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HomeMy WebLinkAbout16123 (22) I . \ \ � � �� --� D PARTMENT OF COMMUNITY&DEVELOPMENT SERVICES EXPI R�D 21660E.CopleyDrivcSuitc190 � � ! " (909)860-3195 Faz(909)861-3117 JUN 17 �u02 PREss ����'� BUQ.DING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION PERMfT P/C o ADDRESS DATE � I��� NUMBER�� Y � ISSUE 7YPE OCC APN LOT TRACT DATE CONST. GROUP ' g OWNER wQ "" ADDRESS � S 7 W � 1 ZONING SEfBACKS � FRONT RW Q CITY "fJ+o.m o n �rZIP�/7L.S TEL. REAA ❑ APPLICANT TEL. ^ PII� SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ g ADDRESS ' PROPOSED USE - CITY P TEL � ARCWENG/ DESIGNER � / I /�_ -- - N0.DWEL. NO. NO. ADDRESS� UNITS STORIES BEDROOMS � CITY_ IP TEL � DESCRIPTION SO.FT. FACTOR PSF ADJ.AREA/1/ALUATION � � OWNER-8111LDER DECLARATION SFWADD/REM O p I MEREBY IiFflRM UNDER PENILLTY OF FEiWHY THAT I AA1 EXEMPT Ff10M TNf CONTMCTORS U� G0feQ0/C81pOrt W CENSEUWFq17HEFOLLOMnNOqFJ1SON{SEG7W1.68USWESSANDCROFEsS�ONSCooF:ANYc17YOH (n � OOINlT7YFfIp1HE0U1RE5AiERMRTOCONSTRUC'LALTER.MAPROVE.DEMOLJSH.OAlIEPNRANYSTRUP � pati0lDeCk � � iUpE,PRq0.TO fT9 ISSUANCE,�LSO REW�RES THE APPLICANT FOR SUCH VERMIT TO CILE�SIGNED � 6TATE4IENT THAT HE Oii SME IS LIGENSED VURSUANT TO THE VROVI91oN5 OF THE CaNTMCTORS L4 � CENSE UW(CHAPTER 0(CdAMENCPIO WIT/SERION 7000)OF DMS�ON]OF}HE BUSINESS 11NO VRO� � PDOUSpO FESSqN5000E70RT1AiMEOH5ME15EXEMPTTMEREFqdAMlDTNEBASISFORTHEKLE4EDEXEMP• (� TqN.ANYYlOLA7�ONOF6E��ON70J1.6BYANVMVIICANTiORAOEPAIITSUBJECTSTHEA7PlICANTTO z Re-Root JD � ACML PENALiY OF NOT AIDRE 71fAN FNE HUNDREO DOLUA3(i5a01.1: � l � O�ASOwNE{iOFiH[PROPERTY.ORA1�EUPLOYEE5W1iHWA6E5ASTMEiR50LECOu7EN5ATpN, 0 COfllrt78fGial � � YAtl DO TME YY�PoC!1M)7HE S7RUCTURE IS NOT IMENDED OR OFFERED FOR S�LE�SEC.7oN,BUSF J HE55 AIA PROFESSION7 COOE TIE COMMCTORS UCFNSE Uw DOfS NOT APPLY TO/W OWNER OF N VROPERiVINqBURDSORMPROVESTHEREON.ANOriT1000E55lKHWORKHIMSELFORHERSEIFOR m d iHR0U0HW50RNEROYMEMPLOYEE5,7iqY1DEDTHATSU61�A1PROVEMEMSMENOTINTENDmOR 4� OFFEREDfOR3FLE�.ItlWEVER7MEBULDINOONMPROVEMEHTIS50lDW�TMfiONEYEAROF�OMpLE ? TION.TME O�NNER�BUILLER VALL HAVE iME BURDEN OF PROVNO TMT HE OR SNE DID NOT BUIID OR � MVROVE FOR TNE VURPOSE OF SA1E). � ❑L A+��ER OF THE VROPEf[T�;AY DtCLUSNELY WNTMCTiNG WITN LICFMSED COMMCTORS [[, TOOONSTRUCf ME VROJ'cCT(SE4 70N,BUSINFS9 AND PROFESSIONS WD[:iME CONTMCTORS LI� V81U8I10t1 ADJ.AREA liJ CENSEUWDOESNOiAPPLYTOANOWNEROfAPROPEflT'WHOBUaD50HN.IPROVE97HER[OtyAND � W/qCONTMCTSFOHSUCHDRO.lECTSWRHACONTRACf0��5)IICENSEDPURSUAHTTOTHECON7MG OUANTITY DESCRIPTION FEE � � TOFiSUCENSEUW.). , J 01 MI EXEYPT UNDER SEC. B.i P.C.FOR THIS iiEA;ON U � ¢ u" OATE � OWNER � U � J F LICENSED CONTRACTORS DECLARATION W � INEHEBVAFFIiWl1NDERPENiLLTYOFVERNHY7NATIMIUCENSEOUNDERFROV�5�ON50FCHAGTER � - � ��C06�wENC?qWRMSECTION7oD0)OFDINSqN�OfTHE8U51NE55ANDPROFfS5iON5CODE,AVO Z W IICENSE 6 M FULL FORCE AND EfFECf. m � � � 110ENSECUSS lIC•NO• J U OAtE COHfMCTOR a 06 WpRKERS'COMPENSATION DECIARATION ¢ � U � IHEAEBVIIFFlRAIUNDERDENAl.TVOFGE0.IIliiVCNEOFTNEFOLLOW�NOOELIARATIONS: N Z Q � ��IHAVEµpMAILMANTAINACE1fTIFKATEOFCONSENTTOSEIF�INSUREF011MORKEpS' 2 ' Q ComEN5AT10N,A5iHOMDE�BYSECTION77oaOFiMEUBOROOOE,FORTNEVEAFOMUNCE w OFT}1E WOiiK fOfi YAtlpl TMS PERMtT IS ISSUED. � 0 ��I HAYE AND W�LL MANTA�N WORKERS CDMVENSATqN INSURANCE.AS RE�U�FED BY SEGTION � 77ooOFiM£UBORCOCE,FOR7YEiERPoR1A�NCE�fTf1EWORKFORWHICHiMISPERMITIS ISSVED.MY MNFKERS'CLMAOF�SAT�ON INSURANCf G�Rq�ER ANO GOIICV NUM9ER AAE CON$TRUC7ION � � �O � �qiER PUW REVIEW � PIX.ICYNUAlBER ELECTRIC - � O (�SgE�7l7Nt�HpTgEp?�lEhDpc7lEpER4(isFORONEHIRLY�EDDotLULsRto�ORl6s} PWMBING Z ICERIIFYTHA7INTNEPEftFORMANCEOFiHEY10FKFORWMICMTH�SFERM1T61S5UED,1 MECHANICAL ���� � '� ��I��� —_ (•} SHALLNOTEMPlOVM1YPERSONNNJVMANNER50ASTOBEC0/1ESl1BJECTTOTHE � WORKERSLOMVENSA710NUWSOFCAL�FOpNU.µOAGREETHATIFISHOULDBECOAIE INSPECTIONFEE � S $UWECTiOTHENqW!ERSCOMOEN5A710NVHOVISIONSOFSECTION]TOOOFTMEUIBOR ISSIlANCE � t"Llti Vl 1 �• ( cao�.i s�uu conrmnn�ca.+a�r wm�nase raovisrorrs. -Bj��NT���f��,-7� O SMIP � p DATE: APPLICAMT: � W ENERGY P!C � WARNINO:FNWAE TO SECURE N'ONCERS'LOMPENSATION CAVEMGE IS VItAW[Ul..AND SNA�L BE SUBJECT/NEMPLOVERTOCRIYWALPENALTIES�NOCIVILFNESU7TOONEMUNDREDTMOUSAND ENERGYPERMI7 pq.LARS(i1U0,000}.IN I1�OIl10N TO iHE COST OF COAIPENSATpN,D�GE$AS DROVIOE�iOR IN � 6EGT�DN�]o!OF 7NE UBOR COOE,NJTEPESi ANOATTORNEYS FEES. ��ENTION FEE: a CQNSTRUCTION LENDING AGENCY PRE-ALT FEE; - O CL INEREBYAFFlRMUNDERPENAl7YOFVERIURYTHAThIERESACONSTRUCTIOH�[NDWGAGENCY nZ- FORTNG PER�ORAIMICE OF THE W0�7K fOR WNICN TMIS PEN.IIT IS ISSUED[SEC.90W.CIV.C.). W � lEN0ER5 NA1AE � � LENDEN511DDRESS l,+) ¢ ICER7iF/THATINAVENEMT/95AGVLICATIONANOSTATE7HATTHEA80VENFORMATqNISCORREGT. TOTAL FEES . � � O I1 `" W IAGR[ET0006�PLYWITNALLCITYANDCOUNT'ORD�NANCESANDSTATEUN'SRELA7�NQTOBVILDING � n' CONSiRUCTION.ANDMEREBVAUT110WZEREPRESENTATIYE50FTNI5CWNrYTOEMERUPONTHE � � /BOVE�MEMqNE�YROPEHTYFOAINSFECT�ONPU�P06ES. COMMENTS � � QV i1M NM1E(V 1 � /.3 O (n � ) � SIUNA RE P �iTTEE OAi S RECPT.NO. PA1D BY VALIDATION F" WHITL-0epartment Copy.YELLOW—Ffnence Copy,PINK—Aisassor Copy,GOLDENROD—File Copy,GREEN—Appicanfs Copy . . _ . _, '. . . "'._.. . - -_" . .. - . . . . , '.. , iF^� �� . . .. .. � . . . .. ��5:"� , , .. . . - � ' CITY OF DIAMOND BAR . ,, � , , -. _. . . _ , � : � - . �,ItvSPECTiOt�,REC�UP.� �: - , . �:�,: .. - , . . . . , . _. � � � .��� �1�+�-�"1�c��,���+P - :���.� �I.l�t-���c�1��7��lkf-`l�+�`;I�le�1°6.s- +����'..�1K� �(��E-�f�-'�;�"m��� �__....._.._.._..._._..:�..w... _,.��...�,...."4......,..��..,,.�....._�..,� . _a.,..,..� �, �.. ...,.b�..d�F.�._�.. �,,.��.,, jSET BACK .. � : , � . i �� � . FLOOR J01ST ,,s.. __.,.�__ .. .,..___ IFTGS!FOR;fS/STEEL— ' . -,. � -- � _ FHA REQPATS. _ _ _ 'ELECTRIC GROUN� ._. ''' ' _ UNDEa FLOOR DUCT �GROUND PLUMBING • UNDER FLOOR CU��IDUIT - � �� lSLAB GRADE— — '• ' -- I - ' ' FIREPLACE FOUtJDATION �! , ___-- 'TEMP POWER - -. 1 FIREPLACEBOND BEAM ' ' �WATER SERVICE --- - - MID HT.BOND BEAM � �ROQF SHEATHING� ' � . �� 8 FT. BOND BEAt�1 - • - - iFRAMI�dG,.NENTILIATI�N ; '• FINAL�BOND BEAM � , �.ROOFCOVF_R c ' PRE-GRADING � • ' • !ROUGH HEATING ' BENCHRJG - r + ' 'ROUGH ELECTRIC_ .: _ ' "':'_:. :. �'." ROUGH GRADING � ;ROUGH PLUMBING ' - - - - FINISH GRADING . SHOWER/TUB TEST ' POOL ELECTRIC ! IEXT.LF+THISIDING - • POOL FENCING ; ;UVALL-i1VSULATiON -- - POOL FINAL CE1LiNG INSUTATION, - OFF SITE IMPS. � ; :�RYINACL NAfLING -; �EDICATIONS SEWcR - FINAL ENG. �SEPTIC 7ANK L4NDSCAPE/IRRIG. SEEP P17ILL._ J • ON SITE IMPS. G�S AIR TEST ' FINAL ZONI�JG ',Fi�''�AL CONST. _ __ FIRE L�E�T. FINAL FI^1AL HEATI:�G. _ _ _ . � IiEALT EP, . FINAL ._ _. .. ,!` I� .� �- � � ,, :�;;��,L�LECTRIC � _ � _ DEV. FEES FAIU ; �. � � i:-_— i_�_'�jn,�PLUb1BINL'-.. - ._ Et•JERGY � , _ . - - - __ _ �. _ _ _ ___ ""`"^' '..:,�'.'.^ � __ __ r, g�_cI.W..��-;<._ ..�_:..:_ �_. _--- - - — _ _ �,, ..� ��.cr��r��r�-�s _ , , , , _ ._ , ;-. , , _ ; _ . _ _ ; . , ; ; � .. : ,. , , _ � , , . _. .. i � ;SEPTIC TANK S{ZE ; , . , _ ; : . !SEEP PI i/l1 SIZE _ `- -; , , , , � '.--'�.--. �"�� ��__ j i � , - , ,. , ; _ ._ .... � _ i � _ , . _:: �'��:.:�-. .' :�� . } , . --' ; j- _.. _ _. _ _ �,p��� i , ; � �� ' :~� . _ _ _ j : _ �- , 1 _ ' .� u \_�� \�.`�`_-��r- _ i�' - � . `-��_.:� .. ,..a � i - t �' - , - , - -