HomeMy WebLinkAbout14289 �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUI�TITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suitc 190 � ���s6o-3issr���)s6i-sit� . PRESS y^' BUII.DING PERMIT APPLICATION • FIRMLY } JOBSffE APPLICATION I ,,, �..G eI PERMfT i P/C o ADDRESS DATE � NUMBE p g ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER LL ADDR S ZONING SETBACKS W ' FRONT RW ❑ � CITY Z�P T - REAR ❑ APPLICANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ ADDRE S . g CITY • ZIP EL � �'(p� PROPOSED USE � ARCFVENG/ • DESIGNER NO.DWEL NO. NO. � C'DTD�RESS Z�P TEL. UNITS STORIES BEDROOMS �n DESCRIPTION SQ.Fi. FACTOFi PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADDlREM O p 1 HEREBY AFRRM UNDER PENALTV OF PERIURY THAT 1 MI E%EMF7 FiWG T11E CONTMCTORS L4 Garape/Carport 11J CENSEUWfORTMEFOLLOWWOREA50N(SEG70.11.6BV51NE55ANDiROFESSION�LODE:ANYqT'OR (n �� COUNTYNR901REOUWESAPE1iMfTTOCONSTRUGT,ALTE1LMPpDVE,DEMOLISN,ORREPAIRANYSTRUG w LL� 7lJRE.GXIOfi TO RS 65UANCE.ALSO REOUWCS THE APPLICANT FOIi SUCH PERMITTO FILE A SiGNED w Patiol�eck .� 6TATEMENT iHAT HE ON SME IS LICENSED PUfLSUANT TO THE PROVISIONS OF THE LOHTRACTOqS L4 � � CENSE UW(�ER 0(COMMENGINO WfTH SECTpN 7000)Oi OMSION]OF THE BUSINESS ANO PRO� POOVSQB fES510N5000E�ORTNA7NEOR5HEISEXEIAPT711EHEFtiOMANDTHEB,l515FORTMEALLEGEDE%E1AP• C7 TION.ANYVIOlAT10NOF5ECilON70�1.68Y11N`/APCLICANTFORAVENUIT5U0JECTSTHEAPPLICANTiO Z Ra-Root '„�, ACMLPENALTYOFNOT40HE7T4WFIVEHUNDREDDOl1AR5(tsoo�.): � 01ASOYMEROFiHEVROPERTY,ORMYEYPLOYEE5WITMWAGE5A5THEIR50LECOUPENSATqN, COfl1(fI0fC1111 - WKL DD THE WOF11C AND 7HE STRUGTURE IS NOT IMENDED OR OFFERED fOii SALE�SEG 7ost,BU54 �J N NESS AND VROFESSIONS COOE:TME CONTHALTOftS IICENSE UW DOES NO7 A7PtY TO lW OWNER OF � CROPERTY YINO BV0.DS OR MPpOVES iMEfiEON.1IND WF1000ES SVCH riVRK HIMSELF OR HERSELF Ofl � THROUGHIUSORHEROWNEMPLOVEES.PfqVIDEDTV1Ai5UCFIMPROVEAIENTSARENOTp1TEN�EDOR m OFFERED PDR S/LE F.M�WEYE0.T1E BVID WO Ofl MPqOYEMEM IS SOI�WITMN ON[YEAR OF COMPL6 TION,TIE ONMER�BUItDER WILL HAVE illE BURDEN OF PqOVpla iHAT HE OR SME DU NOT BURD OR W PROVE FOR THE PUAPOSE OF S:LLE4 O l�OMNER OF 1NE PROPCiRY,11M IXQUSM1IELY CONTI1ACTp1G Wfi}I LIC'ENSED CONTMCTORS � TO COHSTRUCT THE PR0.IECT(SEG 70N,BUSINCSS 11N0 ii10iES5lON5 ODAE THE G�ONfMC70R5 LF Valuatlon ADJ.AREA CENSE UW DOES NOTAPPLV TO NI OYMER OF A PAOPEFTY Yrt�O BUlDS OR IMPFlD'/ES TIEREON.AND � WIiO�NiMCiSFORSUCHPFiO.lEGTSWIiHAGOHfMC.OR(S�LICENSCDFURswvrtron+Ecart�uc pUANTITY._ OCSCRIPTIOt� FEE � TORSLICENSEUw} _ OIAMIXElA7TUNDERSEC. B.iP.GFORiHISRE/50N a `W y � U ,� , � � _ OA7E OWN[R V _ � W � UCENSEO CONTRACTORS O[CLAFlATION � � w