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-- - ---�----_ _ -.---- - i _ .----_. . __._._ _.—.------------- ---�� CITY OF DIAMOND BAR - : ` •. COMMUNITY DEVELOPMENT DEPARTMENT � 21660 E.Copley Drive Suice I90 �. , , � • �]RES$ � (909)86a3195 Fax(909)861-3117' ' ' '�^' BUILDING PERMIT APPLICATION FI R M LY JOBSITE / APPUCATION PERMIT /�� P/C . � . :z.�-y � o ADDRESS �V'� MOU� .S I DATE NUMBER�v f�N � - �ISSUE TYPE � OCC . , APN - LOT- TRACT OATE CONST. GROUP p OWNER,�'ti.�Le.y.. �'iD+JILS . . . - o � v,�T ZONING SETBACKS , w ADDRESS �S ,r FRONT RW O � o CITY � A�- ZIP�116'S TEL. � ���� REAR ❑ o APPLICANT TEL. S - SIDE/SIDE STREET RW ❑ � CONTRACTOR �1�+�-� � �►'v C� - SIDE ❑ � ADDRESS �1S � - - � CIN Rl• ZIP q��� TEL.�� -�/ 1 pROPOSEDUSET�yIb Sl-1/lKh� IyS7A�` d-��CD>. P ti(�+Gc.a p ' _ �7(►H /��T �f��/PL�-ti ILIS V �'Sot3 • wo ARCH/ENG/ - . _ _ ' ` 5. Lti �. < a2 C��? a DESIGNER NO.DWEL , ",NO. NO. _ " : a ADDRESS UNITS STORIES I BEDROOMS � CIN ZIP TEL. N - DESCRIPTION ' SQ.FT. FACTOR PSF -ADJ:AREANALUATION _ Q __.. OWNER•BCILDEA DECLARATION - ' SFR/ADDIREM � , O ; , _ , _ _ ' .p _ .1 HEAEBY AFFIRM UNDEB PENALTY OF PERIURY THA71 AA1 EXEMPT FROM TNE CONiRACTORS U• Gef800/C3fPOft � -� � - - � � � � � W CENSEUWFORTHEiOLLOWMGREASON(SEC.70.71.68USMESSANDPROFESSIONSCODE:ANVG7YOR (n V CWMYWHIQIREOUIRESA7EHMITTOCONSTRUCT,ALTER�MPROVE,DEMOLISH.ORHEPAIR/JIVSTRUC• '� W patlo/Deck • � ' ; w NRE.PRIOR TO RS ISSU/WCE,Q50 fiEOUIRES THE APPLICM7T FOR SUCH PERMIT TO FlLE A SIGNED w - - , � STATEMEM THA7HE OR SHE IS UCENSEO PURSUANT TO TME GROVISIONS OF THE CONTRACTORS l4 , , . � CENSE UW(CHAPTER Y(���ENpNO VlITH SECTION 7000)OF DIVISqN 3 0F THE BU5INESS AND PRO- � P��Pa . , � FESSiONSCADE)ORT/NTHEORSHEISEXEUPTTNEREFRd.IANDTHEBA5ISFONTNEAILE�EDE%EA1P• TION.ANYVIOLATqNOFSECTION7031.68VA4VAPPUCANTFORAOERMIT5U8JECTSTNEACPLICANTTO �. Z Ra-Foof - t � A CML VENALTY OF NOT MORE iHAN FIVE HUNORED DOLLARS(f Sao).1: �. , ., , . 0 ❑4��EROFTHEPFtOPER7Y,ORMYEMPLOYEE5WI7HWACESASTHEtR50LECOlAPENSATqN, ,' � COR1tT18fC171 � ,' Z WILL DO THE WORK,AND THE STRUCNFE IS NOT INTENDEO OR OFFERED FOR SALE(SEC.70u,BUSI• .,.1 � NESS AND VROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT 11PPLY TO AN OwNEROF j_ � PROPERfYWFiOBUADSORIMPROVESTHEREON.ANDWHODOESSUCHWORKNIMSELFORHERSELfOR = � � � THROVGHFpSORHEROWNEMPLOYEES.VROV�DEOTHATSUCNIMPROVEUEHiSARENOTMENDEDON m w OiFEHEDFORSALE.IF,HOVIEVEF�iHEBUILDINGORIMPROVEMENTIS50lDWIT/ENONEYEAROFCOMPLE• ' ' - 0 TpN.THE OWNER�BUIIDER YALL HRVE TME BUROEN OF PROVINa THAT HE OR SNE DID NOT BVIID OR � W CEN�SEUWDOESNOTMPIVTOANONTJEROF�APRSO ERiI'NRIDBUILDSO�RM ROVESTH REON.MlD... ' . �� ' .. = IMPROVE FORTHE PUHPOSE OF SALE). ' .w HiMCTING YATH UCENSED CONTMGTORS . .. . .. ..._ Valuation �sb• ADJ.AREA � � ��Nh1000NTMCTSFORSUCHDRQIECTSWITHACOMMCTOR(5)LICENSE[7PURSUANTTOTHECONTMC•. ' QUANTITY �ESCRIPTION - ' � - �� " FEE.