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HomeMy WebLinkAbout10938 . � . � - , ' �,\ --��—i CITY OF DIAMOND BAR �. . -, .• � ! COMMUNTTY DEVELOPMENT DEPARTMENT 21660 E.Copley Drive Suite 190 • -•� , �,. �� (909)860-3195 Fax(909)861-1117 - PRESS '""` BUILDING PERMITAPPLICATION FIRMLY o DD ESS J�ON I �� �OTiD DR. DATE CAT' _NUMBER ��y3 s #�C 9 7�Y3 c� � ISSUE�" TYPE OCC APN LOT TRACT DATE ' CONST. ` GROUP" � OWNER O "' AD�RESS �i o't7► OR. ZONING SETBACKS ' � gCITY D1 f�_ ZIP�� � TEL. FRONT � RW ❑ APPLICANT TEL. REAR ❑ Z SIDE/SIDESTREEf RW p � CONTRACTOR SIDE p � ADDRESS � CITY 71P TEL � PROPOSED USE w ARCH/ENG/ ' z DESIGNER " N0.DWEI. N0. • , - NO. a ADDRESS UNITS � �"STORIES BEDROOMS ' � GTY ZIP 7EL � u� DESCRIPTION 'SQ.Ff. FACTOR PSF ADJ.AREANALUATION Q ONRJER-BL'ILDER DECLARATION _ _ SFRlADD/REM -- - -- O � p 1 HEREBY AFFIRM UN�ER PENALTY OF PERJUHY TMAT I AM E%EMPT FROM THE GOHTRACTORS U• .G0fe98/CefpOR ' W CENSEUWFORTNEFOLLOWINGPEASON(SfC.70a1.68U51NE55M1DOROFESSIONSCOOEANVCRVOR (/� U COUNTYWMIp1RE0UIRE5APERMITTOCANSTRUCi,ALTEfLIMPROVE,DEMOLISH,OHRE7ARANYSTRUP W at'/Deck - , w iURE,iR10R TO RS ISSUMCE.ALSO RE�UIqES THE APPLIC►NT iOP SUQ/PERMIT TO FILE A SIGNED ' � STA7EMEHT TMA7 HE OR SNE IS UCENSED PURSU/J1T TO THE PHOWSIONS OF THE QONTRACTORS U-' � � CENSE UW(tl1AVTER Y(ODMMENGN6 WITN SECTIDN 7000)OF DIVISION 70F THE BU51NESSAN�DRO. OOUSpB FESSIONSCODE)ORTHATHEORSHEISE%EMPTTMEREfROMMIDTHEBA515FORTHEA�LEOEDEXEMP• (rs _V TION.ANYVIOLATIONOFSECTKKJ7071.6BYANYA7PLICANTFORAPERMITSU&IECiSTNEAPPLICANTTO' � z Re-Raof - , . ACMLPENALTY OF NpT MORE TIW�FIVE HUNDRED DOLLAf1S(Ssoo).1: Z~ ❑�ASOWNEROFTHEPROPENiCORMYEMPLOYEESWITHWAGE5l15THE1RSOLECOMPEN5AT10N, • NALL00 THE WORK,AND THE STRUC7URE IS NO7INTENDfD OR OFFERED FOR SALE(SEC.70N.W51- � COIIlRi0fti81 , � N NESS/ND PROFESSIONS CA�E:THE CAMRACTORS UCENSE UW OOES NOT�7PLY TO AN OWNEq OF � ? PROPERTY WF10 BUIlDS OR IMPRWES TNEREqJ,ANO YMO pOES SUCH WORK HI/ASELF OR HERSFLF Oq � CL TNFIOURHMISORMEROwNEMPLpYEES,PiiONDEOTl1�TSUG11MVROYEMEMSARENOTINTENDEDOR m � OFFEREDFORSPLEIF,HOWEVERTNEBUILDINQORIMPROVEIAENTISSOIDWITHINONEVEAROFCOMPLE- � � Z TION.THE OWNER�BURDER 1MLL MAVE TME BURDEN OF iROYIN6 TFIA7 HE OH SNE DID NOT BUILD Oq � IAIPROVE FOR hIE DURPOSE OF SALE). � . O I.AS OWNEH OF THE PROPERTY,AM EXCLUSNEIY CONiMCTINO N7TH LICEN3ED CONTMCTORS � TO CANSTRUCT THE VROJECT(SEC.7o��.BUSINESS AND PROFESSIONS CO�E:THE CONTRACTORS LL �V01USti0ff �� ' AQI.AREA � W CENSEU'NDOESNOTAGPLYTOANOWNEROFAPROPERTYNRIOBUILDSORIMPROVESTNEREON,MID � W11000NTRACTSFORSIICFIVROJECTSNATHACONTMCiOR(5)UCENSE�PIIRSUANTTOTHECONTRAG QUANTITY DESCR�PTION ' ' ' `�� - FEE Y TORS LICENSE UWJ. ' � D I AM EXEMPT UNDER SEC. B.8 7.C.FOH THIS REASON Q � ' � . .. �\ . . u" DATE ONMER ZU � • . . ' ' ��� - - - f��. � LICENSED CONTRACTORS DECLARAT�ON' w t ti � IHERE9YAFFIRMUNOERPEN/LTYOFPERNflYTHAT1AMlICEN5E0UNDEHPROVI510NSOFCWIPTER � d 0(COMMENCW6WIiH5ECTION7000)OFDMSION]OFTHEBUSMESSANDPROFE5510NSCOOE,AND Z X MY IICENSE IS IN FUl fORCE AN�EFFECi. m LL 'w � � LiCENSECLASS�(� a_LM.. O. C yl ' � V DATE (/"�'�l'��� coNrrucroa T. K. 0 D , a w ' � WORKERS'COMPENSATIONDECLARATION —+ ¢ � � 1 HEREBYAFFIRM UNpER PENALTY OF PERNRY ONE OF7HE FOLLOWING DECLA1iA710N5: V^z, , � � _IHAVEANDIYILLMAINTAINACERTIFICATEOFCONSENTTOSEIF•INSUHEFOHWORKERS' T. - ' !a C0IAPENSATION,AS FRON�ED BV SECTION 770o OF TME UBOR CAOE.FOR TNE DERf-0RAIMICE w 1 O OF TME WOFK FOR WMIp17MIS iERMI7IS ISSUED. � w _IFUVEANOWILLMAINTAINWORKERS'COMPENSATIONINSUMNCE,ASREWIREOBVSECTION ; � 970oOFiHEtABOHCOOE,FOfITHEPERFORMMICEOFiHEWORKFORWHICMTH15PERMITi3 �p��p� ISSUED.MY WORKERS COAIPENSATION INSURANCE CANPoEH AND POIICY NU{ABER ARE: � CONSTRUCTION - - -_- .. > CARRIER PLAN REVIEW. 5��•�� . � � POLICYNUM�ER I ELECTRIC � � ' Q � (fH65ECf10NNEmN0i8EWI.RETEDCFTfGERMf6PoRONEHH1fiEDD011/�1LSR10o70RLQ51 PLUMBING Z ICE0.TIFYTHATNTNEPERFOWAANCEOFTNEWORNFOqWHICHTHISOERMITlSISSUE�,1 MECHAN�CAL C7 SHALLNOTEMPLOYANYCERSONWANYMANNEHSAASTOBECOMESUBJECTTOTHE y WORNERS'COMPENSATIONUWSOFCAIIFOFNI0.AN�AGREETNATIFISHDUlDBECOME INSPECTIONFEE' - � - � - - S SUBJECTTOTHEWORKER5LOMPENSATIONPROVISIONSOF6ECTtONf7o00FTHEUBOR � O,O cao,e,'�sHnu FonrnwirH canvir wini rHosE vao�nsions. ISSUANCE ' p DATE: . �-9�APPLK;AM: �. K . �OO . SMIP N �� �� WARNIN6:FMUHE TO SECURE WORKERS'COMPENSATqN COVERAGf IS UNUWFUL.AND SHALL BE ENERGY P/C � .�y. SUBJECTMlEMPLOYERTOGRIMWALPENALTIESANDGMLFlNESUP700NENUNDAEDTMOVSAND ENERGYPERMIT -OOlUf35�f 100.000),N ADDITION TO 7HE COST OF 0061VENSATION,DIIAAGES AS�ROVIDED FOR IN � SECTION77000FTHEUBORCOOE.MTEPEST.M1DATfORNEY5FEE5. " RETENTIONFEE:� - - ,. O CONSTRUCTION LENDING AGENCY PRE•ALT FEE: - - - � � INEREBVAFFIRMUNDERPENALTYOFDEMIRYTHATTNEREISACONSTRUCTIONIENDNCAGENCY _ � ' - FOR THE PERFORMANGE OF THE WORH FOR WHId1 THIS PERMIT IS ISSVED(SEC.7097,CIV,CJ. Z " W � LENDERSNMAE ' , � � LENDERSADDRESS � ,. W ICEqTIFYTiATIFUVEREAJiHISAP7LICATIONMIDSTATETUTTNEABOVEMFORMAT10NI5CORRECT. TOTAL FEES _ /�g ��� , � IACREETOCOMPLVWITH/�LLCITYANDCWNTVORDPUNCESINDSTATEUWSPEUTINCTOBNLDINO ' - - ' � CONSTRUCTION.MIDHEPEBYAUTHORIZEREPRESENTATIVESOFTHISCOUNTYTOENTERUPONTHE . Z ABOVE�MENTIONEO PROPERTV FOR INSPECTqN PURPOSES. � - COMMENTS _' TA� �C��f� �DO _ m GERMITTEE NAME ryf3lNn � � � -�� 4 � ' (/) SiGNANREOFPERMITfEE OATE��..�7 m � • � r RECPL N0. �S PAID BY VALIDATION � � � � -� 1NHIT —Depanment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLOENR06—File Copy,GREEN—Apphcant's Copy , � 1,,kr.,,r�-y'in ".�,, �:�T,s-• .y'r« t_.i ��Y^�' _ •'�:. -'..k_�..,�Y�},r��r. �"l�r 1�AR�..