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HomeMy WebLinkAbout12712 (11) �� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 G.Copley Drivc Suiu 190 � � (909)860-3195 Faa(909)861-3117 PRESS '���� � BUILDING PERMIT APPLICATION � FIRMLY JOB5ITE 1 APPLICATION j i����G�CL PERMfT � C o ADDRESS �'2��'� t"�"���`7��L ��� � � DATE �� � o NUMBEFi r a � APN LOT �RACT •. ISSUE TYPE OCC �— OATE CONST. GROUP p OWNER Tl%F-t��-C•U' . � _ � AODR SS� �- C - Z�"titi . 2 1�. 20NING SEBACKS � � CIIY ��iVL�� e`+ ZIP ( TEL� -�, , �)� FRONT RW ❑ APPLICANT �TEL. REAR ❑ SIDFJSIDE STREEf RW ❑ � CONTRACTOR� SIDE � ❑ o ADDRESS PROPOSED USE n x- ' �t '� �W�?' S u %C(d CIIY ZIP TEL. .... . . .. . _ • 'r � ARCH/ENG/ � . � )�:. c; 1,�. � � r.��- �� DESIGNER NO.DWEL ; CNO. <,.� .,-:; �, , NO. n. ADDRESS UNITS - � ' � '''STORIES �'� BEDROOMS � CfTY ZIP TEL � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR(ADD/REM O ppp I HEREBY AFF61fA UHDER CENALTY OF PE0.AIRY THAT I M/E%EAIPT FROM TNE CONTMCIORS U• Gaf3g0lC81pOK . ' � � CFHSEUWFORIHEFOLLOYVIN6NEASON(SEG70.71.68US�NESSAN�VROFESSIONSCODE:ANYCITYOR (J) COIRrtYWMtl/REOl11RE5AVERYRTOCONSTRl1CT.ALTER�Pia�VE.DEA10115H.ORREPAIRANYSTRUC- W P8110/DBCk TURE PRIOFl TO RS ISSUANC6 AL50 iiEOUIqES TME AOVLM1Nf FOR SUp/VERMIT TO FILE A SICNED W STAiEMEHT THAT HE OR SHE 6 LICEN5E0 PURSUAM TO TNE PPOVISIONS OF THE CONTMCiDRS LI• � GENSE UW(GUYiER Y(COMMENCIHO YrtM 9ECilON 7000)OF DM510N]OF THE BUSINE59�ND PRO- u- PooVSpa � FESSIONS OODE)OR iIUT ME OR SME IS E7(EMPT TMEREFHOM AND TME BASIS FOR THEKLEOED E%EMP• ipN.1lNYV10LATIDNDF5ECT10N7W1.6BYANYADPLILANTiOR�7ERNITSUBJECfSTHEAPVIICANTTO Z Re•Raol C �,,,� ACIVILPENKTYOFNOT►10(SE7fUNFNEIMJDNEDDOLLAR511500).). � OIASONMEHOFiHEPROOERT/,ORYYEUPLOVEESWI7HWACE5ILSTNEtqSOLECDYPENSATIDN, (',pTmafCldl - � � WILL 00 TFIE WOFi1C IfA THE STRUCTURE IS NOT IMEIIDED OR OFFEFED FOR SALE(SEC 70u,BU51- � � NE53 MO VfiOFE55IONS CODE:THE WNTMCTORS LICENSE LAW DOES NOTMPLY TO AN OVMER OF � . . PIiOPERTV YN10 BUILDS Oii MiRDVES T1IENEON,AND WMO DOES SUp7 YqRK FIIYSELF OR NERSELF OR ([ iHROUOMMI50fiHEHOWNEYPLOTEES,VfiOViOEDiHl1TSUCHMPROVEMEMSARENOTIMENDEDIXt m Q _OFFFAEDFORSAlE1F,HOVYEHER7HE8UlDPJ�ORIMPROVEMENTI550lD1YITMNONEYEAROFCOMRE- Z T1DN.THE OVRIERAUttDER 1VILL HAVE TME BUROEN OF VRONNO THAT ME OR 6HE 010 NOT BUIID OR . = MPROVEFO{i7F(EVURPOSEOFSAL�. ' . W 04ti40WNEROFTMEVRDDEHTY,IU�E%CLUSNELYCOMMCTINUWfTHL�CENSEDCDNTiUCTORS (= TO WNSTiNCT 1HE Pi1WECT(SEC.)oN.BUSMESS AND PROFESSIONS CODE:7HE CON7MC70R5 L4 alU3ti0f1 '� :��-� � ADJ.AREA ' LL CEN3EUWDOESNOTMPLYTOAHOVmEROFAPROPER7YNT10BURDSORMPROVESiMEREON,AND � YAqCONTRlICfSiOHSUCMVROJECT51MTl1�CONTMCTON(5)LILENSEDPURSUANTTOTMECONfMG UANTITY DESCRIPTION � FEE . � 7pLSUCENSEUWJ. . � O IAlA EXEYM UNOEN SEC. B.l V.C.FORTH15 REA50N U - -- �= DATE �� �' OWNER .I� C � . U . . � .. �- - - � Z W F LICENSED CONTRACTORS DECLdRATION W � IHER�YAFFlPl1UNDERVENALTYOFPERRIR17NAT1�UlUCENSEDlMOERPROVISION50FCHAPTER Vr � 0(C06YAENCIIqWfTlISECTION7000)OFOM510N70FTHEBUSINESSANODROFES510N5000[MA Z �j� W LICENSE IS H FULL FORGEAND EFfECL m � UCENSE CLASS LIC.N0. ' J �j wh corrrrueron a w � WORKERS'COMPENSATION DECLARATION a = U -- �N IHEREBYAFFIRAIUNDERPEN►LIYOFGERIURYONEOFTHEFOLLOWINQDECLARATIONS: - � � � � � `—" a � �IHAVENIDN'ILLWUHTAMACERTIFlCATEOFCONSENiTOSELFJNSUREiORN'ORKERS = COAIPENSATqN,ASPHOVDE�BY6ECT10N17000FT11EU00RCODE,FORTNEPERFORMANCE w Q OFTHEVqi1KFORWHICHTHISiERMITI5155UED. � �I HAVE AN�W:LL AMRlTAN N'Oi1KER5'COYPENSATION INSVMNCE,AS REOUIRED BY 5[tt10N ((('''���fff Q970a Of iHE LA90R COOE,FOR TNE iERFORMANCE OF THE WORK fOR WNICH THIS PENAIITIS ��,� /7 � ISSUED.AIY WORNERS'COMPENSATION INSURMICE CMiCER M�D POLICY MIMBER 11HE: CONSTRUCTION L/f/ � urvuEq PUW REVIEW � .PoLICY NUM6EP ELECTRIC � �f1lSs[CttOnNEIDr�7ieEm�REfIDOFnEVEar.RSPoRWEMI�DREnDatAR5R+0olonLFSs} PLUME3ING �� Z ICERTIFY h1AT N TME PERFOMI.WCE OF THE NUHK FOR WHICH T7115 PERUIT IS LSSIIED.1 MECHANICAL ('} 51VLLLNOTEMPIOYIWYPER50NNlANY1AANNERSOIISTOB[COMESU61ECfTOTHE WOqKEP5C061VEN5ATIOf/1AN50fCALIFORNI�ANOAGREETHATIF151qUL�0E00MC INSPECTIONFEE SUBJEGT TO THE W OHRERS'CO�.�PENSATpN FROVIS�ONS OF SECTiON 7700 OF THE UBOR N rj CooE.IS�wJ.FonrrmnrHCa�+PlrvnrnnroSErAo�sron5. ISSUANCE ����9 � � SMIP p DATE: APRICANT: � . W ENERGY P/C CITY OF DI � WARNINO:FMURE TO SECURE YYOlYCEPS COM7ENSATqN COVERAGE IS UNUWFl1L,AND SHALLBE T . � SUBJECTMIEMPLOYERTOCPIMPIALPENALTI[SANOCMLFINESUPTOONEHUNOFEDTHOUSANO ENERGYPERMIT�,;t�-DING AND S i DOUARS(f toa.000).N IDDIiION TO THE COST OF COMPENSATION,DMUGES AS GRWiDED FOR IN .rJ SECTIDN�70sOFTNEL/�BOHCOOE,IN7ERE5T,AN0A77DRNEYSGEES. RETENTIONFEE: � � � CONSTRUCTION LENDINCa AGENCY pRE-ALT FEE: O . � IHEREOYAFFIiiMUNDERVENALTYOFVE0.NilYTHATTHEREISACONSTRUCTIONLENDIN0110ENCY . � FOq TNE VERiOP1AINCE OF TME WORK FOR WHICH THIS PERYIT IS ISSUED(SEG]OV7,dY.G). � � LENDEH'S W1A'E � �� � LENDERS�DORE55 �j w �CERTIFYiNATIFUVEREA0iM511PPLICATIONANDSTATfTUTTNEABOVENFORMATqNISCON7ECT. TOTAL FEES � � . O� � ` � IAGREETOCOAIPLYN7IH/LLLCfTYAhUO�UNiYORDWANCESANDSTATEUWSHELATNf7TOBVILDIHO CONSTRULTION,M1D MEREBY AUTHOflRE RCiRESEMATNES OF THIS WUN7Y i0 ENTER UPON TME . . � AUOYEaAEM7(XIEOPROVEHTYFOqINSPECTIDNPVRPO5E5. COMMENTS F '� ` �r.