HomeMy WebLinkAbout16588 (23) i _ _. .
�� CII1'OF DIAMOND BAR
� � DEPARTME;�IT OF COMMUNITY&DEVELOPMENT SERVICES �
r 21825 E.Copley Drive
� X'"`� (909)860-3195 Fax(909)861-3117 � PRESS
\\�� BUILDIhGPERI►tITAPPLICATION FIRMLY
JOBSITE c ,� APPLICATION PERMIT P!C
o ADDRESSlD J� � ��'�� � DATE I � NUMBER S
c� ISSUE TYPE OCC
APN LOT-�t�� TRACT, DATE CONST. GROUP
¢ OWNER��Q /�c`���_L'�
0
�p ADDRE SJ�+3.ToZ I� O . y2S ZONING SETBACKS
Z CITY ZIP TEL.,�y�Z�o'O FRONT RW ❑
g APPLICANT _ . � TEL�9��� SID SIDE STREE7 RW ❑
� CONTflACTO _ _ � _�� _ _� SIDE ❑
� ADDRESS_ • -� f� PROPOSED USE
� CITY ZIP��3 TEL��'=^,J.f'j�
w ARCH/ENG/
w DESIGNER_�� NO.DWEL. N0. NO.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
N DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION
N
p� OWNER-BUILDEH DECLAFATION SFRIADD/REM
O
1 H[REBY AFFl{iM UNDfR PENALTY OF PEiWRV TU7 I�VA EXE�Pi FROM TME CONiMCTORS L4 Gara9e/Carport
W CENSEUWiORTT1EFOlLOwMGRG50N(SEC.7o7t.S8U5INE55ANDPROfE5510N^+COOC:ANYCITYOR (n
U �q1NNWHICHREWIFl[SADERIAITTOCONSTRUCT,ALTEN.IMPROVE.�EIXJLISH.OfiRE7A:RMlYSTRl1G W patiolDeck
W TURE,PRqH TO RS ISSUANCE,AL50 REWIRES TME APPLIGAM FOR SUCH PERuIT TO FILE A SIGNCO W - - ' '
� -STATEMENi THR7 HE OR SHE IS UCENSED PURSUIWT TO TMF 7RWISIONS OF 7HE CANTFACTOHS U•
� CENSE LAW(piAPTER V(CqAMENCPJC WITH SECTION 7000)OF DINSqN 3 OF TME BUSINESSAM1O PRO- � PooUSpa
fE55iONSCODE)ORTMAiHEOR5NE15E%EMPiTnEREFpO�AANDTHEBASISFORTHEALIEGEDEXEMP• (�
VT�ON.ANYYIOLATpNOFSECTIONT071.68YANVAPVUCANTFOIIAPERMIiSVaIECTSTNEAFPLICM7TT0 Z Re•Roof
� ACMLGENAITYOFNOTMOFic'THANiIVEHUNORED00LUR5�fSoo�J:
� ❑I.ASONRJEHOFiMEVflOPERTYORMYEMP�0YEE5WITHWAGESASTNEIN50lELOMPCNSATION, 0 Commerclal �
Z W:LL DO THE WORK ANO iHE STRUCfUR[IS NOf INTENO[D OR OFFERED FOR SAE(SfC.7o��,BUSb J
� N[55 AND PROFESSIpNS COO[:iHE CONTRAGTOHS LICENSE UW DOES NOT�PPLY TO AN OWN[q OF j
VP07ERTY WF/08UMSOR iuCROVEST7IEREON.ANO W110D0E55Up1 WOHKHIIASELFOR NEFlSELFOR
CL TIROUGHV1150RHEflWVNEYPtOYEES.PROVID[DTT7hTSIKHIMPROVEMENTSARENOTINTENDF00R m
w O�FEREOfORS/LEIF.HOWEYERiMEBU�IDWGOf3iMPROVEAI[N715501DK9TMiNONEYEAROFCOM7LE• �
Z TION,THE OWNER�BURDER VALL HAVE TM[BURDEN OF VROVING THAT ME OR SHE DID NOT BUILD Ofl
= MPROYE FOR TNE GURVOSE OF SALE}
OlASOWNEROFTME PROVEHTV.AM E%LLUSIVELY CANTRACTING WfTH LICENSED CONTRACTORS
Q TO CONSTRUCT THE Pi1Q1ECT�SE4 7014 BUSMC55 M!�PROFESSIONS CODE:7N[CONTHACTO!15 U- V8IU0fiOf1 ADJ.AREA
W CENSEUwpOESNOTAPPLYTOl1NOWNEROFAVROPERTYWHOBUIL�50RIMPROYESiHEP.CON,AND
� NM1qCANTMCTSFORSUCHDRO.IECTSVATMACOffTiUCTOR(5)LICENSEDOURSUANTTOTHECONTMG QUANTITY D[SCRIPTION FEE
Y roasueeNseuw.�.
