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HomeMy WebLinkAbout12094 (14) r�N�V1 �� CITY OF DIAMOND BAR • ' '• ' � DEPARTMENT OF COMMiJHITY&DEVELOPMENT SERVICES � _ 2i�oE.c�i�ynr;�os�ui90 . �. . .,. , (909)860-3195 Fax(909)861-3117 PRESS : �`'�^'"� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE p ¢ ADDRESS_ o���0�1 �V� 'B�� . . APPLICATION I I � PERMIT p/C o DATE NUMBER N � APN LOT TRACT - ISSUE 7YpE pCC p OWNER _����f�PMI�lAI DATE CONST. GROUP " ADDRESS �'�T 2.�l Z/'�o•t1 �A2�' • ZONING SETBACKS � CITY DIAI`�✓NA L�Q� ZIP� TEL. . FRONT - RW ❑ � APPLICANT l[` �dPJ� Fd[t TEL (a REAR p � SIDE/SIDE STREET RW ❑ CONTRACTOR GEdr'c.�iE,IS�'ZlL. SIDE p p� ADDRESS . � C(TY [��tLVfiC l'�1"`r ZIP� TELC � 3- PROPOSED USE o ARCWENG/ x�o// . � DESIGNEFi NO.DWEL. NO. NO. CrD�D�RESS Z�P TEL UNfTS STORIES BEDROOMS . � v� DESCHIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� _ . OWNER-BUILDER D�CLARATION . . SFWADDIREM O � p 1 NEREB'/AFFlRM UNDER PEWILTY OF PEfWRY THAT 1 AM FXEMPT FPOM 7HE CONTMCTORS ll� Ga�999/C01pOR � � _ � CENSEUWFORIMEFOLLWYIN6RFASOH(SEC.70.11.6BUSINESSANDVfiOFE5510NSCODEANYpTYOH ;. (/) COUHIYYM1ECi1RE0UIRE5AGEMIRTOCDNSTPUCT,ALiER�PROVE,0E�10U5H.0itREPA1RANY5TAUC• W PaliolDeek �TURE,PiaOR TO rt3 66UANCE AL50 REOUIRES ME AOPLMAM FOR SUp1 pEHMIT 70 FlLE A SICNED W � � B7ATEMEM 7HAT HE OR&7E IS LICENSED PURSUANT TO THE PROVISIONS OF TNE CONTMCTOfLS U� CENSE UW(Q1AP7ER�(COMMENdNO YnTH SECi70N 7000)OF DIV1910N 7 OF THE BUSINESS AND PAO• u" POO�SPa � FESSqN3 CODk�ORTMAT ME OR SHE IS E%EMPT iMEREFHOM MID Tl1E BA515 FOR 7ME Al1EGED E%EMP• TION.NITVIOL�7IONOFSECTION70]1.6BYANYAPPLIGNTfOR11PERMITSUBIECTSTHEAVVLICANTTO Z qe-Roo1 F ACMLVFNKTYOFNO'f►IOFETIUWFIVEHUNDREOOOLURS(f5001.$ � OI��EROF7HEPRODENTY.ORAtYEYttOYEESNnTHWAGESiISTME1R50lE0OMVENSA7lON, � (`,pmmBfCiel - , � WLL DO 7NE YYORIC ANO THf STRUCTUi1E IS NOT MENDED OR OFFERED FOR SALE(SEC 7u1,BUSI� J � � NE53 AND PRDFESSqNS COOE:TME CONTMCT00.4 LICENSE Uw DOES NOTAPPLY TO AN OYVNER OF j PROPERTY NkfO BU0.D9 OR MPROVES 711EREOt{AND Y+1q DOES SUCN WORK MiMSELf Ofi NERSELF OR � �� i11RdJOMN50qNENOVMEMVIOYEES.VROVI�EDTMATSUCMWPROVEMEPlTSMENOTMENDEDOR m ' � OFFEXEDFORSALEF,MON'EYER7MEBUlD�NaO(7MVHOVEGEM650LOWITHMONEYFANOFCqAVLE• � � Z TqN.THE OWNER�UILDER WILL NAVE TME BURDEN OF PROYWO T/UT HE OR 6HE DI�NOT BUiID OR = MVROVE FOR7ME Pl1RPO5E DF SALE� ' .W ❑1A30MMEROFTIEVRDVERTV.AUDlCLUSNEIYCONTMCTNOWfTHLICENSWWNTRACTORS� � M CONSTPUCT THE P110JECT(SEG 70U,BUSINE55 AND PROFESSIONS CODE:7NE CONTRACTORS U- VdIU8l10f1 ADJ.AREA � CENSE UW DOES NOTAPP�Y TO AN OWNER OF A PROPERTYwHO BUILDS OR IUPPAVE9 iHEREON.AND � WIqLONTMCT�FOR3UCMPROlECf9WRT1AGpfTMCTOR(5)LICENSEDYVRSUMITTOTMEGONTMG Q�J/��TM OESCRIPTION - � FEE � � iORSUGENSEUW.G - . . . . O I AM EYEY{+T I1NDE11 SEC 8.10.C.iOR TMIS REASON q 3 c� . . . , LL. � . OATE OWNER U ' � UCENSED CONTRACTORS DECLARATION w J � W IMER[BYAFFlRYUNDERVENALT/OFVERIURY11uT11U1LICENSE�IM�ERVROVISiON50FCHAPTER . V. p., •(CpA/ENGNfiWITX5FC710NMoo�OFDM5iON70�TMEBUSMESS�NOPROFFSSIONSCOOE,/N0 Z ' � X IA'I LICENSE 6 N FULL FORCE AND EfFECT. m � ucasE cuss C?