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HomeMy WebLinkAbout16479 (37) � _ 3 . . . � � �� CITY OF DIAMOND BAR tT DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suite 190 ' � (909)860-3195 Faz(909)861-3117 � PRE$S �'��"� BUILDING PERMIT APPLICATION FIRMLY } JOBSITE �OOB N. Hourglass PI APPLICATION �_ �,!1 IPERMIT p/C 1 o ADDRESS DATE U INUMBER�Z N O 1� I�� � APN LOT TRACT ISSUE • I y U TYPE • OCC p OWNER��� �"�1 e rand DATE _CONST. GROUP p ADDRESS ame ZONING SETBACKS � CfTY_D_ Rar ZIp 91765Te� y FRONT • • ' .RW ❑ APPLICANT TEL,�T33 REAR � � J SIDE/SIDESTREEf RW ❑ CONTRACTOR t • '�, SIDE p � ADORESS � '�� � ' •'�!6 ' ' ' _ , pROPOSEDUSE •O' �U�r� �I„ CfTY >>'_/�E:i�•�,�� �:,ZIP tc.- TEL �c• ., :�;" �� DESIGNER �—�'it -��i7�- (, �-��"�� ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL UNITS STORIES BEDROOMS � N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION O OVYfVEFi-BUILDER�ECLARATION SFWADD/REM � p I HEREBY AFFiRM UN�ER CENALiY OF VERAIRY iNAT t A/A ExEA1PT FRdA 7ME COHTMCTORS tb G�f89e/C2ry0R W CENSEUWF0117MEFOLLOWWOREASON�SEC.70.71.SBUS:N[SSMIOPROFESSqN5W0E:ANVpTYOR (f� �J CDU/fitYMl[71REOUIRESAGEiWIT7000N5Tf1UCf,1LLTERlJ7ROYE.D[MOUSH,ORREPAIRIINVSTRUG u� TURE.Pp10q TO RS ISSUANCE,ALSO RF WIRES iHE AOPLICANT FOR SUCH iERA1IT TO FIIE A SIGNEO w Patio/pock � STATE4IENT iF1AT HE OR SME l5 LICENSEO iU0.5l1ANT TO THE PpAN510N5 OF TNE CONTMCiORS L4 � , , � CENSE UN�(CHAiTfR i(CdAMENCNO WITH SECTpN 7Doo)OF DIVISION]OF TNF BUSMFSS ANO PRO- POOUSpB ' FESSqNSCOOE�ORTUTHEOR5HE15ExEMPTTHEREFR01.lANOTHEBA515iORTNEALLEGCDE%EA1P- (� TIOH.I1NYVqLAiIOHOFSECT10N70]1.60YM1vAPGL1CAN7fORAPERMIT5UB1EGi57HEMPLIGN7T0 Z �g.qpp� � � ACMLPENALTYOFNOTMORET7ANFIVEHUNDREDDOlUR5�7500).j: o OI�OWNEHOFiNEPRO�'EN7Y.ORMYEMP�OYEESMniHW�GESASiHEIqSOIECOMPEN5A710N, 0 COmmBrCla� ' � - � W1LL DO iHE MIOFK,AND THE STRUCTUR[IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W�.B1151� J N NESS IlO VROFE5510NS COD[:i)1E CONTiUCT00.5 LICENSE UW DOES NOTAPPLY TO AN OWNER OF , . DROV[Hi`/VAIOBUILDSORMGROVESTMEREON.ANDYMODOESSUCNWO/iKMIYSC�FORHERSELiOR � ' ' � TIIFOl1CH MIS OR HER OMM FIAPLOYEE3.PFqNDED iMAf SUCM IMPHpVEMEMSARE NOT RRENDEOOR m OFFEAED PoR SALE 6,/10WEVER 7HE BULdhO OR IYPROVEIAENT IS Sq.p WRHN ONE YEAROF COMPLE- � TqN,T11E 01N�ER�BUILDER VALL NAVE TME BURDEN OF VPOYINO iMAT M[OR SHE 01�NOT BUILp pi W iHOVE FOq ME PURrO:[OF SALE). � ❑�ASOWNEROFTHEPiiOVEHTY,MIE%QUSNEIYCOMRACTINON'R}IUCENSE�CONTfUCTORS TO CONSTRUCi TIE VNOJECT(SEC.70u.BUSINESS MIJ VROFCSSIONS CDDE�TNE CON7RAGTORS l4 