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HomeMy WebLinkAbout12079 (11) �� CITY OF DIAMOND BAR '� - -- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� , 21660 E.Copley Drive Suite 190 � (909)860-3195 Fax(909)861-3117 PRES$ •..��'. . BUII.DING PERMIT APPLICATION . " . FIRMLY } JOBSITE ` 1- �� �p (� .y� APPLICATION � PERMIT��P/�� � o ADDRESS Z`�1� � ��"�x-�- v( DATE NUMBER� •� A �� $ ISSUE TYPE OCC . APN � LaT AC ZZ- DATE - CONST. GRQUP g OWNER SY�L� � p AD�RESS ZONING SEl'BACKS `�' CITY Z TEL FRONT RW - p $ REAR ❑ APPUCANT TEL. SIDE/SIDE STREET RW p • _ . . .SIDE - ❑ � CONTRACTOR � AD�RESS PROPOSEDUSE �LO41� �STLJV�J-- CfTY. 21P TEL. r�� � ARCH/ENG/ • _ ' . � DESIGNER _.. . .._......_ _., . . ADDRESS NO.DWEL NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS uNi . DESCRIPTION SO.Ff. FACTOR PSF ADJ.AREANALUATION p� _ OWNER-BUILDERDECLARATION ' 5FRlADDlREM �� O p I HEREBY AFFlRM IMDER FENALTY OF iE1WM THAT 1 M7 EXE7ACT iROM iHE tONTMCTOHS Ll• G�fH�BlCat�OK . . � W CENSEUWFOf17HEFOLLOWINOREASOH(SEC.70.71.68USMESSIU7DPROFESSIONSCOOE:ANYpTYOR (n C7 CpUNryWFACHpfOUIRESAPEqA1RTOCONSTRUCT.ALTER�P��.DE�OUSH.ORREPAlRM1YSTRUC- . W PatlO/DBtk �L 1URE,PtYOR TO ITS R9UMIGE.J1L50 f1EWIRES TT1E APPLICMlT FOR SUCH PERMR TO FlLE A SIGHEO W �. i..�� . dTATFYEM iIUT ME OR SME IS LICENSED VU0.5U1WT TO TME PROVISIONS OF THE COMMCT00.S U. . � CFNSE UW(GIUPTER 0(COMMFNCCJO WITH SECiION 7000)OF DMSION]OF 1HE BUSINESSAND PR6 u' POOUSP3 � � � ' ' • fE551DN5 WOE)OR iTNT ME OR SME IS E71EMP7 T1EREiROM IND TME BA515 FOR iHE ALLEGED E%EMP• T10N.AMYVIOLATIONOFSECTION707I.6BVAHVAPPLICIVdTFOR�VENAIITSUfl7ECT5Ti1EMPLAC.wTTO Z Re-Raof � ACIYILiENALTYOFNOTMORE711NIFNEHU�AREDDOLIAR5Is5oo).}. . . . . . � � OL11501M1EROF7HEPROPERTY.DRMYEMPIOYEE5WI7HW�GESA57HEIR50lECOMPENSAi1DN, 0 CORIrt10fGlel - 1MLL DO 71�f W011K AND THE STRUCiURE IS NOT MENDED OR OFFERCD FOR S/LE(SEC,70u,BUSI- J . � NESS AND VHOfE55�ONS OOOE:TNE CONTMCTOR9 UCENSE Uw DOES NOT APPLY TO AN OWNER OF ? � HO ►NOOERIY W110 BUTAS OR IYVROVE57NEREON./UD WHO DDES Sl1fS/WOHK MYSELF OR M[0.5ELF OR ' � THROVOHMISORHEROWNEMPLOYEES,VROVOEDTHATSULFIMPROVEIAENTSARENOTRlTElIDEDM ' m OFFEPEO FOH 511LE IF,NOMIEVER'�ME BUIDroQOR IMPROVEMEM IS SOID NrrtKN ONE 1EAROF