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HomeMy WebLinkAbout11442 (5) � _ . . ---�� ---• CITY OF DIAhtOND BAR • � COMMUNITY DEVELOPht6NT DEPARTMENT �� • zi66oe.coP�oy o��es��ce�90 , PRESS � (9D9)8643195 Fax(909)861-3117 ' "^' BUILDING PERhiIT APPLICATION FI R M LY N JOEiSITE ,c� APPLICATI PERMIT 7 P/C oADDRESS �-�O� v�k K�+ol i�r• DATE NUMBER �I�� # c� ISSUE��� TYPE OCC APN LOT TRACT f DATE CONST. GROUP ' p OVINER ?�--C I� ADDRESS�'3�/,g(,�_'�["�r'r_ [iVIL ZONING SETE3ACKS Z CITYT trirLlVl(� 21P�TEL3�Q S`/L►'3�/gfl FRONT RW .❑ � APPLICANT TEL. REAR ❑ � SIDFJ5IDE STREEf RW ❑ � CONTRACTOR L- P1J '(�. sioe o � Q ADDRESS � PROPOSED USE � � CITY ZIPG 17�3 TEL.��l�f"O/S� w ARCH/ENG/ ` �{ w DESIGNER R� l���1�C� �_ 11��Cr NO.DWEL. NO. NO. a ADDRESS "�u�b '�TZ»'rCL�( ��_-- UNITS STORIES �EDROOMS � CITY %t�r✓'M,( cJ� ZIP�B$� TE6�0 tSV3-S'St�f � �ESCRIPTION. SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BI:ILDEA DECLARATION SFRIADD/REM - O p 1 HEREBY AFFIRM UNDER PENILTY OF DERAIRY TMAT I AM EXEMPT FROM iHE CONTMCTOHS U• G8rdg0/COfpOA �� • � ' �` � . � W CENSEUWFORTHEFOLLOWINGREASON�SEC.7071.5BUSINESSJW'JPROFESSIONSCOOE:ANYCITYOR (n � U �OUNTYWNICHREOUIRESAPEPMITTOCONSTFJCT,ALTERIMPROVE,DEiAOLISH.ORNEPA:NMJYSTRUC- W Patio/Deck Z TURE,PRIOfl TO R�ISSUMlCE,�LSO RCGUIRES THE AOp�ICANT FOR SUCH PERMIT TO FlLE A SIG4E� w - � S STATEMENT THA7 HE OR SME IS ULENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTORS ll-' � . � CENSE UW(CHAPTER Y�COMMLNCWG YATi SECTION 7000)OF OIVISION 70F THE BUSINE55 AND PRO- PooUSpa - FESSpNS CODEIOR THAT HE DA SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEOED E%EMP- V TION.ANVVIOUTIONOFSECTION707I.SBVANYAVPLIGWTFORAPERMiTSUBJECTSTHEAPPLICANTTO z Re-Roof � � - � A CML FENALTV OF NOT MORE THAN FNE HUNORED DOLURS�5500)� 0 O(ASOWNEROFiMEPROPERTY,ORMVEMPLOYEESWITHWAGE5A5THEIR50LEC061PENSATION, � COff11TIBICial . Z N'ILl DO THE WORK,AND THE STIiUCTURE IS NOT INTENDED OR OFFEREO FOR SALE(SEC.7a�,BU51- J '- � � NE55 AND GROFESSIONS COOE:TNE CONTRACTORS UCENSL LAW DOES NOT A7PLV TO AN OWNER OF = . PROPEHTY WMO6UlO50HIMPROVESTMEREON,AND WHOOOES SUCH WORKMIMSEIFORMEflSELFOR � THRWGNMISORHEHOWNEMPLDY[ES,�ROVIDE�THATSUp11MPROVEMENTSMENOiPlTEN�EDOR m � OFFEREDFORSALEIF,iIOWEYERiNEBUIIDINGORIMPROVEMENTI550lD1MTHINONEYEAROFGOMP�E- Z TION.7NE OwNEF�eUILDER wRL HAVE TM[BURDEN OF PROVINO TMAT ME OA SHE DID NOi BUILD OR � 0.1PkOVE FOHTXE PURPOSE OF SALE� � ❑4�OWNEROF THE PROPEflTV,AM EXCLUSIVELYCONTRACTWC WITH UCENSED DONTMCTORS � Q TO CONSTRUCT THE