HomeMy WebLinkAbout16581 � . _ . . . .. _._ y.
CITY OF DIAMOND BAR ���•�V
��� DEPARTMEM'OF COIvIIviUNITY&DEVELOPMENT SERVICES
I I �
f �Q Z�� ,� 21825 E.Copley Drive ��
(909)860-3195 Fax(909)861-3117 PRESS
"�-�� BUILDING PER1111T APPLICATION F RMLY
o ADDRESS f�v�a�!!J' _�I�� �'' APPLICATION �' !i� PERMIT P/C
DATE v NUMBER • M
ISSUE TYPE OCC
� APN LOT TRACT DATE CONST. GROUP
p OWNER Ps►�k !-�_ f�+I/v
o ADDRE S � _ / ��� ZONING SETOACKS
oCITY ZIP " TEL._ ��'����- FRONT RW ❑
o APPLICANT��jf'_�L �T�,�•�Q=II�.7/— S DE/SIDE STREET RW ❑
� CONTRACT Ge/ose�rG���, siu�� SIDE ❑
Q ADDRESS���_N_ •��
� CITY Q ZIP f,��'� TEL.7v PROPOSED USE
o ARCH/ENG/
� DESIGNER �� NO.DWEL. NO. NO.
ADDRESS UNITS STORIES _�BEDROOMS
� CITY ZIP TEL.
y DESCRIPTION SQ.Fi. FACTOR PSF ADJ.AREANAUTATION
� OWNER-BUILDER DECLARATION SFR/ADD/FiEM
O
p I HEREBV AFFlPoA UNDER PENALTV OF PEFWRV THAT I All EXEIAPT FROM TNF CONTRACTORS lt- Gyfa9B/Cd�Ofl
W CENSEUN'FOR7MEFOLLOWM�REASONISEC.70�1.SBUSINESSAND7ROFESSbNSCODE:ANVCRYOR (n
U COUNTYNR7ILMREOUIRE511iEWAliTOCONSTRUCT.KiER,IMPROVE.DEMOlJSH,ORREPAIRANY3TRUG w patio/Deck
� NRE.VR10R TO RS ISSUA.^:CE.l�L50 REDUIHES 7HL APPLICANi FOFl SUCM PERMiT TO flLE A SIGNEO .
� STATCIAENT TW�T ME OH SME IS LICENSED PUfi5UAN7 TO 7i1E PROVISIOhS OF THE CONTMGTORS ll�
� CENSE UW(CHAPTEH O�CUA�MENCINO WITH SECTION 7000I OF DIVISION 3 0F 7HE BUSINESS AU�PN0• u" PooVSpa
FESSIONSfADE)ORTHA7HEORSHEISE%E4PTTMEREiR01AANOTNEBA515FORTNEALLEGEDEKEAIP� C7
� iION.ANYVpLATIONOFSECTION70]7.SBYANV�PPLICAMfORAPERVITSV&lECTSTH[�PPLICANTTO Z Re-Roa(
A CML V ENALN OF NOT MORE TFUN FIVE MUNDREO OOLUFS(f SDo���
ZOI.ASOWYEROFiMEPROPERTY,ORMYEMPLOYEESWITHWACE5A57HEIRSOLECOMPENSATqN, 0 C,pmmBfCldl
W:LL DO THE WOHK,ANU iHE STRUCTURE IS NO7INTEN�ED On OFFERED FOR SnLE(SEC.70��,BVSi• J
NE55 ANO VROFESSIONS COOE:THE CONTRACTORS IILENSE UW DOES NOi APP�Y TO AN OWNEN OF
� PROPERTYNrt108URD50NIMPROVESTMEREON,ANOKT1000ES5lKHWOHNHIMSEIFORHEHSELFOH �
Q THROUGHXISORHEROWNEIA7LOVEES.DROVIDED7HAT5lICHIAIPROVEVEMSARENOTINTENDEDOR m
w OFFERC�FOtiS/LE.F,IqwEVERTMEBURDK:GORIMORDVEAIEFRI55qDwRMMONEYEAROFC0IAPLE•
� TqN.TME OWNER�BUILOER WILL HAVE TME BUflDEN OF PROV WO TFIAT HE OR SHE DiD NOT BUILD OR '
Z WPROVEFOflTHEPURP05EOFSFLE}
Q_ ❑�IISOYMEROFiHLPROPERTI;AME%CWSNELYCONTPALTWGW'TMULENSEOCONTMCTORS
TO CONSTRUCT iHE VFOJECT(SEC.7U1�.BUSI�:E55 AND PROFESSIONS CODE:7ME CONiMCTORS LI� 'IU3Ii0f1 AQI.AREA
W CENSEUWDOESNOTAPPLYTOANOWNEROFA7ROPERTYWHOBU0.050RIYPROVESiHEH[ON.AN�
� YM1IOCONTMCf5fOR5UCHVROJECTSWRHACONTMCTOR(5)UCENSE�7URSUANTTOTHECONiMG QUANTITY DESCRIPTION FEE
Y MRStICENSELAW).
