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HomeMy WebLinkAbout13158 �� CITY OF DIAMOND BAR ��' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES (�— J �� � 21660 E.Coptey Drive Suite 190 �/ � (909)860-3195Fa�c(9b9)8b1-3117 PRE$$ '�^�� BUII.D[NG PERMIT APPLICATION - FIRMLY o� JOBSITE �G�gs T�Q� �"�- APPLICATION � 2� NUMBEFl ���v 1t/ �-1`►�+' ADDRESS 1 V�ut DATE c� ISSUE /�,� � '' TYPE '• � OCC APN LOT Z RA T DATE ��'l _CONST. GROUP °C OWNER � , � � ADDR�SS � ZONING SETEACKS '� • � '�`' � CITY - 21 7�7Z- �EL REAR • ' � Rw ❑ APPLICANT EL SIDEISIDE STREET RW D � CONTRACTOR �-P �L SIDE ❑ ADDRESS PROPOSED USE • � � CffY ZIP TEL � ARCH/ENGl���d.��t�� DESIGNER NO.DWEL. NO. NO. ADDR S UNffS STORIES BEDROOMS � CITY ZIP TEL � DESCAIPTION SQ.FT. FACTOR PSF ADJ.AREANAIUATION � OVYNEF-BUILDER DECLARATION SFR/ADWREM O p 1 NEREBV AFFIAM UHDfR PEWLLTY OF PERIURV THAT IAA1 E%EMPT FPOM THE CONTP-�.CTORS U- GefH9���R � r,� CEHSEUWFORiMEiIXlO'MNONEASON(SEC.7o77.68USINESSINDPHOFES510N5CO0E:ANYCRYOR (n r, ��/}y�NR6pUIqFSAViWaTTOCONS7AUCi./LL7E0.�MVROVE,DEE10U9lOFREVAIRANV57AUC. z — W -PatlaDeck------ --- --- -- ---—- -- � - ---�--- . . . � 7URE,GRIDR TO R9 6SUANLE.AlSO 11EOU�NE3 TME APPLIW�lT FON SUCH PERMR TO FILE A SIGNEO W t7A7EA1ENT 7MAT HE OR SME 19 LICENSED N10.5UANi TO 7ME OROVISIONS OF THE CONIMCTORS ll• � LENSE LAW(UTAP7EP�(GOMMENpNO MnTN SECT70N 7000)OF DMS�ON 1 OF THE BVSINESS AND PR0. u' POOVSp2 FE53qN4 OOOE)OR T/I.T NE OR SHE IS EXEVPT TNEREFiIOM M1D THE B/SIS FORTHE AILEOED E%EAIP• TION.ANVNOLATIONOFSECT�ON7W7.6BVANYMPLMJVfTFORAPERMiTSUBJECTSiHEMPIIChNTTO Z Re-Root � ACMlVEW4T'OFNDiY01iET1ANFNEMUN�RED00llM5(f500).}. � OL��EROFTHEPFIOPERT/,ORMYEMPLOYEESMnTHWAGESASi1�Et1150LECOMPENSATqN, � CqmmOfCifll � WIl1 DO iHE WORK INO THE STRUC711RE LS NO71N7ENDm OR OFFERED FOR SALE ISEG 7DN,BU56 J HESS AND PROFESSION9 OOOE:IHE CONiNAC701L4 IICENSL UW DOES NO7 APPLY TO AN OwNER OF � N iROPEqTYW/tlBUlD30HMPIiOVE57HEREON.FNONRI0DOE55UGIWO�KMIAlSELFORNERSELFOR = R; TYqUpHHSORMEHOWNEMPLOYEE5,7ROVIDEDiHATSUCM�MPpOVEu[NiSARENOTHTENDEDOq m L� ,OFFEREDFORSFLE6,HOWEVERiHEBUID�NOORMPROVEMEM650lDWITMWONEYEMOFCOMPLE• z TION,TME O�M�EH-BULDER WILL MAVE TNE BURDEN OF VROVNO THAT HE OR 311E D�D NOT BULD OR � tAVPOVE FORTME PURPO6E OF SILE} � 0�1180M�NEROFiHEPROPERTY,MIE%ClUSNELYtOMTMCTNOMATIILICENSEDCONTIUCTOR3 TOOONSTAUCf TT1E PHOUECT(SE4 TOM,DUSINE55 AND PROFESSIONS CODE:7HE CON7MCTOHS 11• VelU8t10I1 ADJ.AREA � CENSEUWDOESNOTMPLYMI�NOWNEROFAPROVERTVY`MOBULDSORIUPPOVESTHEREON.AND W/qCOMfiACT9FOR3UGMPRQ7ECTSWIT1ACpfTMCTOR�S�UCENSmPU(15UAN7TOTHECONTMG QUANTfTY DESCRIPTION FEE � � roasuc�+sEuw.�. 