COMPLE� �TION,hIE VIMER-BUttDEP VALL HAVE h1E BUFOEN OF VROVINO iHAi ME OR 511E DO NOT BUtD OR = MPHWEFOHTHEPURPOSEOF311LE). � . . �y,� ❑41�40WME110FTHEPROCERTY,/UAE%CLUSNEL�COIRMCTINaWRMLIGEN5E000hliRACTGlS � TO CONSTRl1CT T1G ORD.IECT(SEC.7ou,BUSINE55 AND FROFESS�ONS CODE TNE CONTMCTORS L4 Valuation � ADJ.AREA� ' � � CENSE UW DOE9 NOTIPPIY TO AN OWNER OFA PflOPERTY WF1D BUMS OR MPFipVE3 iIiEREON,ANO � � NRIDCOHTMCf9FOR5UCNDRn1ECT9WITIAODNTRACTOR�S)LICENSEDPURSWWTTOTIECOl1TMG QUANTITY DESCRIPTION � � FEE � 1 � tOii9 UCENSE UW.} . . . ... . . .. . . . . O I1W IXfMpf UNDER SEC B.t V.C.FOR THIS REASON q 3 � • . LL ¢ DATE OVMER � , F LICENSED CONTFlACTORS DECLARA710N W _ J � IHEREBYAFFlRMLNDERVENALTYOfiERURVTIATI/WLICENSEDUNDERVHONSION50FCHAPTER Vr � . � ��COAIIAENCWON7TISECTpN70001�DM51ON70FTHE8U5WE5SANDFAOFE551CHSCOOE.AND z " " X MY LILENSE IS N FUI.I FOR AND EFfECT. 1 . � UCENSE S � L1C.NO. t/����� � ' � � ...._... ..v a�te ' carrrucrons�� aJ. w � WORKERS'COMPENSATION pECLAAATION Q . � y IHEREHYAFFlPoALNDERFENALTYOfPEM1MONEOFTHEFOLLOWwODECLAMilONS: ���- ' U - � ' ' ' y � � �_IHAVEAN0IMLLMAttfTANACERi1FlUTEOFCONSEMTOSEIF-INSUREFORNqFIXERS' _ CdA7ENSATION.ASip01IQEDBVSECT10NS1D00FTNEUBORCOOE,FORTHEPERNPM�NCE �U , OFiHEVVOPKFORMAACHTn9PERMIT181S5UED. � 0 "�^y' [�1 HAVE AN�WILL MA.RlTAVJ WOW(ERS'tOMPENSATqN INSURANCE.�NFOUIRED 8Y SfCT10N'� / : O �77000FiNEUBOHCOOE.FOqTHEPENFORAUNCEOF7XEWOHKFOHYVI/ICMiMiSFERMITIS .. .. . �� iO . . � ISSUED.L(Y KERS'OOIAPENSTqNWSUiUNCECARPoERANDPOIICVNUMBEHARE: CONSTRUGTION ' .�C � cu�aEa �� PLAN REVIEW ��, (�I � raicwr�uueea�� ELECTRIC � �rwssccnpr+r�rqreEodaterepoFntrera.�rsFnaa+ei+aartvocuu�s�s+oo�a+tFss} PLUMBING Z I CERTIFY TMA71N TNE PENFORMANCE OF TME WOfiK FOR WHtpl TNIS VERurt 5 t55UE0,I �MECHANICAL ('J SHALL NO7 EMPLOYANY PERSON W ANY MANNER SOAS i0 6ECOME SU0.IECT TO TME . vj NIaRKER5CO6�PENSATIONUWSOFCMIFORNIAAN�ACREETIUTIFI5/qULDBECOME INSPECTIONFEE S � SV&IECTTOTHEN'OPoCERSCOMPENSATqN►iqN510N50fSECT10N77ooOFTMEUeOR�- - - �� - isiuu Rmm�n�ca.aivvnn�rrase s s_ � ISSUnNCE �- � SMIP_ . o � . . p DATE:� APPLICAM:� � - W ENERGY PI'C � WAqNM�:f�UIUR[ O SECURE Nt7RKEN5'COAIPENSATION COVERAOE IS UNUWFUL/J: S�L1lL BE ; � LUBIECTANEMPLOYEi170CRIUPIKPENALTIESMACMlFNESUPTOqIGNUNDREDTHWSAND