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HomeMy WebLinkAbout11299 -�--��� CTfY OF DIAMOND BAR COh7MUNITY DEVELOPMENT DEPARTMENT '�:,.� 21660E.CopleyDriveSuite190 PRESS - (909)860-3195 Fax(909)861-3117 '��'� BUILDINGPERMITAPPLICATION FIRMLY , � JOBSITE 1 APPLICATION 2 ��J Cr PERMIT � P/C o ADDRESS ' � DATE � NUMBER # c� ISSUE TYPE OCC . APN-�LOT� _ TRACT DATE CONST. GROUP � OWNER R/� .v-� ' - O o ADDRESS ZONING SETBACKS o CfTY� Z P TE �� q REAA Rw ❑ o APPLICANT I "�"'� TEL. � � SIDE/SIDE STREET RW T ❑ � CONTRACTOR �'r. . _ n ���F7D SIDE ❑ Q ADDRESS ���L- ° PROPOSED USE � CITY ZIP TEL o ARCH/ENG/ . w DESIGNER NO.DWEL. NO. NO. a ADDFESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER•BI:ILDER DECLARATION - SFR/ADD,'REM O p 1 HEREBV AFFlRM UNOER PENALTY OF VERAIRV THAT I AA1 E%EMPT fROu THE CONTRAGTONS LL G2f8g8/C8�p0A W CENSEUWFOFTMEGOLLOWINGREMq!(SEG70J1.SBUSINESSIWDPPAFESSIONSCODE:ANVqTYOq (n U CpUNTYWWp1RE0UIRESAPERMI7TOCONSiRUGT,ALTER,IMPFlOVE,DEMOLISH,ORREPAIRANYSTRUC•� w patio/Dock � W TURE.PRqR TO ITS iSSUANCE,AL50 REWIqES TME APPLIWW7 FOH SUCM PERMIT TO FILE A SIGNED � STATEMENT THAT HE OH SHE IS LICENSED PURSUAN7 TO TME FHDVISiONS OF TME CONTMG70R5 l4 .. . � CENSE UW(a1APTER i(COMMENqNG WITH SECTION 7000)OF DIN510N]Of THE BUSINE55 M7�iR0• � PootlSpa FESSiONS CODE)OR iHA7 HE OR SME IS E%EIAP7 THEREFRORI AND THE BASIS FOR THE�LLEG[D E%EAIP• VTION.ANVVIOIAiIONOFSECTION70]1.SBVA4VA7PLICAN7FORAOEFYITSUQIECTSiHEAPVUCAMTO z Re�Roof A CML DENALN OF NOT MORE THAN FIVE MUNDRED DOLLARS(5500).): Z04�4�EROFTHEPROPERTY,ORMYEMMOYEESWITHWAGESASTHEIRSOLECOIAPENSATION, O COf11RIBfCISI � WILI DO THE WORK,ANO TM[STRUCTURE IS NOT IMENDED OR OFFERED FOR SlLLE(SEC.7M�.BU51• J NESS AND PROFESSIONS CA�E:THE GONTRACTORS LIGENSE UW OOES NOT AVPLY TO IN OWNER OF N VROPERTYNRi08UILDSORIMPROVESTHEREON.ANDWHODOE55UCHWORNHIMSELFORMERSELFOR = [t TNROIKHMSMMERONTJEMPLOVEES.PROVIDEDTHATSUCHMPROVEMEMSANENOTNTENDEDOR m .. w OiFEREDFORSALE.IF,HOWEVE0.TME8UlA1N�OR1IIPPOVEMENTI550LDWITHMdJEYEAROFCDuvLE• � T10N,THE GWNER�BUILDER WILL WIVE TME BURDEN OF PROVINO THAT HE OR SHE DID NOT BNID OR . � YAPROVE FORTHE PURPOSE OF SALEJ. � � -• � ' •' O 4 AS OWNER OF TME PROPERTY,AM EXCLUSNELY CONTMGTMG VATN LICENSED CONTMGTOFS � Q TO OONSiHUCT TME PHOJECf(SEG 70��,BUSINESS AND PROFESSIONS CADE:7ME CONTMCTORS LI• Va1U8110f1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOVMEHOFAPROPERTYNRIOBUILDSOHMPROVESTHEREON,AND � � Nn/OCOMRACTSFOHSIKNDRdIECT5YA7HACONTRACTOR(S�IICENSEDPURSUANTTOTHEWNTRAG OUAMITY DESCRIPTION FEE Y TORS UCENSE Uw). � O I AM E%EMPT UNDER SEC. B.�P.G FOR THIS REASON U � LL �.