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HomeMy WebLinkAbout15650 (26) --,*"�� CITY OF DIAMOND BAR EXPIRED �;�' " - --� DEPARTMENT OF COMMLR�IITY&DEVELOPMENT SERVICES at�oE.coPi�y�;��s�ui90 JUN 17 2002 � (909)860-3195 Fax(909)861-3117 ' PAESS ���^� BUII.DING PERMIT APPLICATION I FI Y y JOBSITE _� ` + � APPLICATION �i1 ID NUMB R�.��►�.L1d_ �'� o ADDRESS � DATE�IJ � APN LOT T AC DATE � �b ONST. GROUP � OWNER p ADDRESS �(j�Q ZONING SEfBACKS � CITY ZIP TEL REAfl Rw ❑ APPLICANT TEL SIDE/SIDESTREET RW p � CONTRACTOR��'� T{��'� SIDE ❑ � ADDRESS ?zLj��i' p OPOSED U ��' ' � �/ CITY ZIP TEL � ARCFUENG/ • ' v DESIGNER NO.DWEL. N NO. ' ADDRESS UNRS STORIES BEDROOMS � CITY ZIP TEI. u� DESCRIPTION SQ.FT. FACTOR PSF ADJ_AREANALUATION Q OWNER-BUILDER DECLARATION SFWADOlREM O p I HEREBY AFFlRM UNDER PENALTY OF PERIURY THAT 1 AM EXEMPT iROAI 1HE CONTFIACTOFI;L4 Garege/Carport � il.l CENSEUWFOR7HEWLLOWN�RFA,i0N19EG7071.68U5ViE55AHDPROFE5510N5COOE:ANYqTYOR (n U OOUHTYMMICFIREOUIRESAPEqMtfTOCONS7fiUCT,l�LTERM�PNOVE.DEMOLISf�ORREPNRANVSTRUC- uf LL� 7URE,PPoOR iOITS RSUANCE.ALSO PEWIRES 7NE AVPLICANT FOR SUCH YERMiT TO FlLE A SIGNED W Pdti0/Ded( STATFMEM TYIAT HE ON SNE IS UCENSED PURSUANT TO 7HE PHOVISIONS OF THE CON7NACTOR3 11- � CEHSE UW(CMAPTER�IWMMENGWU WI7M SECiION 7000)OF DIVISION 7 0F TME BUS�NESS/WD PRO � PooVSpe FESSqNS COOE)OR iHAT HE OR SHE IS E%EYPT TNEREFROAIlWD 7HE BASIS FOR TFIE ALLEGED E%EYP• TION.ANYYIOlAT10NOFSECTI0NTW1.68VAMlAPPLICNITFORAPERMRSU&lEGTSTMEAPi�IGWTTO Z B•R00� � �„�, A CML iE1ULTY OF NOT MORE THN7 FNE HUNDREO DOl1ARS(f6001.Y � 04�SOWNEROFTHEPFqPERTY,ORMYEMPLOYEESWITHWAGESASTHEIR50LECOYPEH5AT10N, OTI110fCI8I . - �' W1LL DO TNE WORK A!O THE STRUCfURE IS NOT IMEnOED OR OFFERED FOR 6ALE(SFC 7u1,BUSI� J N NE54 M!D GROFES�NNS COOE:ME WIfTMCTORS LICENSE Uw DOES NOT AVPIY TO AN OWNER OF � , OROPEHiY Y/Vq BUlD4 OR IMPROVES TMEREON,AND YMO DOES SUCN V/ORK HIIASELF OR MERSELF OR �C TMROUGHHISOfiHEqOWNEMFLOYEES,PfqVIOEDTHATBUCNMPROVEMENTSAqENOTNTENpEDOR m 0 OFFERmFORSALEtF,110M�EVERT1EBUtDW(70iiYPROVEYENT650LDWfTHINqJEYEAROiCOA17LE� � -710N,THE OWNER6U0.DER VALL MAVE TME BUR�EN OF PROVINO TNAT/7E OR SME DIO NOT BULD ON MVROVE CORTHE PURPOSE OF SALFJ. W OLh40NNEROFT}IEPROPERTI;N.IEriCLUSNEIYWMMCTNOMATHLICENSEOCdJTMCTOR3 � TO CONSTAUCT THE PHO.IECT�SEG Mu,BUSINE53 AND VROFFSSIONS CODE:THE Cd7TMCTOR5l4 V elIW1 � ADJ.AREA � CEtiSEUWDOE�HOTMPLYTOANOWNEROFAPROVERttWHDBUtDSORWPROVESiMEREON,/Jr� W1tlCONTMCfSGORSUC/1VRQIECTSNnTHACONTRACTOR(S�LICENSEDVURSUAMTO7NECONTMG q��7�y ESCRIPTION FEE � � TORS UCENSE UW.