�o C3� uc.No.�27�'t'�7� � � �� �/�,�[R33 corrtrucToa 6,Fd_P�,F R1'�.12(L a � WORKERS'COMAENSATION DECLARATION\ 3�'�I ' a , � 6�� ��.N��' � � ., ,, ,. . , . � �,. ,, .: .�11:- � � N INEREBYAFF6WUNDERPENALTYOFOEiWRYONEOFTHEFOLIOWINO�ECIARATIONS: z "� � _IHFVEANDNALLWNTNNACEiRIFlCATEOfCONSENTTOSELF-INSUflEFORWORKERS', _ COMPENSA7qN,ASPROVIDEDBYSECTIONS7ooOFTMElA80AC00[,FORTNEPERFORMNICE W Q OFiHEN'OfiKFORWHICHiHISGERYITI5155UED. � _Y�1 HAVE AND WILL Y.UMAPI YYONfER5 COMPENSATION INSVAANGE,AS REOViRED BY SECTION � � 77000FTh1EUBORCODE,fORMEPERFORAINlCEOF7HEWORKFORYMIp1iHI5PEHMRIS ISSUEQWMViUCER5C0Y7ENSATIONINSURANCEGRRIERANDPOIICYNUM�ERME: CONSTF�UCTION j uAwEa D . PLAN REVIEW � POIICYWYBER 1�1 �' .ELECTRIC . Q (M55[CfqNNCmN0T6[C�t.EIIDOF7IEVERMT6�Ofi0NElAlD�K�0011/iLS6��lORLEss1 PLUMBING Z 1 CERTIFY THAT M TNE PERFORMANCE OF TNE WORK FOR WHttl1 THIS DERUR l5 t55VE0.1 MECHANICAL _ � " � � SNALLNO7EMPLOYAN'/VERSONINMlYMAHNERSOASTOBECOMESUOJECTTOTME Uj N'ORKERS'COMPENSATIONUWSOFCAL�FORNI,�/�NOAGREETHATIfISNIXhDBECOME INSPECTIONFEE � `_ SU&IECTTO THE WORKERS COMPENSA710N iRON510N5 5 C7�ON 770o OF iME VBOR � � S cooe,i sru'wu�oarMnTrcaa�r wim rno ISSUANCE , p _���/ff] J �, � SMIP p OATE: APPLIG.M: � WARNINQ:FA0.URETOSECUREWORICERS'GOAAPENSA7IDHCOVERAGEISUNUwFUL.,N�105HALLBE ENERGYP/C � SUBJECfANEMPLOYEHTOCRIMIWLLPENAL7lE5ANUCNILFWE5UPi00NENUNDREDTHOUSAND ENERGYPERMIT - ' "' � - OOL1M5(f 100.0001.W ADDITION TO THE COST OF COMPENSATqN.DA1dACE5 AS PRONDFD FOR IH ¢ SECiION]70eOFTHEIABOqCOOE,INTEREST,ANDATTORNEYSFEES. RETENTIONFEE: ' d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � . � IHEREOYAFFIHAIUNOERPEN�LTYOFPEiWMTHATTHEREISACONSTRUCT10NlENDINOAGENCY _ � ' Z FDq THE VERFOMAANCE OF TNE WORK iOR WHIf}/TMIS DERYIT IS ISSIIED�SEG�OY7.CIV.G�. ( W � LENOER'SNAUE � � � lENOER'SADDRE55 � ICERTFYTUTINAVEREPDTIUSAPiLIGT10NM1U57ATETHATiNEA80VENFONJATqNISWPRER. TOTAL FEES � � ' � IACREETOCOIAPLYWITHAL�CT'ANDCOIMTYORDWANCESANDSTATEUw5i1EUTINUTOBUIL�INCi . � CONSTRUCTION,MAHEREBYAUiHOflIZEREPRESEHTATIVE50F7HI5CO1MiYTOEMEHUPONTNE . . . . . . . ABOYE•GENTIONED VFiOPERiT FOR INSPECiION YURPO5E5. COMMENTS �� J T. l5 V m VERAIRTEE IP n ' Q �/ N ► l • _ SqNAT O E E DATE .. . .. . .. . . . RECPT.NO. � PAI�� VALIDATION � � YYHITE—DepaAment Copy,YELLOW—Flnence Copy,PINK—,Asseasor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy - � ..� . . : +. . ...� ...:.