HomeMy WebLinkAbout17664 (43) ,_ �_ .-- - ------ - —.�_..____...__- � --... _____._.. � ._
�� CITY OF DIAMOND BAR • �
DEPARTN�NT OF COMMUNTIY&DEVELOPMENT SERVICES
21625 E.Copley Drive
"� (909)860-3195 Fax(909)861-3117 PRESS
"'%� BUILDING PERMIT APPLICATION FIRMLY
oJOBSITE J ` DATECATION �Z PERMIT r�/y P/C
ADDRESS-1��.3 I .�hCllG{!iJ ��Q��S NUMBER G(O �
� ISSUE���TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER
a ADDRESS133I 1!f L%2N Vl1P/fS K/ ZONING SETBACKS
gc�ND�a�;hno1 .s��- ZIP Te�.�6/o5F9 o pEART RW pO
APPLICANT TEL. SIDFISIDE STREET RW ❑
� CONTRACTOR SIDE p
o AODRE � PROPOSED USE � �G 1C�,Ri
CIT'( ZIP `/��S"7�fEL. 9'S'��_�8D
w ARCWENG/
-�z DESIGNER
oW.. ADDRESS NO.OWEL. � NO. NO.
� CITY ZiP TEL. UNITS STORIES / BEDROOMS
w
cn DESCAIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNER-BUILDER DECLARATION SFR/ADDIREM
O
0 I HENEBY AiFlRM UlOEH VENALTY OF PE0.AIRY TlUT I lUA E71EMPi FROM TNE CONfMCTOiIS LI. GafB(JB/C2• f{70rt
W CENSEU'NFOHTHEiOILOWINOREASON(SEC.70.71.68USWESSINOGROFESSIOHSCODE:ANYCRYOF (n
U COIMTyWHItl1RE0UIFlESAPEWAITTOLON5Ti1UCT,ALTER�PA�E.0E410U51/,ORPEPAiRANY3TRUC W PaIlO/08Ck
� NRE,PfUOR TO RS ISSUANCE.A130 REOUINES THE APPLIC+WT FOR SUCH iERMIT TO illE A SIGNEO �
STATEUEM THAT HE OR SNE IS 110ENSED GURSUANT TO TNE FROVISIONS OF THE CONTMCTORS LM
� CENSEUW(Q/�PTEHi(COMMENCIN6WrtH5ECTION7000)OFDIVISION�OFTMEBVSINESSANDPRO- � POOUSp3
FESSIONS CODF)Oq TNAT NE OR SHE�S EXEIAPT THEREFRpA AND THE BA515 FOR 7XE ALLEOED EXEIAP�
� T�ON.ANYVqLATqNOfSECTION70�1.68YANYMPLICMITFORAPERMIiSUBJEGTSTME�PPUCANiTO Z R8-ROof
A CML PENALTV OF NOT MOHE THI�N FNE HUNDRED OOLLARS(f5oa).):
pO4�OWNENOFTMEVHOPEHTY.ORMYEMPLDYEESWITMWAGES�STHEIRSOLECOMPENSATK)N, � (`,pTrtlOfClel -
Z WILI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFEREO FOR S�LE(SEC.70s1,BU54 J
N NE55 AND VqOFE5510N5 CODE:TME CONTMCTORS LICENSE UW DOES NOTAPVLV i0 AN OWNER OF j
PROPERTY VYYiO BVILDS OR IMPNOVES THEREON,AND 1VH0 DOES SUGI WORKl11MSElF ON HERSELF Oq
� 7HROlXiHHISORHEROWNEMPLOYEES,DROVIDEOTHATSUCHMPROVEMENiSARENOfWTENDEDOq m
QOFFEHEDFOHSALEIF,NOWEYE0.7HEBUIIDINGORIMPqOVEMENT1550lDWITHINONEVEAROFCOMP�E•
,Z TION.7HE OWNERBUILDER WILL HAVE ME BUROEN OF VROVING THAT HE OR SNE DID NOT BUILD OR
� �.1PipVE FOq T11E PURPOSE OFS�LE}
�y,� 04���1EROFTHEPFOPERTY,AMEXCLUSNELYCON7MCfINOWIfMLICENSEDCONTMCTORS
CC TO GONSTRUCT TME PR0.IECT(SEC.TW�.BUSINE55 AND PROFESSIONS GODE:THE CONiAACTORS LI• VHIU0ll0� ADJ.AREA
W CENSEUWDOESNOTAGPIYTOANOWNEROFAPROPERTVWMOBUROSORIIAPPOVESTiEREON.AND
� WIIOCONfMCiSiORSUCHPROJECTSVATHIICONTMCTOfl(S)UCENSEOPURSUMITTOTHEOOHTFi�G QUANTITY DESCRIPTION �E
Y TORSLICENSEUW.�
� OINdP(EMPTUNOERSEC. B.l7.GFORhIISREASON U
�
�=" DATE OWNER �
Z W
� LICENSEO CONTRACTORS DECLARATION W
� IHEREBYAFi1RMl.f�I�EflVEN�1TYOFiERA1RYTHATIAMLIGEN5E0UN0ENPROVI5lON50FCHAPTER V.
