HomeMy WebLinkAbout17461 -- - -- _Y �:_:::.�.�_..:_�_�._1.--- -- -----_�--- --- - ---�---- _ __. . ,
�` CITY OF DIAMOND BAR
DEPARTMENT OF COMMUM'I'Y&DEVELOPMENT 5ERVICES
,�.T� 21825 E.Copiey Drive
(909)860.3195 Fax(909)861-3117 PRESS
�''%�'� BUILDINGPERMITAPPLICATION FIRMLY
� JOBSITE APPLICATI PERMIT PlC
o AO�RESS 23670 Monument Canyon DA7E � � NUMBER 175��/ p
c� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
S OWNER Cimar on Oa s NOA
ADDRESS ZONING SETBACKS
gCITYr��e� ZIP�_ TEL.�S}C�_Z�4n�_ RE�R Rw o
APPLIC?�AT TEL SIDE/SIDE STREET RW ❑
� CONTRACTOR ROy�7 ROOf CO. SIDE O
� ADDRESS (�{������E�� PROPOSED USE
� crnr ZIP ni� TEL���Ag3(+Ae�( Tear off wood shakes Tngtal l
o ARC N .
� DESIGNER
ADDRESS NO.DWEL ' tW0 NO.
� CITY ZIP TEL UNITS STORIES BEDROOMS
� �ESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION
�
� OWNER-BUILDER DECLAFATION SFR/A�D/REM
O
� I HEREBY AFFlRM UNDE0.OEN,LLTV OF PENURV TMAi 1IUA E%E4PT FRdA 7HE CONiRACTONS L4 GaragelCarport
W CENSEUWFORTIEFOLIOWINC+MEA330N(SEC.T0.71.60USWESSMIDiROFES510N5CODEANYUTYOR (A
� COUMYWHIpIRE0UIRES�PERMITTOWNSTRUCT,ALTERMAPROVE.DE�OLISH,ORREVA�RANYSTRUG W patio/Deck
TURE.VRIOR TO ITS ISSUANCE.11L50 REW IRES 1ME APPLICANT FOR SUCH PEHMIT TO flLE A SIONE� W
� STATEA/EM THAT NE OR SHE�5 LICENSED WPSUANT TO THE iRONSIONS OF TME CONTRAGTORS L4
� CENSE UW(GFI�VTEfl Y(COMMENpN(i WITH SECfION 7000)OF DIVISION�OF7NE BUSINESSAND FR6 � PooUSpa
� iES510NSCODE�OfiTINTHEORSHEISE%EMPTTNEREFROMANDTIEBASiSFONTHEALLEGE�EXEMP.
TION.ANYVqLATI0NOF3ECTION7031.68VANYAPPLIGANTFOR�VERMITSUBJECT57MEAPPLIGINTTO Z Re-Raol
� A pNL VENALT'OF NOT b10RE TMM!FNE HIXlDRED DOIUAS�f500).�: .
0 OLASOWNEROFiHEPROPEHiY,OHMYEMPLOYEESYVITHWA0E5A5THEIR50lECOMPENSATiON, O COTrt�BfCidl �
Z WILL DO THE WORK,AN�THE STRUCTURE IS NOT INTENDED OH OFFERED FOR SALE(SEC.701�,BU51. J
NESS ANO PROFESSIONS COOE:THE LONTMGTORS UCENSE UN�DOES NOTMPLV TO AN OWNER OF
N PiqPERTVWHOBU0.DSONIMPROVESTHEREON.MIDINNODOESSUCNWORKWMSELFORHERSELfpq �
LL THROUGHHISORHEROWNEMPLOYEES,iROVIDEDTHATSUCMIMPROVEMEMSARENOTIMEN0E00(i m
LL1 OFFERED FOR SALE IP,110M/EVER 1ME BNLDWOOR MvpOVEUENT IS SdD Vn7MN ONE YFIA OF COMPLE•
� TION.TME OWNER�BULDER W�LL/1�VE iME BURDEN OF iPOVINO TW�T HE OR SME Oi0 NOT 8UIL0 OR
� IMPROVEFORTNEPURP0.SEOFSAIE}
O 4�S OwNER OF THE VROVER'fY.Ak7 E%GLUSIVELYCOMMCTIN6 N7TH lKEHSED CONTMCTORS
� TO CONSTRUCT 7NE PRWECT(SEC.)Wl BUSINE55 AND PROFESSidJS CODE TNE COHTMCTORS Lb V31U8tiW1 ADJ.AREA
W CENSEUWOOESNOTAPPLYTOANOYMEqOFAPROPERTYM?fOBUILOSORIAACROVESiHEREON.AND
� WFqCOMMM3FORSUCHPROJECfSWITHACdlTMC70R�S�LICENSEDVUHSU�TOTHECONTMC- pUM7TITY DESCRIPTION FEE
� TORS LICENSE LAw.).
