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HomeMy WebLinkAbout11101 � . - - . . _ .. .'.. - _ _ .. --- — - -_ .. _ - --��— CITY OF DIAMOND BAR / � ✓ ' '' COMMUNITY DEVELOPMENT DEPARTMENT '��,.¢ 21660E.Copley Drive Suite l9D - ' � PRESS (909)860-3195 Fax(909)861-3117 ' ' '""" BUILDING PERh1IT APPLICATION � FI R M LY � JOBSITE . C ' APPLICATIO � PERMIT P!C o ADDRESS Z Z p3 6 Ma� ✓) �-(�1'� �' � DATE � �3 �� NUMBER� � # . , c� ISSUE TYPE OCC ' APN ' LOT T CT DATE CONST. GROUP ' - p OWNER � "" ADDAESS � Y �- ' ZONING SETEiACKS Z CITYrD__I�i yy��� ZIP�6S TEL. — L FRONT - qW � ❑' g APPLICANT TEL. ��� -42.7� , _REAR - ❑ � SIDE/SIDE STREET RW O � CONTRACTOR SIDE ❑ � ADDRESS � CITY ZIP TEL PROPOSED US o ARCH/ENG/ w DESIGNER - NO.DWEL y' NO., NO. a ADDRESS UNITS STORIES BEDROOMS � CIN ZIP TEL. r�i� DESCRIPTION SQ.FT. 'FACTOR PSF ADJ.AREANALUATION p� OWNER-BL'ILDER DECLARATION - SFR/ADDIREM • O , _- 1 HE0.EBY AFFWM UNDER PENALN OF PERIURY TMAT I AA1 E1(EMPT FROM THE CONTFACTORS U-' _Gaf2Q0/C•3fpOR- -- W CENSEUWFORTMEFOLIOWINaREASON(SEC.7a71.6BU51NE55ANODROFESSIONSCODE:ANYCITYOR (n - � U �1NTYVh11CHREOUIRESAPERMITTOCONSTflUCT,ALTERMAPROVE,OEMOLISH.ORREPAIRANVSTRUC-� W '.Pat�O/DBCI( Z TURE,PRIOR TO IT@ ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMI7 TO flLE A SIGNED� - - � w STATEMENT TNAT HE OR SME IS LICENSEO PURSUNIT TO THE VROVISiONS OF TME CANTMCTORS lM ' W � CENSE UW(CIUPTER 0(CAMMENCIN(i VA7H SECTqN 7000)OF DIVISION 7 OF TME BUSINESS IWO PRO•. � POOVSpd � � , _ FESSIONSCOOE)OflTHATHEORSHEISFXEMPTTTiEREFROMANDTHEBAS15FORTHEALLE6EDEXEMP• (� VT10N_ANVViOUTIONOF5ECT10N7m1.58YANVAPVIICANTFORAPERMITSUBJECTSTMEA7PLMJWTTO z Re•Roof � - � A CNIL OENALTY OF NOT MORE iH�l1 FNE HUNORED DOLURS(SSCO)J: - 04A+�'NNEROFTHEPROPERTY,ORAIVEMPLOVEESWITHWAGESASTHEIFlSOLFCOMPENSATqN, Q Z Commercial ' _ • WILL DO 1HE WORK AND THE STRUCTURE IS NOT IN7ENDED OR OFFEFED FOR SALE ISEC.7W1.BU51•� J � NE55 M1O iROFES510NS WDE:TME CONTRACTORS UCENSE LAW DOES NOTAFPLY i0 AN ON'NER OF � � . - _. PROPERTY NMO BUILDS OR IMPROVES THEREON,IWD WFiO DOES SUCH WOFK HIMSELF OR MERSELF OR � THRWGHHISORHEROWNEMPLOYEES.�ROVIDEDTHATSULHM7ROVEMENTSARENOTWTENDEDOR m pOFFERE�FORSILLEIF,IIOWEVER7MEBUILDINGORIAAPROVEUENTISSOLDWITMINONEYEAROF�IADLE� � � " � Z TION,iHE OWNER�BUILDER WILL FIAVE THE BURDEN OF PROVINQ THAT ME OR SNE DI�NO7 BUI�p OR _ . . � IMPROVE FOR THE VURPOSE OF SALEJ. ' �• � � w DlA50WNEFOFiHEPROPERiY,AME%CLUSNELYCONTMCTWGYlITHl10EN5FDCONTMCTOH3 . , ,.. ... . Q TO CANSTRUCT THE PROJECT�SEG 7oN,BUSINESS AND PROFESSpNS GODE:THE CONTRAC70R5 U• V31U8110f1 ADJ.AREA� �� � , W CENSEUWDOESNOTMPLVTOANOWNEROFAPROPERTYNTiOBUILD50RIMPROVESTHEREON,AND F WFfOCONiMCTSfORSUCHOROJECTSWITHACOMMCTOP(S)IICENSmPURSUMJTTOTHECONTMG OUANTITY �" DESCRIPTION � FEE . TORSLICENSEIAW). . , �' " - � . . _.. _ . ' _ ._ ._ . . _ . . � O I AM IXEMPT UNDER SEG B.i F.0 FOR iH15 RE/uON a � � .