADDRESS " ZONING SETBACKS gCITY ZI j��_ TEL. FRONT RW ❑ APPLICANT TEL. REAR ❑ � SIDE/SIDE STFiEET RW ❑ � CONTRACTOR SIDE p ADDRESS � o¢ PROP� CITY ZtP TEL ^ Z . o ARCHlENG/,A �1- � �� � DESIGNER +i-�,�y;L��T �2Aa^"�w .�ln�-- ADDRESS � NO.DWEL NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECIARATION SFF/ADO/REM O I HEREBV AFFlRM UNDER PENA�TY OF PERRIRY THAT I AM D(EMPT FROM THE CONTMCTORS LI- G3(299JC8�OR W CENSEUWFORTHEFOILOWWOREA50N(SEC.70.71.SBUSINESSIWDVROFESSIONSCODE:MIYCITYOR (n U CpUMyW1i1CHRE0UIRE5AVERMITTOCd1S7RUCf,ALTER�PROVE.DEA�OLISN,pqREPAWANYSTRUG W patiolDeck � TUPE,PHIDR TO RS LSSUANCE,/LL50 REOUIRES TME APPLICANT FOH SUCFI PERIAIT TO FILE A SIGNEO W STATEMENT TNAT HE OR SHE IS LICENSE�PUNSUANT TO THE VROVISIpIS OF THE CONTMCTOAS�I• � CENSE UW(d1APTER 0(CdAAIENCINO YATH 5ECTION T000)OF�IVISION l OF THE BUSWESS AN�PR0• LL' PoollSpa FESSIONSCOOE)ORTFUlHEONSHEISEXE4P7MEREFROMANDTHEBA5i5FORTHEALLE6EDEXEMP• (� � TION.ANYVIOLATIONOFSECTION70�7.5BYANVAPPLICANTFOHAPERMIiSUaIECTSTHEAPFLICANTTO z Re-Roo1 ACML pENALTV OF NO7 MORE THAN FIVE NUNDREO OOLUAS(f500�.): Z ❑4��EROFIHEPROPEqN.ORMVEAIPLOYEESYATNWAGESASTNEIRSOLECOIAPEN5A7qN, � COmrtlBfdal WILL DO TNE N'ORI(AND THE STRUCiURE IS NOT INTENDED OR OFFERED FOR SALE�SEG 70��,BUSi- J � � NESS Ml0 PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT AVPIV TO AN OWNEN OF � OROPERTY WI-10 BUROS OR IMVROVES TNEREON,ANO YMO OOES SUCH WORK HIMSELF OR HEHSEIF OR CC TMROUCHHISORHEROWNEMPIOVEES,VROVIDEDTHATSUCHMPROVEMENTSARENOTIMENDE00R C� QOfFERE0FOR5ALE1F,FqWEYEFITHEBULDINGORIMPROVEMENTI550LDNATMNONEYEAROFCAM7�E- Z T10N.7HE OWNER�BUMEH WILL HAVE TME 9UROEN OF PROVINO THAT HE OR SHE DIO NOi 9UILD OR � IMPROVEFOflTNEFURPOSEOFSALEF W ❑I,JISONMEROFTNEVROPEHiY.AME%CLUSIVEIYCONTMCTWGYAiMLICENSEDCONTMCTORS Q TO CONSTRUCf Ti[PRQIECT(SEG 701l,OUSMESS AND PROFESSIONS COD[:THE CON�MLTORS U- V81U8SIOf1 ADJ.AREA W CENSEIAWDOESNOTAPPLYTOMIDNTlEROFAPR07ERTYWHOBUILDSOFlIMPROVESiHEREON.AN7 F WFWCONfMCTSFORSUCHPPOIECTSWiT/ACANTMCTOA�S�IICENSCDPURSUAMTOTI[CONTMG OUANTITY DESCRIPTION FEE � TORSLICENSEUW.). � � ❑IAA1 EXEAIPTUNOEH SEC. B.6 P.C.FORTHIS REASDN Q 3 U ti. � UATE OWNER U � W �Q IICENSED CONTAACTORS DECIARATION W Cr IHEREBVIIFFIRMUNOERPENALTYOFPERNRYTHATIAMLICENSEDUNDEHPROVISIONSOFCHAVTER � � 9(COMMENCINOWITHSECTION7000jOFDIyI510N70FTHEBU5ME5SANOPROfE55lONSC00E.AND z �� W LICENSE LS IN FUIL FOPCE Ml�EFFECL m � UCENSECU55 LIC.NO. j ' V DAtE CONTMCiOR d W � WORKERS'COMPENSATION DECLARATION Q = U NIHEFlEBYIIFFIRMUNDERPENALTYOFPE0.IURYONEOFTMEFO�LO`MNGDECUMTqNS: Z � _�IHAVEMpVALL4AINTAINACERTIFlGTEOFCONSEMTOSELFJNSUREFORWORKERS' _ � COMPENSATION,ASPROVIDEDBYSECTiON37ooOFTHEUBORCODE,FORTHEPENFORMMICE W OF THE WORK FORV//11p1T111S PEN.