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CITY OF DIAMOND BAR � - - " -- DEPARTMENT OF COMMUNITl'&DEVELOPMENT SERVICES ,�-/ 21660 E.Copley Drive Suite 190 ��� '� (909)860-3195Fax(909)861-3117 PRESS '���. � BUILDING PERMIT APPLICATION � . �FIRMLY JOBSITE � �y - APPLICATION � PERMR / o ADDRESS2��j � y�/v G� DATE NUMBER N� ��� � , ISSUE TYPE � OCC APN LOT TRACT DATE • CONST. '� GROUP g OWNER R"n Ti4���' /�.✓ /.'f�E'S'a✓ . , .. . ADDRESSZ-�/?f2 R161�✓ L'T ZONING SETBACKS % W ciTvD.�.�o�n /42 ziP q� _b'6 - 'fq FRorir `Rw ❑ � APPLICANTl.n/. �an/r �' n� S �. REAR ❑ � � r'�� SIDE/SIDE STREET FiW O CONTRACTOI�� � r q oo/ � 4f SIDE O ADDRESS 7/0_ t5.Gro� rC-✓A�'c�- S�ou. . � CffY!(,�rrTCnv•.v4 IP TEL�Z6' ?1L o/ PROPOSEDUSE'_C.�� 5,�9 o ARCH/ENG/ � � DESIGNER S�� �n a'nCv✓ NO.DWEL NO. NO. ADDRESS UNITS STDRIES BEOROOMS � CITY ZIP TEIE2l'-,T7Z-1'0�� � DESCRIPTION S0.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDEF DECUIFiATION SFR/ADDlREM O p 1 HEPEBV AFFUW UNDER OEWLLTY OF VEiL1URY THAT 1 AA1 EXEAIPT FROIA THE CDHTMCT00.5 L4 Garaga�Carport W CENSEUWFOiiT11EFOLL0'MiNOHFA+ON(SEG7071.68USWE55/�NDVNOFESSiONSCOOE:ANVCrtYOR (f) � COUHfYN4fpiRE0URE5AGERIARTOCONSTRUCT,ALTER�PA�.DEUOL'SKONREVAINANYSTRUb W PatiolDeck . NRE,Vfip11 TO ffS IS.+I`1�NCE,ALSO 11EOUYlE3 THE APPLICANT FOR SUCH PERNIT TO FILE A SIGNED w � STAiFMENT 7HA7 ME OR SNE IS LICENSED PUi15UANT TO 7HE PROVISqN3 OF TME CONTMCTOR9 U• / COlBE UW(QU7TER�(COMMENCiNO N77N SECTION 7aao)OF DIVISiON]OF iME BVSINE55 AMJ PRO• V" Poo�Da FE5910N5 COD�OR7HAT NE OR SME IS E7fE4PT 7HEREFROM INIU TME BASIS FOR 7HE/�LLEOED EIIEMP- TION.AMINOL/RIDNOFSECTI�N7m1.6B`/ANYMPLIGNifdiAVERMITSUBJECTSTHEMPLICJWTTO Z Ra-Roaf � A CIVR CEWLLTY OF NDT MORE Tl1AN i7VE MINOREO DOLU0.5 lfGO�)} I Ol�4�MEROFTHEPROPENTV.ORMVE4PLOVFE5WI7HWAGESASTHEIR50LECOAIDENSATqN, 0 (`,pmm0fCl�l yMlypp 7F1E Wp{11C AW THE STRUCNRf t5 MOT�MEIDED OR OFFERED iOR SALE(SEG 7at,BUSi- J NE53 N�U FRDF�ESSIOHS COOE TME CONTRAGTOR9 LICENSE UW DOES NOT�PPLY TO AN OwNER OF N i110PERTYIM�OBUlD90RwIPROYESTIEREON,ANDY/1K700E55UpIWORKNIMSELFORMEHSELFOR � � iXi10U0HH190RHEHOWNEI�PLOYEES,VROWDEDTHATSUGIMPROVEMENi511HENOTMENOEDOR m �1 .OFiEiim�OR SALE li 110MIEVE0.711E BULdN00N W PROVEIAQlf IS SOLD WRNN ONE YEAROFCOMPLE- Z •TION,T11E OWMER-BURDER WILL HI.VE THE BUitlEN OF PROVIHa THAT HE di 6XE DD NOT BURD OR ! � MPAD'VE FOR T1E PURPOSE OF BALEi O l A90NT1ER OF THE VROOEirtY,N.1 E%CLUSNELY COMMC771M VYITH LICENSED COHTMCTOfLS 7p WNSTAUCT THE Vf10UECT(SEG 7DK BUSiNE55 AND PROFES910N4 OODE:TNE CONTMCTCN75 L4 Vatuatlo � ADJ.AREA „ CEN9EUWDOE9NOTAPPl7TO/WOWNEROFAPROPEHTYm10BUttD50RMPROYE3Tf1EREON.AND �L 1MqCOMMGT9FORSUCHVROJECiSYA7HACOHTMCfOH(S�UCENSEDPUHSU�WTTOTMECONTRAG QUANTITY DESCRIPTION FEE �'� foriauccrsEuw4 ..J "" � O I MI E)(E�'i UNDE11 SEQ B.d P.G iON THIS PEASON 4 ' . .