�.. DATE OWrJEF U �Q LICENSED COPlTRACTORS DECLARATION w . _ Ct IHEREBYAFFIFMUNOERPENr1LTYOFFERIURYTMAT1AMlICENSEDUNDERPROVIS10N90FCW1PTER Vr _p i 1 d, Y(COMMLNCINGWIiHSECTIDN700U)OFDIVISION]OFTHEBUSINESSNiDVROFESSpNSCODE,AND Z LW � `X 4Y UCENSE IS IN FIILL FORC vD EFFECL . n7 ♦��:,' � ' � LIGENSE SS IIC.NO. � j , . V DAh 1 � �CONTRACTDfI a W � WORKERS'COMPENSATION DECLAAATION a • - = U � I NEREBY�FFIRM UN�ER PENALTY OF CE0.RIRY ONE OF THE FOLL0IMNG OELUM7qN5: � "-' a � _IHAVEANDWILLMAINTNNACERTIFICATEOFCANSENTTOSELFaNSUREFONMIORNERS' 2 . CdAPENSATqN,AS PROV�OED BY SECTION]7o00F THE UDOR CODE,FORTIE VERFO{UTANCE U � OF T1E WORK FOR WHICH TMIS FEp�1T IS ISSUED. , . � � - - • , • . . , 0 �/� W • 1 HAVE AND WILL MAINTAIN WORKER5 COMPENSATION INSURANCE,AS REQUIRED BY SECTION 4 �7oo0FTHEUBORCODE,FONTHEDERFOR4ANCEOFTHEWORKiORWHif31TMISGERAlIT15 � ISSUED.MY �1KER'CO -NSATqN INSURANCE CARRIER MA POIICV NUMBEA ARE: CONSTRUCTION � 4 � CARRIER � � �v� - C�l.-i D PLANREVIEW Z vaicrNuraeen ,z ��- ELECTRIC �—r-r�v-�'�• Q 0 (f}iSSECIKNNEmNOTBE00Np.E'fEDOFMPEPMTBK(iOhEHI.t�Q7FDDOl1AR5(S�Oc)CQLESSI `P--�- B�N� � w �n _ � Z 1 CERTIFYTHAT IN 1HE PERFORMANCE DF THE N'DNK FOR WH1CH iMiS PERMIT IS ISSUED.I 'IMt ANICAL L} SHALLNOTEMPLOYANYFERSONINANYIAMINERSOASTOBECAMESUFfJECTTOTHE . . _ y MIORNERS'CO�APENSA7qNUw50FG1LIFORNI0.�NDAGREE7HATIFIS/DULDBECOME INSPECTIONFEE SU[iJECT TO T11E WORKEiiS'COI.IPENSATqN VROY�(ISiONS OF SECTqN 770o OF iME IABOii Qcoo^,i-�nicaav�rwinitra�ROVISIONS���� ISSUANCE �� , DATE: APPLICANL � SMIP � W�ANIN6:FALURETOSEWREWORKERS'COMPENSATIONCOVEMGEISUNUWFUL./�NDSNALLBE ENERGYP/C � SURIEGT�NEMPLOYEHTOCRiMINN.PENALTIESANDGIVILFiNE3UPTOONEHUNOREDiNWSAND ENERGYPERMIT DOlURS(5100.D00�N►DDITION TO TME COST OF COMPENSATqN,DAMAGES!l5 PROVIDED FOR IN � SECTION 770!OFTHE IABOR CODE.WTEREST.ANDATTORNEYS FEES. RETENTION FEE: ' a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � 1 HEREBV AFFIRM UNDER PENALTY OF PE0.NRY THAT TMERE IS A LONSTRUC7ION LENDING AGENCY FOR THE PERFORMANCE OF iME WORN FOR WHICN THIS PEM�IT IS ISSUED(SEC.70Y7,CIV.C.). Z W � LENDER'S NAME F— LENDER'SADDRESS ¢ ICfRTtiYiHATINAVEREADTHISAPPLIGTqNANDSTATET�UTTME�BOVEINFORMATqNISCORRECT. TOTAL FEES � w IACREETOC/JMPLYWIrr1ALLCRYANDOIXINTYOR0INANCESANDSTATEUN'SREUTINCTOBUILDING ' � CONSTFUCiION, YD HEREBY AUi110R2E REVRESEN7ATIVES DF THIS CWNTY TO EMERUPON THE ZABOVE-MEN N GROVERTYFORI PECT vuaroscs. . . . COMMENTS .'.� � . � , .N PERMITTEENAME(PRINT) Y� ` � �� � � '�, SIGNATVHEOFVEPAIITTEE OATE _ � RECPT.NO. PPJD BY VALIDATION ` �' WHITE-0epartment Copy,YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENRO�File Copy,GFEEN—Applicant's Copy , . . ,, , . ....._.... �....., . . : .., t... ..,... .. ... . . . . .