HomeMy WebLinkAbout17555 �� CTIY OF DIAMOND BAR � DEPARTMENT OF COIvIIv1UNTTY&DEVELOPMENT SERVICES � 21825 E.Copley Drive (909)H60-3195 Fax(909)861-3117 PRESS �`••�' BUILDING PERMIT APPLICATION FIRMLY � JOBSITE �1 ,(�,, �/ APPLICATIO PERMIT P/C o ADDRESS ' v�'1'"v� ��rUbl. DATE O O NUMBER �� # c� ISSUE TYPE OCC .- pPN LO TRACT DATE CONST. GROUP p OWNER o� U � "" ADDRESS � �Z ZONING SETBACKS g CITY � ZI ��TEL. �' - FRONT RW O APPLIC NT TEL. R�'R � SIDEJSIDE STREET RW ❑ � CONTRACTOR SIDE ❑ o ADDRESS PROPOSED USE_ �LL•7 S�� CITY ZIP TEL o ARCH/ENG/ z� DESIGNER NO.DWEL NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� ONMER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFlRM UNOER PENALTY OF PERNRY THAT I AM El(EMPT FRJA1 TNE CONTMCTOfiS ll• Gef8g0/C0�p0A W CENSEUWFORTHEFOLLOWMORFASOH(SEG709t.5BUSMESSANDDROFESSIONSGODE:ANYGTYOR (n C1 COUMYWNIp/REOUIRESA�ERMITTOCONSTRUCT,ALTE0.�PROVE,DEINOUSH.ORRE7AIRANYSTRUC- W P8t1�BCk Z TURE,PRqR TO ITS ISSUANCE,f150 f1EWIRES THE MPIICANT FOR SUC11 PERMIT TO FILE A SIGNED W � STA7EMENT TUT ME OR SHE IS UCENSED iURSUANT TO TME VROVISIONS OF 7ME CONTMCTORS U- � CENSE LAW(CM�PTEH 9(COMMENGMd WITM SELTqN 7000)OF DIVISION�OF THE BUSiNE55 AND PRO• � FooVSpa FESSiONS COOE)OR TMAT ME OR SNE IS E%EMPT THEREFPOM AND THE B�SIS FOR TME ALIEGED EXEAIP• VTION.AM'VIOLATIONOFSECT10N7001.68YANYAPPUCANiFORAPEFMITSUBIECT57F1EMPLICMl7T0 Z Re•Rao1 � AdVILVENALTYOFNOTMORETHANFNEHUNOREDDOIURS(SS[OIY. 0 OtA50'M�EROFTHEVRODfRTY,ORIAVEAIPLOYEESWITHWAGESASTHEIRSOLECOMPENSAT10N, ❑ Commarcial Z YVILL DO THE WORI(.AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SiILE(SEG 70u,BUSI• J � NE55 AND VROFESSIONS COOE:THE COqTRACTORS LICENSE UW�OES NOTA�PLY TO AN OWNEP OF ? . 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J � V pp7E CONTMCTOR a W . � � WORKEHS'COMPENSATIONOECLARATION 4 � U N IHEREBVAFFIRMUNDERPENALTVOFOERJURVONEOFTNEfOLIOWINGDECLARATIONS: N a � _IHAVEIINDYlILLMAINTARIACERTIFICATEOFCONSENtTOSELF�NSUREFORWORKERS' 2 � COMPENSATqN.A57ROVIDE0BY5ECT10N37D00fTMEUBORCODE,FONiHEPERFORMANCE W OFTNE WORK FOR VMICHTMIS DER/AIT IS ISSUED. � � � _I HAVE MlO WILL AWNTAM WORKERS'GOMPENSATION INSUfiANCE,AS REOUIHED BY SECTION O ]7000FTHELABORCODE,FORTHEPERWRMANGEOFTHEWOWCFOHWM�CNTM�SVERMITIS ISSUED.MVMORNERS'COMPENSATpNINSURANCECARRIERANOPOLiCYNUMBERME: CONSTRUCTION � CARRIER PU1N REVIEW � POLICYNUI.�BER ELECTRIC , ` o fn+SS[crorin�mrpreE�rmoFnfv�w.irs�or+e�,waE000iuns�s�m�oAtFss1 PLUMBING �� W MECHANICAL Z ICERTIFV THAT N THE PERFORM/wtE OFTHE WORK FOR WHlp/TMIS PERMIT IS ISSUED.1 (} SWLLLNOTEMPLOVANYPERSONWANVMMINERSOASiOBEC061E5UBJECTTOTHE � i..