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HomeMy WebLinkAbout15226 (20) � . � _ . ` � J� CITY OF DIAMOND BAR DEPARTMENT OF COMM[J1vITY&DEVELOPMENT SERVICES 21660 E.Copley Drive S�cite 190 (909)860-3195 Fax(909)861-3117 PR E$$ �`'�^ BUQ,DING PERMiT APPLICATION FIRMLY Q ADD ESSZj'�'�J'� Z��� ��. APPLICATION� �'�-- V PERMR 5a���lC p DATE NUMBER g ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER " ADDRESS...22 I. IJ ZONING SETBACKS "' CffY ���++ ZIP TEL�o C� FRONT RW ❑ � APPLICANT�_��� TEL,7 _ REAR ❑ � , ` SIDE/SIDE STREET RW O CONTRACTOR � SIDE p p� C�DRESS ZIP� TEL • 1. PROPOS�D USE� "�'� L ` � � � / O ARC NG/ � C�D..^�� � � � � , �. DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS � STORIES -Z/ BEDROOMS�._ ' � CffY ZIP TEL. r�i� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLAAATION SFR/ADD/REM � O � IHEREBYAFFIRMUNpERVENALTYOFVEiWRYTMATI/UJE%E4PTiROA1THECONTMCTORSU• G8f8gBIC8fpOf( � CENSEUWfORTHEFOILOWNORFA.�ONryEG.70.11.68U5ME55M1DPROFES5IDNSCOOE:ANYC17YOR (n COIMIYN11tlClIREOUIRE5110ERAARTOCOFIS��JCf.AITERIMPROVE.�EY�L15KORPE7AIqANY57RUC- W PdtIOIDBCk TURE,PR10f1 TO RS ISSUANCE,ALSO REOUIRES T/E AGPLILANi FOR SUCH FERMIT TO FlLE A SIGNEO W STATFIAEM THAT HE OR SHE IS LICENSED WRSUANT TD iHE PfiOVI510N5 OF THE CONTMCTORS ll- � CENSEUWI�P7FRC(CDMMENCW�WITHSECT10N7a00�OFDIV15WNlOFTMEBUSINESSIWDPRO- LL PooUSpa fE5SqN5CO0�OHTlY1TMEOR5MEISE%E4PTMEREFpOGAN0TNE8AS15FORTMEALLE6EDEXEMP• (� TqN.AN'/VqLAiqNOFbECT10N70.7f.68YANYAPPUCANTFORl1PEHrAiTSu61ECTSTXEAPPLIGNTTO Z Re-Rool � • � AGVILPENALTTOFNOiMOfiET1UWFNEMINDREODOUAFi5p5oo).): � OL/�aM1EROFiHEVROPERTV,ORYYEUPLOYEESV✓T1IWAOESASTHEIRSOLEC0I.IPENSATION, O Cqmmerciat - YML 00 7HE MKNiK.AND iHE STRUC7URE IS NOT INTENDED OR OFFERED FOR 5/LE(SEC.7D41,BU54 rl � NESS AND PROFESSION9 CODE:T1E CONTMCTORS IICENSE LAw DOES NOTAPPLv TO AN GWNER OF = PROPEI1TYlM�O BULD9 OR NAPROVESTNEREON.IND MT10 DOES SUCN YqHK MIMSELF Oq MERSELF OR Q THROU4H HIS OR MER 01NJ E�/PLOYEES.Vf10V�0EDTHATSUCH 617ROVEUENTSARE NOT ME�ED OR m � OFFEAEOFOHSALEIF,HOWEVER7I�EBULDINGORYPROVEYENTISSOLDMTf1nNONEYEMOFCOMRE- � TION,THE OWNER-0URDER WiLL NAVE THE BUR�EN OF CpOV1N�TMAi HE OH SHE DID NOT BUIID Oq Mii1DVE FOH TNE PUPPOSE�F S�LLE} �y OlI�ROWNEROFTIEOROPER7Y.AMEXCLUSNELYCONfMCTWUWfi11LICENSEDCOHiMCTOR4 L p � TO CONST/1UCf TME iNOJECT(SEC.7DN,Btl`+�NE53 MY�PfiOFESSpNS COOE:THE CONTAACTOFlS LI- VdIU8ti0f1 Y�aV•� ADJ.AREA CENSE UW DOES NQTMPLYTOAN OW4EH OFAiROPEf17Y W/UBUM1DS OH MPROYESTFIEREON.MA YRqCONTiUCTSFORSUp1PA0J[CTSWITiACONiMCfOii(SjLICENSEDPUR5UIVlTTOTMECOHTMG ounrmrr DESCRIPTION FEE � � 100.5LJCENSEUWJ. . . . .. O 