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HomeMy WebLinkAbout12530 (6) �` , CITY OF DIAMOND BAR • � �, DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 . _ (909)860-3195 Fax(909)861-3117 PR ESS '�^^ BUILDING PERMIT APPLICATION . . ' FIRMLY y�, JOBSffE I S 1"�� H��y�u�F ar. D 1��'1l�`t� ,APPLICATION PERMIT ^ P!C o ADDRESS � OATE '�,-�,�-I— LI�NUMBER I`S�d R � APN LOT TRACT ISSUE _ ��� TYPE OCC . � DATE � �CONST. GROUP p OWNER ' a ADDRESS�� y br. _�-i ' ZONING SETE3ACKS �"' CITY_D�t3,�e,�• ZIP� TEL.�l?�,�_ REAR RW p APPUCANT � (��_('H/� TEL� - � SIDElSIDE STREET RW ❑ � CONTRACTOR � SIDE p O ADDRESS _ CfTY ZIP TEL PROPOSED USE �' r � e'. • w AflCFVENG/ • �� �' �� z DESIGNER NO.DWEL'• ,'� •"., /PJO. + ��• � ADDRESS UNITS '� � ` ;',TORIES B DROOMS � CITY ZIP TEL y DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OYYNEH-BUILDER OECLAFiATION SFR/ADD/REM O . p 1 HEREBY AFFlRu UNDER CENAL7Y OF PFRRIRV THAT 1 MI FXEuvT FRWJ h1E CONTMCTORS l4 Garege/Carpon. 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W PatiaDeck IURE,GRqR 70 R9 ISSUANCE,AL50 REOUIR[5 THE APVLICANT FDR SUp1 PEHIAT TO F4E A SIONED W STATEMENT i1fAT HE OR SME R LICENSED PU1i5UANT TO THE PROVISIONS OF 711E COHTRACfOR3 LL . � CEHSE UW(pUPTER Y(COMMENdNO M7iH SECTION 7D70)OF DMSION]OF h1E BUSINESS AND PFiO � PooVSva ' f ESSiONS COO�OR THAT NE OR SHE IS EXEMPT iMEHEFAOM ANO 7NE B�1515 FOR THE KLEGED EXEMP• TION.AM/VIOtAT1DNOFSECTION)o71.l9YANVAPPLIGWTFORAPEHMRSUBIECTSTNEAPPIICANTiO Re-Roof �,,,� AtMLVENAI.T'OFNOTEIORETUNi1VENUNDREDDOLURS(f5e0�-): .--. � Ot��NEROfTHEPROPERTV,OqA1VE4PLOYEESWIiHwACE5A5THEIR50lECOA1PEN5ATqN, � WILL DO TME NCitlC,AND THE STRUCTURE IS NOT IMENO[D Oi1 OFFERED FOH SALE(SEG 70��,0U5�� J � NESS AND PIqFE4S10N3 COOE:7HE CONfMCTOiLS LICEHSE Uw DOES NO7 APPLY TO AN OWNER OF ? . ifqPEHiY YAq BUILOS OR�APROVES 711EREON.lWD 1M�0 DOES SUCIINURK MiMSELF OR NERSELF OH '�'� TMROU6MHISOflNEROWNEMPLOYEES,PROVIDEDTHATSUCHIMPROKAICMSARENOTINTENOEDOR m � OfFERmiOR9ALEFNOWEVER7HEBUlDINGDRIYPROVEIAEMIS50lDVAT/aNONEYEAROFCOMPLE• Z TION.T/1E 0'NNERBUILDER WILL W1VE TNE BURDEN OF PROVPIO THAT HE Oq SME�i0 NO7&1IlD ON = MDRDVEFORiHEVl1PPQ5EOFSLLE�. W OI,A401VNEROFINEVROVEHiY,1WE71CLUSNELYCOMPACTNOVRTHIICENSEDCONTRACTORS � TOCONSTRUCTTMEVqDJECT(SEC7oN,BU5INE55M10VROfE55iON50DDE:TNECONiRACiORSLL Valuatbn � ADJ.AREA CENSE UW DOES NOT MPLV TO/W ONMER OF A PROPERTV NM11D BV 0.D5 OR MPFiOVE51HEREON.AND � W/qCOHTRACfSFORSUCMPHOJECTSWITIACON�RACTOfyS)LICENSED7UR5UANTTO7HECONTRAC pUANTITY OESCRIPTI0�1 FEE � U SE UW.