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HomeMy WebLinkAbout17871 (17) �,` CTfY OF DIAMOND BAR � � DEPARTMENT OF COMMUNITY&DEVELOPMEM SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRE$$ ��-��' BUILDING PERMIT APPLICATION FIRMLY � JOBSRE APPLICATION PERMIT P/C ��/ o ADDRESS DATE �IU �Q��NUMBER�� it c� ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER " ADD SS ZONING SETBACKS � CIT� '��_ FRONT RW O APPLICANT TEL. REAR ❑ SIDE/SIDE STREET RW O � CONTRACTOR' SIOE ❑ QCIDnDRESS v ZIP EL PROPOSED�1SE � w ARCH/ENG/ ��� l � ,,n • � W DESIGNER NO�DW EL NO. � n. ADDRESS UNITS STORIE�S BEDR MS � CIN ZIP TEL. N DESCRIPTION S0.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLAF7ATION SFWADD/HEM O p I HEREBY AFFlRM UNOER FENALTY OF PERNi7Y THAT i AM E%EMPT FROM TME CONTiUCTORS U• fR90/CdIp01l W CENSEUWFORTHEfOLLOWINORE/150N(SEC.70.tt.5BU5ME5SANDiROFES5bN5C00E:ANVCITYOR (n U COUMYWNIGiREOUIRESA�Etu11TTOCONSTRUCT.ALTER.VAPROVE.DEMOLISM.ORRE7NRANYSTRUC• W Pd1i0 Ck � TURE.VRIOp TO RS ISSUANCE.AL50 REOUIRES THE APPLICANT FOR SUCH VERMIT TO FILE A S�GNED W � STATEIAENT 7HAT HE OR SHE IS UCENSED PURSUANT TO THE CROVISiONS OF THE CANTMCTORS ll- � � CENSE LAW(LFi��TEfl 9(COMM[NCOJO WITH SECTION 7000)OF DIVISION]OF TNE BUSINESS AND PRO- � USpa FESSIONSCADE)ORh1ATNEOR5HEISE%EMPTTHEREFROMANDTNEBASISFORTHEALLEGEDEXEMP• (� � TION.l�M/VIOLATpNOFSECT10N7071.68YANYAPPLICANTFORIIPERMITSUBJEGTSTHEMPLICANTTO Z Fj0-R001 A CML VENALTY OF NOT MORE TMAN FNE HUNDRED DOLURS(i5C01.t ZOIIISOYVNEROFTHEPROPERTY.ORA1VEMVLOYEESNnTHWAGESASTHEIRSOLECOMPENSATpN, � COmmefClal � � YALL DO THE WORK,AND THE STRUCTIIRE IS NOT INTENDED OR OFFERED FOR SALE ISEG 70�I.BU51• J N NE55 ANO DROFESSIONS COOE:THE CONTRACTORS UCENSE Uw�OES NOUVPLV TO AN OWNER OF � PROPERTYNhqBUILD50RIlAPROVESiHEREON.MIONMODOE55UpIWORKHIMSELFOqHERSELFOR = � Q THibUGHNI50RHEROYRIEMPLOYEES,PRONOEDTHATSUCNIMPROVE/AENTSMENOTINTFNDEDOR m . 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ISSUANCE 'p DATE:� ( � �ICnNT: _ SMIP � ENERGY P/C �-•-%� i'^� �r ' � WAM1iNG:FA0.URf TO SECURE WORICERS COMPENSATI N COVERAGE I N WFUL,ANO SHALL9E ���• �y SUBJECTANEMPLOYERTOCNMWALPENALTIESANDCMLFINESUPTO N UNDREDTNOUSAND ENERGYPERMIT DOLLARS(iloo,oDo),IN I�DDITtON TOTHE COST OF CAAIPENSATqN.D AS PROVIDEO FOR IN � ¢ SECTION]7ae OF T11E LABON CODE.INTEREST,ANDATTORNEYS FEES. RETENTION FEE: �p� ��� 7 n n� � � a �� CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFIRMUNDEfl7ENALTYOFPERJUMTNATTNEREISACONSTRUCiKKJLENDING�liENCV �- iORTMEPERfORMPNCEOFTNEWORKFORWHICHTHISPERMITISISSUED(SEC.�o91.CIV.C.j. Z b Y. ._._ '— W � LENDER'S tU1AE � � LENOERSADDRE55� • w ICERTIFYT7ATIMAVEREAOTHISAPPLICATIONANOSiATEtMATT/EABOVEINFORMATqNISCARRECT. TOTAL FEES � IAGREETOCOMPLYH7711AlLGIT'f/�NOGOUNT'lORDINMlCESANOSTATEUWSREUTWGTOBUILDINC /' �� J ��(( CONSTFUCTION,/W�HEREBVAUTHO IZEREPRESE NTYTOEMEHUPONTIE �'%' ' _ �L/� �„ / � ,�30 Z ABOVE-MEMIONEUCRO�E TVFOR SPECTIONP [s. 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Ut�lDER FLOOR CUI�!DUIT � - SLAB GRADE I ^ I FIREP�ACE FOUNDATI�N • � TEMP POWER I I � FIREPLACE BOND E3EAM WATER SEAVICE I . i_� MID H�:E30ND BEAFJ! __ � ROOF SHEATHIPJG ; 8 F7. BOND BEAM ! . FRAMINGNENTILIF;TION� ! FINAL BOND BEAh,1 � Fi00F COVER ( � PRE-GRADING FiOUGH H�ATING BENCHIi•dG ROUGH ELECTRIC ; RQU�H GRADING ROUGH PLUMBING � FINISH GRADIPJG SHOWERITUB TEST I POOL ELECTRIC EXT. LATHJSIDWG j � POOL FEhdCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IP�IPS. DRYWALL NAILING DEDICATIOPJS SEWER FINAL ENG. SEPTICTANK LAPJDSCAPE/IRRIG. � SEEP PITlL.L. ' ON 51TE IPAPS. GAS AIR TEST � FINAL ZONING FINAL CONST. �/��� .�/�'� �!RE DEPT. FWA! FINAL HEATING hiEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMEIIPJG E�•dERGY NuU „��0��. 3 �� � - - - r9�i`C" f'j.'•E'If..(C � CUMPJIENTS SEPTIC TANF<SIZE SEEP PIT/U SIZE - .�_ ._._______....� , �',�p F��� R; ::; . , J � .