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HomeMy WebLinkAbout13237 (16) i ',r'� ���/ CITY OF DIAMOND BAR - �� - DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suite 190 � • (909)660-3195 Fax(909)861-3117 PRESS ���^'�. � . BUILDING PERMIT APPLICATION �� � FIRMLY � JOBSITE � ' ' t� /� APPLICATION PERMff P/C � o ADORESS.Z�-7�L '�.,I�F1�!J4Q�2-1� 1 ll.�, DATE _NUMBER�� N � ISSUE yC..� TYPE aCC APN LOT TRACT DATE �1✓' CONST. GROUP. p OWNER S, JEiAn+�.'�rL ADDRESS S ZONING SETBACKS Z CITY�. B. ZIP ti'nt�TEL9 � REAR RW .❑ g APPUCANT TEL. SIDE/SIDE STREET RW � O ; � CONTRACT R C� SIDE ❑ � ADDRESS CITY ZIP / TEL. PROPOSED USE �1� oARC NG/ � . � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � � CfTY ZIP TEL N DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION . y Q OWNER-BUILDER DECLANATION SFWADD/HEM � - O ' Q I HEREBY AFFlRM UNDER FENALTY OF PEiWfiY THAT I AM El(EMPT FRqA THE CONfMCTORS U• Ga�egB1C2ry0R� � � CLI CENSEUWFd1T11EFOLLOWiNONE�ISON(SEG7m1.6BU51NE55/WDPROFESSIONSCDDE:ANYCITYOR (n U CDUNTYWIApIqEONHESADERIARTOGONSTRUCi,ILLTEi�NDROVE,DEYOLISH.ORREDAIRANYSTRUG W .Palb/Dedc • � � � � �•� � Z 7URE,PFiqH TD RS IS6U/�NCE, • REW WES TME MPLICANT fOR SUCH PERMIT TO FRE A SIGNED �� ETATEMEHT 7HAT HE OR SHE l5 LICENSED iURSUANT TO THE Pf10VISiONS OF TNE CONTFlACTORS LI� W . ..� GENSE UW(QIMTER Y�COMMENC7N0 YfrtH SECTION 7Woj OF DMSIDN�Of TME BUSINE55 M1D PRO- LL P��Pa FESSqNS CODE)OR iHAT HE OR SME IS IXEAIPT THEREFHOM ANDTHE BASIS fOR iHE I�LLEOED E%EMP• TqN.ANYV101A710NOFSECT10N7W1.6BYANYlIDPIICAHfFORAVFfWITSUBJECTSiHEAPPLMJWTTO Z Re-Raot � A CML PENALTY OF NOT 1AORE 7HAN FNE MUNDREO DOLURS(55001.1: , � OI.ASCAM�EROFTHEVR07ERTY.ORYYE��LOYfESWIlMWACE5ISIHEIRSOLEC04PEN5ATqN, O CdnmBfGl31 ' � YALL DD THE YVORI�AND iME SiAUC7UR[t5 NOT INTENOED OR OFFEHED FOR SALE(SEC.70u,BU51- J � � NESS AVD PNOFESSIONS CODE TNE OOffTMCTORS UCENSE UW OOES NOT APttY TO AN OwNER OF j � . . PRDPEHiY WMO BUlDS q11MPROYESTXEREON.MD WMO DOES SUp1 YNFiN MYSEIF OR NERSELF OR CL THROUONHISORHEROMrt7FMPLOYEES,iROV�EDTHATSULIIMPROVEMENTS�RENOTNTENDEDOR m . , � OFFEAmiO1ISALEIF.FIOMlEVERTNEBUIDINGORMPROVE►IENTISSOIDWITMNONEYEAROFCOM�IE Z �710N,iHE OWNERBUtlI7ER WILL NAVE THE BURDEN OF PROVINO 1TUT ME OR SHE DID NOT BURD OH . = MPHOVEFORiHEiURPO5EOF8ALE). " W O11180�MlEHOFh1E0ROPERfY.AA�EXCLUSNFLYCONiRACTPWWRMLICENSEDCONTMCT00.S � TO QONSTAUCT THE VR0.IECT(SEC.toN.BUStNE55 AND FROFESSIONS CO�E:IHE CONTNACTORS ll� V01Ueli0fl /1DJ.AREA CENSE UW DOES NOTAPPLY TOAN OMMER OF A PROVERTY M/HO BURDS OR W PROVES iHEAEDN,IWO � 1MqCONTRACTSiOFlSUOfPNWECiSMnTHl1COHifUCTOR(S�LICENSEOPURSUANTTOTMECOHTMG pUANTITY DESCRIPTION � �� FEE � � TORSLICENSEUW.). _ _ . _ -.. O I AA1 E%EM7TUNDER SEG B.1 P.0 iOR THIS REASON . Q � V . � � DATE OWNER V • � � UCENSED CONTRACTORS DECIARATION -� � W ` • INfRfBY�FFIRIJUNDEFPENILT`/OFVERNifVTHATIAIILICENSEDUNDERVRON5qN50FCHAV7ER �r � � •(CO�.e�ENCNOWi'TMSECTIONfOD710FOM510N]OFTHEBUSINfSSANDPPAFE5510NSCO0E,AND Z � . �� W LIGENSE IS N FULL FORCEAND EFFECT. m � � uccr+se cuss �-7!