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HomeMy WebLinkAbout11936 J� CITY OF DIAMOND BAR ' •� � � `- ' � yj— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 7 �w . 21660E.CopleyDriveSuite190 ' � � PRESS � (909)860-3195 Fax(909)861-3117 � �'�'� BUILDING PERMIT APPLICATION � � FIRMLY � JOBSITE /� �j APPLICATIO PERMff /C o ADDRESS,-3�-�1 ���' " �l`"�� DATE 4 NUMBER N ; � ISSUE 7YPE OCC . � APN LOT TRACT ' DATE CONST. GROUP p OWNER - . . LL ADDRES 0 ZONING SETBACKS � CITY ZIP � _ TEL FRONT _ RVN p - - APPL C NT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE ,� �{�15�' i1��17 �FIhIC'l' �.�J�,�� CITY o ZIP�TEL. � � • o ARCFUE / � - � � DESIGNER - - NO.DWEL . .. ' NO. ADDRESS UNITS � STORIES ` BEDROOMS � CITY ZIP TEL. � v� DESCRIPTION SQ.FT. FACTOF PSF ADJ.AREANALUATION p� „ . OWNER-BUILDER DSCLARATION . � ' SFR/ADD/REM O p I HEREBY AFFlRM UNDER PENALiY OF OERJUiiY iHAT I MI EXEIAPT FROM iHE CdtfMCTORS L4 GaregelCarport �� ' • lL CElISEUWFORTHEFOl1OWNOREA50N�5EG7m1.68U5W[SSANDDfiOFESSIONSC00EANYGTYOH (n �� COl1�RVYMIdIREOUlAESAGERMRTOCONSTRUCT,ALTE0.MDROYE,DE4101J5i�ORREPAIR/JlYSTRUG ' W Z �7LAE iR10R TO RS ISSUANCE AL..O REOUIRES THE APPL�CANf FOR SUCH PERMIT TO iILE A SiGNED P����eck �I� STATfYEM THAT HE OR SHE IS LICEHSE�PU0.5UANf TO TNE PRONSqNS OF THE CON7MCTORS LL W . � CFNSE UW(CMAPTFR Y(COMMENGNO N1TN SECTION 7000)OF DMS�ON]OF TNE BUSINE55 MfJ PR6 � PooVSpe � FESSqNS CODE)OR 1TUT ME OH SHE IS E%EMPT7MEREFROM AND TNE BASIS FOR TME IILLEGED E%EMP- TION.ANYVIOLATIONOFSECTI0NTW1.68YIWYAPVLICANTFORAiERA11T6UBJ[CTSIHEMPIICAHTiO Z q�q�f �,,,, A fNd PENALT'OF NOT NORE 7HAN FNE HUNDRED DOILAiIS p500).k � . � O�A.:OhN�EROFTHEDROPERiY,OqA1YfMPLOVEESVATIWACfSASiMEIpSOLECOYGENSATqN,' O COrtIfflBfCi81 - ' N7LL DD iHE YYOFIK AND THE STiNCTUAE t5 NOT INTENDED 01t OFFEFED FOR SALE(SEC.7W.BU54 J � NESSAND iRDFE5510N4 OODE:iNE CONTMCTOR9 LICENSE UW DOES NOT APPLY TO AN OWNER OF ? . . PfiOPEHiYMAp8UlD50RMGFiDVE57MEREON./V+DNMODOE55UCHNNfiKHIMSELFdiHERSELFOR ' ' Q i1Ci0UGHM190R/1ENOWNEMPLOYEES,VROVDEDTHATSUCMMPROVEMQl�SARENOTMENDE�Oq m �l� OfFEAEDFOHSALEIf,lIOWEVEi�THEBUlDP100RtAPROVEYEHT550lDWITHINONEYFAHOFCOYPLE• Z �ilOH.7HE OWNER�BIIItDER WILL HAVE TME BURDfN OF PROVR�O TiAT ME OR SIiE DIO NOT BUitD OR = 4PROVEFORTHEiURPO5EOF3ALE} . " W OI.A90WNEROFiHEVRDVEHfY,/u�ExCLUSNELVCONTMC7WOMrtT/LICENSEDCOHTMCTORS : � TO CONSTi41CT TNE DFqJECT(SEC.7a�,BUSiNE55 AND GHOFESSIONS CODE:THE CONTMCTORS U- VelUOtiOf1 L'Z1� ADJ.AREA " CENSE UW OOES NOTMPLY TOAN OwNER OF A PROYERTY WHO BULDS OR W PROVE9 TNEREON,AND � WIqWNTRJ1CiSiOHSUCMVRO.IECTSW�TMACONTRACfOR(S�LICENSEDPUHSUANTTOTMECONfMG pUANTITY � DESCRIPTION � � - � FEE -� , _I IORS LICENSE UW.