� OIAMEXEMPTUNDERSEC. B.BP.C.FORTNISRE�SON U
�i ¢
LL' DATE OWNEH V
�Q UCENSED CONTRACTORS DECLARATION W
2 INEREBYAFFIRMUNOERPENALTYOFPERtt1RY7HAilAMIICENSEDUNDENPROVIS10N90FCHAPTER Vr
p_ Y�CqAMENCWOWITHSECTqN7000)OFDMSION�OFtHEBU51NE5SANDPROFESSION5C00E,AN� Z
�u L1YlICENSE IS N FULL FORCEl1ND EFFECT.
m
� ��cer,se cuss _ uc.No.�q�16�— �
� o�rE 5—�1— 3 - eoMancroa -T2Q3�a1 Rngf (:n, a
w
� WOFKERS'COMPENSATION DECLARATION �
� U
� IHEREBVAFflRMUNDERVENALTYOFVERNMONEOFTHEFOLIOwIN00ECUMTIONS:
N Z
Q
� __INAVEANDWILLMAWTNNACERTIFIGTEOFCONSENT705ELFdNSUREFORN'ORKERS' S
COMPENSATION,ASpROVIDEDBVSECTON�7o00FTMEl1DORtOOE,FORTHEPfAFON.IANCE W
OFTHE WORK FORNMICH THIS VERAII713ISSUED. �
0
� �XIH�VEANDNnLLAUINTNNWOF4tERS'COMCENS�TqNINSVRANCE.A5RE0UIREDBVSECT�N /�
4Q �7000F TIE L/HOR CWE.FORTI7E PERFORMANCE OF THE WOfU(FOR WMICM TMIS PERMIT IS y� ��
ISSUEO.MYWONCERS'COMPEN9ATIONWSUHANCECARRIERANOPOUCYNUMBENME: CONSTRUCTION ,.�+
� CARRIER—,A.I+� � PLANREVIEW '
� vo��crnweEn ELECTRIC
0 (iTlSSECfICNNEmNOYBE00MPLETEDOFT#GEFMT6FOqCHEH1�OFiCDDOLLAiLS(i�aoI0RLE5..`1 PLUMBING
Z ICERiIFY7HATN7HEPERFORMANCEOFTMEWORKfORWnICl/THISPEiWIiI5155UE0,1 MECHANICAL
('} 51iALLNOTEMPLOYANYVERSONINANYMANNER50ASTO8ECOMESUBJECTTOTXE
� YqqKERS'COAIPENSATIONLAWSOFCALIFOqN1AANDAGREETMATIFI5F�0ULDBEGOAIE INSPECTIONFEE .
