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HomeMy WebLinkAbout11204 � - C1TY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTh1ENT �i� �,. ' 21660 E.Copley Drive Suite 190 ' . /� PRESS (909)860-3195 Fax(909)861•3117 ""' BUILDING PERMIT APPLICATION ( FIRMLY � JOBSRE �/ � / APPLICATION � r PERMIT 2� P/C o ADDRESS�lll?7/�,����i��//��J1 DATE � NUMBER � ' N ISSUE � APN LOT TRACT L������� DATE �l.'� '���� ONST. GROUP T �� p OWNER � ++ p ADDflE � ��J C.� -�. 20NING SETBACKS W CI���'l>' .(/ ZIP TEL� f5�i'TS�'C� FRONT RW ❑ � I���—�E �!� � REAR O APPLICANT TEL. SIDEISIDESTREET RW O CONTRACTO A n ; , � � - SIDE p � ADDflE�S /�Si��/ ��aAlt/i /�N���r � CITY C'N��vn ��1�7/l' TE � �l'1 GZZS` PROPOSEDUSE o ARCH/ENG/ z� DESIGNER NO.DWEL NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY 21P TEL. cNi� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BL'�LDER DECLARATION SFR/ADDlREM O p I MEREBY 11FFlRM UNDER PENALTY OF VERJURY i11AT I Il.�EXEMPT FHOM iNE CONTMCTORS LI- G31H9B/C81pOR - W CENSEUWFOHiHEFOLIOWNOREASONISEG703f.68U5M[SSANOVPAFESSIONSCODE:ANYGTYOR U COUNiYWHId/REOUIfiESAPERY1T7000NSTRUCT.ALiERM�if10VE.DEMOLISHORREPAIR�M/STRUC• � �''� ��+,�� � NRE.VR�OR TO RS ISSUANCE ALSO REOUIRES THE MVLM�WT FOq SUdI OERAIIT TO iILE A SiGNE� W P81iO/DOtk � _ . 6TATEUEHT 7HATHE OR SME IS UCEN5E0 PURSUANT TO TNE VROVISiC+IS OF TME tCNTRACTORS IL � CENSE Uw(CHAPTE110(COMMENC�NO VATH SECTqN 7ao0)OF DM510N 7 0F THE BUSMESS FNO PR0- ' � PooUSpa � � ' FESSqNSCODE)ORTFIATHEORSXEISE%EMPTTHEREFROMANDTIIEBASISiORTHEALLEOEDEXEAIP• (� TION.IIN'IVIOLATIONOFSECTION7071.68'lANYMPLICAN�fOR11VEWdITSUBJECTSiHEMPLILANiTO Z R9•ROOf A CML iENALTY OF NOT MOHE TlUN FIVE MMDRED DOLLAHS p500�.): � OlA50YMEROFTHEPROPENMORAIYEMPLOYEESWITHWAGESASTHEIRSOIECOAIPENSATqN, ❑ Commercial WILL DO TNE W011K,AND THE STRUC7URE LS NOT IMENOE�OH OFFEFED FOR SALE(SEC.7w,Bt151- J � NESS AND GROFESSiONS CO0E:7HE CONTRRCTORS LICENSE UW DOES NOTAP7LY TO AN OWNER OF ? PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUG1 MqRK HiMSEIF OR NENSELF OR � iHROUGMNI50RHEROVMEMPLOVEES.PRONCEDTHATSUCHWPROYcMENTSARENOTMENDE�OR m w OiFEREDFORSKEIF,/10Y�EYERTI�LBULqN00N11IVROVEMEM15501DYlrtwNONEYEAROFCOMPLE• � 0 TION,TNE OWNER-BUIIDER MALL IUVE THE B1IRDEN OF PHOVWO T11Ai ME OH SNE 010 NOT BUIID Oq Z