} O I AM IXEMVT UHOER SEG 0.i P.C.FOH THIS REASON � U � ORE OWNER � � w LICENSED CONTRACTORS�ECLARATION w � IHEREBY/�FFIiWUNOERPENAI.TYOFPE0.A1RVTHATIAMLICENSEDUNOERPimVISIONSOFCH�PTER Ur � f(�ENCIHOWIiHSECTION70oolOFDMSqN]OFTHEBUSINESSANDVROFESSIONSGOOE.AND z X ►IY tICENSE IS N FULL FOIICE AN�EFFEM. � � � UCENSE CUSS LIC.NO. . �j �. 1 O ✓ j F— �j DATE CONTMCTOFi��((�l� � W � ��_ � WOFIKERS'COMPENSATION DECLARATION —r ,- , ¢ � N IHEREHYAFFlRMUN�ERVENAL7YOFGEiWflYONEOFTFIEFOLLOWINGOECUMTI0N5: z � � O _IHAVEANONnLL4AMTAMACERTIFICA7EOFCONSENTTOSELF.INSUREFORWORKfRS 2 . COMPENSATION,AS VqOVIDED BY SEC710N AaoOFTME L/�BON COOE,FON THE iERFORMANCE C.) �¢ OF iHE VMRN iOR WNlp/TMS VEHMrt IS ISSUED. � � Q �I MAYE J1W WILLMAIM�PI WON(ERS'COMPENSATION INSURANCE,AS REOUI0.ED BY SECTION 77000FTHE{ABOi1COD[,iOP1HEPERFORMANCEOFTMEWORKFORWHipITNISVERMITl9 ��/�1!T, � 15SUE�.1.(YWORKERS'COMPEHSATIONWSUHANLECARRIERANOPOLICYNUMBERME: CONSTRUCTION S,�f S�J � crww¢n PLAN REVIEW Y�, o vo��cvNuueER ELECTRIC � 1 � (MsSECIIMt+EIDNo7BEoa.ilPlmoFhEPEPMTISiCPGNEH.1t�fiED0011NtsR��%ORl6s? PLUMBING Z ICENTIFY7HA7P1THEVERFOiiMANCEDFiHEMIORKFORWMIpITHISPEPIAITiSISSUED,1 MECHANICAL V' SHALLNOiEUPLOY�NYPERSONINANVM/fMERSOASTOBECOMESUBJECTT07HE (p WOPoCERSCOIAPENSATqNUW5OFG1LIFpRNIA�NUAGREETMATIFI5/q{JLDBECOME INSPECTIONFEE S 8U61ECTT07HEW'ORKERS'COAIPENS�TqNPHOV1510NSOFSECTIONl7 COFTMEUBOR 000E^� wRrmnrncanv�rmrnnasE rao�sans. ISSUANCE CI��� � pDATE: C/ APPLICANL 9..� .SMIP TfT W 'U� � WMNINO:f ETOSECURENORKERS' NSAiqNCOVEMGEISUNLAWFUL,M105NALLBE ENERGYPIC , , � 6UBJECTANEMPLOYEHTOCWMINALPENALTIESMIOCMLFPiESUPTOONEMINONEOT1qU5AND ENERGYPERMIT } DOl1AFl5�floa,000),NIDDITIONTOTMECASTOFCOMVENSATI0N.D1JAA6E5ASiNOViDEDFORIN � SECTIONJ70lOF7HEIABORWOE.INTEREST.ANDIITTORNEY'SFEES. � REjENTIONFEE: d CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � IHEREBVAFFlWAUJOFRVENALTVOFPEiUURYTNATTHENEISACONSTRUCTIONLElIOWQ�CENCY � Z FOP Tl1E iERFORMANCE OF TME WORK FOR WHICH THIS iERM1715�SSUEO(SEF Joa7,qV.C.