VelUation_ ADJ.ARG CENSE UW DOES NOT APRY TO AN OWNE R OF A iqOVERN W/q Bl1ttDS OR�aPi1OYES tHERCOw,MD � YrNOCOHTMCT9FDRSUCHVRQIECTSWITHACONTRACTOF(S)I�CEN5EDR1R5UURTOiHECONiMG OUANTITY DESCRIPTION � TORSUCENSELAW} FEE O INd EXEMPT UNDCR SEC. B.1 i.C.iOR TMIS REASpJ Q � Cti.I��t-� 3 � � LL OATE OwNER U / �f � LICENSED CONTRACTORS D[CLAAATION w j OC 1HEREBVAi'FIRMUNDERPENALTYOFiEiWRYiHATI�MLICENSEDUNDERPROVIS��ONSOFC1uviEH � �(COMMENGUqWITHSECTIONl00a�OFON15!ON]OFTMEBUSI1iE5SANOPROFE5510N5COCE.AYD Z H _ �F W�NSEISNFULLF �iG£ANDEFiECi. � �� m � UCENSE CUSS LIC.NO. � j �j OATE���^ � CON7fUCTOR J � a W � WOFlKERS'COMPENSATION DECLARATION a NIMCREBYAFFlR/AUNOERCENAL�`/OFDE0.IURYONEOCTNEFOLLO'M.NGCECLA�LlTqNS: Z � � �IW[lEANDM�ILNAIMAINACER77FiGTEOFCON5EMT09ELF•1NSUREFO•lNfOqKERS' _ CD��ENSATqN,ASPROVIDEDBYSECTION]7000FT71ELADd1CO0EFORTM'cPERfORMIwCE W � Q OF TME WORK FORN11K7/THIS PERMIT IS ISSJCD. � 1� ; Q _I MAVE AND WILL W.MA:N riMiNER3'CAMFENSATqN INSUHAt+CE,AS REOUIRED BY SEGTiOH ��n�•(1� �, �O d 7700 OF TNE U1DOR CODE,FOR TML PER�ORI/I1NCE OF THE WORK FOR WXIQI iM15 PERMIT IS X � ISSUED.MY WORKERS' MD[N9�:ION V+SU 4CE CARRIEH/9D POLICYNUMOEHME: CONSTRUCTION 1] ��.1 � � CARRIER � PLAN PEVIEW � � oa�crrniueEa , r7Q� �1 ELECTRIC • C � (i/E;5ECI1RIN�NOTREQMLE7L�OFi/EPETMi6fORChLi4fL1f1EDOQL�1t5(510CJOR;FSS? PLUM�ING � � � ICERTIi'YTUTNiHEPERFORAUNCEOFTIENORKFORW�+i017Hi5PEwIT151S5UED,l �!ECHANICAL SHALL NOT EIIPLOV ANY PFHSON N AN'I AUNNER 50 Au TO BECOME SUfiJECi TO TNC � (/j WOPo(ERS'CpAVEHSATqNU�OF�IFORNI/�/WDACREETHATIFISMOVIDBECOME INSPECTIONfEE S SUBJECTTOTMEYK�RKERS'C0IIPENi/�7qNVFYOV1510N50FSELTION]�OOOFiMEUBOR �y COOE,ISMALLFOf7T111M COMPLYWITIlHOSEPROVI5qN5. ISSUANCE � SMIP � l7 � p �ATE:���V ICAN7: � ENCRGY P/C WAflNiN�:fALUPL TO SECURE WORKCRS'0�1APENSAiqN COYEMGE IS U�UWFUL,/U+D 51uLLL BE - LL SIAJECTIINEMPLOYERTOCRIAI:N�LVENALT1E31V:DCMLiWESUPTOONEHUNDf7EOTMIX)SANO EN[RGYPERMIT �l • DOLL�RS p100,0001.IN ADDITION TO iME C0.ST OF CqAPEN5A7qN,DAAUG[5 RS PfiOVIDED FOR IN 2 � � SECT70N]IOeOFTHELABOROWE,NTEREST,ANDATTORNEYSFEES. RETENTIONFEE: J ' C7� OCONSTRUCTION LENDING AG[NCY PR[•ALT FEE: � IHEREBVAFFIRMUNOERVENALTVOfPERR1RYTNATiHER[ISACONSTRUCTIDNLENDWGAGENCY FOfl TME PER�OFVAANCE OF THE WORK fOR NMICII MIS pEW.��T IS ISSUED(SEC.7oY7.�tY.G). � � �y IENOCR4NAME � . S � IENDER'S/DOn[55 W ICERTIFYTIATIHAVEREADiHISAPPLICATIONMlOSTATETNAiTHEABOVElI�ONA�TIONISCORNECi TOTALFEES � �• • � � IACREEiOCOlA7LYN7TMALLtT'ANDCOUNTYORDwANCESANDSTATEUWSRCUTIN0T00UILDINC � CONSTRUCTION,ANOMEREBVAVTFqRIZEREPRESENTATNE50FiNISCOVNTYTOENTERUPONTME �J ^^`1�1� O . A[SOVE#�:NTIONED PHOPERTV FOR WSPECTION PURPOSES. Y 1( 1. 