�IT IS ISSUEO. � G ��IHAVEANDW4LMAINTNNWORKEqS'COMPENSA7qNIN5URANCE,ASREWiREDBYSECTqN �G�� '��� �� � Q 7TOOOFTY/EUIBORC00E.FORTHEVERFOAMMlCEOFTHEWORKFORYMICNTHISVEHMRIS ISSUED.MYWORKERS'COMPENSATIONINSURANCECARRIERANOVOIICYNUMBERARE: CONSTRUCTION d ] G1IRRIER PLAN REVIEW � POLICYNUTABER ELECTRIC � �MSSECiqNNEmNOTBEW.AEIIDOFMPEFMT6PoROhEHLt�DREDDR1Ili5RiW70qlESS) PLUMBING Z I CERTIFV 7HAT N THf OERFOqM�NCE OF THE KOPK iOR WHICH THIS PERuiT IS ISSUED.1 MECHANICAL C"} SHALLNOTEMPLOVANYpER50NMANYMANNER50A5TO8ECAMESUBJECTTOiHE � WOP1cER5'COAIPENSATION�AWSOFC.LLiFOfiNIA.AND�GREETHATIF151101A0BECOME INSPECTIONFEE SU&IECT TO 7ME WORKERS'COMPENS�TION GROYISIONS OF SECT�ON��00 OF TNE VBOR s cooE,�sw�u�oan�wi»+con�a�rwm�nasEvaowsior+s. ISSUANCE � SMIP p DATE: APPLICANT: J WARN�NC:FA0.URETOSECVREM/ORKERS'COMPENSATIDNCOVERA6E�SUNLAWFI/L,ANDSHALL9E ENEfiGYP/C �y, SUBJECTANEMPLOYERTOCRIMWALpENALTIESANOCMLFMESUPTOONENUNDHEDTHOUSAND ENERGYPERMIT D011AHS(f t00.00a).N MDITON TO7FIE C0.5T OF�OMPENSATqN.DAMAGES AS PROVIOEO FOfl M � SECTqN77o80FTHEU80RCODE,W7ERE5T.ANDATTONNEv'SFEES. RETENTIONFEE: '�'�.� a CONSTRUCTION LEND�NG AGENCY pRE-ALT FEE: O � IMEREBVAFFIRMUNOERPENi1LTYOfVERNRYTHATiMEREISACANSTRUCTIONLEHDMCAOENCY FORTME PERFpRA/ANCE OF T1E WORK FOR N11ICH 7NI5 PERAl1T IS ISSUED(SEC.7077.CIV.C.} Z W � LENDEN5NAAIE � LENDER'SADORE55 � ICERTIFVTMATIIUVEREADTH�SMPL�CATKKJANOS7ATETHATTME190VENFORMATqNISCAFRECL TOTALFEES �'�����IL t��� �QD � q IAGqEETOCOMPLYWITHALLGTYANOCWNTYORDINANCESMIDSTATEUWSREUTINOTOBUILDING � CONSTNUCTION.ANOMEREBVAUTMORIZEREPRESEHTATIVESOFTn15CWNTYTOENTERUPONTME Z ABOVE-MENTIONEOPROPERTYFORINSVECTqNOURPO5E5. COMMENTS O � � � DERMITTEENqAAF(N�M) Q � N � e ERM E' D�TE '� � RECPL NO._ _ _PAID BY VALIDATION y .. WHITE—DepartmentCopy.YELLOW—Finance Copy.PINK—Assessor Copy.GOLDENR File Copy.GREEN—Applicant's Copy - , . .. .,., .. i.�;;.':7.,'.:.�. . � ,�.:��.��..n. •�.,t ;x..t:�.sv�,::::'�b . r7` • u t r J �— �i"r..i ,,.,-,... .. _ . . . - ti �.�i. i � .. . ., . ._ , ' �.!....... .>. :t� �••l''. .:i�l'_.�..Ri:r:'.'� 'L.1s -.N..Y!:t '�M1i ' ^�'�'������ �• cir�' OF DIAt�t�f�+D B�,F3 RvSP�C i iON RECC3�D II►!�-'ia���!I'If�►'� °.�:,'�� =� '�I►�E�`l;�=t�:1'�1.� I►��-`��h�:!�lcl►�d ���t;n= �li'�-��-'�c�"�'�,a�� ' ________�_________�.____._-------.;... .___....�..-_--------.------ -.�_-.---...._.u..._----.�. ...__�_---.-.�__..__-------._.__________. __._ SET BACK • � � • � FLOOR J�IST . � , � I _� Fi'GS/FORMS/STEEL �, ' � FHA REQMTS ' ELECTRIC GROUND UNDER FLOOR D.UCT GROUND PLUMBING UNDER FLOOR CU�IDUIT ' SLAB GRADE FIREPLACE F�UNDA710N � - TEMP POWER FIREPLACE BOND BEAM WATER SERVICE � MID HT. BONQ BEAM • ' " • ROOF SHEATHING � II FT. BO�dD BEAM FRAMINGNENTILIATION � FINAL f30ND BEAM RO�F COVER PRc-GRADING ROUGH HEATING BENCHING � ' ` . ROUGH ELECTRIC ROUGH GRADING RDUGH PLUMBING FINISH GRADING SHOWERl1'UB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION PO�L FINAL � CEILING INSULATION OFF 51TE IMPS. ` DRYWALL PJAILING DEDICATIONS `Di� SEWER FINAL ENG. ¢,�6L SEP71C TANK LANDSCAPE/IRRIG. �1� SEEP PIT/L.L. ON SITE IP�1PS. � ������ GAS AIR TEST FINAL ZONING FINAL CONST. \� FIRE DEPT. FINAL �.,��7 jd'L FINAL HEATING \ _ HEALTH DEPY. FINAL � r FINAL ELECTRIC ti DEV. FEES PAID FINAL PLUMBING ENERGY .`,�'�*rf.���=�j���•_._.�_.�____.l_ COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE ����i � I '����� �I� � � � -------�------_.__� '