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J � o�� 4% � coNr�ucro��Q��� a. `M^ WORKERS'COMPENSATIONDECLARATION Q u , � U I'� N IHEREBY/FFGWUNOfRiENALTYOFGERA1qYONEOF7HEiOLLOWINQDECLAiUT10NS: Z V Q � Q _IIM�EANDWRLIMMNNACEifTIFIG7EOFCONSEMTOSELF-INSUREFORNORNERS' _ /1 T OpYPENSATION,AS PRD�ADEO BV SECf10N 77W OFTNE UBOR COOE,FOf17ME pENFORhUwCE U \) a pF7FIE WdiK FOH'NHICM 71113 PERMIT B ISSUED. � � Q �J�/ 1V =IiUVEAND WILLNANiNN WONKERS'CO�APENSATION INSURANCE,AS REWIqED BY SEC7qN AI �-s -- -'O ]7000FTHElABOROODE,FORT�HlEPERFOMIANCEOFTMEWOHKiORYAnp/TMISDERAIITIS •/6gZ, �y� __65UED.HY ftKE�/'-'I 'pNWSUMNCECARRIERNlJVOIIC'INUY9ERME:_____ — __ CONSTRUCTION __'___'____ .�'.____./_'.___ _.._. yCARRIER � � . . .PLAN REVIEW I• I _� -- � raicrtnrueEA � _. ELECTRIC _l�t Ol b� � �nscEemNr,�mraraeoa,s�.ertnoFnfrff►xr6roaone�a.wr�noauir,R+m�oatess? PLUMDING �c.7Oi� � Z ICERTIFY7FU7NiHEPERFORMANCEOFTNEWORKFORWNIp1iN15PEiLaI715155UED,1 MECHANICAL �C� 01�� (� S/�N.L N�T EMPLOV/NY VERSON N NIY AIANNER 50 il4 TO BFCOME SUBJECT TO THE ,�,'; ,� � WONKERSCOMPENSATIOf1UW50FLALIFORMAIWDAGREETMAiIFISMOVIDBECO�AE INSPECTIONFEE {� S 6U61ECT TO TME NM1�KERS'W�.�vENSATIDN VRONSIOHS OF SECTION]1n7 OF TXE U90H ISSUANCE y �/ L �j .i romNvnn�coe�a�r mn�_ nqs¢vrjo���� _^1 � DATE:'`� AVPLICANT: ���5�� �1 SMIP � WARNiNO:FAILUi1GTOSECUHEW'ON(ERS'COMPENSATIONCOVERAGEISUNLAWFIIL,/JASWILLBE ENERGYP/C � � SU&IECTM1EMPlOYERTOCRIMwALPENALTIE3AN�CMLFNESUPTOONEHUKJ1iEDiT1W5AND ENERGYPERMIT �� (��r� 'r'L\� � �� DOLIMS(f I Oo,000).N ADD1710N TO iNE COST OF COUPEN5AT10N,DMUGES Il5 VROVIDEO fOR IN �t"[�'�� y� J SEttpN�7oeOFTHEtABONOODE,NTEREST,ANDATTORNEY5FEE5. - ! 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PAID BY VALJDATO WHITE-0epanment Copy,YELLOW—Fnarxie Copy,PINK—AaseasorCopy,GOLDENR06—File Copy,GREEN—Appicanfs Copy . . , ,. .. , .. . . ..,.,.,. . , � -• . - . , - . . , . , � .. . ., . . . � CITY OF DIAMOND.BAR . . .. : , , ,;.; ' � itJSPECTION RECO`RD � � � I . .. ..,. .. . , .._ . .. . . . 11i+�=���,c?'F��']►.� ��':,�P= !�►!��i������ :� s,°•.�►�� ;��c5 j �;t�_++�.�d • �� � y.� `l� ci` � �,._....,� .� �� ►���.1 l���,�.� .S�T;BAC�' . � . � • �� FLOOR JOIST ---• ; .�•. -- '�•�,-{`. -. ..I_ �___ � � . :FTGS/�ORPJIS,STEEL �Z? � � : FHA REQMTS � - - " _ _ . . .._ _ � ; r - • ,.� . �ELECTRIC GROUND .___. � -.�; �1 �` UNDER FLOOFj DUCt=. '� ..�• � : -- �••'- ' •' ' �• �.a-----+,—i. . �GROUND PLUMBING ��lj�J � UNDEf�FLOOR G�OP�IDUIT ,f-r I ,:', �� :,;•� ����`.i-=�. � : '�SL�,F3 GRADE --- � y �,^_� '.!� � FIREPI;A'Cc FOUNDATIO�J `;�I•;_ '' : • ` - ' . . _ �• 1 : 7.' �, . . . I �TFIr1P POWER � FIREPLACE BOND 6EAAA � .4 •!" �'! � ••.�; ���.:� - � 4ti�ATER SERVICE __ -= ' ti11D HT. 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