� ��c.No. G S ' � � � o����/S 5' % eamucrora � a . � WOFiKERS'COMPENSATION DECLARATION1 n� ��/ � � N �l' �Y`� v N IHER£9YAFFlRAIUNDEROENALTYOfVE0.NMONEOFTHEiOLLOWWGDECLAW1T10NS: pb � Q � _IIMVEANDYALLWMAIHACENTIFIGTEOFCONSEMTOSElFINSUREFIXiWORKERS' S COMPENSJtTpN,145PHOVIOEDBYSECT10N770oOFTHEUBORWDE.FORiHEPERFORM�NCE W OF iME WOFiI(FOR NMICN THIS VERMIT IS ISSUEO. � � �IHAVEANDN�LLMAIMAINWORKERS'Cd.�PENSAipNINSUUNCE,ASREOUIREDBVSECTqN ' ' - QO ]7000FTMELABORCOOEiqiTHEPERFORMNiCEOFTNEWORNFORriHICHTHISFEHM1T15 � ISSUED.MYYYOIiKERS'COMPENSATIONINSURANCECARRIER/WDP0.1CYM1AIB[RME: CONSTRUCTION . . ' ' . ' _____ ..... . . _ _ .. _.... .._..._ . . _ � CARRIER PLAN REVIEW . ..._ ... . ... � POLICYMIAIBER� �� � _ ELECTRIC / Q �Ss�aqnn[IDrqrgEoor,��mpFn[peqr.rrsrnnor��wta[n u�pioc� �, PLUMBING lL Y Z I CEHTFV iH1R NTHE PERFORY/�NCE OF THE WORK FOR NM1IICIITH15 PERYIT 1515511ED.1 MECHANICAL �6 (y S�WiNOiEMPLOV/NYPERSpJNPNlMANNERSOASTOBECOMESUBJECTTOTHE -,� '� � WOPo(ERS'COMPENSATIONU�MSOFGILIFORMAM1D�CqEETNTIFiSMOULDB[COML INSPECTIONFEE (� SU6JECfTOTMEWOFUCER5CtM1iEN5ATiONGROVISqNSOFSECTION77o00FTHELABOR � ISSUANCE '�y,M� � COOE,�SFU1LL FOfTTHW�T11 CW�PLY YA7H TMOSE PROVISiONS. � OATE:�I�'� APPLICANT.. f SMIP . '� `J �� '��Z W . � WAANINO:i�LURETOSE(.1JREWORRERS'Wr.�PEN5�T10NCOYERAGEISUNUwFUI,ANDSHALLBE ENERGYP/C ��S`����'� �y SUBJECTANEMP�OVERTOCPoA1PlALPENALiiESANOCMLFNESUPTOONEMUNDREDIYlOU51W0 ENERGYPERMIT �� � OOIl/JLS�S IOD.00D).N ADOITION TO iHE COST OF COMPENSATqN,DAMACES AS VROVDED fOR W / � SEtt10N7�oeOFTNELABOIiCODE,NTEREST,/iNOATtORNEYSFEES RETENTIONFEE: C Sl_.S � � � • pw., CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � O � INEREBYIIFFlRAIUNOEROENAITYOFGE0.NMiMATTHEREISACONSTRUCTpNLENDWOAGENCY iOH ME VEtiFORMANCE OF iNE WORN FOR WNICH 7HIS VERMITIS ISSUEO(SEC.�097.CIV.C.). � � LENDER'SWWE � C LENDERSADORESS WICERiIFYT1ATIWIVENEPDT9SAPPL�CATIONANDSTATETUTTMEABOVENFORI�AT10NI5CORRECT. TOTAL FEES ' . � � IAOREETOCOMPLYWITNALLCfTVAN�OOIMTYORDRIANCESANOSTATEUWSREUi1NUTOBUM1DiN6 . . COHSTRUCTpN.AND MEREBYAUTNORIZE REPRESENTATIVES OF iH15 COUNTY TO ENiEfl UPON iHE . . . � S� ABOVE�4EHTIONEDVROPERTYFORINSPECTqNPURPO5E5. COMMENTS � � ��� - - m � vewairrcE rw�e ryarrn .. . . . . ,�, - �t.{--�� 9 � �._�N8pr1A7UREOFVEWNTTEE ` - D�lE x ` RECFT.N0. PAlO BY VALIDATIO ~ VYFtITE—DepeRment Copy,YELLOW--Finenee Copy.PINK—Aefessa Copy,GOIDENROD—File Copy,GREEN�Ilpplicanfa Copy � � � . ,..