WPROVEFOFlTHEPURPOSEOFSALE4 ' _ �I,ASOwNEHOFTHEVROPEfiT`/.AMExCW51VELYCONTRACTMOWfTHLICENSEDCONTMCTORS W � TO CONSTRUCT T1E GRO.IECT(SEG 70u,BUSINE55 M10 VHOFESSiONS CODE:TNE CONiRAC70q5 LL Velu81i0f1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOIWOWHEROFAPROPERTYWFIDBURDSORMPHOVESTHEREON.AND � N71000MRACTSFOqSUp/FRO.IECiSVnTHACDNTMCTOR(SJL�CENSEDPUPSUANiTOTNE00N1MC QUANTITY DESCRIPTION FEE � IDRS UCENSE lAw.). . ., � / �^ p� O I IUI E%E4PT UNDEH SEC. 8.l P.C.FOi1 THIS REASON. _ ,� �S•!�� u'—' OATE OWNER �s � " � , �/o . 7S� � UCENSED CONTRACTORS DECLARATION j ✓ '.y✓���2. O _']S � INEREBY�FFIRAIUNOERFENAlTYOiVERNRYMATIIUAUCENSEDUNDERVqOVISIONSOFCNAPTER V. • • / O d Y(CONMENGNO WITN SECTION 700D)OF DMSION�OF THE BUSINESS hN7 VROiE5510NS CODE,AND Z ' 1' 1.1Y LICENSE IS N F11L1 RCE AIJD EFFECT. .� J 0 /� � • m /v � l /! . � � 1--� �py� }�:� LICENSE CUSS LIC.NO. �L � V DATE CONTRAC _�•� �7�•�: d ,7� '' ' . W '� � � WORKERS'COMPENSATION D[CLARATION / S � �:c�.� . - � I NEREBYAFFIfUA UNOER VENALTY Of VERNRY ONE OF T11E FOLIOVnNC DEQAMTIONS:� �� � ' � � �iy-�� ' f�- .+ � _INAVEIWDWILLL/AMTAINAtERTIFICATEOFCONSENTiOSELFJNSUR[FORVqnNE0.5' COMVENSATqN,AS PHOVIDED BY SEGTION 7700 OF TME UBOR COOE.FOR TME PERFORAWICE OF 1HE WORK FOR WMILl1 TMS iERNiT IS ISSUE�. O _I HAVE/W D WILL MAINTNN WORKER4 COAICENSATION INSURANCE,AS RfOUIRED BY SECTION Q J7oo OF TNE LABOR CODE.FOA THE PERFORNANCE OF THE N'ORK FOH WNiCN TNIS PEiU1RIS ISSUEO.MYVVOR ERSCDMPENSATiONINSURMIGECARRIER YOLICYHUMOEflAAE: CONSTRUCTION � ��J-/1 � _�/ei7/l� PLANREVIEW � uAa¢e /�r� � VOIICYNUMBER ,�_� � 7'L/ �' ELECTHIC - � (n�ssccna+r+[mr+orti��maFnf�aKrcror+a+[�ua�000tiinsR��a��css1 PLUMBING J 3 Z ICERTIiYTHATPITHEPERFOHIAANCEOFIHEWORIfFOAWHiCHiH15VEHYRISISSUED.I MECHANICAL � � C7 SN.LLI NOT EIAPLOV ANY OERSON N 1NV W WNER SOIS TO BEODu[SU&IECT TO THE N SNORNERS'COMPENSATIONUU/SOFG4IFORNItiANDAGREETMAiIF15110ULD8EC0�1E INSPECTIONFEE SUBJECiTOTHEWORNERS'C0�.�7ENSAT�ONPROVISIONSOFSECTqN77ooOFTMEUBOR �D� rj cooE,i swu Foarnwin�coe�v�r wirn/np�5,e Prw�nsans./� ./ ISSUANCE -5 p DATE: APPLICaNT: /�/:'.E�C�//%T YI��N SMIP � ENERGY P/C r P A � .,1 WARNiNO;i�LURE i0 SECURE WORKERS'COMPENSATqN COVERAGE IS UNLAVlFU�AND SNALLBE � SUBIECTANEMPLOYENTOCRIYPIALPENALTIESANDCMLFWESUPTOON[MJNDREDTFIWSAND ENERGYPERMIT