�. . _ . � OIAMIXE4PTUNDERSEC. B-iD.C.FORiHISNEASON d 3 " -.. .. . �= DATE ONMER � . � UCENSED CONTRACTORS DECLARAT�ON W � IHER�YAFFlPl1UNDERVENALTVOFPfRR1R'/TMATIA4LCENSEDUNDERORONSIONSOFCHA�TER � ' . ' � 0(Cp.oAENCWONTT115ECT10Nl0oo1�OM5iON70FTHE8U51NESS/wDOROFE5510N5C00E,MlD Z � ��� WLICENSEISNFULLFOqCEANDEFfECL m , 0 UCENSE CLASS '� �IC.N0. � � . ..�j DATE �CONTRACTOR a W � � � WORKERS'COMPENSATIONDECUIRATION -� ¢ �� IHEREBYPFFUWUHOERVENAL7YOFPEKMIYONEOFiHEFOLlO1NN�DECLARAT10N5. z � � �IFIAVEANDYALLMAMTAMACERTIFlUTEOFCONSENfTOSELFaNSUREiORWOFIKERS 2 COMPEHSATpN,ASPROVDEOBYSECilON770oOFTNEUBORCODE,FORTMEPERFOHMMICE � W OFTHE WORIf FOR WNiCHTl115 CERMIT IS ISSUW. � � �I HAVE ANO N^LL MIUNTAPI MCAKE(75'COMPENSATION RlSURJVlCE.AS RE WIflED BV SECTqN ' Q 97000FTMElABOqCOOE,FORiHEVERFOFlMANGEOFTHEWORKFORYrt11CNTfiSPERM1T15 ' � ISSUED.MVWORKERS'COMPENSATqNINSUfUNCEC RRiFRANDVOLICYM11A8�RARE: CONSTRUCTION � � GRRIER� �I PLANREVIEW � POLICYNUAIBER ELEC7RIC . � Rrssccronremnote[aM�rIDOFnECE �swAor+eMrnrxoocwt�s�s:oyontcss� PLUM6ING Z ICERTIFYTUTRITHEGERFORMANCEOFiHEWORKFORWHICNTX15FER1.a715155UED,l � MECHANICAL � � ('} 51u41NOTEMPLOYANVFEit50NNIlNYMIwNERSOA5T08[COMESUBJECTTOTHE � WORKERS'CONPENSATqNUYYSOFCALIFOMlIAANOACREETMATIFISNOVLDBECOME INSPECTIONFEE SIAJEG770THEW0�1KER5'CDA�PENSATqNVROYI510N50FSECTqNl7000FTHEUBOR ' " ' � � s eaoE,�sr�rticamrvniNcoua�rvnn�n+osevAo�sions. ISSUANCE � SMIP ..p DATE: APPLICANT: �� � ENERGY P/C WIIRMN(i:iARURE TO SEWRE WOWCERS CpAPENS�TION GOVERAGE ISUNIAWFUL.AND SWLLLBE �y SUBJECiM1EMDLOYERTOCRIMPIALPENlLLTIESANDGMLFWESUPTOONEMINDFEDTHOUSAND ENEFiGYPERMIT � DOLLAitS(iioo.0o0).N ADOrt10N TOTH[COSTOF CpA1PENSATION.DAMAGESAS PROVIDED FOR N ¢ EEC710N�7os OF T/E U100R OODE,INTERE57,AND 11TfORNEYS FEE4. RETENTION FEE: d CONSTFiUCTION LENDING AGENCY PRE•ALT FEE: ' � � O , - � IHEREBYAFFlMIUNDERVENALTYOFCE0.NR'lTNATiHERE151CON5TRUCTIONLENDPlOAGENCY ' Z iOR TME VERFORMINCf OF TXE WORK FOR VMICN TMIS VEiWIT IS ISSUED(SEGloY7,GY.GR W �� LfNDERS NAA1E � � LENOER'S.IDORE55 � ICEflTIFYTW�TIWNEREADTiISMPUGRIONM'DSTATEiMATT1EA80VEWFOIIMATIONISCORRECT. TOTAL FEES �� w IAOREEMCOAIPLYN7TFIALLCfTYANDCOIMTYOPDINMlCESMDSTATEUWSREUTNOTOBU0.DINO //�� //�� /�� �" CONSTRUCTICN,ANDMEREBYAUT/10HIZEPEGRESENTATrvESOF7HtSCOtM7YTOFNTERUPON7HE . � � (7 � „//� ' S� A90VE•YEHTqNEDVRo7ERTYFORM P$ECYJf1VURPO5E5. COMMC-NTS �� �� G � , � ��w.�� . . ... _ �/V V^• m PERAA A/AE(PN n / 4 . � � $ql{A RF R DATE ' ' � RECPT.NO. PAID BY VALIDAT10N 1NFiITE-0epartment Capy,YELLOW—F�ante Copy,PINK—Aseeesor Copy,GOIDENROD—File Copy,GREEN—Applicent'a Copy � - \ / ' . .� .�. . ., .. .. .•� �.., i . . � . i� ... . ..�. . .. . •�' �" �� ��. . .. '_ ^ • . .. _ .