- . � � TORS LICENSE Uw.). ' �'� ' �. .. _ _ . _.. ... _ .. . . � . . . _.. _ ; � O I AM E%EMPT UNDEH SEC. B.a P.C.FOR TNIS REASON U � _ _ _ ' � " _ . . _ . . . . . _ _ . . .. . � DA7E OWNER - � . . . . . � („) . . .. � . ..�'..: .� �" `. � .. ._ . . w �_ �¢ _ _ LICENSED CONTRACTORS DECLARATION ' w ' CL - . _. ' IHEREBY�FFIRMUNDERPENAL7YOFiERNRYM�TIAMtICENSEDUNDERiROVI5iON50FCHAPTER� � � ' � �.. � ' � d o�CO/AMENCMG WITH SECTION 7D0010F DM510N 7 OFTHE 8U51NE55 ANO PROFE5SqN5 COOE,AND--- Z A1Y LICENSE�S IN FUl FORCE AND EFFECT. m ' 0 LICENSECUS C� • LIC.NO.� ���� � . . -. � � . . . ' � � 7 V DATE �� �1 . . . CONTRACTOR N ��C.A✓'L a W . _ ._ . . . . __ .. -.- _ . . � WORKERS'COMPENSATION DECLARATION t��,J"� ^ a N IHEREBYAFFIRMUNDERPENALTYOFPERJURYONEOFTHEFOLLOWINGDECUMTIONS: A t U � � � � V � � � _INAVEANOW�LLAUMTNNACERTIFICATEOFCONSENTTOSELF•INSUHEFONMK7PKER5' � - � �� - � COMPENSATION,AS PROVIDED BV bECTION�7o00FTME LABOR COOE,FOR THE VERFORIIANCE W _ OFTHEWORKFORWHICMTMISGERMITISISSUED. r � O . _ ._. . . ..... . �.. .. .. . _. .__... _ . W _I NAVE ANO WILL IdAINTA�N WORKERS'COMPENSATION INSUA/NCE.AS REOUIRED BY SECTION Q 97o00F7HELABOROODE.FORTHEPERFORMANCEOFTHEWORKFORWHICH7NISPEPAnT15 _ ISSUEQMYWORKEHS'COMPENSAT NSUMN�j ARRIERANDPOUCYNUMBEBME: -CONSTRUCTION- -- /I / � j CARRIER STA ��/N✓ PLAN REVIEW _ _. .. _ . 0 . va�cvauusEa �.Lel1�.S . ��� ELECTRIC . _ . _ _ _ -� - -(iH55EcnoNNEmra78EKM°tE'tmOFnEaEplAiSRxiaMElaxDfiE.DOotWlSR�oc�ORIES� .PLUM8ING_. Z I CERTIFY THAT IN THE PERFORMANCE OF THE WOfiK iORV1MICH THIS PE1iM1T IS ISSUED.1 MECHAN�CAL . (J SHALLNOTE4PLAYANVPERSONW�NVMANNERSOASTOBECAMESUBJECTTOTHE _ _ . . . . . . vj WORKERS'COMPENSATqNUWSOFCALIFORNII�ANDAQREE7HATIFISHOUL�BECOAIE INSPECTIONFEE SU&IECTTO THE WORKERS'COMPENSATION PROVISION OF SECTqN 370oOF THE UBOR ISSUANCE � CWE,ISMlLLLFORTMWITHCOMPLYWIiH��\ro�SEPRO NS /� � p DATE:�•tC I APPLICANT. �X�� `�^�� SMIP - . . . - � - -. . . . . .. � , W ENERGY P/C --. �L�.�«�_�� , � WAFiNING:F/uLURETOSEWFEWOFiKERS'COMVENSATIONCAVEHAGEISUNUWFU..ANOSHALLBE-- SUBJECTANEMGLOYERTOCHIMINALPENALTIESMIDCMLFwE5Uvi00NEHVNDREDTMWSAND ENERGYPERMIT DOLURS(f 700.0001.IN ADOITION TO THE COST OF CAMPENSATION,DAMAGES AS PFOVIDEO FOR IN � SECTION37olOFiHELABORCODE,IN7EREST,ANDATTORNEYSFEES� � - � RETENTIONFEE: � �� � pW_, CONSTRUCTION LEN�ING AGENCY PRE•AlT FEE: - � � � , CL IHEREBVAFFIRAIUNDERDENALTVOFPERIUMTHATTHEREISACONSTRUCTIONLENDINOACENCY - �� � n- FOR TME VERFOR6IANCE OF TNE WORK FORNTIICH THIS PERMIT IS ISSUED($EC.JOB7.CIV.CJ. . . . . Z . ' ' _. __' _ . . _ ..._ . W . � LENDER'S NNAE - � ' . . . . ._ . . .. . _ . . ... . . . . . .. . F- lEN0ER5ADDRE55 W ICERTIFYTHATIHAVEREAOTHISMPUCATIONANDSTATETHATTMEABOVEINFORMATqNISCORRECT. TOTAL FEES ` , . 