- ,�..� ,•. � ' `'ti '��•, CITY.OF DIAMOND. BlaR � ;.�: �:.., �. , . , � � �� '� INSPECTION RECORD� ... __J . • . • ' � e 1� Q ' ���:.An I LI i�if?�:J'Y� O � '+ • ! • SET BACK ' � _: � � FLOOR JOIST, , � � � � ' " - � � __. FTGSlFORMS/STEEL � ' FHA REQMTS` � , ; = - ' - ' ' � � -' ELECTRIC GROUND �. . UNDER FLOOR DU�T,� , � � ��' -- . .- ; - . _ . .. ... , GR�UND PLUMBING � � - - -- UNOE�R FLObR COtJDUIT�.' '__: ' � � •�`.' '� ' ' .,. �_._ ... .__.. SLAB GRADE -- � ` -- - ' " � FIRERLACE.FOUNDATION ":" -� � � �' ' TEMP POWER - � - -= •--= = - - = - =- FIREPLACE BOND BEAM''= � ' ' ' _ ._. . . ,�-=; .. . . WATER SERVICE- =- '- .. _ -. . . . - ' . MID HT.BOND BEAM - - ' � ROOF SHEATHING E3 FT.BOND BEAM �:�^ � � � FRAMINGNENTILIATION `.� ' ' FINAL BOND BEAM - � ' � : . ROOF COVER - PRE-GRADING ... . - -. .._...--- -. .. . ..._ ; - . , . _ �, .,,...., — - - _ ._.. . . - � , ROUGH HEATiNG --; -- ' --- :. _ : _ . : : ..- =�- BENCHING - - - -- -- - -- ROUGN ELEC7RIC-'- � - --- - � i. - � - ROUGH.GRADING . � �.� ROUGH PLUMBING ' --- � -- " - --- �-- � � - FINISH GRADING SHOWERlTUB TEST � -- -- - � : - - - . POOL ELECTRIC s � EXT.LATH/SIDING � : - . POOL'FENCING ' � ' ' WALL INSULATION � POOL FINAL . ' CEILING INSULATION OFF SITE IMPS.: DRYWALL NAILING � DEDICATIONS ' ! SEWER __......_.. . _ _ -2.� FINAL'ENG. � SEPTIC TANK-.=, _ . ' __ ` LANOSCAPE/IRRIG. • • ' ; � SEEP PIT/L.L.. _. ... . _._ ... __. .__' _ ' ON SITE IMPS. " ' , : GAS AIR TEST' - - - .- - ---- . . ' _ . _FINAC ZONING • - .. � FINAL CONST. : � � - � ----- ; - -- FIRE DEPT.FWAI , .., FINAL-HEATING - - �- �- --� - - �- � : HEALTH DEPT. FINAL�� . - - - - ------ -- - . . . , . , .. FINAL ELECTRIC " 1 ':--...'- � "'� �- • ; DEV. FEES PAID . . . , , = FINAL PLUMBING ' - �� _ . ENERGY ;. ; .:- • � • . , � � , Me � k,a s .�.:.:.. . . . . . . . __......-- - - • - - -- - ; . . .. _ . . ..- - -- ... __ _ ... . . -.� i �: , _ . .__.... __. ..,. _ ; _ COMMENTS � .:: }`��.� , . � 6 �G/s� g.�.,.� �� � m,� - � - • ' .} . �,f . . . . . . _ . . . . .., , , ._ , • �; _ _ . .. . � . . . . .y � � ' . • , �l. ' /. .�i . . � -. . . . .. . . . ' � .i � . "' ` ` { t �• �1 ..� . .. , . 1. 1 ' � � { � 1 � k 1 I I • . . .. .. .. . . ' ' . _ I _ . . _.." "'_ ". .. . . . . .. . . .... . . . � . . . . . 1 � - �! l�lr___s�� , � �- 4...t � \i _ ,t _ _�.' � .. J : ., . . . ' � - . . . . SEPTIC TANK SIZE - � ' � SEEP PIT/U SIZE � � � , _ . .. .. . . _ . . .. . ;.., . , . .. _._... - - .. .._...., i . : . . - �� � � , �j , . . -����_ �, ; .; - _. , � �� � � 8 � . , � - --:, :_._----::_. '_ ` :. ..:_.. _ _! : .. . .. . .. .�. . , . � . .. .__. . _... . . _._.i�� � 4