IMEfffBYAFFIRMUNOERPENALTYOFPERNRYTNATIAMIICEN�EDU�:DERPRONSIONSOFCfUPTEF{ � s i(COA�AENCWO1MiNSECTION)OOOI�DMSqN70FTHEBU51NE55M![IiROFES5qN7000EAN0 Z K W LICENSE IS N M.L FO/RC1EANO EFFECi. � IICENSE CUSS `� UC.NO. O� j ' �j DATE CONTRACTOR a ' = 1��31- < � WORKERS'COMPENSATION DECLARATIGN � / � INER[BYAfFlMlUNDER7ENALTVOFPERNMON[OFTHEfOLLOWINODECUiLt7qN5: Z ' � �IHIIVEANOWILLMANTINNACEHTIFICATEOFCONSENTTOSELFdNSUREFORWORKERS' _ Q COMPEN5.1TqN,ASFHO��DEDBVSECTIONl7000FTHEUBOriCODE,FIXiTHEVERFORMMICE �U Q OFMEW[XiKFONNMICHTN15CERA1:T13{SSt1E0. � � �IHAVEANDNnLLMAMAulY/ORKERSCOMPENSATqNINSURANCE,ASHEOUiREDOVSECTqN O J7000F7HEWORWDE,fORT/1EVERWRMMKEOFTXEYVORKWRN?71p1TMI5PERA1�T15 � ISSUED.MYWONERSCOMPENSATpNWSUAANCECAHqIERM1�iOLICYMINB[NAAE: CONSTflUCT10N � CApAIEN �O PLAN REVIEW Z PauCv MnaeEA ELECTRIC ��� . r_ � .\ d � ft�s[trioar�r+ore�oor.FtFrIDOFner�n+'rcwnu+eHu�+IDoatucR�ao�on�Es.,•7 PLUMBING i 2 ICCNTIFYiHAfPiTHEPERFORIAINCEOFTHEWORKFCRWHICHTH15PEFlMITI5155UED,l MECHANICAL U' SwLLLNOT E1AttOYAHY OERSON N ANY uANNER SOAS TO BEC0IAE SUBJECT TO 7HE / (ry WOR1(E0.5'COAIPENSATIONUWSOFCALIFORNII�MID�CREEM�TIFISFIOULOBECOu[ INSPECTIONFEE S SUBJECTTOTMCWOi7KERS'C01.1PENSATIONVROVISIONSOFSECTION97DOOiiMEU00N � CODEIStiALLFORTfW�TMCOMPIYW�MTNOSEPFtOVI5qN5. ISSUMICE T^l7l�'��i`�ry,;���j, 0 V• � UA7E: APPLICANF. SMIP n7�=y . . �t�tLll u� t�e't: WAAMNfi:FAIURETOSECUREVNRKERSCOMPENSATIONCOVERACEISUNUWFUI.ANDSHKLBE EN[RGYP/C (—y SUBJECTANEIA%AYERTOCi11AWALPENALTIESANDCMLFINESUPTOONEMINDREOTFWUSANO ENERGYPERMIT � OOILAFt51i10o.o00).N/�DDfT10N i0 THE COST OF COMPENSATqN,DMIACES AS PROVIDED FOH IN � 6EGTtON]7aeOFiNELABOHCODE.INtEHEST,uVDATTOnNEYSFEES. RETENTIONFEE: OCONSTRUCTIO�I LENDING AGENCY PRE-ALT FEE: � IHEREBYAFFIRYUNDERPENALTYOFPERNRVTHATTNEREISACONSTRUCTIONLENDINCAGENCY FORTHE PERiORMFNCE OF ME WOPoC iOR MMICN THIS VERMR IS ISSUED(SEG 70a�,CIV.C�. � � IENDERS NAUE � LENDER511DORE55 1 � TOTAL FEES (/J� � I CERTIFY THAT I NAVE READ TNIS 11PFLICATION M!D STATE 71UT THE ABOYE NFOMIATqN IS CDMECL / � �O � IACREETOCOMPLYN1h1ALLGiYANDCOUNTYORDWANCESAHDSTATEUwSREUiw6TOBU1DIN6 • / i � GONSTRUGTION,INDMEREBYAU11qRIZEREPflESEMATIVE50FTM15COUN7YTOENTERUPONTME ' Z 1100YE�MEM70NEDiROPEflttFOHINSVECTiONPURPO5E5. COMMENTS =G �s���}�7 t �i`'7"/.—_� .�-r�ci ./'��.�r •��/✓I�TG� m VEHAIITTEE! G v � //�C�f� ni/�f!� 1/�2 1� 61GNANRE OF PFiWITTEf DATE � RECPT.NO. PA'D BY YALIDATtON WHITE-0epenmenl Copy,YELLOW--Finence Copy,PINK�Asseesa Copy,GOLDENROD—file Copy,GREEN—App6canPs Copy . ' . . . . . � .. . . . �. .. . . ., ,.. . � � .� � .,� �� , � ...�� ' � . . . • � . . .. i �1. .� . . .. � . 1 • . -�.5, CITY OF D1A(�iOND BAR , , ,:.. . 1 .. -.��-�.