ENERGYPERMIT DOLURS Ii100,000�N ADOfT10N TO 1HE C0.5TOF COMPENSATION,DAMAGES AS PROVDED FOR W ¢ SECTIDN170eOFiHELA80RCODE,NTEREST,ANDIITTORNEY'SiEES. RETENTIONFEE: d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � ' O . � IHEREBVAFFlMIUNDERVENALTYOFFERIURY111A7TNERELSACONSTRUCTIONLENDPJOAGENCY FOR TME PEAFOMIANCE OF TNE WORK FOq WHICM TM�S PEPM�T IS ISSUE�(SEC.7007,CN.C} , ,I � � IENDER'S NAYE �i� - � � L � C LENDERSAODRE55 � ICEHTIFYTHATIHAYE1iE1DiHISM7UCAT10NM1USTATETXATT1El180YENFOR1A�TqNISCORPECL TOTAL FEES � � � IAGREETOCOMttYWITHALICT'N�DCQINTYORDP7ANCES�NDSTATEU�RElAi1N�TOBUILDING , ' � CONSTHUCTION,A�DHEREBYAUf}/ORIZEREGRESEMA7IVESOFiHISCOUN7YTOENTFHUPONTHE . . . � ABOVEJdEHTqNEDPROPEHTVFORIN5PfC7 vur�aoses. COMMENiS ' 9 �-cu � . � m GERMRTF �IVA[(vRitln ��j . . . . .. (� ✓ (,/) Eq1uTUH F ERM�TIEE D � _ _ . . . . RECPT.NO. PAID BY VALI�ATION "WHITE—Department Copy,YELLOW—Finence Copy,PINK—Asxssor Capy,GOLDENROD—File Copy,GREEN—ApplicanPa Copy � - � � I 1 (/� ✓l 1 _ _ �. . -. . , . . ._. . ., . .. ..,,,.. . , .. . , .. , , . . _ . �. ,�� , . , . . ... , . . _ .. . .., ,. •., . ,,. , ......• . . , ;. „>. .. . .. .... ,. �.. . . .. . . ._ . . . . . .. . . . ../. � . � . . .. , . . � �� .. . . . - •� .. , - CITY OF DIAMOND.BAR ,.;;�. , ,�, , ,-� . .,...,, , .. . _.. . - � . . � . . .. , :� �,�._. . . _ . . _ . f , , INSPECTION'RECORD` �„�:'.', _ -..:� � �, , ..., , .. . , ., _ _ . . . ,�, • � � � - � � � • • • - SET BACK ' :: , � . . .,-�' . ., ., . �.. FLOORJOIS7 --�...'� 1�J_ ��_� t• :.� _ }i.) r �'• � . „: .... .. . . . . ..... .... . ... ----. .. __ . , FTGS/FORMSlSTEEL � �FHAREQMTS, •�;, �•; �. , � ELECTRIC GAOUND -.--- - ---`-. . _-- _. . UNDER FLbOFi UCT .,•,,=.,, ;;�_{'� i`;,�� , . .:�•;..:.. .;_ i :. GROUND PLUMBING '-' 'UNDER F�LOOR CO�IDUITf:' ( ;r^:?��•t; . .'_ t ;%�'i��{• ' . � ; -• SLABGRADE --- - . - -- -; � FIREPL�AGE�OUNDATIQN>�: ` ' ' . - �� . �`� i� '> •.•, .. . ., ..: . _.:._.: . . . . , . TEMP POWER-- ---. '•'' _. .. _.. ,. ,:. ;•:: . � FIREPLACE BOND BEAM - - ---- - _.._. • WA7ER SERVICE-....:. . : . ...._. . .. :-;-�,;�.� -� .. : :MID HT.BOND BEAM - -.. . ..�t- -�, _��_: -�•_- . :�� � . . , , . ,. ,� � �r,.. , ..