�:.,r . ... .. . , r:.:.,.nc::•.:.a-.:•::... � . ��.,. . . ,�1,. � , , , . , , �..a..,�,,,..,�,,. ;.... . .-e.::.�..;;.6"r:.,;�.�' � �•R:.�!;�.y.•�t�'��nr..y..�nr�. ...ie:.,.,,... .t.- . . . . . . . . . . ... . I . . j... � CITY OF DIAMOND;BAR ..�-; - ; � , , �� . . _ .; .. . '` -`• � `; ::��" �INSPECTION REC�RD ': � � . . „ , • . � , -,: .. .-. ...._. . . . �": ' .. . 'y . , ' _ . �. � p � � � . � � � � . SET BACK . . , ' � � • FLOOR JOIST ���.�- ?�.'��',� `' ;_(';'_:. FTGSlFORMS/STEEL • • FHA REQMTS � -- - - � � � - -- - --- - — - ELECTRICGROUND - " ' . � UNDER FLOOR DUCT � , , ;: �.,_�; :� �ry ',;^...,- ,... � , i -- GROUND PLUMBING � ' �� UNDER FLOOR CO�IDUIT�::..�Z �,,•:.-� • �r�s-, .. , . , • . ., SCAB GRADE--- - - - - FIREPLb,�C���FOUNDATION t•= ��; : �. '•�-�� �'�'��"�1,�� ', � _...,_� ,'._ <<_,:i _ . : , TEMP POWER . • : - -- ` . � ' � FIREPL�I�E�ON BEAM...- -- _ ._. ... --.-.--- --- - � WATER SERVICE - -- --� � -- � - - "MID HT.BOND BEAM -- -" " -"''•_'''' ,'"� '. ', • „ ROOF SHEATHING -. _ _ . '' 8 FT.Bpap•BEAM:,� - - .._ _ , _ -, - • c: ��;• ' � �.�^'�,.� ,r � . . ,. FRAMING/1/ENTILIATION FINAl80�1A�BEAN1 � ' -"' ROOF COVER.. ,: .... PRE-GRADING - �- -- - - -- � + ROUGH HEATING � - - --- - - - BENCHING ''� '�' ROUGH ELECTRIC - " � -ROUGH GRADING � • . ; � ROUGH PLUMBING : � - � � � FINISH GRADING . . SHOWER/TUB TEST ��� -- - -- -- � POOL ELECTRlC ' ,, EXT.LATHISIDING � POOL FENCING � � � WALL INSULATION POOL FINAL . : . ' . - CEILING INSULATION OFF SITE IMPS. - � • ; DRYWALL NAILING � DEDICATIONS : ' .. SEWER ' FINAL ENG. • � . - .. SEP_TICTANK_ _....._ . _ _.. _._ LANDSCAPE/IRRIG. . � ' � � -SEEP PIT/L.L... . � '. � . . ' . - ON SITE IMPS. . •. . GAS AIR TEST,- � - - - FINAL ZONING � • FIRE DEPT.FINAL ' ` ' • FINAL CONST:. � /c-:ll-R �ua:4' ,� - �FINAL HEATiNG --- - �- � �� HEALTH DEPT. FINAL FiNAL ELECTRIC �� � �"- - - ---� ; DEV.FEES PAID - " � FINAL PLUMBING • ENERGY • �.. �: r o e "`- \`.' --' � _ . � . ... _, _..��,. .,, .:�� ���ti . , COMMENTS 1L�-�1��4"�� �'1�`��.`'l'��ii� C�r,�`i--�:--,�t�;,�/ G�'C'__ 1.a.c�e`� �i,�f�,� ' . , �sr� � ,.�, � ;�, . , �� � , . . �:v>,.� _r..���_ . r: / .( �� —��'sC- , .. , . . . . . . ._ ... . . � � 1� . �. . . . . . _ - -- - • - - - - - -- � .. . � , . . , .. �� � �. ' j � � . . �. • . ... .. . ' ' i � +� r, � \. \� .\ _ `� .`�h �' < ti _. . `..`, --.. . _ _._ . . . , i . . SEPTIC TANK SIZE - - ` � ' � i , SEEP_.PIT/U SIZE . ... � _ . _ _ ; � ,. i . '���--.--..-� F'I .. r�, +r... . . .. . � I - . . . . . . .. . . �. i a'1� ` � I . � . � . . � .- � . � . . . , � .� . J� . . ._ ..._..._ . _ _ ... . � : ' � . . .. � . � � .. . . .. . . . . .. . .. � . �� ,. �._� . ��y-;. �1 . __. . = �...,• J ' � , . ` . , _ ._.._.._.._ ; �;.� .\ F 1 1 �, (�. - : : 1 • � �� �, ,� _.I � � _. . . . _ _ __ _ . 1, ,1i i t '