�.a � Fi�'1�.�-r'7':.r-�..•�—•r:-__.--_-t . . ^"-_—^.zr .. 'ry:,, � .... ��'e y.l i.,����1- �>'�,,`) rJ{''}�,P��� . . ^9�i'r'��� .��•(. S • . . � r , .. � '� ' �,CITY OF DIAMO�ND BAR ' ' '� ' '. , , � . . �, . . , . �� "� �INSPECTION RECORD ,� = „' .' ,- - �._ � , . �' ) . > � � �: � .-� � . . � - • • � � � • - • • � � . E.;�...� . SET BACK': ; ; ` � �� �-\ FLOOR JOIST• --- — - - -- ,FT'GS/FOF�MS/STEEL (� jO """'� " FHA REQMTS " �,, , , ' �„,; ,- '� r�+; � ' i -� ;ELECTRIC GROUND - � � UNDER FLOOR DU�.T, ry�; !:,;�,,;,r.`•; , c;-^,�� . . ' -' 'GROUND PLUMBING - - - - � I UNDER FLOOR COMDUIT ��L?i\ ' �\V � � 1 � � _ . SLAB GRADE ---- - - �' ' ` � FIREPLACE FOUNDATION , __ - " ' ' .. -- TEMP POWER -- - - - FIREPLACE BOND BEAtJI�,,, �'�,�.�=:': -' ;� _ :. .� ., % ! � � WATER SERVICE- - - - - ' ' MID HT.-�'ONQ-��Mt. =yi ^ G;�-, '�, � °t:,_�; ROOF SHEATHING 8 FL BOND BEAM ": �'>•' , '' FRAMINGNENTILIATION / FINAL BOND BEAM - - - - � " ROOF COVER - - --; - _ _ -- - ,- PRE-GRADING ' . ' - - ', i� , ; �. ROUGH HEATING ! ' BENCHING - - - - - ' " �ROUGH ELECTRIC i ""-"�- - - - ROUGH GRADING , � ROUGH PLUMBING �, - �-- .(`i-n,; �! FINISH GRADING SHOWEFiriUB TEST . � ' ��'� � - ` �FOOL'ELECTRIC � - - � EXT.LATH/SIDING POOL FENCING " � �-._ WALL INSULATION I POOL'FINAL' CEILING INSULATIQN OFF SITE IMPS. � DRYWALL NAILING DEDICATIONS; � " � r;; SEWER -- - - :— --- -- -- FINAL ENG. � �: SEPTICTANK __.__. ._ _ ` -�� � .LANDSCAPE/IRRIG. �.. ' SEEP PIT/L.L. - - --- -- -- � ON SITE IMPS. � . ; GAS AIR TEST ,-- -- - - ' - � • - FINAL ZONING '' - ' , `, _ .. , . � . FINAL CONST.-; --- - - - FIRE DEPT, FINAL � :. � . FINAL HEATiNG - � --� � � HEALTH DEPT.FINAL -. - � - - - -- -- - - -- � :� FINACELECTRIC - - '- - - • : � �"��' � DEV.�FEES PAID ,. . ., , � r ',^ FINAL PLUMBWG � ENERGY ' ' .�, . .. ; . ; � : �:J _ �-. . �;1�'�*c�,i. . . � ; - � ' : '-�, — -- - -- - - - - -- - --- _ _. . � . , . • � COMMENTS - . . .�;.:',. .,. �. . �, .. ., . ------- - - -- - -- • . � ..,'.....: ',. „ ' ' � r� ,., ... . . � . . - --- ---- --- - - -- -- - - .. . ... .. ... . ...__. ,. . . . . � , . � 1;r <^,.\" - -- --- - --- - -- -- .. . _ _ .. _ _ . 1 , i , � , � -- z�.'\�' ' .. . . .. , ,. _. - - - � i -: -— - - v� - ,tr- � v�-1-� , , , , r-.. ., i . ._..- - - � ---- � . . � I ' i . , , , I ;_ -« . _ � . � ,� , . , �`�Z\ - - � - i . '" � "� " . . c � c.. . • � J�? - . , , _ . 4O t! .�i. .� >: � �t~�,``���. � i.. -- -- ,, , i � . � - SEPTIC TANK SIZE � �' � . i :..— -,-_- - - SEEP PIT/U SIZE - - - --. . � ! , � . . . � , , i , : � , � , - ' � - _. �, � ' , ' - - = - � �. � � . , : . . . I - � . � � j � ;;p�' ���J�;. =;�-.� � ; r,�:r� \r c. �v , , — - . , r;�__���--�.\`�-.� I � � `� �_ . ._ _.. _. . --- .. . a. ` __. _. . . - --'- -�� - ---• ----�� — ----