1 AM E%FLPT UNDER SEG B.a P.C.FOR TXIS REASON U LL � OATE OWNER V . � UCENSED COrIfRACTORS DECL4RATION -� � w IFIEREBYAFF�ANUNDERVElUL7YOFPERIURI'TMAiIAMLtCENSEDINlOERPRONSIONSOFCHAPTER � � �(COMMENG7NOWITMSECTION70WI�DIVIS�ON7DFTMEBUSINESSNIDPROFESSiON5CO0E,AN� Z X EfYIICFHSESNFVLLFORCE/NDEFFECT. � LLl /7 Q UCENSE CU55� I I' LIC.NO. /� � j �jOATE� �/I�Jb CONTRACTOR _ W . . n . ._ ... '_ _."_ _ '. .. � V�'ORKERS'COMPENSATION DECLARATION L��" Q � IHEREBYAFFlRMUNDEFVEHILLTYOFGE0.NNYONEOFTHEFOLLOW�NOOEGU�U7i0N5: U C� ¢ � �I/UVEANDWRLY�NTNNACEIlTIFIG7EDFCONSENTTOSELFiNSUNEfORM'OW(ERS' 2 Cp,IPENSATqN,ASVFlON�OEDBYSECTI0N�T000FTNELABORCODE,FOHTHE7ERFORMANCE �U OF THE M'ORK FOR WNiCH iHiS VfRuiT 6ISSUED. � C � �I IMVE/�YD VALLMAMTlUN WORKERS C011PENSATION INSUiUNCE.AS REOUIRGD BV SECTION I �� ` � Q�� 770oOFT11ElA90RCODEFdiTHEPERFDRAINJCEOFiMEWORKfORWMK?/TMISPENMITIS � _65UED.MYWORNERS'WM7ENSATIONWS ECMPIERANDPOL�CYNUAIOERME: CONSTRUCTION � GliViiER A J(L �D � TV 1 PLAN REVIEW � va��'e�u�e�n_;.S�i — ELECTRIC 0 (n65ECroNH[�NOTBEooRs�E'rEDacTEVEp.�iSrona+EwrtpCDOaUuti^R:x10alESs} PLUMBING �T� Z ICERTIFY7HATNh1EVERFONWICEOFTHEYVDWCfORWMICHh115PERMiTI5155UE0,1 MECHANICAL � SIIALLHOTEYPLOYANYiER50NNFNYMANNER50A5TOBECDMESU&lECTTO7ME � N WppNERS'COA�PENSATqNUW50FCALIFORNi/�MK1AGRfETMATIFI5M0ULDBECOME INSPECTIONFEE .� � S SU6IECTTOTXEWORNENS'CDIAPENSATIDNPROVISqN FSE �ON77000fTMEUBOR cm�.isr+uiFonnrvnn+caua�rNnn�� �6r+s. ISSUANCE � pA� I/ f'� APPIIGNT.�/ . SMIP C,II-S-eFr�-L"11v1V � W ENERGY P/C � WIUWiN(i:FALURE TO SECURE WORI(ERS'GOM7EN5A7qN COYERAGE�S UNUN'FUL.AND SHALLBE B����� SV6)ECTANEMPLOYERTOCAudRULLPENALT�ESANOCMLFWESUPTOONEHUNOREDTMOUSAND ENEFlGYPERMIT DOLLARS Ii1 a0,oD0�N dDO1710N TO THE COST OF COYPENSATIDN,OAMAQES AS PROVCIEO FOfi�N ¢ SECTION�70eOF711ELABORCODE,NTERESLANDATTOiWEYSFEES. � RETENTIONFEE: a CONSTRUCTION LENDINGAGENCY PRE•ALT FEE: � I HEREOV�FFIRM UhUER 7ENALTY OF PERNMTNATTHLi1E 15�CONSTRUCTION IENDN10110ENCY ' FOR TNE PERWRMMICE OF TNE M/ORK FOR WH�pI 7Mi5 PERMIT IS ISSUFD(SEG]OY7,CIV.C.} � ,�.Z LENDERSNAME s � LENDER'SADDRE55 }� W ICEHTIFYTHATI/MVEpF1DiH1511PPLICAT10NMlOST�TETUTTVEA80VENiOR1AAT10NI50DRRECT. TOTAL FEES I �� �V p� IAGREETOCOMPL�WITXALLCRYNIOCOVNTYORDINANCES�NOSTATEUWSNEUTINOTOBULDINO � n � CONSTRUCf10H.AND HEREB�AUf WRRE REPRESENTATNES OF TW 5 CIX1NN TO EMER UPON TME if � ABOVE�NENTIONED7FqPERttFORINSPECT�ONiURPO5E5. COMMENTS J 0 _ lf _ �T m PE HT) ' a // =17 � uJ ANRE OF PERMI TEE DATE � � RECPi NO. PAID BY VALIDATION WHITE—Departmenl Copy.YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant'a Copy . ... ,..,. .c. •• �,' .