•.. . II�SPECTION RECORD '. ;�• �,�., � :�... � -. . � �. . � ;. . .. '*��►��7�3:��tc;1��� � I���€�.�,� �(:►��-������f.i �•�1��-=_i:��t��Cc����[4 .,�+�-��-��� �C►�:E-�i:�==:',-��.��� u._, 'SET BACK�.+� `- - � ,i� .- �� �FLOOR JOIST�.C '._ , .,..._ ��,�,.� --... . _ , . . , _ �FTGSIFORR7S;5TEEL -= =-. . - - - - -' FHA REQ'�1T5=,::���.:� • . . ` . , . .' .. ..-- -.._.. �. : �ELECTRIC GROUND_...__ __. '� ' _.. UNDER FLOOR DUCT ��'� `' �' '�' �: . .._.. _.. . . - - �GROUND PLU��4BING • - UNDEf�FLOOR CUC;;D'JIT.�' �- � � ;' ' � ___,^ � �. 1' - � -�-. _ . . __ -- �SLABGRADE _. . . . � � _._ ._. _ ; , � ' � FIREf'.L'ACE FQU_tiDATiJN ' .`;�'," : . • .; ''. i '-_ , � _ " '.- � �-r ;TEF,�P POWER - - �----�.. . ----- . -, _ _ FIREPLACE BOND BEAM - - -- - ... ;.� �- 'WATER SERVICE - -- ---- -- - ' - PJ�ID HT.BOND BEAh7:_.� ���.� ; .': ,. . . : ..� . . � ROOF SHEATHING 8 F7. C�OND BEAM , -. . .. � -` - ` � ' ! 'FRAh"IP�G,NENTILIATION - - - - FINl1L BOND BEAPJI � -• � � 'ROOF COVER ': �• PRE-GRADING - - ' ' 'ROUGH H�ATING � - ' � - � � 6ENCHRJG • �� .�, 1 ' __ ROUG}�ELECTRIC__._'. _. . . �� ' .�.' . . ROUGH GRADING -- - �ROU:�H Pl.Uh1BING--- ---- -�� - - � �- FINISH GRADING � � : 'SHO�V�RITUBTEST�-�-- - ---- - �-: • - POOLELECTRIC � � �CXi':LAiHrSIDING --� - � - -- - - POOL'FENCING ' �;1,"1�.LLINSULATfON- -;--- -- - - -- - P�OL�FINAL � � � � . .. . : .- � CEILirJG Ih?SUI:ATION, - --- �"- ' OFF SITE IMPS. DRYVJ:�LL NAiLiNG � � - DEDICATIONS � - . .. : - -- _ - FINAL EP�G. �'SE�"lER__. _....- � - ; i.StF'TI�TAPJK LAPJDSGAPE/1RRIG. � �.S�.ca�tT/LL.----. - ON SITE IMPS. � . �;G�S�',(�i EST ' _ FINAL ZO,NING . �/ � ..t'�i'�`_:i�NST. ' 1�l��' �.�I�� - — FIRE DEPT. FIPdAL - - -- - - - , � �EATING _ _ _. _ . HEALTH DEPT. FINAL i :�. . - =_�LECTRIC - --- � DEV. FEES PAID - •-� � --- �-- + � �. ._ _ : - '�.�PLUh1BiPtG . ENERGY , � - �---�- --- - - - - � - - - � :c -:g� c, .r(t�rs� . � . I ) . - � , , � , � 9 • � I�-- __-. . . ... . -- - _ -,_z{_.'...�;.\.�,t\:.._�___;; ... �, . . . , t .. '�::.,C�,,�MENTS_. ..- - -- -� - - - - , �. _. i . , , . ' . � . � - � � i-. - . .. . � � , ; -- -- -- - -. ._ . . - � � � � , � " � � ; . � , ��., :,, �,\_ i .. � . ; .. . . . , . . -_ --• - • -- � � , . . . - - - - -- - . . - � � , � � . , ; . :_ , .- � , , � �� � _ . . .. , , , � _ i �, ' ` i : 'SEPT'IC TANK SiZ� - ' ' ' ' � - ' ' - �SEEP PIT/U SIZE � � i ._..��._._-� - � , . -. . .. ... i ., I .1�� . _ . . _ . .. ; . . . . � _. ; . . . .. _ � - i _. . - � � i � � - � ; .. ... _ _. . �;��1� , . . ��� .. .. , . . ,. �� � � � _ .... _ .. ; - - ._ . . - - .. . . _ _ . . ,. , .. -,, . . .. . "_ - - .'��_ _- - .. .y� . I .' - - • • . ': ..�.�;. . - - . . _ ' . ! .,