p. •(ODMM[NdNOWITHSECTION)000�OFDIV151ON70FTHE8U51NESSANDFROFE55qNSCODE,AND Z
LL� YY LICENSE IS N F11LL FORCE ANO EFFECT. �
� UCENSE SS UC.NO. ���$ 7 � �
� V DATE -CONTMGTOR��'I P�1JS � 0.
W '
� WORKERS'COMPENSATION DECLAFiATION a
� INEPEBY�FitRMUNpERiENALTYOFVERIURVONEOFTHEFOLLOW�N4DEClARATIONS: Z �
0 _�IHAVEANDWILL�NTAINACERfIFICATEOFCONSENTTOSELFaNSUREFORWORKER3' _
� COMPENSATION,ASFRONDEDBYSECTION77o00FTHElA60NCODE,FORTHEP6RFOM/NJCE ,U
Q Of TNE YYORK fOR WNIp1 THIS�ERMIT IS ISSUED. �
�I HAVEANO WILL�MNTAP7 WOPI(ERS'ODIAPENSATION INSUMNCE,AS REOUIqEO 8Y SECTION
� 4O 7700aFTNEUIBORCOOE,FOHTHEPERWRMANCEOFTMEWORKiORWHIQ7iHI5CENAARIS ���CJ
ISSUED.MYIYORKERS'LOMPENSA7qNIN5UfLWCECMRIEi1MIDPOIICYNUMBERME: CONSTRUCTION
� CARiiIER PLAN pEVIEW
� POLICYNU/ABER ELECTRIC
0 (fFs5ECf1�t��EmNOTBECL1e.�R.ETmOF7FEVEfMT6faRONEHl��001L10.S{ft�OqL65) PLUMBING �]_�� ��__—���" '}�'��'_.
Z ICEH7IF`/iHAT/ITHEPERFORMANCEOFTHEWONKFORWHICHTHISDFRM�TISISSUED,1 MECHANICAL ���
C7 SHALLNOTEMPLOVANYPERSONRJAHI'MANNERSOASTOBECOMESUBJECTTOiME
vj WORNERS'CdAPEN5ATI0NLAW50FCALIFORNIA,lWD�GREE7HATIFISFqULDBECOME INSPECTIONFEE I
S SU&lECTTOTHEWORKERS'COMPENSATqNVROYISIONSOFSECTqNJ7000FTNElABOH - . �
CODE,I SFIALL FORTHYnTM COMPIY WITH THOSE PROVISIONS. ISSUANCE
p DATE: APP�MANT. SMIP �' � SV
W ENEfiGYP/C ��'�-----.-
� WARNIN6:iARURETOSECUREWORNENS'COMVENSATIDNCOVERAGEISUNLAWFUL.M103HALLBE ,
�y SU9JECfANEMPLOYENtOCHIMPIALPEN�LTIESANDCMLFINESUPTOONEYIUNOREOTNOUS�ND ENERGYPERMIT
DOLUlRS(5100.000).W ADDITION TO THE COST OF COIAPENSATION,DN.IAGES AS PROVIDEO FOq IN
� SECTION]70C OFTME U1BOR COOE.NTEFEST,ANO ATTORNEYS FEES. RETENTION FEE: �+,
oCONSTRUCTION LENDING AGENCY PflE•ALT FEE:
� IHEREBYAFFIRMUNDERPENALTYOFPEM1RYfHATTHEREISACONSTRUCTIONLENDINOAGENCY
iOfi iXE PERFORMANCE Oi 711E WORK FOR NOtlG1 THIS VERMIT IS ISSUEO(SEC.�OD7,GV.G).