� 3 � a u' OATE OK'NEiI • w .,� \ � � LICENSEDCOMRACTORSDECIARATION W 1, ;,� •, t"� OC IHEREBYAFFVMAIRDEi1VENAL7YOfPERR1HYTHATIAMLICENSEDUNDER7ROVi5lON50FCNAv7ER � Ur �.� \�� s �(W4wENCNOYVIT115EGTiON7o0o)OFDM510N70FTHEBUSINESSIWOPROFESSiON5C00E,AN0 Z • X MY LICENSE IS N iULL FORCE ANO EFFECT. m D' L1J � o ucer+se cuss uc.No. /d s/D z � �� � U !_�� w� �-/�-00 corrra�cro�'Ft/. /'oo/s �'Si � ' WORKERS'COMPENSATION DECLAFtATION � U ' � � � ��� � rINERE9VAFiIRAIUNDERVENALIYOFVERAIMONEOFiHEFOLLOWIN4DCCLAfiAT10NS: � �� � � -. Z Q � �INAVEMAYALLWUNTANACERTIFICATEOFCONSEMTOSEIF•INSUflEFORKGRKERS' S ' .. • �� � .. � � COMPENSATION.ASPiiOVDE�BY6ECi10NJ1000FTNELABOHCOOE,FORiHEPERFOMINICE� w _ OFTNEWORKFOiiNM1ACNTWSVER/AITL9155UED. � � . � , _IHAVE FND WILLIMRITAW WORKERS'GOMPENSAT70N PISUMNCE.AS REWIRED BY SCCTqN Q 77000FTMEU80RCOOE,FOR7HEPERWRMANCEOFTHEWOFlKiORWHiCMiM13iERw1T15' _ . C!G 65UEO.WWORKE0.SCdAPENSATIONWSURANCECA�iPoERMlDGOLICYNUAI�£RAR[:��.` � CONSTRUCTION � .• � LlGCO�L .�� PUW REVIEW � � CMRIER � . . .. ZP0.�CYN� co G//� '� �-- O�i •..' ELECTRIC .. ,. � _ 4 � W (nss[crcNtiiEnwisEooralEimoF7FEVEa�rrsw�ta€�arartEnoawsR�o�an�fssl .PLUMBING Z IGEifTIFYTW�TINiH[PERFOpMANCEOFTHEWORKFORN71IpITN15GEiWiTI5t55UE�.1 MECHANICAL nnfl 3 �—C�J (,7 SMILLLNOTEMPLOYANYPERSONINAFtYMMMERSOASTOBECOMESU8IECTTOTHE , N riORKEAS'COAIPENSATIONUWSOFGLL�FORNIAMIDAGREETHATIFISIIOlADBELOME INSPECTIONFEE •,_i{y e '�� S SIAJECTTOTHEWOWCERSCW7EN5ATqNPROVI510N50FSECTqN77000FTMElABOR �SSUANCE , r •�� coo�i sru�u coan�vhn�eoua�r wm�nase varnns�ons./� 0 0��:�`�3'OS�AFPLICIWT. ��G_� �O(�OuJI^� •SMIP,- �.;1� _ �Tr�S � WARNINO:FAIURETOSEWREWONKERS'COMPENSATIONCOVEMGEISUNUwFUL,ANDSHALLBE � � ENERGYP/C . _���I j—y SUBJECfANEUPIOYERTOCHMPIALPENALTIESANDCMLFINESUPTOONEMINDRFDTFqU5.W0 �ENERGYPERMIT, � pOLLMS(tt 00,000),N ADDITION TO TME COST OF WMPENSATION.DAMAGES AS VROVOED FOR R! ¢ SECT10N770EOF7HEU80RCOOE.NTEREST,ANOATTORNEY'SLEES ` RETEN'fIONFEE: a CONSTHUCTION LENDING AGENCY PRE-AlT FEE: � � O � IHERFBYALFIMIUNDERPEN/�LTYOFPEM1RIMTHATTH[RELSACONSTRUCTIONIENDNlQAGENCY FOq TNE OER W(SMANCE OF 1ME WOFK FOR WNICH iH15 VER4IT IS ISSUEU(SEG 70a7,CN.C.} � � IENDER'S N�YE C LENDERSIIDDRESS � 1 WICERTIFYTIATIMAYEREADiM5AP7L1C.�TIONAN�STATEh1ATT1EABOVENfORMATIONISCORRECT. TOTAL FEES Q � IAQHEETOCOr.�PLYWITNALLGRY/VlOCOIMfYONDPUNCESANOSTATEUWSPELATINOTOBUlDINO � � LONSTRUCiq/1 AND HENEBY AllflqfilZE NEPRESENTATIVES OF TW S COUN7Y TO EMEH UPON THE S� ABOVE�MEMqNEOPROPERTfFORR15PECfIDNVUAPOSES COMMENTS 9 ��J t/ +�r�nGlJ�/ m PEFI�RT M�E P /�/w `f�� �p � _!���/ G�.'C� J /J�U'� . Cn �/J bqNA7UftEOFPERMITTEE OA7E � R[CPT.NO. PA1D BY VALIDATION WMITE—Department Copy.YELLOW--Flnenee Copy,PINK—�As»ssor Copy.GOLDENRO�Fde Copy,GREEtJ—�Applieanfs Copy " � . ; . . , . .