� O 1 M1 E%EMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q I ,' �
� � O f�'�
LL DATE OWN[R F'
Z W �
�Q UCENSED CONTFiACTORS�[CLARATION W � ���
CC IHEREBYAFFIRMUkDERVENA�TYOFiERIURYTHATIAMLICENSEDUND[RFROVISIONSOFCMAPTER Ur S� S
p_, y�CpMMENCWaWIMSECTUN7000)OFOM510N�OFTMEBUS:NESSANDPROFESS�ONSC00[.A`ID Z '
IAYLICENSE IS W FULLFORCEANJ EFFEC7. / � �
� LICENSE CU55 � LIC.NO. " �� J � �/ �'���
� oare /� •3B cmarnacroa a �v.
U -- . .. ..- —
w
a� WORKERS'COMPENSATION DECLARATION Q
= U
� IHERCBYAFFIRMUNDE0.PENALTVOFPE0.IUMONEOF7MEiOLLOW!NGDECURATIONS.
� Z
Q
0 �I/1�VEANDWILLMAINTNNACENTiFICATEOFGONSENTTOSELFdNSUREFORIMOliNERS' _
� COMPENSAiqN.AS VROViDEO BY SECTION 770o OF TME 1A80R COOE.FORTHE PENFORAIANCE �U
OF TNE WORK FOR NMICH THIS PERA/IT IS ISSUEO- �
�
W _IHAVEANDWILIMIUNTAINWOFU(ERS'C�MPENSATqNINSURANCE,A5RE0UIREDBY5ELT10N �� ' /
0 77000FiNELABORC00E.FORTH[PERFORMANCEOFTH[WORKFORWHICHTNISPERMITIS �1/1� �u
ISSUED.MVWORNERS'COIICENSATIONIN^l1PnNCECA ;IERAN�OOLICYNl11ACERARE� CONSTRUCTION V� t
JJ
_ 7 . CARRIER���t ". -. _ .- � - PLAN REVIEW ...� .. ._ . .. . _
Z POLICV MIMBER�J�pI� ELECTRIC
Q
� (INiS5EC11paK�t�OTBE�IETEDOFT�EVERMTISf0110NEF+l►�iED0011M56t0o)IXIlESS� PLUM�ING
Z 1 CERTIFY T/UT INTNE PERFORIAANCE OF TME WORN fOR WHICH THiS PE�iT IS ISSUED,1 MECHANICAL
('} SHALLNOTEMP�OYANYGERSONW�wYMANNER50ASTOBECAME5U0.1ECTTOTME
(n WORKERS'COMPENSATIONUWSOFLALIFORNI/�AND� 1EETMATIFISMOULD6ECOME INS?ECTIONFEE
S SU&IECTTOMEN'ORKENS'COMPENS�TIONPROVISIO OFSEC KKJ7�00 TnEV .R
cooE, s�I1TH�'ITH COMPIY 1MM TF105E P SiONS ISSUANCE `
p DATE:�j�I�/APPLICAM: _ � SMIP �Ax 1
w ENERGY P!C
� WARNING:F�0.UR[TOSECURENXIRKERS'COMPEN54TqNCOVERAGEISUNUWFU�,ANDSHALLBE
�y SUBJECTANEIAPLOVERTOCRIMINALPEN/�lilESANOCMLFWESUPTOONEHlR3�REDTHWSAND ENERGYPERMIT
DOlURS(S1oo.000).W/�DDITiON TO TME COST OF COMPENSATION.DAMAGES AS PROVIOED FOR IN ^
� SECT10N77000FiHEU00RCO0E.NiEREST,/JJDATfORNEV'SFEES. RETENTIONFEE: i� �--
a CONSTRUCTION LENDING AGENCY PRE•ALT FEE:
Q IHCRCBYAFFIRMUNOERPENALTYOFPE0.IURYTHATTHFREISACONSTR:ICTIONIEN�INC�GCNCY
a- F0f1THEVERFORMANCEOFTNEIWO N' HICMTNISPERAaTI5155UE�(SEC.7o9],CIV.C.�.