1 � , COM4IENTS 1� 4'�� � � 1/.-i/�.-;� /�+%1l�-,�>�-� � PEiWfTfCEMAUE(PWrlT� . ' N �:-�� i,���/i�,,,�,�� y�"'�� y SI NATUNEOFPER�AiTtEE D�TE . � ' RECPL NO. PAIO�Y VALIDATION WHITE-0epeM1ment Ccpy,YELLOW—Finence Copy,PINK—Asseseor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy , ' ti . . . . � � . I- • ��, -- • � , CITY OF DIAf�iOI�D BAR . . � •...• If�iSPECTiO��l.RECO�D , . . :_____.�______ � _ _ .._.___..., ., _._, �.---.—_.___.__ _.,._..._... .._, z _.._ .�.._.�.__��_, ._ _. -. --�� ,�(���-7�a_�c�"P1cJ►`N �:�FF=. # �►��-��3�"F�'.�;�,,S�II►��-''I''��:��1¢.1`,* ry�t?r�' !�`�.y: �c���ej;. . .� _ _...__._.�._..�_�_________.� __.� �- - - - , _...,_�...�..., r. ...�......------..._,... �__.... ._... ..:....__.._.... . .. ..._. SET BACY,., •. : . ` � � � ; i � ~ FLO�R JOIST y� � � ,.� . _ _^ _ FTGSlPORt�1S/STEEL � I ��[`(,c('� � --� = FHA REatlTS � � 'ELECTRIC GROUND ... _ ._. . : • ..� ; UNDER FLOOR DUCT _� _ _. iGROUND PLUt•ABING • UtJDER FLOOR Cbi•iDUIT I _ �, ----------... -- -- SLAB GRADE �p��'� FIREPLi,CE FOU`JDATION . I iTEP.1P PO4vER - FIREPL/10E BOP�D 6EAP�9 • �WATEF SERVICE _� � MID HT.E30ND BEA�•f _ _ ' � - 'ROOF SHEATHING � � � I ��• BOND BEAPA • •; - - 1_ v_ _ •FRAh�+ItdG.NENTILIATIOI, - I FINAL B�ND E3EAP,� . iR00F COVER . ' � PRE-GRADING • • - "RO'JGH NEA7ING BENCHING �ROUGH ELCC i R!C. .�.. `7 j ^J ��— ROUGH GRADI^JG �ROUGH PLUME3ING � ' FINISH GRADING 'SHOL"JER,?UB TEST - - ' POOL'ELECTFiIC �EaT.-L�,TN!SIDING � y. o ,� PC�L FEP�CIfJG � 1,"1ALL fh'SULAi ION � - � � -�� PQOL'FINAL CEILtN3 I�•:SULATION � OFF 51TE IMPS. DRYI�'JA�L NAILiNG , ��..�,� OE�ICATIOPIS _^i . .5�1�",cR FINI`.L EP�u. SEPTIC TANK (1aNDSCAPE/1RRIG. � SEEP PITlL.L. . • ON 51TE iP.1PS. GP,S f,IR'fEST � � FINAL ZONI��G +FI�iAt_CONST. d-1 -ol �, ,. , `•.� FIREDEPT. FINAL � —_ �F1i�.:iL NEA?ING � . � HEALTH DEPT. FINF,L _� � ��i.`:<_1_ELECTRIC - � °-'• DEV. FEES PAID I !`�_"•:/•.L PLU".9�ING ENERGY ;� .._._. _ - - - � I --�-- — -------- ;• • �.-�.,,m......,,._,.._1..� ..._�_.__. - _. ------- I . _. , . . _ e;t=s� �i: e �:s , - ---- _ ... , ....,. _. _ --- -----— 1 ...... :. .. ..... :. . - ... . , . - -_ -_._ --. � i - �' ' C01J1MENTS � � . ,� � , �,. ----- ;, . _ . _ .i _ -. -- , . � �- � �',� , -- -� __._ iSEPTIC TANK SIZE � �SEEP PIT/U SIZE — —-- i � ----- ;+�G ' .. �--.--_---. — — . ; ��, , � — — . ; : -y���, : -. — ; -- -- ----- ------ -- � , . , ', V ; ; . � � - ---_. _.— .. ,, - , _