OOLlARS(S�OD.000).N IDDITpN i0 THE CAST OF COMPENSATICN,DAAUGES AS PRONOED FOR IN � BECTIONf70lOFTNELA80ROOOE,NTEREST,ANDATTORNEYSFEES RETENTIONFEE: a CONSTRUCTION LENDING AGENCY pRE•ALT FEE: ' O � IHER[BVAFFIRUUN�ERCENILLTYOFOEfUURY7IUTTNEREISALONSTRUGTIONIENDWOAGENGY ' Z FOR THE VERFOWAAHCE OF TNE WORN iOR Vv111tli iMIS FERIAITIS ISSUE�(SEC.7007,dV.CJ. W � LENDEiF3 NAME � LENDERSAOORE55 ' ' ' � ICEFtTIfYT11ATIHAVEREADTHISAPPL1CATqNANDSTATETHATTHEIIBOVEWFORVATqNISCORRECT. TOTAL FEES 3 S ��� � �AOREEiOCOYPLVYN7MKLCfttI�NOCOUN7YORDINANCE5ANO5TATEUw5NEU1NOTO8UM1DINO � CONSTRUCi1pyANDNEREBYAUf1qiU2EREDRESENTATIVE50FTNI5COUNTVlOEMTERUPONTXE ,- , ABOVE�NEMqNED VROVER7YFOH INSPEGTION YURPOSES. COMMENTS o ' '✓ y,? � � m VERl1i ENAA1 iNn . .. � Cn � �-�L . . (n 9iUNA OF Y , ' OATE ' � RECPt NO. PAID BY VALIDATION rtment py,YELLOW--Finence Copy,PINK-�lsseeeor Copy,GOLDENROO-file Copy,GREEN-/1pplbanCs Gopy .. ..%�i'F �>'n.':�:, - , �r � . . ...i�: .i'. .?''.F..�.r.1 �.�.^a„� �✓ - " . . - •- . .. � . � . . . ' .. . . . . . . . . . �'?�-�R�' � �. .... . . ' ' . . . � . . i. . . . . - •a�: . . ' i-�`:.� CITY. OF DIAPJi01���6AR .. `. : � � .. �.. . . . � �`� 1NSPECTfC�I` REC�}�D . ., '.:� .. . . . 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ROOF COVER - ------..... .. . .. .... . _.. . .._ ... . _ . PRE-GRADING -- ._�.: .. . -- "� - - - '. ;; � I ' . ROUGH HEATING ---- � ` - - ' BENCHING j ` ROUGH ELECTRIC-� � --- -� ' -- �ROUGH GRADING . : , � '; ROUGH PLUP,ABING-' -- Z�L/fj ;-- � - - FINISH GRADING � � � SHOWER/TUB TEST - - " " - :-� � -� - -- POOI.ELECTRIC ' _ . . i : -- - - -- - - . . PODL' FENCING ' _ EXT.LATH/SIDING-- � - . . : , ' : i s, WALL INSULATION I POOL FINRL � � j �=.` CEILING INSULATION ; ' OFFSITE Ih1PS. � � , j ��� DRYWALL NAILING i DEDICATIQNS ": . ': �. � SEWER -.--.- --.-- ' ' _.. FINAL ENG. ; : SEF.TIC TANK.,:. _ ... _: '.. .'..' .__ LANDSCAPE/IRRIG. � . SEEP PITIL:L:.-- -.- - - ' - ' ON SITE IP�1PS. � - ' GASAfRTEST ; -- -- -- . '. '�:,,.��_� . i`� FIPJAIZONING ' '• � � : FINRLCONST:; ----__. -- - -- • : •`�-�'�_-_-` -� FI EDEPT. FINAL . . � - - � . FINAL HEATING - ----- �� � -- ': '. ,;' - �' HEALTH DEPT.FINAL FINAL ELECTRIC - -- - - �•` � \'� DEV. FEES FAID • ' ,;. . . , FINAL PLUh9BING � � �. 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