W ,1
� LENDEfYSwwE r-
F= LENDER'SADDRE55
�
W ICERTIFYTMATIHAVEREADTHISAPVLICATIONANDSTATETHAfTMEl1BOKNFOAMATqNISCORRECL TOTAL FEES � U I � �
� IAGREETOLONPLYYATNALICRYANDCOUNTI'OADINANLESANOSTATEUwSREUTiNOTOBUI�DINC �
� CONSTRUCTION,ANO HEREDV AUTMORIZE FlEPRESENTRTIVES OF THIS GWNTY i0 EN7ER UPON TNE
Z ABOVE�MEHTIONEDGHOGERT/FOIIINSPECTqNPURPOSES. COMMENTS
0 �
m p �L
¢ PE �tTEEN u �iiN7) / �
� I ' '
(fj S...rvA� _OFVERMITTEE �� �
� RECPT.N0. _PAID BY _ VALIDATION
WHITE—DeDartmer.[Copy,YELLOW—Finance Gopy,PINK—Assessor Capy.GOLDENROD—File Copy,GFEEN—Applicant's Copy
�.�r;.-•r.��., ....•v,�ur-1�•. :<n;T.,y.�.�- an r w,..i.r�r•rv,-�^ .'i�"'Y- • ;^'t •err• . i'Mt. • . � . « . r� •-•-... . .. �-.-� ..... . .
, . . 7� . ..�'t:'��i�;..;:;. ,i.�,,r. ,.ra•f�• _ _�..��..�.�r�- . ..
.
CITI' OF D1�►iJiO��D BAR
li�lSPECTIOI���RECORD
_ _,�_______________�_�______.�
�I�k-`�����l'I�]�`E �-�_t'I"-. � _. ��._. �:' ._ _ ` .`.'. �.c.`,_[c�►�� E�.�'.E�'_
_.. . �- _ — � �1��-��������:�
�,�.�R��c c��1 1► �.�_ � [
—__._—------�---�-- ---. ---�-----`..�._-- -----------_.---____,� _--_ -----__----�-----�__._._____---------
5ET BACK � � � ` FLOOR JD� :. '�:�� •�' ,: � ' •` . •
FTGSlFORh1S,'STEEL ' ' � � � FHA RE�"�1TS
�---
ELECTRIC GROUND ' ' � � � UNDER FLOOR DUCT • -
� .
GROUND PLUMBING I UNDER FLOOr`i�CUP+D�IT ` ���� �-' '• .
SLAB GRADE FI�E"FO,UfVDATIO�d •
� , ,.• .
TEMP POVVER FIREPLACE BOND BEAM•"� �
WATER SERL�ICE I MID HT. 60NU B�A��1 � � ' � �• ' � - '
•,;�rt
ROOF SHEATHING 6�Ol I � 8 FT. BO!:D BEA:.4, �: �, .� � '•�.•' '�
FRAMINGNENTILIATION r� FINAL BONO BEAF�4 .
ROOF COVER (o-_lZol �� PRc-GRADING
ROUGH HEATING BENCHIPJG
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUPABIiJG � FINISH GRADIP�G � .
SHOWER/TUB TEST POOL ELECTRIC
EXT. I�,TH/SIDING I I POOL FENCING
VVALL INSULIITION ' • � POOL FINAL �
CEILING INSULATION OFF SITE IMPS.
DRYINALL NAILING DEDICATIONS
SEVJER FINAL ENG.
SEPTICTANK ., �':� . LANDSCAPElIRRIG. �
SEEP PIT/L.L. "�` ON SITE IFJIPS.
GAS AIR TEST ' � - FINAL ZaNING
FINAL CONST. �r-�� ���. FIRE DEPT. FINAL
FINAL HEATING •�'~�:'� � "• � HEALTH DEPT. FINAL
FINAL ELECTRIC ; � ' DEV. FEES PAID
FINAL PLUMBING • : � ENERGY
� _ � _. �
'•, . .. . �,
.
'. . .. �� C;ri�l�i' C]::Gj�t�: � _ .
' "''_'""'. ` . .
COMMENTS
;
, � � � �c .
� ,
� � �.; � � •
.�• .�•'-;� _
SEPTIC TANK SIZE .
SEEP PIT/U SIZE �
�r�
-i�y� �'
� � -� ,� , . - ..-
. , .
� . 'S . . .\' y ' ' . . . • . . .