Loading...
HomeMy WebLinkAbout12-75 CITY OF DIAI�IOND BAR I _, � -�--���-� UEPARTNIENT OF COR�INIUNITI' 8 DEYELOPA•IENT SERVICES � r �q���� 2182�Copley Dri��e,Diamond Bar,CA 9176� (909)839-7020 Fa�(904)861-3117 Buifding Inspection Hotline(909)839-7027 PRESS '- ���^� BUILDING PERNIIT APPLICATION FIRNiLY � JOBSITE `�. /� (� APPLICATION PERMIT 1C o ADDRESS �7 �� �IL-LC9� f12R(J l 1IJk��� DATE NUMBER ` � � ISSUE TYPE G OCC � APN LOT TRACT DATE /�— CONST. �I^CY�/ GROUP p OWNER��Ij(plba I��-���/�/t� -�19� ^�� ZONING SETBACKS o ADDRESS�,�,�{,�,g�� ����� �� oCITY ZIP TEL� FRONT RW ❑ APPLICAN7 TEL. REAR p o SIDE/SIDE STREET RW ❑ � CONTRACTOR� . � SIDE O Q ADDRESS ' PROPOSED USE D�-V{J17� C,7�)1�� �v'-`=i�'� �V � CITY C��1<Tlr�;c-« ClCrZIP���El. -�' oARCI-UENG/ w DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CI7Y ZIP TEI. � DESCRIPTION Sd.FT. FACTOR PSF ADJ.AREANALUATION co � ¢ OWNER-BUIIDER DECLARATION SFWADD/REM O p 1 HEREBY AFFIqM 11NDEA PENAL7Y OF GERJURY TiLtT I AM EXEGPT FR01A 7HE COMRACTORS LI� Ga�a9B/Ca�pOrt W CENSEUWFORTHEFOLLOWINGREASON(SEC.7Wi.58U5WE55.bYDPaOFE5510N5CODE:ANYCITYOR (n U ��yWH��REWIR£SAPERMITTOCO45�UCT,ALTEi�VAPROVE.DFl.10U5H.OflHcPAIRANVSTFiUG UJ patio/peck w TU.'i�PR10R TO ITS ISSUANCE.AL50 REOUIRES THE APFlICA17T FOR SUCH PERMIT TO FILE A SICNED w � � STATEMENT 7HRT HE OR SHE LS UCENSFD PURSUANT TO TNE PROVISIONS OF THE CONTFIACTORS U� � CENSE LAY!jCH�PT'eR 9(C01AI.IENCIM16 VAhi SECT10:�7000)Oi D7VIStON]OF THE BUStNE55 M:O GRO- � POOUSpd FESSIONS CADE)OR THAT HE OR SHE IS EXEIAVT TMEREFRp1A MD 71�E B�5i5 FOR THE ALLEGEO EXElA7• � TION.ANYVIOLATIONOFSECTION70]t.SBVANYAPPL�CA7TFORAPEFMITSUdJECTSTHEA77UCANTTO Z Re-Roaf � A CML PENALTY OF NO7 MORE 7}/iW FIVE HU�DRED DOLLAflS�5506).): � ❑I,ASOYlNEROFTHEPROPERTV.O.iMYEMPLOYEES�'ATNWAGESASTHEIRSOLELOMP'cNSATION, � CORIf71BfGldl � Z WILL 00 TIE VJORK,hN�THE STRUCTURE IS NOT INTcNDFD OR OFFEFcD FO.i SALE(SEC.70a4,BUS�� J NESS AND PROFESSIONS CADE TNE CANTiiAL70R5 LICENSE UW DOES NOi APPLV TO AN OWNER OF � PHOPEHTYNM1108UILDSOPIMPROVE57HEREON.ANDWHODOESSUCHWOHI(HIlASELFORMERSEIFOFi � CC THROUGHHlSaRH'eROWNE1APi0YEE5,7ROViDEDTNATSUCNUAPROVeMENTSARe�OTIMENDEDOR