� . . . . .. . , . • � , . w'. . . ' ' . � -i�., . , .. . .. . . ,. ,. . ..,y. �..,..1r ,r.. ... • . . ,�__ CITY OF DIAMOND,BAR �,� ;.� .-. . � , ; ; �'\�� ` `� � .`...;. �INSPECTION'RECORD �' ':. . � . "� � . , � � � I , ,�., . '�' . - � , ��1`��i�='�.c����.1���,a� .. J���,��:�1C�K7. .�'�.�,IL,. � _ !,I ,�► - - D ����� : :�1�.��.�.f���'�r.L iSET BACK. - = '..�� '��: ��p .,� FLOOR JOIST ;.�. . - : -- ;FTGS/FORb�1S/STEEL � . • FHA REQMTS---- - - -- - - - - -- - --- ' �ELECTRIC GROUND� ����. - -� - - � UNDER FLOOR DUCT; . : .. , - .. - ' _ . ;GROUND PLUMBING I \ ' �'' � � � UNDER FLOOR C�MDUIT '�' - - • ' . .. _ ,._ . .. . ;SLABGRADE - -�� �- � - � " - -�- - . •- � FIFEFL�ACEFOUNDATION � � ' . .. . . .._� , . . .. 'TEMP POWER• � ' .. � „ - • . . �.: ._ ; FIREPLAC�BOND BEAM -: -._' - .. -�----�-� ��- - - - ' -t , - - � � - , , . :. ,, • � , ,WATER SERVICE --�- - . -:- �. - - MiD HT. BOND BEAM ' '-�•. � ;� : - �.. ,.. ' . :ROOF SHEATHING �-- - -- `�- �� "' ' 8 FT. BOND BEAM • • � �. 'FRAP�IINGNENTILIATION FINAL'BOND BEAM _ ' (ROOF COVER..`' . PRE-GRADING � -- � -' ;ROUGH HEATING -- -- -- - - -- - - - - BENCHIPJG'.-�•,, � � ' . , � , :ROUGH ECECTRIC - ; - - - - -- -� -- - � ROUGH GRADING � � iROUGH PLUMBING i -- - � - FINISH GRADING ;SHOWER/TUB TEST -- — - -- �-- - - POOL�ELECTRIC• ' � . - - - -- --- . . ,EXT.LATH/SIDING � � -' � � POOL FENCING . ,�--J�--:�• .�•:�;�;�._�J;G-�.:...:' ; ' ��:. - �WALL INSULATION ! � POOL FINAL . , lQ�o -op � 'CEILING INSULATION� ; OFFSITE IMPS. . - !DRYWALL NAILING DEDICATIONS ' ' '.• �� :SEWER --- - --.--.------ FINAL'ENG. � . -� SEPTIC TANK._.._ _. _ _. .__. .. . . , . . LANDSCAPE/IRRIG. � � ,SEEP P1TlL.L:- ---'= _ • ." `_'' ON SITE IMPS.' . - , ' , - 'GAS AIR TEST- ,-- �.-�,a • ��� � FINAL•ZONING ' ' f :.- • - � -� --.. _ .._ � — �FINAL HEATING " ' � . FIRE DEPT. F1NAL , A 5 . J � . - -� � � � � HEl�.LTH DEPT. FINAL_ . � .,� �FINAL ELECTRIC-- - - � " - � DEV. FEES PAID - - - - � � ;FINAL PLUh181NG a �. I1 � ENERGY . - . - . . � , , +� , , ' • � � � � � ; cfa-rs �)-:��r-�a:. . 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(-OO ��.�Os1s�s-�• � ' ,. , - . .- - .: '�C� � , 'SEPTIC TANK SIZE " ' � � (SEEP PIT/U SIZE - �:�,� • � � ,. .. . � . , ' __�..__.. . , ' - } r+„i�r� + � ' • - --�- � - - � -� - • 'j ( � � ' . . . � i 7 �• � -• - - - � • + . . .. �i �� : j' ` . . .. _ . ._ ' . . ._ • � . .. . ._. . . . _ � � . , _.. ���jr�p . . . � � � : _�. .�; � i , . . � � �- -•.�� " -� -��- � �- - . . � _! � _- . � .. . . i . �i " � � , �. . . .. . . . .. . . , � 1 .1� , � i _ . ' � . _"'_" '" _" ' . .. .. . � _. .. . . . . _. . - I I ,,.. _��\ ., , .`.._ .... . �� ..1 . _ '_' i I .. l: - . ' __ _ .. . , ; . . . . , • . ` . ,. ;. _