1 `� � I�GREE TO COMPLY WITii ALl CITY AND GOUNTY ORDINANCES/WD 57A7E IAwS FEU7IN6 TOBUiLDING I � n D �^� � CONSTRUCTION,AN�NEREBYAUTF/ORREREPRESENTAT.NESOFTHISLOUNT'TOENTERUPONTHE ;i;f� � ABOVE�MENiqNED VR PERTY fORINSPECTION VURVOSES. ' Z COMMENTS — t� [� ' o � -� �o ��z.a � � PERM' "ENAME(� TI . .._ _ ..._ . . .. . _.__.. ...__ , ¢ ��i`,�-�.-�'e�l. �.�,,� �I�-S 1�? � (n 5� NAiUREOFPERMITfEE OATE � RECPT.NCL PAID BY DATIO • - � - - WHITE—DeDartment Gopy,YELLOW—Finance Gopy.PINK—AssessorCopy.GOLDENFiO File Copy,GREEN—Applicanl's Copy , • . -, -- � ,. .,r..�- ._.... . . � • . .t �.�d n , . . . �•�:� ,t' • . . `� ':i"'' ')' , ,,li�': . . �� v..� .. ., � , . . . . .,. . �.�' ., � . �r . ,�� i CITY.OF.DIAMOND BAR � ' "� � � , „ , ,.. � , , �,. � , . - �_ �: INSPECTION �RECORD ,''`,'.;-�. :.' '.�� : , - ,.' ._ . � . . . ., � „ ,_ . � • � � • - � � + • - SET BACK - ' - � FLOOR JOIST - --- ' � FTGS/FORMS/STEEL _ _�. _ �" ___� - _ . FHA REQMTS - � - ' ' ' ELECTRIC GROUND � � UNDER FLOOR DUCT - 1 : �- �•� ,:, t �•� - � GROUND PLUMBING � - ���� UNDER�FLOOR GO�IDUIT c `.!, ' -- , �� �; , SLAB GRADE -- - `'' { ' FIREPLAG��FbUT�1DATION - � " • � ..' " . -- TEMP POWER - - , _ - � - FIREPLACE BOND BEAM . , -r _, ,: '�;-, � : 1NATER'SERVICE' _ _ ,. „• � •, �� � � MID HT.BONQ�BEAM- - �`� � ;�C. _, �' - -;,i� °. � ROOF SHEATHING .{':��' -Z-S 7 _'- 8 FT:BOND BEAM ' FRAMINGNENTILIATION � � .FINAL BOND BEAM - ' - - ' . ROOFCOVER- - - p� •47 -- PRE-GRADING � � ' - - ROUGH HEATING- - ' - � ' BENCHING � - �- � ROUGH ELECTR(C " - -- - - � ROUGH GRADING ROUGH PLUMBING �- - � - FINISH GRADING � SHOWERlfUB TEST - - =- P�OL ELECTRIC � • � •• ' EXT.LATH/SIDING POOL'FENCING . . WALL INSULATION � POOL'FINAL � CEILING INSULATION i OFF SITE IMPS.. : DRYWALL NAILING DEDICATIONS . • SEWER_ _ _ __ FINAL ENG. , SEPTIC TANK. . .- -.-- _ _ - _._ _ - -- 1 `"_ .. LANDSCAPE/IRRIG. ' SEEP PIT/L.L. - - - - - - ON SITE IMPS. , GAS AIR TEST; - --- --- -- - - ; FINAL'ZONING FINAL CONST. -�-�--- -(o , - - ; - FIRE DEPT.FINAL FINAL HEATING� - � - -- - � HEALTH DEPT.FINAL - - - . - - � FINAL ELECTRIC- �� � -- - ' DEV. FEES PAID FINAL PLUMBING ENERGY _� . ,�� �' �_ � � - . � � � . „ , . , .. . .. . _ . , . ., _ _- _ _ , ,�� - i ; - ; -• COMMENTS - � � �'� i - --- - - -- _ � . . . , _ . .. . — -- - . , � , ' ' . ��'-'� ..-• r;��j.. ' . � � ,�1� i. . ��,/:� �+; _ • ' , , - -- _ - ' G-�" .� ',: . , , --��- . � - - . _. .. . �,1: rt.� � � , - ' • , . � ` . 4 C� � , i . II .. , , � . -- � � - �, ;. ., �� ` � .. . __.. . ;'_'��.. � .�J • \1'�, ;� ., ,. f ' .. - � , - ' -- - -- — SEPTIC TANK SIZE '" ; , I � - - - - SEEP PIT/U SIZE , . _ � i � -- - � ; - - . ,- , . . _.. : -= - = - - - - --- t�- �\. , ` .J I : , , � � � 4-. , . r � , -- - ',. r' �.,�`, -� (' � , „ � l.�l .) "1 �. 1 ^ � 1 I { , ,.,�r ' i j�` __ t ' 1 '� �' � � .