Z
w
� LENOERS N�ME
� IENDER'SADDRESS
� ICEA�FYTMATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVFNFORIAATIONISCORqEM. TOTAL FEES 'r 3 ��
p� IAGREETOCOM7LYWRHKLCITYMl�COUNTYOflDINMICESMIDSTATEUNSfiEUTINGTOBUILDINO , ,
� CONSTRUCTION,ANDHEREBYAUTFIOHREREPPESENTATIVESOFTHISCOIMh'TOENTERUPONTNE
Z ABOVE�MEN�lONEOVROPERTYFORINSPECTIONPUflPOSES. CQMMENTS
n C /�S
�
m VEflM�E lPflltfTl �
Q O
N
N E PERMITfE D�
� RECPT.�0. PAID BY VAUDAT�ON
WHITE—Department Copy.YELLOW—Finance Copy.PINK—Assessor Cqpy,GOIDENROD--File Copy,GREEN—Appiicant's Copy �
. _ ... . . - - -
.,._. .�:. .... . .-:;.. �:.Z-...t...t:... .,-. .-.,,... . F:.._r-;n ,.. i:..' .t . , � . . ,,.. ^-�n�- „rJt . ...r .. . . ,a. . . .. . . .. . . . .. . .
. . . , �,
CITY OF DIAIVIOND BAR
. INSPEC�"!ON F�ECOl��
, _ ,
. ......._.._,�.�.�.� .�.�._...._._,....._...�..�..,�
_. �..
i1��.����,�-. . _ ����,a�. ����-�����•� ;;C���:��,,..._�``�� ���1: ,���� ._.il�.�'�`.� �
- � -�
+ .
_..��..�.. ..r.......�. �-
- - _ � ._ .__ _ �_��.._..r. __ _ .__._:._:_._.:�.
SET BACK ' � � FLOOR JOIST �� . I. ' ,
FTGS/FORMS/STEEL � FHA REQMTS
ELECTRIC GROUND ; UNdER FLOOR DUCT ,.,, �
GROUND PLUMBING UNDER FLOOR CUP�IDUIT - , .� . . . � - \ ` =
SLAB GRADE FIREPLAC�FOl1t�DATION ' •� '•' �`
TEMP POWER �_`� � FIREPLACE BOND BEAM
WATER SERVICE I MID HT.BQND BEAM .' ' .. � ,•;", '
RDOF SHEATHING' � �' �2l�OL� iC. _ 8 FT.BOND BEf�M� .' ,z
FRAMINGNENTILIATION t.��,• � ' . - FINAL BOND BEAM
ROOF C�VER `�`'�,l=Gj� f PRE-GRADING
ROUGH HEATING BENCHING -
R�UGH ELECTRIC ' ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
I SHOWER/TUB TEST POOL ELECTRIC
I EXT.LATHlSIDING i I POOL FENCING
, WALL INSULATION � POOL FINAL
CEILING INSULATipN OFF S(TE IMPS;
DRYWAL�NAILING � DEDICATIONS
SEWER FINAL ENG.
SEPTICTANK � . ,, LANDSCAPE/IRRIG.
SEEP PITlL.L.. '� ' ON SITE IMPS.
GAS AIR 7EST FINAL ZONING
FINA�CONST. � - ! F!RE DEPT. FINA!
FINAL HEATING HEAL7H DEPT. FINAL
' FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING � ENERGY
� �nr:�r-��e��•.. . . . �. , ��
� ,
. _. ___ _._ .,_ ...-._ __.____._. _--._..__. ------..- --____ - - - -
� ___ _ __. _ __
COMMENTS
I 5EP71C TANK SIZE
' SEEP P1T/U SIZE
i . . E�� : . ,
� �
f '�i� �, �:i
. .���� _
. _ . _ , , . . - . , . .
_ . , . ._ ,, .
��� _.. . _. � - � ,:
-- .�,~ � . ,,
�
