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HomeMy WebLinkAbout14593 (20) �� CITY OF DIAMOND BAR '����1 DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � �,c 21660 E.Copley Drive Suite 190 � (909)86(�3195 Faz(909)861-3117 PRESS '�^'� BUILDING PERMIT APPLICATION FIRMLY Q ADDRESS � '� APPLICATION � G �/� PERMR J � P/C o DATE { �NUMBER� N $ ISSUE TYPE OCC APN LOT TRACT DATE CONST. • GROUP g OWNE p ADDA S ZONING SETBACKS W CITY ZIP �TEL. FRONT RW ❑ � APPUCANT TEL REAR � � SIDEJSIDE STREEf RW ❑ CONTRACT SIDE p ADD S • g C ZI T PROPOSED USE � ARCH/ENG/ • DE5IGNER NO.DWEL. NO. NO. = C�DRESS Z�P TEL UNITS STORIES BEDROOMS � v� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADDh7EM p I HEREBY AFFGW LNDER PEIULTY OF PERAIRY THAT 1 AIA EXEYPT FROM THE CONTRACTORS ll• G8�ep9/CeryOrt � LENSEUWFONTHEFOLLOWINOREASON(SEC.7mf.68uSP1E55ANOCHOFE55101�L5CO0E:ANVCINOR (J� OOINfIYYNOpIRfdUIRE6APEHYRTOCONSTFUCT./LTE0.�PROVE,OEIAOLISH,ORREPAIqANYSiRUC-, __. �jJ -PBIIOIDBLI( lURE,PRqR TO If3 ISSUANCE,ILLSO IIEOUIRES THE APPLICANT FOR SUCM PERAIR TO FllE A SIGNED w � S7ATEMEM T}iAT ME Oq SNE IS UCENSED VURSUAM TO THE PROVI310N5 OF TNE CONTMCTqtS U• � � CENSEUM!(GI�GTEpY(COMMENCPIOYAT15ECT10N7000)OFDIVISqN]OFTHEBUSINESSANDPflO• P00�$Pa FESSIONSCDDE)ORTMATMEDRSHEISEXEUPTh1EHEFROMANUTMEBASI5FOR7HEALLEOEDE%EYP• C7 TION.MIYVqIAiIONOFSECiiOHI071.6BYANYAPPLICAl1TFORAPERMITSU6IECTSiHEMPLICANTTO Z qo.q�� � A GVIL iENALTY OF NOT MORE THAN FNE MINDHED DOIUAS(1500).1: � O1�50MMEROFiNEPRO�ENTY.ORMVEM7LOYEESWI7NWAGCSASiNEli1SOLECOIAPENSATION, COR1mBfCl31 � W�LL 00 THE YIOi1K MlD T11E STRi1CfURE IS NOT IMENDf�OR OFFERED FOR SALE ISEG 70s1,BUSb O NESS A!m PROfESS10N5 CODE:THE GONTMCTORS UCENSE LAW DOES NOT MPLY TO AN OWNER OF � PiqPEHTYYAIOSUlD50i114PROVESTMEREON.MIDYINO00E55Up1VYJfiKNIMSELFORMERSELFOR = Q 7HROUGHHISORNERONRIEYPlA1'EES,VWOVIOE07W1T5UG1MPROVEMENi511REHO7MENDEDOfi � � .OfFEAmfORS�LE1F�110WEVERIHEBUILDIN�ORIIAPROVE4INTISSOLDWITFIWONEYEMOfCOMPLE• Z 'TION.THE OWNER�UIIDER YALL FUVE TH[BURDEN OF VROVINO TNAT HE OR SHE�ID NOT Bt11tD Oil . � Y71i0YE FORTIE VURPOSE OF SALE� W Ot�SdM1EROFiHEVROOEHi`/,AMEXCLUSNEIYCOHTMCTNOM1iHLICENSEOCONTRACTORS [L TO CONSTRUCT THE%iOJECT(SEG Ta1,BUSMESSAND PiqFE55lON5 COUE:THE CONTMCTOHS LI• V3!UeS10f1 ADJ.AREJ4 LLl �HSEUWDOESN01MPlYTOANONNENOFAPROPERiYMRqBUILD50R0.IPROVESTXEP.EON,Mq � 1MiOCOMPAGTSFOqSUpIVRQIECT5M17NACONTMCTOR(S�LICENSmPUR5l1ANTTOTNECONTMG QUANTITY DESCRIPTION FEE � � TOHS LIGCNSE UW.�. OIA/IE%EYPTU�7DERSEC. B.lV.C.F00.TH:SRE�SON Q 3 ¢ t! 7 / ' zDATE OYMER V � UCENSED CONTRACTORS DECLARATION W , J � W IHEREBYAFFpAIUNDERPEN.4LTYOFpE0.A1RYTHATIMILIGEN5E0UNDENVROVISIONSOFCHADTER � � ��COMYENCNOWI7HSEC710N10oo)OFDMS�ON70FTHEBUSINESSANOPfaOFE55iW:5CODE,AND Z �� W LICENSE t5 M FLLL FO �j/WD EFFEC7. �^ m � LICENSE 5 / LIC.N0. � �'j o�� ���'-�"�} corrr�u �, a � WORKERS'COMPENSATION DECLARATION Q � IHEREBVAFfIRYUN:IERiEW4TYOFPE0.AJMONEOFMEFOLLOWINGDECUMT10NS Z � �IHAYEMIOWILLtWMAMACERTIFlGTEOFCONSEMTOSELF-MSURCFORWORNERS' _ � Q OOMVENSATION,ASPftOYIDEDBYSECTpN77ooOFTMEU�B00.COCE,FORTHEVEHFORMANCE W �Oi TME WOIiK FOR MMlpl iHIS VEiU11T IS ISSU[�. � I NAVE/ND IMLL MAIMAN WOFiKERS'COUPENSATqN W SUHANCE,AS REOUIRED BY SECTION � J7o00FTNELABOfiCOOE,FORTTIEFERFOR4ANCEOFTHEWOPXfORWHIpiTHISPERM1T15 � ISSUED.A(YNORKER'COMOENSATIONWSU „ AR iERINDPOUCYNUAIOERARE: CONS7RUCTION _ � uaa¢n �� P VIEW � voucrHu+eEa_0 7 { _ � �c � (f}�SSECf10NHmNOTBEW6iLETIDCf7/EPEtMf6fORp:EHI�DRFD00.1JJ15R�a%ORLESS? PLUMDING ��� T— Z ICERi1iVTHATlITHEiERFORUANCEOFTME'M�f1KFORNMICHiH15VEiWI7151SSUED,1 MECHANICAL C7 51MLlNOiEA1PLOVANVPER50NNANYA1uJN[RSOAS70BECOMESUBJEC7TOTHE (/� WDRKERS'COAIPENSA1qNUW50FGLLIFORNI/�ANDAGflEETMATIFI5��0UlDBECOGE INSP CTIONFEE SUBJEGT TO 7HE WORKERS'CqAPENSATqN iROV1510N5 OF SECTION]70o OF M[U80R f1 ^ /► �j COOE.I SHAII fORTM41iH GOMPLY MIITH 7HOSE PROVISIONS. IS F�, R� 1 I�.l, _t� / .1�"�.7V p DATE:��� AaP�ICANT:.�����ll� -L"� SMIP � . W ENERGY P/C� ll1AM ND B�R � WMNIN(i:FAILURE TO SECURE WOHKERS'COMPENSATION COVEMGE IS UNU»'FU4 ANO SIVLI BE � SUBJECTANEMPIOYERTOCAM!NALFENALTIESAKDCMLFINESUPTOONEYNNOREDTqUSAND ENERGYPER��j�LDINGANDS�FE7'Y D�U.J�FiS If IOO.DOD).W ADDITON TO iHE COST Of WMPENSATION,OAAIACES AS PROY'-0EO FOR W � SECTpNl7DeOFiNEUeORCODE,NTEREST,ANDATTORNEY5FEf5. RETENTIONFEE: � CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � INEREBVAiFIAAIUNOERVENALTYOFVE0.NRYTHATTMER[ISACONSTRUCTIONIENDIN(iAGENCY FOR ME CERLORAIANCE OF 7HE M/ORK W R WHIC111HIS iEiW1T iS ISSUEO(SEG]OY7,CN.G). . � � LENDER'SNAYE C LENDER'SADORE55 � ICER'ftiYTUTINAVEREADTH�5MPL1CATqNANDSTATETXAiTMEABOVENFOM1ATqNISCORRECT. TOTAL FEES � �� p� IACREETOCOMPLVN77HALLC/TYANOCOUMYOMRIANCESMl�STATEUWSREUTNOTOBURDING � CONSTflUGT10N,NiDHEREBYAUT/qRREREPRESENTATNE50FTHISCOUNTY70ENTERUPONTHE ' � z ABOVHdENilONEO PHOGEHTY FOfl INSPECTION PURP06ES. COMMENTS � `— �W m I E 1!n Q , � n � SIONANflE PEHMIRE UATE - � RECPT.NO. � PAID BY VALIDATION YVFIITE-0epartment Copy,YELLOW-finance Copy,PINK-Assassa Copy,GOIDENROD--File Copy,GREEN-Applicanfs Copy . . . • , .. • . ' . . . . . . . , . v. . ... -. _. . .. . . . .