� - V _ '_ ' _. . . - . _ .. '. _ . . . _._ .� . Lt. � OATE OWNER V . � . Zw ... . .. _ . _ ,. ... . . _ ._ � LICENSED CONTRACTORS UECLARATION w � I NEREBY�FFIRM UN�ER PENAITY OF FEWURY T1UT IAM UCENSED UNDER PROVISIONS OFCHAPTER - Vr , , . -� 9�COMMENqNGWITTI5ECT10N70ao)OFDIYISIONJOFTFIEBUSINESS�NDPROFE5510NSCODE,AND Z Xl� MY LICENSE IS W FULL FOfiCE ANO EFFECT, m 11J . . . __. . _ ._. . � � LICENSE CLA55 LIC.NO. � J • V DATE CONTRACTOR � a W � WORKERS'COMPENSATION DECLARATION a = U � � IHEREBVIIFFIRMUNDERPENAINOFPERJURYONEOFTHEFOLIAMAN�OECtAMTqNS: Z , , , � _IHAVEANDWILLMAINTAINACERTIFICATEOFCANSENTTOSELFaNSUREFORWORKEHS' S - - � � � ""- � COMPENSATION.AS PROVIDED BY SECTION�70o OF THE LA9ON CODE,iOR THE PEPFOPI.UIJCE U Q OF THE WORK FOR NM1/ICN TNIS PEFMIT IS ISSUED. � � . .. . _ . . . . . . __... .... W _I HAVE ANO WILL MAINTAIN WORKERS COMPENSATION INSURANCE,AS PEQUIHED BY SECTION � '_ ,Q ]7oo0FTHELABOFCO�E,FOHTHEPERFOHMANCEOFTHEWORKfOHWHIdITHISPERMITIS �� • ISSUED.MYWORKERS'COMPENSATIONINSURANCECARRIERANDPOIICYNUMBERME: CONSTRUCTION J j GRRIER PLAN REVIEW o vaarNun+een ELECTRIC - - - _ __ . _ . _ 2 . ¢ � �nassEcrrNUE�naTasao�.s�rcoocnevcw.rrsFcaor+EH.rn��oou.uaK+�l��ss! PLUMBING Z �CERTIFYTHATNTHEPERFORMANCEOFiNEWORKFORWHICHh115PERMITI5155UED,l MECHANICA� '� C7 SWLLLNOTEMPLOYANYPERSONINANYAIANNERSOASTOBECOMESUBJECTTOTHE � WORNERS'COMPENSATqNUWSOFCALIFORNI0.ANDACREETHATIFISHDUIDBECOIAE INSPECTIONFEE � --��- � S SUBJECTiOTMENIORNERS'C0IAPENSATIDNVROVISiON50F5ECiqN�7000FiHELABOR � , � CODE,1 SHALL FOfiTNW17N COMPLV WITH TMOSE PROVISIONS. �SSUANCE � SMIP . .._ . � _ . . -.. . p DATE: APPLICANT: J WMNIN6:fA1LURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUI,AND SWLLI BE ENEFiGY P!C .. � SUBJECTANEMPLOYERTOCRIMWALPENPLTIESANDCIVILFWESUPMONEFNNDREDT/OUSAN� ENERGYPERMIT DOLLARS(fla0.D0o],IN ADDfTION TO TNE COSTOF COMPENSATqN,OMUGES AS PROVIDED FOR IN ¢ SECTIDNJ70EOFTHELABOiiCODE,NTERE57,ANDA7TOfiNEYSFEES.