¢ ❑IAME%EMPTUNOERSEC. 8.8P.C.FORTNISRCASON Q
3 c> .
� � �,,�� 'e�
OATE ONTJ[R �
Z W
�Q LlCENSED CONTFiACTORS DECLARATION W �
CC IMEREBYAiF1iWUNDERDENALiVOFPER1Ufh'iHATIAMIICENSEDUNDCRPROVI5�ON5OFClV,v7Efl �.
d 0(COMMENCINGWITMSELTION7000)OFDIVIS�ON70FTNE9USINESSANDPROfE55lON5CODL.A.VD Z �
M�'LICENSE IS W FIRL FORCE AND EFF ELT.
x �
� IIGENSE QA -��LIC.NO.�J/�/ J �
" � V DATE�� � COI�ITIUCTOiI�,�..Qj�� d
W
� WORKERS'COMPENSATION DECLARATION -�
¢
� I NEFEBV AFLIRM UNDER 7ENAL7Y OF DERIURY ONE OF 7NE FOILOWING�ECLAMiqNS: V
Cl] a
� �_IHAVEMlDYNLL��NTNNACERTIFICATEOFCONSEMTOSEIF�I�SUREFOi1NKfRNERS' _
� COMPENSATION,ASPROVIOEDBYSECTpN7l000FTHEUW�iCODE,iORTHEPEfliOPMMICE W
OF WORK FOR WHICH iH'S OER1.117IS ISSUED. �
G
W IHAVEANDWILLMAINTAINWORNERS'CdIPENSATqNIN5UR4YGE.�SREOUIREDBVSECTION /�
Q �7000F TME 1A60R CACE.fOR THE PENFORMANLE CF TH[W �7K FOR WHICH iM15 PERM1715 � � ��
� ISSUEO.MVNqRNERS'C P SA7 INSUMu^ G1RniE vDVOIICVHUMOERARE: CONSTRUCTION L
J
j �qp�Eq � PLAN REVIEW �
Z POUCYNUMBER�(J���6�(�� ELECTRIC
a �
� (nussccrqaN[mr+oree�e�orn�r[rv.�ra�a:e�uroamoouu�sR�mlon��ss�. PLUM6ING , .
Z 1 CERTIFY TNl1T IN7HL PERFOHMANLE OF TME WO�K FOR VYHICM TWS iEAMIT IS ISSUED,I MECHANICAL
(J SMALLNOT EMPLOY M!V DEA�N IN ANV YANNER SOAS TO BECOME SL'�JECf TO THE '1
N WOPo(ERS'GOMPENSATqNUw50FCAUfORNIA,AN'�CREETHAiIFISHp�J� BECOUE INS?ECTIONFEE �.
� S1161ELiT THE RKERS'CObivEN5�T10NPflOV� JNSOFSF.T N77000 -HEV�BO
� CO/DC.1 .LLLFC.fM!MTHCOMPLVWITHTMOSEP .JVISM ISSUANCE
0 7�fp� � SMIP
p OATE:_f APPLICANT: _ _ ._
� ' ENERGY P/C �
J WARNIN�:FAILUi7ETO5ECUREWORKEflS'COMPENSATIONCOVERAGEISUNUWFUL.MlDSMALLBE -�=--�� ��---
� SUBIECTANEMP�OYERTOCRIMWALPFNALTILSANDLNILFWESUPTOONEHUNDREDTMOUSAND ENERGYPERMIT
DOLUiiS(f 100.000�.N ADOITION TO THE COST OF WUPENSATION,DAAIALES AS PROVID[D FOR IN
� SECTqN77a80FTMEL/�[i�RCOOE.MTEREST,MiDA770PNEYSFEES. RETENT�ONFEE:
a CONSTFUCTION LENOING AGENCY PRE-ALT FEE:
� IHEREBYAFFlRMUNDENPENALTYOFPERIURYTNATTHERE15ALON5TRULT�ONLENDINGAOEHCY
n- FORTNE DERLORAIANCE DF THE WDRK FOR WMICH THIS PERMIi IS ISSUEO(SEC.70Y1,CIV.L.).