� � .. .� ... .�/•�;�� �1.. .j. • ...i I.M•.... ,. .. . . . . '� .� . CITY OF DIAMOND;BAR . .;:��. _: - ,;�: �;� `�, , ':.:�.. . . 'INSPECTION RECORD�' ,. .;' .-, � .. � .,. . � -J� r . . .. � - ' . L . .. . . �I. �- . � � . ..' ' . O , � • / , � • � SET BACK ' � �' � ' ;;�: f� 1'� r` ' FLOOR JOIST �r� '�.��:+`�,� %' .'� ' ; - , . . , . , . . . .... FfGS/FORMS/STEEL ='"'- ` � ' � � � FHA REQMTS - - - -- � -- - --— - ELECTRIC GROUND-.-___ -_ _':. � . . _ � " --- � UNDER FLOOR DUCT �;�' - � ' - '� .: GROUND PLUMBING � UNDER FLOOR CONDUIT'-•,`� .t,\�%1�.� �._::'• •:�:• ' .� ' � � SLAB GRADE --- _ _ _ __. ._. ; , FIREPLACE F�UNDATION"��.f�•:.1'•,� , ._= t.;, ��...`•„J,^ ` „ TEMP POWER �--._ �• -- - -- :` ':: . � � FIREPL�;GE60NDEEAM . . . , ` . : `•" - � WATERSERVJCE..._... . . . -.: . . . ....:.....-__ _. .�._. MIDHT.BONDBEAM r:� ��� .i: :.� � �.,,-,. :,._; :. . �. f3QOF SHEATHING•---'. 5. _...._.. 8 FT. BON�BEAM:� �:,_".: -: :" -- •. �,: .r ��;�:`.; �'.�,� ;r , - =�' �FRAMINGNENTILIATIbN . `'�:. �_ - � �� �'� FINALBONDBEAM � ' � ' ROOF COVER.� ' �y . •- ' PRE-GRADING -_ _. _. _ _. .. ._ . _ . . ROUGH HEATING - - - - -...._.._ .. . - - - BENCHING - •, -. _.. �:.•.. . _.. . . � : , ; . ROUGH ELECTRIC -' - -' ' - � �� � � � . - ROUGH GRADING , ' ROUGH PLUMBING � �� -� �- " � ���� �� � " FINISH GRADING , , .•. SHOWER/TUB TEST � - � � � POOL ELECTRIC ' - EXT.LATH/SIDING ; POOL FENCING • - WALL INSULATION -��.�-"•� POOL FINAL , �� � • CEILING INSULATION � � ' OFF SITE IMPS. - "- DRYWALL NAILING DEDICATIONS ' ' ' . .. SEWER. . .._._.._..._ .. .. FINALENG. • . _..--- - -- -- SEPTIC TANK - -.�- -- - - -- -------- � ---,. _ _.. _._ LAN�SCAPE/IRRIG. . . , , � .. SEEP PIT/L.L: � -- --� -- " -- �' ' � � ON SIl"E IMPS. • . . GAS AIR TEST ---- - - �� - - FINAL ZONING - ` F.IRE DEPT.FINAL -- � � • - FWAL-CONST. -- - 1 yB- __ - FINAL HEATING - -- � � � � - HEALTH DEPT.FINAL . . : ; .� FINAL ELECTRIC - - - " - - - � - -- DEV. FEES PAID , - FINAL PLUMBING ENERGY � • • _ , ,. � �.� e a . � . �;r . '. . . .. . � . � tl ° , . _.. 5 '•+ r\ _ _'_ __' _ _ '_ ' '.._ .._ _ . . . ..__. ... _. . .'. . • '. - ' � ,', . `�.\'. COMMENTS - ---- ------- _._. .. , ; . -- --- -- - . . _ - - - --- - -- - . .. _ .. , , . ,, . - � - - - - ------ - � .� , � '_ .� -- -' , � . . • . . ' j . -- - . . • ` ," .�'e. � , � c; � , - . �.•.. , �� . , _ . . . . _ . ; � . '� � _`'.\_ �. • _ .. � , . { . SEPTIC TANK SIZE ' � � + -� SEEP.PITN SIZE -- r- - . _ - , . � � �:.,. �- �';� + � r.. . , 1. :� t _ � .. , j i - _ _ --. .. . _�•. . , � , � . . ;_.- -, �1 �_. -. __ _ ; .. ; ,. _ _._ ___ . .� _-�..�, -:`, � ; , • '� . ' . '�" • ''�"�` �'•'`' . � - ,`,.�,� . - - ., .. .. ,