-� ' - -- � ��� RETENTIONFEE: �C��' �1 �'IQQ7 - ��' - � � - a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: L������ � ' � - � ' � O - - . . . _ . . .. . . _ , � 1 HEREBYAFFIRM UNDER FENALIY OF iERJUPY THAT iHERE IS A CONSTRUCTION LENDING 11GENCY ' - ' Z PoH ME PERFORMMlCE OF THE WORK FOR WHICH THIS GERMIT IS ISSUED(SEG 7097,CIV.CJ, W . .. _. __ . . __ � . . � LENDER'S NAME � � LENDERSADORE55 �� - -� � � ICERTIFVTHATIHAVENEAD7HISAPVLIC�TIONAN�STAiET11ATiHEABOVE WFORM�TIONISCDRRECT. TOTAL FEES � �� W IAGREETOCOIA7LYWITiIALLCT'ANOCOUNTVORDINMICESANDSTATEUwSREU7INCTOBU�LDING ' ' ' - ' "'� '-- ' � ' � CONSTRUCTION,AND HEREBV AUTlK)RIZE REPRESEMATIVES OF 7HI5 COUNTY TO ENTER UPON THE � ' � � ' ' ZA80VE-MEMIONEDPROPERiYFOflINSPECTqNFURPO5E5. . �. � � {-i'� �V!T r(�I C� 1 A �EL ' COMMENTS _ , .m PERMI T N E•(-PR.IrNT)� � � - - . . . . - . - - " �"" . � W\ � Vj SiCNA FVERMii7EE DATE � --� - y � RECPL N0. PAID BY VAUDATIO � - ��WHITE—DepaRment Copy,YELLOW—Finance Copy,PINK—Assessor Capy,GOLDENROD—File Copy,GREEN—ApplicanPs Copy , . . . �.. . �. � ,... , . , , . '- �� . . . h,.. ..,� ,,.... , c-�....-,..•,r:t�^�'Fv•��,p.;aa e , _�_.... • .�.F�.�.,' - �., i4...; ���. ....� -� CITY.OF DIAMOND BAR ', �,' , . ,!', _ , - . ; -- � . INSPECTI�N RECORD : _'. ' � .._ . : ;. . � , — • , . � _ . � � ` . _� : SET BACK' ' � FLOOR JOIST -- --- - - - - - FTGS/FORMS/STEEL__: _�. FHA REQMTS -1 _ ` '.; �- ' .' -�-, ELECTRIC GROUND ' � UNDER FLOOR DUCT � ; ,�. ' � � , � � � GROUND PLUMBING - � UNDER FLOOR�CONDUIT = •• " �- �- � � � � SLAB GRADE �' '• FIREPLACE FOUNDATION _ '` ' ' '" ` '� TEMP POWER = -- - - - �_ - - •. FIREPLACE BOND BEAM ,-_...�.:.: . _ �. . WATER SERVICE '� - • - � ' `' MID HT.BOND BEAM �� • RO�F SHEATHING � � � 8 FL BOND BEAM FRAMINGNENTIUATION -- � FINAL BOND BEAM - - - � ROOF COVER - - -- -- -- - - .- PRE-GRADING . : ` � ! ROUGH HEATING - ' � �- - - � �- BENCHING . , -- - _. ROUGH ELECTRIC - --� ' � ROUGH GRAQING '� ROUGH PLUMBING �- - - --- - - - " � FINISH GRADING � � ' SHOWER/TUB TEST � � - .. POOL'ELECTRIC EXT.LATHlSIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS - - SEWER_.. -----. ..-- - - - - - .. _.. _ .. . FINALENG.. , �SEPTIC TANK . - -- -.=- - - -== --- - LANDSCAPE/IRRIG. ' ; SEEP PIT/L.L. ; -- - - - - ' ON SITE IMPS. GAS AIR TEST - -- � � FINAL ZONING - ' ' ' FINAL CONST. ��- - � , FIRE DEPT.FINAL �� ' ' FINAL HEATING - - - ' - HEALTH DEPT.FINAL -, - FINAL ELECTRIC - - DEV.FEES PAID FINAL PLUMBING ENERGY � � • • � � � COMMENTS- - - - - - � � _ ` ,; . _ _. , .. ,_. - • , . - , . • ; � - � ���L� ,c���� - , ; , , , - — -- ; SEPTIC TANK SIZE ' , .. .::... , _- - - - -- - _ - -- - � ; SEEP PIT/U SIZE . � � - - - - - -- - ' � , ' �' � � i' i ,.i .. �� � . � I'� ; ' �- i /J 7 ,_�� �?. Z. � , � . � �.,. �