� . ' . .. . ...�.;e.���,......�.� .. �. . . � . .. � -' ' � � CITY OF�DIA�J10fVD,BAR \ � ';` '' . , , , �� - , „ ' � � . � � � : ItdSPECTiON�RECOFaD . ' ' , , � � . , . • 1i1►��'3,1_c;iF.jca►�i �;;��C�: � `]l��;��,�'.l:�C� �f.�t.�-y;���-�`������...�:_...,,�+�iii�;d,��'. �i.l.���-��������, '� i 'SET BF�CK , ti, �=�� • '� , i ' - FLOOR JOIST---- , _... _� _...\\ _.,._'. _..,.. »i. IFTGS/FORl1151STE L' - ' � . ; � ��� FHA REQMTS , � -.� ` ` �� ' � �' �'�' !ELECTRIC GROUND..._ -�,ld � UNDER FLOOR pUCT•�-- � � � , _ - - �� -_ • GROUND PLU��181�dG - UNDER FLO �R"CUMDUIT : : I ." . ;'� ;SLAB GRADE -- - FIREPLACE FOUNDAT(ON '�; • • � -• • � �: ' � � ITEP.4P POWER " FIREPLACE�BOPJD BEAM � ;V�.+1T�R SERVICE , ti11D HL BOND BEAPA �. , _ -' '- � "� -•-� - � �,. • � , . ._ . S FT. BOND BEAM. - ;;�'� '� •`- � •. ',��'• } � i i �RO.E7,- ShjEETH�VG ,\' . . _,., . .. . . . IFR11MIhlG,NENTILIATION - FINAL BOND�BEAM ` � � • � '� ^ � ' � �R�OF COVFR .� � PRE-GRADINC - ' 'R:)UGH HEATING 6ENCHING ROUGH ELECTRIC . ��.18_c�� g� . - I ROUGH GRADING - - ROUGfI PLllP�1BING - - - - � FINISH GRADING 'SH04YERlTUB TEST ' - - -POOL ELECTRIC EXT.-lATH!SIDING - � - - - � - • POOL FENCING � � ' ;^,�ALL INSUUITION - -- - �.� POOL FINAL 'GEILiNG I�•1SUU�TION' - - OFF SITE IMPS. . ' �DRYVJAL:L Nr'IILING � - DEDICATIONS • S�WER � FINAL E�JG. SEPTIC TANK LANDSCAPE/{RRIG. ' ' SEEP_PIT/LL. ON SiTE If,�PS. � �G.AS tiIR TEST FINAL ZONING � i Fi;�AI•CO;•lST. � ��,. �` �•, �}�FIR�DEPT. FIN�L ' Fi^:r",LHcA31NC, ' ' ��•� •,� HEALTN DEPT. FINAL � - � �rl�d�L ELEGTRIC � ��_�_� • •• '�.. �` DEV. FEES PAID � - - - � - '�=t^:?`,i_PLUh1!BihJG - �. • ENFRGY � .—. _ . _ - - . . . ... :.. ... . .. . . _ _ I_..�,..^,.-..'.�.-^.".� ' � �� .,'i;�g,�a' I �- 1 . , .,3�`m:'4...:�.:_r.1u'=a:�t�r`'_. .. . .. i�uo��r;���r�Ts-. -- __ . � . , � :.:: . .. - � , _ � � . . ; . � , . ..,_ '.;;-=-� . ._ ._:.. . - - _ . . . . _ , ; � �� . ;. ,.-....� . • <'_.. ' � . , . _. : . . _ - - _ ... --•• _. , . , . > .. ,'�_-. . .. . SEPTIC TANK SIZE . . � ,� ' ;SEFP PI i/U SIZE -- -` ; � ��__,_,...�._.__.���._ ._. _. $ - - . i • � 3 . . . . . . . . �,.r`�� , � '�; ; , �' �. . . .. . ...... _ _ . , � . . .. _.... . . _ ` , , i ! ` ��`_� + �`\ `, -- . .. ";\`, +ti \-�,,`i/ :��_....._.. . :`=��.. _..�. __ . � ; �,_ _.._