� Lc.�.,� _ •..•m OERMiTTEE NAM[(FHi -Z . . � . . . ���ti.�,V Y.,� ,-�tJ r�/��-��,f � � SqnA7UHEOFPEfuuT1EE DAiE � � . . _ RECPT� ' PA1D BY ALIDATION WHITE—Oepanmont Copy.YELLOW—Fnance Copy,PINK—Asaessa Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy - - „ . . .. .. .:... �� ..•.. 1 -- .. � . , � , � .. . . .. . .�,;�:.�. _.,.....�: .. ...-. :..�..e.:,... ..,.. _.. .".,v..:... :� 1 . . . . . ., � : . .;...:. .�..,.,..�. ...., �._,. �-'�- \ . . � _...._._.... ..-•'—.'-.. -'----. . . , ,, CITY OF DIAMOND.BAR ;:: , ,_ _ .... . . . ; �� �� � .. - ' INSPECTION�REC,ORD'.� .' � �. � . .: . .. � � , �� . , _ e s � � � • - � � � . � . SET BACK - ...:, i � ` r: , • . ' j . FLOOR JOIST : ,•_ . ' . . FTGS/FORMS/STEEL � � FHA REQMTS - - � - � - - - - -------- ELECTRIC GFiOUND � � � � UNOER FLOOR DUCT ; � j ' GROUND PLUMBING ” " ' • ' �UNDER FLOOR COMDUIT � ` � -` - - • ' • .. _ . . , .,. , . . SLAB GRADE - • �� '. FIREPL.�ACE�FOUNDATION-�^•• • --'- --� • TEMP POWER -- - - - - - • • "�' ` FIREPLACE BOND BEAM : - � � ' WATER SERVICE � . - • -- • : --• - � MID HT. BOND BEAM ' ' ROOFSHEATHING - ' f ot � • /O/ ' `� ' 8 FT.BOND BEAM � • FRAMINGNENTILIATIO(V � � ' � FINAL BOND BEAM • � . ' ' ,. '. :P.RE-GRADING. . .. _. . _... . ROOF COVER '. Io?-�i S�� .. ,it.7�✓ - �Z • � � ROUGH HEATING � - � �� - - - - �� -- BENCHING --- ' � ROUGH ELECTRIC - -- - - - � ROUGH GRADING -ROUGH PLUPJIBIIVG , � -� � ' -. :- FINISH GRADING • � SHOWERITUB TEST' � P�OL ELECTRIC � EXT.LATH/SIDING � POOL FENCING , ' WALL INSULJITION � ' .POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYI�NALL NAILING DEDICATIONS - ' . � SEWER F1NAL ENG. . SEPTIC TANK ... . . _ , ., .. .� . LANDSCAPFJIRRIG. •SEEP PITIL.L.- • - � '- -� -ON SITE IMPS. �. • GAS AIR TEST - � - - - FINAL ZONING FINAL CONST. - J �$-9' "'��,,,,/f' � FIRE DEPT. FINAL FINAL HEATING - � - , - � HEALTH DEPT.FINAL . �• • ' . . . . . . . . FINAL ELECTRIC - pEV. FEES PAID � - FINAL PLUMBING ENERGY • • ' � �,��� • . . __ . _ , . . . _. .. COMMENTS - -- � � � ' _ . _ .. . _ ; . . _ . � . �. � . • . � : _ . -�?7�;�,!. . . , _ � , . .. ,r.; �: .:� ':;11'i , � � >�:�� _�,:... ;;:�'.. �T(?"'j't•'� , . • � : .- . . �1.,1.,:��_ `J' �e, r��.L_ ..i � . . .. � , . SEPTIC TANK SIZE � ` � ; ' , ' . ; SEEP PIT/U SIZE • � � ;�v�- I ;��� �' .., . � . �,. i - � .� -.� , � � � 7 �� L�. �� . -. , . . ��; 1 ' ', ' ' - ���� �. � � � � , , ; � 7�7-`