} � AAIIXEYPTUNDERSEC. B.�P.C.FOR7MISREASOH � • . ti � � ¢ •i ,�1 ' � \ .���" . . u' DATF � OWNER � . "� W F UCENSED CONTRACTORS D[CLARATION W . � iHERCBYAFFttWUNOERPENAI.TYOFPEIWRYTHATIFMLICENSEDUNDERPROVIS10N50FCMAPiER � � i�COMMENCNOYRiHSECTION7000)OFOMSION�OF7HE6US:NESSAnDPROFE5510N5CO0E.M7D Z �l� W UCENSE IS N Ml FOfiCE AND EFFECL m � LICENSE CU55 LIC.N0. ' j V OATE CONTRACTOR d . W � WORKERS'COMPENSATION DECLAFlATION U � � ...:. .�. L'.;'. .. . •:,.L•, : .. ,:•. : � .)' ;�',. •. . , � I HEREBYAFFlRM UNDER VENALTY OF VERUR"�ONE OF111E FOLLOW:NG DECUM710N5: �� Z . Q G ��NAVEANpWI��WIlRARiACERTiFlCATEOFCONSENTTOSEIF•INSUREFORN'ORKERS' _ Z COMPENSll7qN,ASPROVIOEDBYSECT10NJ70aOFTMEL�eOqCOOEFORiNEVERFOWAANCE U QOf TME WOIU(FOH MA9d11Hi5 PERAtlT S ISSUED. � _I HAVE AND WM1I4AMTAIN WORKERS COMPENSATiON MSUiWJCE,ll5 RfOUIRED BY SECT�ON O �7ooOFTT�EUBORCOO�fORTMEPERiORM�NCEOFTHEwOPoCFORYmidiTHISPEP.MIT15 Q /1 � � ISSUED.MYWORNEASCOMPENSA7qNW5UliANCEGIRNIEHANDPCIIC'IMIM�ERME: ONSTRUCTI O L � CMRIEH PLAN REVIEW � POIICYNUd6EFl ELECTRIC. � (iH55ECTC��hEmtqTB[O�.s'tEiE�OFMVEar.rT6F0�i0nfwOREDOd.WSR+��lE55? PLUMBING Z I CERTIfYTNAT N h1E PERFOFiMANCE OF iHE N'ONK FOH WHICH THIS PERIAIT IS 55UED,I MECHANICAL C7 SMALLNOTEMPLOYANYFERSONINAN'lAIM'NEHSOASTOBECOMESUBJECTTOTHE � WOW(ER5COA17ENSATqNUW50FCALIFORNIAANDACREETHATIFISFqULDBECORIE INSP NFEE S SU0.1ECTft1THEWONKERSCO��PENS�TIONP170VI510NSOFSECTION�70oOFTNELABOR COOE,ISH�iLFORTMVf7HC01.1PLYWiTHT1105EPROM5qN5. IS UCE / � SMIP �5O p DATE: APi'LICANT: � WAANIN(i:F�ILURETOSECUREM.ORNER5COA1�EN5AT10NCOVER�GEISUM.AwFUL/UASNALL9E ENERGYP/C �y 6V&lECfANEMPLOYERTOCRIMINN.PENALTIESNACMLFPlE5U7TOONEHUN�REDiMDUSANO EN[RGYPERMIT ' � DOILAFiS(f 700.000�,IN ADDITION i0 7ME GOST OF COMPENSATION,ONMCES AS VROVIOED FOR W ¢ SECTIDN77oeOFTHEUBOFiCODE,NTEREST,M�0A770fWEY5FEE5. RETENTIONFEE: ' a CONSTRUCT70N LENDING AGENCY PRE•ALT FEE: O � IHEREBVJIFFIHMUNOERPCNKTYOFPE0.NRYTHATTHFREISACONSTRUCTIONIENOWGACCNCY ' FOR TME PERFORAIANCE OF TME WORN FOR WHICH THIS PERMIT IS ISSUE��SEC.90a7,CIV.C�. . � � LfHDER'S WVAE . S C IENDEF5A00RE55 � ICERTIFYTHATIIUVEREADTMISAVPLIGTqNANDSTATET1UiTHEA80VENFOANAT10NI5CORFECL TOTAL FEES �,m ,' � h �� � IA6REETOCOMOLYN7THALLUTVANOWIrt�TYORDINANCE5IWO57ATElAw5REU71NOTOBULDINC �LLL '/ � CON5T11UCTION,ANDNERE6VAUT1qRREREPRESENTAiNE50FiHI5COUNTYTOEN7ERUPONTHE . , ABOVE�GEM70NED VFi07ERTY FOft INSPECTION PURPoSES. COMMENTS � � MA RK C�-wrJ� ����Q m PE ENAMEIPW/!T) � ��a��. . , .. .. .r Z f.9� r^' �3j�,Q y S NR60F ITf �... � �_'..! OATE.L... �1' , l.11 l V � � . — RECPT.NO. _P . VALIDATION WHITE—Departmen[Copy,YELLOW—Finanee Copy,PINK—Asseuor Copy, O de Copy,GREEN�Appicanl'a Copy -�� �� , . .. , . , . . , . ; . .. , . . � • � � ., . • . �, . • . , . , � � ', CITY OF DIAMOND:BAR„� ; , .. _ � � ' � ' �� {' INSPECTIDN RECORD = "�: . ' ., � � , +s � � � • ' • � � . � . SET BACK � ' �-.E` � " � , � FLOC�F3 J015T, ;: '�' - �•, '.�•-�l'� ( t . . . . . , , .. . . FTGS/FORMS/STEEL �� � FHA REQMTS- - � -- � ELECTRIC GROUND - ` ' - ' UNDER FLOOR DUCT � GROUND PLUMBING UNDER FLOOR COt�DUIT :"• , ,' .- •- � - SLABGRADE - - - - � FIREPLACE�FOUNDATION � i .-- � - -�-- TEMP POWER • - � FIREPLACE BOND BEAM � ` � '�' '''" '' " " ` WATER SERVICE - � � � - - � MID HT.BOND BEAM � • ROOF SHEATHING =: '. - - - �= �_�2�� 8 FT.BOND BEAM -� FRAt�AING%VENTILIATION :� - FINAL BOND BEAM � ROOFC�VER .: . a• -9 PRE-GRADING - ROUGH HEATING - � - --- - - -. � BENCHING � ' , ROUGH ELECTRIC -. - - � - ROUGH GRADING ' ROUGH PLUMBING � - � " - - FINISH GRADING '� SHOWER�TUB TEST � -�- - - PO�L ELECTRIC . EXT.LATH/SIDING PO�L FENCING WALL INSULATION � •- r' POOL FINAL . CEILING INSULATION .. OFF SITE IMPS. DRYWALL NAILING DEDICATIONS ' SEWER FINAL ENG. • SEPTIC TANK . LANDSCAPE/IRRIG. SEEP P!T/L.L. •' ' ��'�- ON SITE IMPS. � GAS AIR TEST• - FINAL ZONING FINAL-CONST. - - � ��- FIRE DEPT. FINAL � f�., FINAL HEATING HEALTH DEPT.FINAL� . - � � ' • �" -� % -- ' ' FINAL ELECTRIC- " DEV.FEES PAID FINAL PLUMBING ENERGY � • a�s �� oee . COMMENTS �b=��-Q� .��.���, �� . o,� � ����_�:��� �.�.��_ : . 1`�\ r' - ' , . . ., . . � . . . .. t � �1,� '�- • - , SEPTIC TANK 51ZE ' ' _..... SEEP PIT/U SIZE - . . , . .��� �—� � • . � . . � ;�r �� �,:Y��l�'� ; . , . . ; . � .. � , . , .:. � - : ,_.__ .._.. .._.. _...._. . , , , , i . , ', . 1 .. . .. . � . . . . . I v�.�.�.i � ; .I V _ .... ... .... .. .. ... ..... . - - ,.' • ' ._' i ., ,�.. �, � : - - ---. ._._. .. ..... . j .,i �/ i i ,a.�i;�c�t�r•r� �;�>�r�t��� - ..... ... � . g�—��Z--o - � - , � � . . , r�. ,. _ , ,. .. . __ , • . . _ . .. T.1A? _ . . r�-�;�.... . .._. '.._ ....._._........__ --.. _..---- -....