m ' w OFFEPEDFORSIJ.EIF,HOWEVERTMEBUIlDIN60RUAPROVEAIENTI550LDV/fTHPlONEYEAHOFCANPLE � TION,THE O\'1NER�8UIlDEF YALL HAVE THE BUi1�EN OF PROVING THAT HE OR SHE DIO NO7 BU�ID OF Z IMPPOVE FORTHE PURPOSE OF SALE� Q_ ❑4�+'OWNER OF 7HE PftOPEHfY,AM E](LLUSNELY COMRACTING YrtTH UCENSED CONTMCTORS TO CONSTFUCT 7HE PFQIEGi(SEC.7aN,BUSINE59 AND PROFESSIONS CODE T71E C-0MMCTORS ll� Va{U81I071 ADJAAEA W CENSEUWDOESNOTAPPLYTOANOX7JEfiOFAPROPERIYWHOBURD50qIMPROVEShIEREON,PND � WF40CAMRACTSFORSUp/PRQIECTSWITHACONTMCTOR(5)UCENSEDPURSl/ANTTOTHECOYTRAG QUANTITY DESCFIPTION FEE Y TORSIlCENSELAv1.}. � ❑I AM EXEMPT UNDER SEC. 9.8 P.0 FOA iN15 REASON Q � U � � OATE OYMER U Z W �Q LICENSED CONTftACTORS OECLARATION w CC 1 MEPEBY AFFIRM UNDER PENALTY OF PERIURY THA7 1,VA UCENSED UNOER PROVIStONS oF CHAP7ER � � 9(fAMFAENCIN(3 W(TM SECT�Ot17D00)OF DMSION 3 OF THE BUSINE55 AND PROFESSY�NS COOE,AND z X �.f1'UCENSE IS w FULL FORCE AND EFFEC7. � LICENSE CIASS ��•�L�� LIC.NO. 1��/��/G1I� j � V DATE �7� �i'� I Z . CONTRACTOR � I W � WOFKERS'COMPENSATION DECLARATION � Q = U � 1 HERcBY FIqM UNDER PENALTY OF PERILIRY OHS OF THE fOLIOVlING DEClARATlONS: Z a � IMAVE.V�DWILl1.1AItJTA1NACEFiIFICATeDFCANSFMTOSELF•INSUpEi0.7YlORK'cF5' _ Z COMPENSATION.A5 7pOVIDED BY 5ECT10N J]OO OG THE LABOF CODE,FOR TNE PERWRMNICE W 4 OF 7HE VlOriK r'OR\'MICN THIS 7EfUA1T IS ISSUEO. ' � � _I HAVElJ:D WILL MAIMAP!wORNERS'CA!.IPENSATION INSLIRANCE,AS REOUIRED BY SECTIO�! Q ]700 OF THE LAfiOA CADc.FOR THE PERFOAAIANCE OF TM=�YOpK FOR YMipi iH15 PERMIT�5 ISSUED.IAV WO.L'CeRS'CA1.IPENSATION I�SUf�M'Cc CARRIERAI7D PO�ICY tN1A9ERME: CONSTRUCTION �/ � j , caawEa ���.�.`S ���jO f 1�S(I2./4�� PLAN REVIEW z POLICYNUl.16ER �eZ,�_��,fT�� ELECTRIC '¢ 0 (n�ssec'�a+n2�r»ra=_car�rEoaneaEw.sracoaut��ooi.uas�simloa�ss1 PLUMBING i - w 'Z I CERTIFY TF!AT IN h1E P'cRFOR1.lANCe O' 'c 1YOFN FOR WM1CH THIS PERMIT IS ISSUED,1 MECHANICAL �} SH/�LNOTEIA7LOY.WY7ERSONIN M ,Y;RSOASTOBECAS!ESUBJECTTOTNe 1NSPECTIONFEE (/} WOHK5R5'COl.1PEf15Aii0`JLA`ffSOF nLIF tnA,�.'.DAGaEETNATIFISHWLDOeCO�AE S110.