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HomeMy WebLinkAbout11704 (5) f� _ CITY OF DIAMOND BAR � � " � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� Zi�oE.coP�oyn�;Yes,�c�i9o� . PRESS '�' �`%�� BUQ.DIIVGSPERMIT APPLICATION � � FIRMLY , o DDR SS�sn �Lx/'/ _S��/N�S LJYC. DATEICATION R � NUMB RJ�z� #� ~ D $ issue TYPE CC ' APN LOT TRACT � n � DATE CONST. GROUP g OWNER G' . � ADDRESS �7 W• - � ZONING SETBACKS � CITY ' �ZIP TEL D FRONT ` ' RW ❑ � APPLICANT TEL. REAR O SIDE/SIDE STREET RW ❑ � CONTAACTOR SI�E � ❑ � AOD SS " PROPOSED USE ��- G CITY ZIP TEL o ARCH/ENG/ • , � DESIGNER � �� E- - . - NO.DWEL. NO. NO. - ADDRESS ' UNITS STORIES BEDROOMS ' ; N CITY(� ZIP � E y . �ESCFiIPTION ' SQ.FT. FACTOR PSF ADJ.AREANALUATION ¢ OWNER-BUILDER DECLARATION . ' SFfllADD/REM O ' ' B � 1 HEHEBY AFFYiM UNDER FEWLLTY OF PE0.AIRY THAT I M1 EXEYPT iROM THE CONIMGTORS U• G8r8Q9K.fl1pOrt " CENSEIAWFd1TMEFOl10WiNOREASON(SEG7071.6BUSIHESSIVmVROFESS10N5CODE:ANYpTYOH (n (� OpUHryW1qCHRE0U1RE5AGERMRTOCONSTRUCT.ALTERN7ROVE0E1.101JSH,ORREPNRANYSTRUC• W Palio/Dack �L7UqE,Pqqfi TO RS ISSUANCE,ALSO 11EWiRES iNE APPLMIUff FOR 6lKM iERUIT TO FlLE�SIGNEO W � 6TATEMEM 7HAT HE OR SHE IS LICENSED PURSUMIT TO THE PROVISIONS OF TNE CONTMCTOliS ll• � C£NSE UW(GTNPTEN�(COMMENCWO WITM SECTION 7000)OF DIVISION 7 OF THE BUSiNE55�ND PRO- LL" P��Pa FESSIONS CODE)OR TMAT HE OR SME IS E7(EMPT TMERCFHOM AND TME BASiS FOR TNE NLEOED EXEMP• TpN./iM'VIOI/�T10NOFSECTqN70�1.6BYANYAFPIICANTfOR11VERMRSUBJEGfSiHEMPlIC1�N7T0 � Z Re•Raol � A CML PENAITY OF NOT YOfiE TTUN FNE MJNDRED DOlUR4 If5001): ' ' , . � �1AS01N�FROFiHEVROPERi1:OH�MYEuttOYEESNATNWAGESASTHEIHSOLECOMPENSATpN. � COmIn6fCl31 YY61 p0 iNE YVOAIC MO TiE STRUCNR[IS NOT IMENDED OR OFFER[D FOF S�LE(SEG 70u,BU54 J NESSAND iAOFESS10N3 OOOE:iNE CONTHl1CfORS LICENSE Uw DOES NOTAPPLV TO AN OWNER OF � ppOPERT1YN10BURD50RMVROVESTMEi1EON.AND1N10DOE55Up1V+ORKHIMSELFORHERSELFOp m � [[ 7NROUGHHISORNEROWNEYPLOYEES,VRONDEDiW�iSUG1MPPOYEIAENTS�RENOTRfTENDEDOFi . 1.