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__ �___.�___... .. .. _._._ . . - -- .._- -- -. ---��--• CITY OF DIAMOND BAR • • n � COMMUNITY DCV$LOPh1ENT DEPARTMENT 21660 E.Copley Drive Suite 190 ' �. PRESS (909)860-3195 Fax(909)861-3117 "'` BUILDING PERD9IT APPLICATION FI R M LY � JOBSITE N I APPLICATION , �� � PERMIT � C p AbDRESS DATE NUMBER q ISSUE TYPE OCC � APN LOT TRACT ��J g S�I DATE CONST. GROUP p OWNER r M o ADDR�F$� 34��0 �/'�Y'1/'�� • . ZONING SETDACKS z CITY ��1f�1rLlMCJt� ZIP�IO�TEL�� S'�FD39�� FRONT RW p � APPLICANT TEL. REAR ❑ � SIDFJSIDE STREET RW ❑ z Q CONTRACTOR L � SIDE ❑ � AD�RESS _("��'• � CITY ZIP�jl1]� TEL�^GVSS PROPOSED USE o ARCHlENG/ iz DESIGNER NO.ONlEL. NO. NO. a'�. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � �n DESCRIPTION S0.F7 FACTOR PSF ADJ.AREANALUATION � OWNER•BI:ILDER DECLARATION SFRlADDlREM O ' p 1 MEREBY AFFlPM UNDER PENALTY OF PERJURY THAT I MI EXEMPT iROM THE CONTHACTORS LI• Gyfega/COrpOf1 � W CENSEUWFORTNEFOIIOWINCREA50N(SEC.70af.bBUSINESSANDVRpFESSIONSCODE:ANVCT'OR (n U ��./n'WIIICHREWIRESAPERMITTpLONSTfiULT,ALTER,lA1PROYE,DEMOLISH,ORREPAIRAWSiflUC• W Patio/Dnck W Tl1qE,GRiOR TO RS�SSUANCE,ALSO RCd11RE5 THE 1�PLIGNT FOR SUCH PERMIT 70 FILE A SIGNED w STATEMENT THAT HE OH SHE IS LILENSED PUfiSUANT TO THE FROVISiONS OF iHE CONTRAC70RS LI• S CENSE UW�Cl1�PiER Y(COMMENCINa WITM SECTION 7000�OF O�VISION 7 OF TME BUSINE55 M!D Pp0• � P�USpd � � . FESSqNSCOOE�ORTHATHEORSHEISEXEMPTTNEREfROMANDTIIEBASISFOR1NEAlLEGCDE%EMP• (� � TqN.ANYV10tATIONOFSECT10N70]1.SBYANV�PPLICANTFORAGERMITSU0.IECTSiHE�PPLiGNTTO Z Re•Roaf . A CML PENALTY OF NOT MOR[THAN FlVE Hl1NDRED DOLLAHS(f50o�.�: j �. OlA50WNEROFTHEPROPEflTY,ORMVEMP�OVEESWITHWACE5A57NEIR50lECOMPENSATION, � (,`pTI11BfC131 ' WILL DO THE WORK AND TME STRVCTURE IS NOi INTEN'JED OR OFFERED FOR SAIE ISEG 7W�,BUSI• J N NESS AND PROFESStONS CODE:THE CONfMCTORS LICENSE LAW DOFS NOT AV�LV TO A.4 OWNER OF ? PROPERiY 1NM0 BUILDS OA OAPROYES THEREON,pfrD MMO DOES SUCH WORK HIMSELF OR NERSEIF OR [[ TNROUGHHISORMEROYNEAAPLOY�ES,DHOVIOEO7HATSl1CHWPROVE4ENi5ARENOTW7ENDEDOR CD . 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D LIC.NO.y54�Z Z � V DATE��CONTRACTOR��+ � � W � WORKERS'COMPENSATION DECLARATION Q � INEREBYAFFIRMUNDERPENALTYOFVEH.IURYONEOFTHEFOLLOVfNGDECUHATIONS: Z � _IHAVEANDWIIL►IAINTAINACERTIFICATEOFCONSEMTOSELF.INSUREFOf1V/OHNERS' a 2 WMPENSATqN,ASiROVIDEDBY5ECT10N7f0oOFTHEUBOHCODE.FORTHEGERFOqMANCE W Q OF TXE WORK FOR WHICH iN15 DE�iT IS ISSUED. � W _IHAVEANDN'ILLM.4NTAMWON(ERS'COUPEN5A7iONINSURANCE,ASPEOUiREDBYSEC710N Q 77ooOFilfEU80RCADE.FOR7HEPERFORMANCEOFTHEWORKFORWH�CH7HI5PERMITIS ISSUED.IAYWORKERS'COMPEiSATIONINSUiUNCECA 71ERANDPOLICYNUTA�ERARE: CONSTRUCT�ON ' ¢ .