SUBJECTTOTHEWORKERS'COMPENSATpNPROVISIONSOFSECT10N77000FTMElABOR �SSUANCE �
s CODE.ISHAILFORTHWITHLOMPLYWIiMiMOSEPROVIS�ONS. '__ _"'___ ___"
pDATE: APPLICANT: SMIP �n.. �.'.�� �.-.' � �d
w ENERGY P/C �
WARNINa:FAILURE TD SEW RE WORKER5 COMPENSATION COVEN�OE IS UNUWFUL,ANO SN/LL BE
N
� SU6IECTANEMPLOYERTOCRIMWALOENALi1ESANDCMLFWESUVTO0NEM/NDREDTHOUSANO ENERGYPEHMIT �(�
DOLLAi14(f7oa.00D),INADDITIONTO7HECOSTOFCOMVENSnTqN,DAMACESASVROVWEDiORN P�—Zr��{!�1 ���
J SECTbN77010FTMELABORCODE.MEREST,IW�ATTORNEY'SFEES. RETENTIONFEE: I
� �
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � �Of
Q IHEREBYAFFIRMUNDER7ENANOFPERNRYTHATTHEREISACONSiRUCT10NlENDINGti6ENCV �-�-" �' '•-- �
n- FOR TME VERFORAIANCE OF ME WORI(FOfl NM11�CH T1115 VERM1715155UED(SEG 90G7.pV.G). �
�
� LENDERS NAME
� IENDERSADDAESS
� 10ERTIFYTHATINAYEFlEAD7H�5MGLICATqNANDSTATETUTTHEABOVEWFORMATqNISCORPECT. TOTAL FEES //� �O
� IACREETOCpAPLVWRHALLCRYANDCOUNTYORDIWNCESANDSTATEUWSREU7W�TOBU[OINO
CONSTRUCTION.AND MEREBY AUIHORI2E REPPESENTATIYES OF iH14 CWNTY TO ENiER UCON THE
Z ABOVE-MEHTIONEDPNOCERTYFOPIN57ECTIONOURPOSES. COMMENTS � �
�
�
m aENAIiTTE N E IPWNn ��_U 1
Q
�
� SIGIUTUR O EflMIiTEE ' DATE ' p
� RECPL NO. PAID BY rL VALIDATION
WHITE—Oapartment Capy,YELLOW—Finance Copy.PINK—Assessor CoDY.GOLDENROQ—Fila CApy,GREEN—ApplicanPa COpy
.....:'t,_..'.-/i:...,: : ., ..... , ,.e ,,��--,.�,•.. v. . .. n. cr"Tr".M..�. .:�-�� r t. ,:a- � _. . ... . .. . - .
- -� .�.�. .. . . � . . . r• _r�_ ,...T,.... . e . �.
�IT'�' C�F I�lAMOT`!D BAR
iNSPEC s iON RECOf�D �
----- __ . ._
� �a�. �,;.��1;:��1 �' �[��_��� �C�r��� �C i -- .
,.�►, � E � ► �� ����'. .. .i �'��'`t�'��A� ..... ' �c�. e�I,� . . i¢�!,:�� ly.� �'
�.___ �_. _.�.. . .�...__,_._.w '� �
5ET BACK L_ �� FLO�R JOIST
FTGS/FORMSiSTEEL � u�_ � FHA REQ'V1TS
ELECTRIC GROUND UNDER FLOOR DUCT •
GROUND PLUMBING UNDER FLOOR CU�IDUIT, �
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER I ' FIREPLACE BOND BEAM
WATER SERVICE MID HT.BOND BEAM
ROOF SHEATHING� h,_Z=,ol �_" , 8 FT. BOND BEAM � '
FRAMINGNENTILIATION I • � i FINAL BOND BEAM
ROOF COVER I���dy • _ ' PRE-GRADING I
ROUGH HEATING BENGHING I
ROUGH ELECTRIC � , ROUGH GRADING �
ROUGH PLUMBING � ; FINISH uRADING
SHOWERRUB TEST i � POUL ELECTRIC
EXT.LATH/SIDING ( � •, POOL FENCING
WALL INSULATION � POOL FINAL • .
CEIUNG INSULATION j OFF SITE IMPS.
DRYWALL NAILING j DEDICATIONS
SEWER . _ j FINAL ENG.
SEPTIC TANK -. LANDSCAPE/IRRIG.
SEEP PIT/LL. � ON SITE IMPS.
GAS AIR TEST � FINAL ZONING
FINAL CONST. I • FIRE DEPT. FINAL
FINAL HEATING ; � HEALTH DEPT. FINAL
FiNAL ELECTFiIC ; I DEV.FEES PAID
FINAL PLUMBING � j I ENERGY �
� �
1 — - - - --- ---- - - � - -�_ ;@��P�2� ���.�� d_�s.. �- - --
COMMENTS
�, .
SEPTIC TANh SIZE
SEEP PIT/U SIZE
_ . ��.� . . �
. ! . .
i
,4�l� ;�i
��
. .._ �. . _� �. ' .
�...Y..... - ~�-�....-- - -' . � - , �, ,, _ , . . .