�. . W � LENOERSNAME '� � LENDERSADDNE55 � ICERTIFYTIATINAVERFIDTHISAPOIICATION/NOSTATETNATTHEABOYENFOR/AATIONISCORRECT. TOTAL FEES � ,OI ��� , � IAGREETOCCMPLYWITH/�LLGiYANDGOl1NTYORDWANCE3AND5TATEUWSREUTWXITOBULOINO � CONSTRUCTION.INDNEREBVAUfNOW2EREPRESENTATNESOFTIUSCIXINTVTOEMERUPONiHE . - �BOVE-MEMIDNEO iFlOPEFTY FOR MSPECTION PURPOSES. COMMENTS " _ �afll'1 7c7b1 m R1ArtTEE NAME(PRIN� � � �� O y S�NANflE OF P E DATE � \ RECPT.N0. PAID BY VAIJDATION ' WHITE—Oepenment Copy,YELLOW—Finence Copy,PINK—A�xesa Copy,GOLDENRO�File CopY.GREEN—ApplicanYs Copy .� . ,.a.'-� . .,� ... �... .. ..... ... . ...... .,.... . .. . . . .- . �. ..r s . . , , .. � ��r! � /.t-� c. . . ... ...... . . . , . . .. . , c . , .. . .. .. .. _ ... . .. . .. . . ,..� .. . . ..:e., � - GTY OF DIAMOND BAR _ �, �:_ - INSPECI"ION RECORD � � ��°�����,�'��.° ' � 1` ` � ����-�' ��_� . .° r��= ,. ._:r��y (������� ' ��-._ _ � �. __.. ,�, .._ �,.. _.. . ._4.. SET BACK•,, ,. ^. �-;� ~ I c � i :i'� FLOOR JOI,ST("i �� FTGS/FORMS/STEEC�- '� T— ; `,'t FHA REQMTS `� ; , ' .... _' ' _ . ;ELECTRIC GROUND J•� "� UNDER FLOOR DUCT 'GROUND PLUMBING I UNDER FLOOR CU�IDUIT' � ' ' ' '� 'SLAB GRADE- ` ' - FIREPLACE F�UNDATION � ' � 'TEMP POWER FIAEPLAC�80N0 BEAM . 'WATER SERVICE - --- MID HT. BOND BEAM ; ` ' ROOF SHEATHING � � p�4L.. •�_ ' 8 F7.EJND BEAM IFRAMINGNENTfLIATiON - � • FINAL�BOND BEAM ;ROOFCOVER - PRE-GRADING � 'ROUGH HEATING - BENCHING 'ROUGH ELECTAIC _ • ROUGH GRADING - - :ROUGH PLUMBING - -- - FINISH GRADING �SNOWER/TUB TEST-' - POOL ELECTRIC •� �EXT.LATH/SIDING - - POOL FENCING ;VUALL INSULATION - - POOL FINAL !CEILfNG 1NSUCATION ' ' OFF SITE IMPS. . 'DRYWALL NAILING ", DEDICAT'IONS ----- SEWER ---- -- FINALENG. SEPTIC TANK ' LANDSCAPEIIRRIG. ,SEEPPlTlLL. ; : " - , ,ON SITE IP.1PS. G.AS AIR T[ST ' FINAL ZONING - FIt�AL COiVST. ' _ _ _._ _ _ FIRE DEP.T. FINAL FIf�lAL HEATINC _ __ _ _._ _ . HEALTH DEPT. FINAL • � — -- FfNAL ELECTRIC - - - - - DEV. FEES PAID - - -- - E=lNAL PLUh1BING- - - � ENERGY .: _ _ _ _ — _ � - _. . --_ _-- iF: �f��i����^^ ; � .tr:h=x ..�-.�ec......�^_si:c�.':� .._ ..�.�i .. - . .. __ .__. .. _ . __ - . .. __ . _.._. . - � . �__._.r___' .,' . .- — . ..� •�� �'� � � . 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