�. ..� . . . ... . . . . . . . • ... �. _.. .. _ 9 . .. , .. . i ..�.�... ..........,...� ... . At-r.. . ,.. _t._, ...n, . . � � CITY OF DI�iMOND,BAR . - ,., . �� ._.... .:�::.�i,':If�ESPECTION�RECORD � ' � '�•-� �.. ' . _ .. � . . . - _ _ t . [� x :-- 'l�ii a3,e nl.��`:1 ��R�1.� 'I��-�.��•�m�_.� ��*'.l'►'..l-�'r���`�A1�!��-+ ,��#�.�':.��'i�=,.. �l� .rl:�,c;:�o�1.�{_ 11�f'� 1 w.. l �. � � .�...>� �. .� ....... ...�........�sr..,�.� ..��, iSET BACK ,.. • ;' � ; 1 . .. I � . ; ! �`,.._. FLOOR JOIST ' ,, - . - t IFTGS/FORMS(STEEL..�. _., __,�� ..... •- -- - - ' -- - -- FNA R�QMTS ...-... • . ---.._ :_ _ _ - � �..z jELECTRIC GR�UND.._.___ __.. " ' �� ' ' UNDER FLOOR DUGT - � � � �- • ,. ' ' �' • --- . . - --- -- --- . - — -_' IGROUND PLUMBING � UNDER FLOOR CO�d0U1T �.: . .�'" ' = ` � �---..___._ ISLAB GRADE - - ------- --- -- ---- :. ` ' ' FIREPLACE FOl7NDATION - ' ': ,,....=�: , � ..___.._ I7EMP POVVER - _. _. _ . .._. .. - . . ;.� FIREPLACE BOfJD BEAM' "' . . . _._. . _ . . . _ �, . , , . _ , . !WATER SERVICE: - - - h11D HT.BOND'.BEAPA � ,'. ��. , :'� :� � • • . - . . , ; ; •,ROOF SHEA'�HING.'•... 'i'-�J.�'�!� ' — - 8 FT. BOND BEAM . • . . . . , i ; ;FRAPJIING.NENTILIATION '- . : _ :-• _ . . : ';`;= i_.� � FINAL B�ND BEAM . _ . . -` ., . . . ;. , ;ROOF,COVFR .:. •. . �- , .: PRE-GRADING - . . . �- ' - . ;ROUGH HEATING . ._ . .. _.•-._ :. . . . __.;. _ . • . BENCHING . - --- - �ROUGN ELECTAIC_ ..'_ ` ' ' ' . '. .-_ •• . ROUGH GRADING 'ROUGH PLUNIBING �- ----- -- � - � -= � FINISH GRADING � • . • 'SHO�"JER.rfUB TEST- •- �--- �- --- - - � POOL'ELECTRIC. ' • � !E�'T:!1',TH/SIDING� . _ ..._._ . ..-. ... . . . ... . ... . . POOL FENCIPJG � . �UUALL INSULATION- - � - � - -� - - POOLFINAL � � � ;CEILlD�u I[�]SULATION' - -� - � ��- --�-� OF�SITE IMPS. � ;DRYVJAL.L NAICING ; - - - - DEDICATIONS . : . . - ' : . ;SEUrER---.. _.;.._.. .. _. .. _ - FINAU.ENG. . .. � ;SEPTI:.TANK � LAPdDSCAPE/IFiRIG. 1SEE?PiT/LL. _ _ • •• - ' - ON SIT� IMPS. ' IG;S PJR TEST FINAL'ZONING � ' jF.1iJ�`�l.CONST. _�___ _"��- .��' FIRE DEPL FINAL � _ . --- — — , � . !Flt•:H�I-IEf,TING ---.----- .--- - ---. _........_..._ .. : .. HEALTH DEPT. FINAL - _ -: i : � —--- ... li.:�?Jr`.L-ELECTRIC - - -- DEV. FEES PAID - - . -.. ._. -- -- - � �___ � �i"c'•:'ht.PLUP.IBINC�--- _.. ._. __.. _ . . -_. . . ENERGY . ! ���--. .. , _.... . _ ..---- _ ... -- . .. .. ..... . ... _ ;� , , . ...._ . �'' �,�� �, ..... _. ._. .. . .. . ..,_ -. _.. _ . ..__....._.. ., .... .__'_�._�_._�r � _, �T�` =._• .. ,. .__.w�.. . . .�__ . _ ' . , .. . _ . 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