�1 ,OFFEAEDFORSKEIF.NOWEVERTHEBULDN60RIMPROVEMENT650lDNnT�nNONE1'EAROFOOINPLE• ZTION,THE OWNER.BUIIDEH WILL HAVE THE BURDEN OF PRONNO if1AT NE OR SHE DID NOT BUIID OR � MvpOVFFOilTHEWRP05EOFSALE} ' W OL��MHEROFTHEPROVERfY.AMIXCLUSNELYtONTRACtt1CWITHLICENSEDCONTMCTORS . � TO OONSTRUCT T/7E 7RO.IECT(SE4 7oa,.BUSINE55 ANO PROFESSIONS CODE:T11E CONTMCTONS U• �V81ueCb11 ADJ.AREA CENSE UW DOE9 NOT MPLY TOAN OWNER OF A GROOERTY VR�O BURDS OR MPROVES iHEREON.AND W/qOOHTMCfSiORSUCHiRQ1ECTSWITMACON7MCTON�3)LICENSED%1RSUAHTTOTHECONTMG� pUANTITY ESCRIPTION .FEE � TO(1.4 UCENSE UW� _ ' ' . . .J . _ . - .. p IMI FXEMaT UNOER SfG B.l P.C.FORTHIS REASON Q 3 � . - uzz' DA7E ONNER V � J ' 4 LICENSED CONTRACTORS OECLARATION W 2 I HEREBYAFi1RA1 UNOER PEIUIT/OF VERIUpY TUi lAM LICENSEO UNCER PRON510NS OF CINPTEH � � _ � i(OOAw1ENGYq MrtT}I SEC717N 7oD01�OM510N 10i ME&15iNE55 AND VfiOFE5510NS CDDE,AND Z X IAYUGENSEISNFUILiORCE/I�W�EFFECT. Jy m `� IICENSE CIA�SS�_�—,f�f�—LIC.NO. V �� J � VpAh�=( y� -7��CONTMCTOR � a W —��--� i � WORKERS'COMPENSATION DECLARATION � • . � . U � IN[REBYAF�IRA7lRAERPENALTYOFFE0.1URY0NEOFTHEFOLIDY.�NGDECIAMTI�NS. Z Q . G ��WIVEPNDW:LILUMAINACERTFIGTEOFCONSENTTOSfIF�INSUREiORN�ORNERS' _ Q CpAPEN5AT10N,ASPHO'Y�DCDBYSECTION]70oOFTHEUBORCODEFORTHEPERV'ORMMICE W � Of THE WOPo(FOR WHIC/I TH6 PEPoAI715 RSUEO. � � 1 HAVE ANO N7LL MAIM/UN WORKfR50D1.�0EN5AiqN INSUiUNCE.AS NEOUIREO 9Y SECTION QO �7000FTMELAE30iiOOOE,iORTNEVERFORMNiCEOFTMEWOIiKFORWHICHTHISPERAIITIS �Z� ,wJ = ISSUED.AIY RS'COYPENSATION� UNANCEGRRIERM'DVOlIC1'MN9r.q�qE;�/� CONSTRUCT1ON �7/-s7y— � j GRRIER � �—O f_�•!JS �/4�L PLAN REVIEW ��,��i_f"�_* �� � 1 /� Z POLIGYNUAIOER� ��� ELECTRIC Qpp (f}65EGfpHry��p7gEppM1fiE7mpFTYEpEqA�T6Fpi0N[�lR.prlEppcUARslt7m�oRlE55�. PLUMBING � I CERTIFYT1u7 N THE iERFORMANCE Of THE WOHK FOit YMICFITHIS PERMR IS ISSUED,1 � MECHANICAL - � SMALLNOTEMPLOYANYiER50NN/NYYANNCR50A5TOBELOME5U0.1ECTTOTHE . � YYORKERSCOMPENSATqNLAWSOFCALIFORN�tiAND11CREETMATffISNOUIDBECOh1E INSPECTIONFEE S SUBlEGTTOTMEVVORKERSCOMPENSATIONPROV15iON50FSECTION�70oOCTNEUBOR ISSUANCE '��� -- COOE,I SNlLLl iORTMw�M W�.�PL�WIiH T105E YROV15lON4. O SMIP �• �� ' p DATE: �APPLICANT: " . . • � ENER�Y P!C --�AY��� WMNIFq:FA0.URE TO SEWRE KdiKERS'C0IAPENSATION CDVFMGE IS UNUWFUL 1ND SHM1 BE �y SU6JECTNIEMPLOVERTOCRaAwN.PENALTIESANDpVRFW[SUPTOONE1MdDRCDTNDU5AN0 ENERGYPERMIT DOLLARS(f100,000),N/�DITION f0 THE COST OF WMPENSA710N,DANAGES�S VROVIOED FOR IN , � J SECT1DNf7oeOF7MEUBOHCOOE,MREREST.ANDATTORNEY5FEE5. RETENTIONFEE: Q � GONSTFIUCTION LENDING AGENCY PHE•ALT FEE: � � O � � IHEREBYAFFlRAIUNDERPENALTYOFPERNRY7HAT7NERE6ACONSTRUCTIONLENDwCAGENC`! 2 FOR iN[VERFORUANCE OF TME WORN FOR WHIpI lHIS PERMR IS ISSUED(SEC.70Y7.CIV.G} W � LENDEi15 NAME � � ' � IENDEfl'SADDflE55 1�1 G � ICERTIFYMA7INAVERE�DTMSA07UG710NAPIDSTA7ETNATiHEABOVENFORMATIONISCDRRECT. TOTAL FEES �r ` � � � � IAOREETOCOMPLYVATNALLCT'ANDCOUFRYORDRIINCESANOSTATEUWSHELA7INOTOBURDIN6 ' CONSTRUCTIOH.MA NEREBY AURbWZE REPRESENTATIVES OF 1}71S COU�TY 70 ENTER 11PON TME . S� ABOVE#IENTIONED iRDVERTY FOR INSPECTIOH FURP06E5. COMMENTS ' � � � r �• fYT—�i �G . ¢ i£RAIRTEE N�-EA'��7� � _ ��^/��n n. _ � �lQil s �JT � � o�rE —'� � SqNAT F Ti� pECPT.NO. Q PAID BY VALIDATION � �� � � WHITE—Depertment CoFy,YELLOW—Finenee Copy,PINK—Ilssessa Copy,GOLDENROD—Fdo Copy.GREEN—Apqicant'a Copy � � . � . . .. ,.f'. ... ! ,., .�A' .. t� . . . . ..�',� � . .� _ .. � � . � , � . .. , . . .. � . , . . . � . . . . , . ' . .h, � ., . . . '' . . ' . . CITY �F DIAMOND BAR ,- ;;�-,: �. ,�;,, , . � . - `�� ..� -`"�`.�_ ... INSPECTION�RECORD_� -` '. • '� •.' � � � ,_ . . ; ,. ..... . '�. ,.��, �•� . �,.. .. . i • `,; ,� ', , • ' - • • 6 � • ' � � � i ' �SET:BACK' -` ' �,�`,.�` • ` � :` I`," _. , �FLOOR JOISI',(� `�_ •.'_-. , �•;= • . -: , ' , . . - . . . . . . . . . . � FTGS/FORMS/STEEL � :�'�. , _� �... •FHA REQMTS,,_:., ._:,� - - --- ---- - -... ._•_.... -- ---.� ELECTRIC GROUND _- - � ' � `'"" `� ' - 'UNDER FLOOR'DUCT ? -,_:. � •. ,,: ., � ��- � - ��-- ' - - :.� GROUND PLUMBING � - - UNDER FLOOR COJ�fDUIT•�. . '•;�� ,,�, �:_ .' ,'�� :; ^. - � ! " SCAB GRADE �� �- -� � - • � FIREPk.�4CE FOUNDATION � `, i � __ .�,_ ,.. . ., . _. . TEMP POWER ---- -`•• �� - - '" - • � � : FIREPLdCEhOND BEAM `'" . '� _';''., � ' . � -" - - -- - - - - . . , . . � WATER SERVICE-_._.._ .. .-- --:. - _--- -.. . _. MID HT. BOND BEAM ' �.- , ,_ .���. :•. ,_.:�,.:.� ::. .. ,. . ; , ROOF�SHEATHING -...� - �. . - - •- . . _.. , BF,T'.�ONaaEAM•,:', __ .,_ _,-:. -,---.:�. �.-' - � :,'�.•�� � . FRAMINGNENTILIATION FINAL BOND BEAPJI .. ,. , -. - � • • ' ; , ROOF COVER:�." .PRE-GRADING:�;�;-`^„ , . � :,: ' _-'--,••,:; -., • i ROUGH HEATING - - - - - - - -- � - --- BENG NG.�\,.{�'`..l'' ��,� . , ,, ` - ;',"._::�s: . . . � ., ROUGH ELECTRIC � � -�- � -- - = - = � � ROUGH GRADING • , • :,., � < : ROUGH PLUMBING ' - -- - - -- -" -�--"." �� FINISH GRADING .. + ' ' , , SHOWER/TUB TEST � - � � - --� i - - ' - - P,OOL ELECTRIC ••• , , EXT.LATH/SIDING -� - POOL FENCING � ' ' i . WALL INSULATION ��! -�$ POOL FINAL •� ' ' ' , CEILING INSULATION OFF SITE IMPS. • � ' =-' DRYWALL NAILING DEDICATIONS . ,- . • SEWER._. . .... __ ... . . ' . FINAL ENG. � SEPTIC TANK. ...- - -- - - -- .---- .. .__.. .•. �_ _. LANDSCAPE/IRRIG. .. :' : � SEEP PITlL.L ; _--- -= . - '" ' + . . ON SITE IMPS. . . , . GAS AIR TEST; - �� -- - -- ��� - - FINAL ZONING • �• - ; �.: �FINAL CONST. ' - - - �_z z f� -- - . FIRE DEPT. FINAL ' - ' ; �, FINAL�HEATING - � � - -- � � - - HEALTH DEPT. FINAL . ,. : -. . .- - - - , .. FINAL ELECTRIC-- -- - - - - - DEV.FEES PAID -- �-- . _ � �. FINAL PLUMBING ENERGY • • • • : � � .\ . , . , � �n i1� • • U. � • � ' ' , ' . - -- -� �-- � -'- - - -. ._. ._ _ ��.._ .___�_ ' ... � . •- .. .��- :.��� _. - �.. .. � - t• t •l ' ` � , � COMMENTS �- -- ' ' � � ' - .. - - - -- � . - -- - -- - �- � �------ ...--.:.. .. �:.. . . . � _. . _�. . .- - --- -- , � , , �. �-. . �c � .-- _ . . � . � � ! � . . . . , , - � . � . � --.�' , _. __,� , _,_- - •. .��� . •��� _ . � , . �, ,= �:-;.- -�;- - , ; : -�-- - -- - - -. -- . . � � �, . ,. , ; .. _ «�- � . - - �- � , . � ;. � , . - - - _ ;;c��?� � � Y�r� . . . . : - - , . SEPTIC TANK SIZE -- _ . � . . . ; ' . : ,-: - - - ; . . , . . .. SEEP PIT/U SIZE . . � ; � � �_ � , , -. .. - --- -- -�- � �- - � i - _. .. _.. _ . � , -_- -- . . - - _ ! ! _. .. . . . . . j : � � , . .. � .. ., . . , , . _ . , ; , - - - . ... . ; _ \\. . . � ; . . . .. ... . _. ._ " �' � _"_ . . � � �. � J _ � \ i ,�. .. . . . _ . . � �.�.-., ;,` . . . � . t . " � " �: � \ � . . . . - . � � � `,. . ����,� � � , .. . _ -- , '` , . � ' I