- , ..........,......_, .,..-. ,. ..,, ... ., , .. , , . _ . _ . .. . . . ....... .. . ...... .. , . , .. , ,.. : ,. • ,.. . ., . ...:....... , . .. . ., . • . "['• . . •, • � ... a CITY OF DIAMOND:BAR , �.; ;;,�, ;,,: . -� � ... . ... . . . .. . . � ._. .. . . . .. , ., . . , . . _� , -. , � -� . . . ; ; �'INSPECTION RECORD: . . . . : ' ;.. _ ... - :'°: _ . _ - ` � .. . . . . a� e e � � ' • � � a ' SET BACK ., }-,`�� � ( ' FLOOR JOIST '. r� . , , , . .. , •. +t �- �:' i . . , .. __. . . , ' ' , FHA REQMTS - - .._.... " . FTGS/FORMSISTEEL � : ..r .if��. � ._ _..... . ...... .._ .. .. _. . __. .. _.,-- ELECTRIC GROUND----�� '" __ � � - � � ��� UNDER FLOOR DUCT - ' GROUND PLUMBING UNDER FLOOR CU�IDUIT = , ,:; ���.':• • � .. .. . ,. SLAB GRADE-- -- � . ; -• FIREPLA�E�bUNDATiON�=` ' " ' ' . l'�- . _ _ . • :��_ TEMP POWER - - � -- --- - ' ' ' � �� " FIREPLACE BOND BEAM � � -WATER SERVICE-.- .�,-.-_-- �_ . - . : MID HT.BOND BEAM �� :�. �•!; : .,�` �. , � , � _ . ROOF SHEATHING -'� '� �'1 , ._ . . � �.• � � 8 FT.BOND 6EAM ��.' •�� � .,• -. -- - � - --�.• : :;; I � FRAMINGNENTILIATION � FINAL BOND BEAM � •" I � ROOF COVER . .. _ ;:' PRE-GRADING � -' . � , . ROUGH HEATING - . -- - - � -- ----� - - ... - BENCHING .. ' . . _. .. _. . . �; . ROt1GH ELECTRIC " ' �- �- � � ROUGH GRADING , -, -ROUGH PLUPABING . - - ---- - --"- - - "." FINISH GRADING , , , . . . . .. ' • � SHOWER/TUB TEST� � � � � � � �� - �� ` -� POOL ELECTRlC � : . : . EXT.LATH/SIDING � - - -- - -' ._. -� POOL FENCING , WALL INSULATION POOL FINAL • . '. • CEILING INSULATION i OFF SITE IMPS.. ' • DRYWALL NAILING DEDICATIONS ' . SEWER - - - - - - -- - ' _ _ FINAL ENG. • , . SEFTIC TANK � LANDSCAPE/IRRIG. . . . - . _ • , , ; � SEEP PIT/L:L. - _ . - - _ : . _ . . ON SITE IMPS. : • , GAS AIR TEST;-- - - -- - � - - - --- --. - - FINAL ZONING • 1 :.. FINAL:CONST.' - --- - � -- - FIRE.DEPT. FINAL ; :: FINAL'HEATING - � � - - HEALTH DEPT. FINAL - � ...__. , FINAL ELECTRIC � �- � � - - - - ; DEV.,FEES PAID . � - -- �INAL.PL(�MBING 5- �, ;� � ENERGY � • • - . � a' !i e �—..� ' - —-----.._. . : . _ .._... .. .. . ' ---.._..----. •. - ' ---- _ _. .. .. _ — • , . _ .. � ',.;" .. .. ;'\1,:�--1.',�,� . . . . ' COMMENTS ._ . -- - -_ _ _.. . .:. . . ; .. , �; , ---- .._ .. . _ . . . . . -. � ._ ___._. . _ _ ;.,. : , _ _. . . . .,�,�� ',.., - � ; -. � , . . �- '.J - . _%J ' ' ; U l,� '.'! . . , � _ _ - - _ _ _. ,. , ' _ . _ . _ , i ; : ,.�. . . . i . SEPTIC TANK SIZE • '. . . � SEEP PIT/U SIZE __ , , � �>• . .. _. _ _. . _ _ � . , , .. _ , - . . __ . � . . _ _ . � ; -� ,.� �I _ . .. . .. ; i ,.'. ' ' . � , , _ . . . , t ,w; � ..��,) l <<. -�`�� ��."� --�� - . _ ��'����Z�'.