�-� � d � GRRIER L �1' PLAN REVIEW Z GOLICV M1IABER 2�CI^'� ,_ � LECTRIC - . . . . Q � �� �(nossEcna�r�mr+o�ree�er¢ocFnEvoYwrs�aa�000tuns�s�ro�on�ss} LUMBING z ICER7IFYTHA7INTHEPERFORMANCEOFTHEWONKFORWHiCNTHISiERMITI515SUE0.1 MECHANICAL (� SHALLNOTEUPLOVANYDERSONN�UIYAAANNERSOA5TO8ECOA1E5U[iJECTTOTHE ' (n 1NOFMERS'CAMPENSATIONUWSOFCA�IFOF{NiAANOAGREETHATIFI51KK1LD0ECOME INSPECTIONFEE � � � � SUBJECTTOTHEWONKERS'COMPENSAiIONPRON510N50F5FCTION77000FTHEUBOR �, ,�) � CADf,ISkLLLLFONhM1YITMCOMPLYWITHTMOSEPROV1510N5. ISSUANCE p: 'DATE: APPUCANP. . . . SMIP ^t1b�► ' ~. W •� WARNM�;FAILURLTOSECUREWORNERS'CAMPENSATION�OYEMGEISUNLAWFUL,ANDSWV.LBE ENERGYP/C ^ �y SU(iJEC�ANEMVLOYERTOCRIMINALPENALTIESANDCMLFWESUPTOpKEHUNDRE01HOU5MID ENEHGYPEFiMIT __I�`_��_���1�� DOLLARS(Stao,aaD),pl ADDITION TO iME COST OF C0IAPENSATION,�AMAGES AS PHOViDED FOq IN � SLCTION07a80FiHEU00RO0DE,W7ERE5T,ANDATfORNEY5FEE5. � RETENTIONFEE: I � . ���� OCONSTRUCTION LENDING AGENCY PFlE-ALT FEE: � I HEftEBYAFFiRM UN�ER PENALTY OF DERIUqY iHAi MEF[IS ACONSTRUCTION LENOING 11GENCY FOR 7XE 7ERFORrAu:CE OF THE YiORK iOR WHip1 THIS VERuIi IS t55UED(SEC.0097,CIV.C.). Z _. . . , W � LEN�ER�SNAME F-� lENOER'SAODRE55 � � � ¢ ICERTIFYT/UTIMAVEREADTHISAPPLICATqNANDSTATETUTTHEABOVEWFORlAATIONISCORRECT. TOTALFEES W IACREETOCOMPLYWITi1A��CfTYANDCOVNTYOR0INANCESAN�$TATEUWSREUTINGTOBUILDING ' ' ► . d � CONS7RUC710N,ANDHEREBYAUTFqiiIZEREPRESENTATIVE50FTHI5COUNTYTOEMERl1PONTHE . � Z ABOVE�AIENTqNEDPROPERT/FORINSPEGTIONVUFiPOSES. � . COMMENTS � f� IM.C.b L.- Q O�� . � PERMIT7EE [(PRINT) � � Q � �_ N SiG � H r FERMiTTEE DAT " - � ' RECPT.NO. FAID BY VALIOATION v � WHITE—DeDartment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy.GREEN—ApplicanYs Copy j .. . .. ...f. . .. . . . . . . .� .. �. . ,.. � . ' . .«..a . ' .. .: .�/� � .I'� •1?' . �.. . •. . .. .,. . � . •� � �' .. �. . .'1^.� .. ,.i CITY.OF DIAMOND.BAR „' , �,�, � ' . " � • INSPECTION RECORD , � ; � � . , � . . � • . � � •��- ,o F 1��• � � � • - SET BACK ' ' . FLOOR JOIST;_;. . . , ,- -�- - � - -- • FTGS/FORMS/STEEL ' FHA RE�MTS ' `' ' ' ' ' ELECTRIC GROUND UNDER FLOOR.DUCT : . :�. i, •;�, -' '1 i'- , u � . ' GROUND PLUMBING - • UNDER FLOOR'CO�IDUIT ��_ :�� ' '�'--" � , .�! , SLAB GRADE •' FIREPLACE FOUNDATION. ' � TEMP POWER - � FIREPLACE BOND BEAM . ' ' �• ' ' ` '" ' _ .. �• WATER SERVICE - • - - MID HT."BOND,BEAM. - �-,', .-' �� " �' ROOF SHEATHING 8 FT.BOND BEAM � FRAMINGNENTILIATION � ' FINAL BOND BEAM - � - - � ROOF COVER - -- -- - PRE-GRADING _ _ ROUGH HEATING � - � BENCHING � - � - - - � ROUGH ELECTRIC - - ' - ROUGH GRADING .. � ROUGH PLUMBING - - - -- FINISH GRADING . ; ,. SHOWER/TUBTEST ' - -- � POOL'ELECTRIC EXT.LATH/SIDING � POOL FENCING WALL INSULATION � POOL FINAL CEILING INSULATION OFF SITE IMPS. ' DRYWALL NAILING DEDICATIONS ' SEWER _ , _ FINAL�ENG. SEPTIC TANK L'ANDSCAPE/IRRIG. SEEP PIT/L.L. -- _ ON'SITE IMPS. GAS AIR TEST � - - ' � - - ' — `" �� FINAL'Z�NING � FINAL CONST. - -- - - - • ' • -- i FIRE DEPT.FINAL , FINAL HEATING - � - �" i � ` - �+ HEALTH DEPT. FINAL . - � - - - - - . FINAL ELEC7RIC_,: ,, ' � — --- � DEV. FEES PAID . , FINAL PLUMBING . ' ENERGY ' = _. � � �� -- . ti� - �;e • . . . , ._ , ---- - . . _ . _ ...._. . . COMMENTS ' � �� . , . ,:, . _ _ _ .... .- -- - - . � . . - -. . _ . _ . _. , ' _ i:� �-T f',•. '• - , , . . . � .. . _._.� ... ; . • _ .. � _. � . , . _ �� _, i j i ' f"^ , - - � , __.. . . _.. . _ . � , , f� , SEPTIC TANK SIZE ` � � - � _.. __. .. --- � � . ; . SEEP PIT/U SIZE - . . , , ; -- _ _. _-- - � . . - � �... - . ,�;- , . _.. �, �� r , . (' ` 1 ' ' , , 1'\ 1 ' _'�... .-; -, , ' � .. , , ,.' . �, � - - �, _ . . „ � � ,,