-� �'� I I � WORKEFiS'COM7ENSATqNUW50FCAUFOFNIA,ANDAGREE7IUT�FISHOIhDBECOIAE INSPECTIONFEE �`s�' SUBJECTTOTHEWORKERS'CdAGENSATIONGRON510NSOFSECT1ON77000FiHElABOR �SSUANCE ' �/ o � _v COOE,I SMALLFOflTMWITM COMPLY WITMTHOSE PROVISIONS. p DATE: ' APPLICANE SMIP I �W WARNIN(i:FAtLURETOSECUfiEWORKEHS'COMPENSATIONCOVEMGEISUNUWFU�ANDSHALLBE ENERGYP/C ( � SUBJECTANEMPLOYERTOCfliMIlULVENALTIES�NDCMLFINESUPTOONEHUNDREDTIOUSANU ENERGYPERMIT ����"r D�LLARS lf tOD.OW).M1 ADDITION TO THE CAST OF COMPENSATpN,OAMAGES AS PROVIOED FOR IN � SECTIONa7oeOFTHEUBORCODE.MTEREST,ANDA7TORNEY5fEE5. RETENTIONFEE: �"'- -- �- --- � pw_, � CONSTRUCTION LENDING AGENCY PREALT FEE: Q IHEREBYAFFIRAIUNOERPENALTYOFPEiiJURYTNAT7MERE15ACON5TRUCTIONIENDINOAGENCV a- FORTHE PERiORMANCE Of THE WORK FOR W111CH THIS PERMIT IS ISSUEU(SEG.7ou7.CIV.C.). Z W � IENDERSNAME � LENDER'SADDRESS� �i wICERTIFVTNAi1HAVEREADTH15APGLILATqNANOSTATETHATTMEAeOVENFORMATiONISCORREGt TOTAL FEES � � U � IAGREETOCOMPLYN7THQLGTVANDCOUNTYOROMANCESANDSTATEUWSHEUTiNaTOBUILD�NG CONSTRUCTION.M'0 HEREBV Au7HOFRE PEVflESENTATNES OF TMIS COUNTY TO ENTER UPON THE � �BWE-IAEMIONfDPR07ERTViOPINS�ECTIONPUFPoSES. COMMENTS � 1U1� 1�� � ¢ GERIAITTEENM�E(PiVHT7 ' � � � O J2� Vj SIGNANREOFPERMI E OATE � RECPT.AO.� PAIO BV VALIDATION WHITE—Deparlment Copy,YELLOW—Finance Copy,PINK—Assassor Copy,GOLDENFiO�File Copy,GREEN—Applicanl's Copy . . _ _ . . . � - ?� - � - -- .,. _ ._. _ . . • . ... . � .. , , . . -' . � ' • � . . , . . . � . . �, �i .i ' " . . � - _ ..... i. �{ I !;� i�� ��.�''v�s���4�.+t �'if-�� ��'�����+ E i��� �L.�.C.J�I� II►�k-y�-�=;�`'t11�1►°I' �:tY�Wc� _ .1►�l�`��=?�:'=�'e.�Ct��_Mr`f�'i'?�"c;�['tca�►y8 o�;1�r�. �I►��.`i.l�c��'�=i. . _ _ .. . _ _�.___.____ � � � ..__. __ ....._� ._. ._ _ --_..__�._...- -�...- --. . _ ..----__.._._ .._ . �. - , -- --- � •- -._.�-----.___. __ _ . ___ -_-"�---------�-- --- � SET BACK � ___I . � FLOOR JOIST FfGS/FORP�IS/STEEL � FH.A REQh1TS' j ELECTRIC GAOUND � UNDER FLOOR DUCT —T GROUND PLU�A6ING U�dDER FLOpR CU�IDUIT SLAB GRADE FIREPLACE'FOU�JDATION TEMP POWER I � FIREPLACE�E30ND BEAh1 I WATER SERVICE I h11D HT.BOND BEAM ROOF SHEATHING 8 F7. BOND BEAM FRAMINGNENTILIATION _� FINAL BOPdD BEAM � ROOF COVER j PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC i R�UGH GRADING ROUGH PLUMBING FINISH GRADlP�G SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING V'JALL INSULATION POOL FINAL CEILING INSULATION � OFF SITE IMPS. DRYV'JALL NAILING . _�_ DEDICATIONS SEWER �-��-(�l) �L� , FINAL ENG. SEPTIC TANK LAPJDSCAPE/IRRIG. SEEP PIT/L.L. O�J SITE Ih�1PS. GAS AIR TEST FINAL ZONING FINAL CONST. ' � , � GlRE D�PT. FINAL FINAL HEATING HEALTH DEPT. FINAL Flf`dAL ELECTRIC � DEV. FEES PAID FINAL PLUMBI�JG E�dERGY ,-.mY,.,-.,.,.--�-.,�-A-_-.._....�...�.�... '-:D.�;.z r rl" �`Ir;�t COMMENTS SEPTIC TANK 51ZE SEEP PITIU SIZE ------------, �y� � I ���� - �i ,�� ; . • -------••---- ___ . ._.__._