�EC7TOTHEY10a1cER5'COAIPEN ATIOD PrlO`/i510Y50F5ECTION]7o00FTHELA90R /'� COOfi,ISHALLFORTMYATNCOIAPLYY/IiHT SEPqO SIONS. � �SSUA7`ICE • /V O I � Q p DATE:�1�APPLICANT: SMIP / W ENERGY P/C � YIAANING:FAtLuaE 70 SECURE Y�ORKERS'G PEIISATION COVER�GE IS UNN�'FUL.AND SNAL{,8E � SUd1ECT.VJEM�LOYEFITOCRI!AL4ALVENALIESA7:OCIV�LFYfESUPTOONEMUNDRE0THW5AN0 ENEAGYPEAMiT DOLIARS�S 10o.D00A iH ADDITION TO THE COST OF COMPENSATION.DMfA0E5 AS 7ROVI�ED FOR IN � SECTION]70!OF TME U1BOR CADE�NTEREST AfJD ATTORt7E�"5 FEES. RETENTION FEE: ,�� OCONSTRUCTION LENDII.G AGENCY P E-]A�l�T FE�EJ LC tNEREBYd.FFIF1dUNDERPcNALTYOFPcRNRVTMATTH�R`c�SACONSTRUCTI04LENDRt6AGENLY �/'��J/^`J /L d- GOR THE PERF-0RAIAHCE OF THE WORI(FOR VlHlpl THtS PEAMIT IS ISSUED(SEC.]D97.CIV.C.). Z W � IENDcR'SNNd' F— LENDER'9ADDRE55 ��y � TOTAL FEES ��r� ,�d � 1 CERTIFY TNAT 1 HAVE ReAD T7715 APPLICATIpN AhD STATE T1UT THE A90VE W FORMATqN IS CARRECT. w 1 AGGIEE Tp CO1dPLV YlITH hLl.CfTY AND COUNTY ORDINANCES ANp STATE UWS REUTWO TO 6UdDING � CANSTr�UCT10N,M:D HEREBY AUTNORf2E q_PRESEN'fAlNES OF THiS GOUNTY 70 EMER UPON THE zA90VE-MEMIONED PROPERTY FOR iNSPECiION PURPOSES. CO�+IMENTS � � � m PERMI lAA1E(P ` � j-I�-lZ � SIGNATU oFp DA7E RECPT.NO. , PAID BY f' VALIDATION _ ~ WHITE—Depanmenl Copy,YELLOW--Finance Capy.PINK—Assassa Capy,GOLDENROD—File Copy,GREEN—Applicanl's Copy , . - ' CITY OF DIAMOND BAR INSPECTION RECORD • � � . � . . � � . • • - SET BACK FLOOR JOIST FTGS/FORMSlSTEEL FHA RE�MTS ELECTRIC GROUND UNDER FIO�R DUCT GROUND PLUMBING • UNDER FLOOR GONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP PGWER FIREPLACE BOND BEAM WA7ER SERVICE MID HT.BOND BEAM ROQF SHEATHING 3 ti 8 FT.BOND BEAM � F.RAMI��IGNENTIL�TION • FINAL BOtJD BEAM ROOF CO���R PRE-GRADING AOUGH HEATINC� BENCHIPiG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBIPIG FINISH GRADING � ' SHO`�IVER/TUB TEST POOL ELECTRIC EY,T. LATHlSIDINu POOL FENCING � WALL IMSULATIQN POOL FINAL � CEILING INSULATfON OFF SITE IMPS. DRYWALL NAILING DEDICATIONS � SEWER FINAL ENG.. SEPTIC TANK LANDSCAPEIIRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONiNG FINAL CONST. z- � FIRE DEPT. F1NAL FINAL HEATI�JG HEAL7H DEPT.FINAL FINAL ELECTRIC V DEV. FEES PAID FINAL PLUMBING . ENERGY • COMMENTS ._ _ SEPTIC TANK SIZE SEEP FiTIU SIZE �