Z
w .
� LENDER'S NAME
F_- lEN0ER5ADDHE55 f{.�
wICERTIFY7MATIMAVEREADTNISAPPLICATIONANOSTATETHATTHEABWEINFORMAilONISCORRELT. TOTAL FEES D �J(�
� IAGREETOCOMGLYWITHALLCITYANDCOUN7YOfl01NANCESANOSfATEUwSAEU1TWCTOBUILDING
CONSTRUG710N.AND HERE6Y AIf�HORIZE REPFESENTATIVES OF THIS GWNTY TO ENTE R UPON THE
z ABOVE�MENTIONEUPROCERTYFONINSPECipNPURPO5E5.
COM�dENTS
� _�� _�
�
m PERMITTEEN L�P /
¢ �/�
y S�GNATUHEOFPERNIT EE DAT!
� RECPL�O. PAID BY _VALIDATION
WHITE—Depanment Copy.YELLOW—Finance CoDY�PINK—Assessor Copy,GOLDENRO�FiIo Copy,GREEN—Applicant's Copy
,..'.....,. ._..... _.�...,..�._.._......_..e_,._.�.__...::.,-. . .1..••r�: • � . .4 . �;� . ..1 . :R:J- ,�;` , .."7 , {-� "•.i` - '�L' . . r .. ._ -
......... .. .....� . ...�....
..... ..
. . ., . � �. _.. ..., .. ... :.p. � . � Y - _ ., • . .
CIT4' OF DIA��fOND EAf�
It�lSPECT(OP� RECORD
�1►�-y:�=��E[�7��1' :c�'_��['= !j��F-`�a�ci tcJ�i :�►` �c;�*(� ti! . ��y�r[c . � c?i o
; _ _
�. �'��_. �� )► . _' -1►.�-�:��,�?� :t
� - - -
._._._ ____.___..�.�.___........__..--_..------.._.._._. _ ___
._.__....__. -- -...---..__---..._...--�---......,,..__._r_.. _��-------- �
SET BACK , •. � -. � � FLOQR JOIST-'. , ..-� � ,I„•, • . • _
FTGS/FORMS;STEEL , I FHA REQP�ITS
ELECTRIC GROUND ' � " � ' � UNDER FLOOR DU�T .I � � .'
GROUND PWt�ABING U1�1DER FL�OOR CO;,IDUI•fi' � � � ' � •
SLAB GRADE FIREPLACE FOUNDATION I � �
TEMP POWER I FIREPLACE E30ND BEAM � ' - � ' '
WATEFi SERVICE h�AID HT. B�PJD BEAPA . ' �
ROOF SHEATHING �SKi� ! �� _ t3 FT.BONp,BEAPl,
FRAPAINGNENTILIATION FINAL BOND BEAP,�
ROOF COVER �-� -+1j PRE-GRADING � ' �
ROUGN HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBIfdG I FINISH GRADING
SHOWERlTUB TEST � POOL ELECTRIC
EXT.LF,TH/51DING � POOL FENCING I
WALL INSULATION POOL FINAL �
CEILING INSULATION OFF SITE Ih1PS. �
DRYWALL NAILING �EDICATIOPJS
SEWER \ FI�JAL ENG.
SEPTIC TANK , '•. LAhJDSCAPE/IRRIG.
SEEP PIT/L.L. � '•` OPJ SITE IPJIPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. Q �, FIRE DEPT. FIPJAL
�O�_
FINAL HEATING ' HEALTH DEPT. FINAL
FINAL ELECTRIC I ' I I �EV. FEES PAID .
FINAL PLUMBING • ENERGY
. . . ' ,�j�.�:�6 c:�l: r(e;r:
— - - ......��,y..,....�-.....�-�.._..�_._.�._
COMMENTS
- � , .
SEPTIC TANK SIZE
SEEP PIT/U SIZE
�►'�C I
'ti��,� —
�
+� ; �. . ,