� ���_r," _. . _ . __ . ROOF SFi�ATHING �`. - ,, . �... . . _.... ' � ` ' $FT.BOND BEAM �- - - .. .. , , FRAMINGNENTILIATION . `� ' FINAL BOND BEAM • • i • . _...- -- - . . _ ... _ ROOF COVER '`. , PRE-GRADING � - ROUGH HEATING- .- - -- --- - -_ . _. BENCHING .. .. . _.. '='; __. - _... . ...- -.... �. :: � : �iOUGH'ELECTRIC... ... :--- _.. .� _...: ... ROUGH GRADING �.. :. . _,. ._ .. ; , ' ROUGH PLUMBING�' �� � -� -- -� -- i-- :� . FINISH GRAOING • -� SHDWEH/TUB TEST: - - - i POOL ELECTRIC - • , • EXT.LATH/SIDING ` � i � �� �ROOL FENCING WALL INSULEITION , PO�L FINAL. , ' CEILING INSULATION . OFF 51TE IMPS. ' • • i =' DRYWALL NAILING : DEDICATIONS. ' . SEWER . . . . ....__ _;..._ . FINALENG. . ; : LANDSCAPFJIRRIG. ' • SEPTIC TANK ---._..... . _ . ...--- - -- ... . ..._ . . �. '�-'_ '-' _ -ON SITE IMPS. . ' , SEEP PIT/L.l:._ ..._....... .. . ... .._.. GAS AIR TEST ---- - - - -- - � �- FINAL 20NING - � ' ' FINAL CONST. -- - • -- FIRE DEPT. FINAL ' ' ~ 0'� FINAL HEATING - � - -�� - - - � � HEALTH DEPT.FINAL -- - -- -•- FINAL ELECTRIC --...... __ ....,. . .. .. _... _ DEV.FEES PAID .._. ... .. -- ----- FINAL PLUMBING ENERGY • � � --� � � �:� � ; _ � , ={" 'a s � -� ? # :�;��. . _. . . .� .. �J.J •. �-: --. . .,., ... i.. f ✓� f; .. ... .... ..... ....._. . . .'. .. __' .__'.. '_ . .'_. .'_.. .., � . COMMENTS .... . ._ ... - - - - - - . , . . ; - -- - _ - - - � \ . C)`' C C� - , . . ., . -. �-; - � .v �; , . , , . . . .. � , ,t ..�: _� - � �.,f_SlI� _ j � � . . . � i I I � . .. . . . . ' . ..__. _.. ._... _. _ . . _. _ . . . . ' . ' i . � j ' . ... . ' _ � --._. ..— - r `' . . } . __ ..._.._ ..';' _' - . . ... � . \ (. � ^1 �1' t `j. �. .�, � }11 ` , ... . , � . . . t-q."_ . �,_ : l' SEPTIC�TANK SIZE ` � � ' . -� . , . i ---- - ' SEEP PIT/U SIZE r�- � . � , , _ �. --�', ! ; . �1 �``_._. :. ��-i ' : ` . . . . - , , �� � i � , . ..... . . .. _ ._ ... � i � ( .� � i�. ; ;. . . . _ .. . . _... ,_.. ; � , � . . . ._ .. _. . ... .. .. _. _.. r. �.. _. .._� .�i i ; . ' . .. . , , ., � �,. .. ... . ; i t f. . . , . � ; . ...._ __. .. . . •. , \\ : , (, � : _ -- . ... _. ._ , . ��. .•- �� -: ��_�- .. .... . � i :;t�; � ay . ..:( . ..� ., . •i ( � . . _; -� . �. - � i � �� � ,� j •t� �--� � ` L 1.....i_/��. :�.J' -:.J� . ... ' � , . . . ,., i ; { .. .. . .