iRQIEGT(SEC.70u.BUSINE55 AND PROFESSIONS CODE iME CONiMCTORS U- V81U31iIX1 ADJ.AREA W CENSEUWDOESNOTAPVLYTOANOWNEROFAGROPEflTYWHOBUILD50RIMPROYESTNERLON.AND � WFpCAhTMCTSFOFSUCHPROJECfSWITHAGONTMCTOR(S�LICENSEDPURSUANTTOTMECOHTRAG OUANTITY OESCRIPTION �� � FEE � Y TORS LICENSE UW.1. . ¢ O I AM E%EAIPT UNDER SEC. B.d PC.FOF TNIS REASON U DO �� •P�`� - � �. y� Z DATE OWNER V 2u G ` ' J "' ._Zv � LICENSED CONTRACTORS DECLAFiATION —� � w _ — t .O�l�N � IHEREBVAfFIRMUNDERPEwLLTVOFpER1URYTHA7IAMLICENSEDUNO[RPROVIS�ONSOFC11APiER .\ • p_ Y(COMMENCING WITH SECTION 70ao)OF DMSiON 7 OFTH[BUSINESS AND PROFESSqNS COOE.AND � '�' uY L�CENSE IS IN FULL FORCE AND EFFECT. C v`t-. 0 LICENSEC S G` _L� _LIC.NO.� {��Z ` !� � . V OATE�b !� CONTMCTOR�y�� W � � WORKERS'COMPENSATION DECLARATION y�� � s' D 0 � IHEREBYAGFIRMUNOERPEWLLTYOFPE(�IURYONEOFIHEFOLLOWING�ECLAMTqNS: � . N ' . 0 �IHAYEMIUWILLMAINTAINACEHT�FICATEOFCONSENTTOSELF-INSUREFORWORKERS' � COMPENSA710N,ASPFiOYIDEDBY5EC710N77ooOFTHEL�BOIiGODEFORTHEPERFORMANCE Of TNE WORK FOR WHICH 1HIS FERMIT IS ISSU[D. � � _ �1 HAVE M/D WILL MAIMAIN WORKEAS'CO�.�PENSATION INSUMNCE,AS REWIRED BV SECTION Q 37000FTHE UBOR CADE,FORTME PERFORMANLE OF THE WORK FOR WMICHTNIS PERGR IS . J ISSUED.MY�ERS' ENSATIONI�iiANCE�RIERANDPOLICYNUMBERARE: CONSTRUCTION � CARqIER Vl PLAN REVIEW Z voucr nuraoEa�-2q-9 S� Lr1 O f 3 EIECTR�C . � �� ¢ 0 [nesSEGfIONN[mNot9EoxuLE7moFT�EPEi3.+T5FnRon'EhutNiEODalMis�ftocl0RLE55} �PLUMf3ING . . Z I CERTIN THAT IN TNE OERFOR�AANCE Of THE WONK FOR WNICH THIS VERMIT IS ISSUEQ l MECHANICAL C7 SHALLNO7EMPLOVANYPER50NWAN'�MANNERSOASTOBECOMESUDJECTTOTHE � N9RKER4'COMPENS�TpNUWSOFGLLIFORNitiANDACREETHAiIFISFqULDBECOME INSPECTIONFEE � � � ' SU&IECT 70 7HE WORNERS'COMPENSA710N FROVI510N5 OF SEC7qN 7700 OF THE IADOR � � COOE,I SNALL iORTMY1iH COMPLY N1TH 7FIOSE PRONS�ONS. ISSUANCE ^�'�' �� � SMIP . p DATE: APPLICANT: W ENERGY P/C J WARNINO:FNLURE TO SECURE WORKERS'OD��PENSATION CAVERAG[IS UNLAWFUL,AND SHALL B[ _ �y 6U&IECfANEMPLOYERTOCR:MWALFENALTIESM:DCIY1LFiNESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOILAAS(f 7 m.000),IN A�OITION TO iHE CAST Of COMPENSATION,OAMAGES AS PROVIDED FOR IN � � 6ECTIDN77o80FTHEU�BORCODE,IN7EREST,ANDATTOW:EV'SFfES. � � RETENTIONFEE: `� � � � � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV�FFiRM UNDER VENALTV OF pERIURY iHAi THERE IS ACANSTRUCiION�EN�INC AGENCY ' �- FOR TNE PERFORMANCE OF iH[WORK FOR WHipI 7MIS GE1iMlT IS ISSUEO(SEC.]09�,dV.CJ. , , Z ' W � LENDERSWWE • � � LENDERS/u7DRE55 � � � � ¢ ICERTIFYTHATIHAVEREADTHISMPL�CA710NANDSTATETHAiTHEABOVEMFORMATqNISCORRECT. TOTAL FEES �� ��� w IAGREETOCOM7�YVATiIALLCRYANOCWNTYORDWRNCE5ANO5TATEUWSREUTINGTOBUILDING � � ' � CONSTRUCTION,ANDHEHEBYAUTMOfiIZEREVRESENTpiIVE50FTM15GOUNTYiOENTERUPONTNE ' Z ABOVE�MENTIONEDVROFERTYFORINSPECTIONVURPOSES. . COMMC-NTS � � �av�-s—L��—v o o kt m x/) /J /� ) . . ¢ PERMi7T AME(7RINT) ' ' I__v'—� _--�/� {{{ �jy�� � (/� SIG fU .OFVERIAITTEE OpTE � ��� (J7 7'� � RECPT.N0. �� PAID BY / �' �� VALIDATION � WHITE—Department CODY�YELLOW—Finance Copy,PINK—Assessor CoDK GOLDENROD—File Copy.GREEN—Applicant's Copy � . . ,. � ...... ...... ,. .-.�._,.�.,.-..�.-.re.- . . . • .. ,. .�.. -'-'. /. • ..... ...-... . , . ., .. .... , „ .. ..... , �. . .. . .-� , "' - , i ��� �`�\ \�_.``. , CITY OF DIAMOND BAR ; � , . � � ; � � � �`\'\` INSPECTION RECORD • ' ' � � � , . � � �; ��� . • � � � - :. . ' � \- E � � 5ET BACK :: �.� + • '-• FLOOR JOIST, ...•. , •', .- .._ FTGSIFORMS/STEEL - FHA REQMTS� �' � ' - 1' � " ELECTRIC GROUND � UNDER FLOOR.DUCT -:,' ,r, , � '�- ' •,' ,�: •�� GROUND PLUMBING - - UNDER FLO�R CO�IDUIT� =_� =.'. _= � �� �.� �� ��::i SLAB GRADE - � - � FIREPLACE FOUNDATION .�. TEMP POWER --- -- - FIREPLACE BOND BEAM ` ` ': :� ' ' '•�� ' WATER SERVICE MID HT:$OND BEAM ��- t t-� , � ��� �'-�.:; ; , . ; � � ROOF SHEATHING 8 FT.BOND BEAM., . . • FRAMINGNENTILIATION FINAL BOND BEAM �,�.• ,� ' ,, • ,', , �, .; ' ;�_;:. " . , ROOF COVER - -- � - - - - - PRE-GRADING'-`� ' `= � �; �_:; --..� �. , � ���1. ROUGH HEATING � ` BENCHING ROUGH ELECTRIC � � l'2/' - ROUGH GRADING ROUGH PLUMBING � FINISH GRADING SHOWERlfUB TEST �-- POOL ELECTRIC - -- EXT. LATH/SIDING PaOL FENCING WALL INSULATION POOL FINAL ' CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER ' FINAL ENG. SEPTIC TANK _ _ LANDSCAPE/IRRIG. . . SEEP PIT/L.L.- -�.- - � -= . - ON SITE IMPS. GASAIRTEST '�' ' ' ' ` '• '- �"" ' � �� FINALZONING � FINAL CONST. - -- • ' '� "' ` ' . � � FIRE DEPT. FINAL FINAL HEATING ��- --� -,:. ' � ; ., . ,1 HEALTH DEPT. FINAL - - FINAL ELECTRIC ' DEV. FEES PAID FINAL'PLUMBING -�, - .' ' ,'. ENERGY • i � •� � ' �' . _ ... �•�'�' _ . — . - ' • � • 1 , ' �' � � -- . . . . . . . • , ". . _ � . � <:. .. ' .._.. _ � � ' . . .:. .. ._._. . . . � � . . � . COMMENTS - ' � � - ' �.;, �- ��- ; , _ . . � . _ . �; .. . . . _. . , -� . , - 1 r � . . . i j•` i� . �ti. d « ! ' ' _ i . 'i i: � 4 L 1 � � SEPTIC TANK SIZE __. �. . SEEP PIT/U SIZE - ' .� , 5 � '7 . . .? � . ,. '�1: � ��' ' �� i1t - i' r� • );1�. ,' � '� c 1' , • _- . � �� �: ,