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HomeMy WebLinkAbout10681 o� CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT :,•.G 21660 E.Coplcy Drive Suite 190 , ' ' PRESS {909)860-3195 I'ax(909)961•7117 '*"� BUILDING PERMIT APPLICATION FIRMLY N JOBSITE r, � • APPLICATION r / PERMIT P/C .� p AODRESS 2�41 O�K KAIDl.� b�• pq� u�I(`Q 7 NUMBER� M � $ ISSUE , TYPE OCC APN ' LOT TRACT DATE CONST. GROUP p OWNER , ADDRESS ZONING SETBACKS � CITIf ZIP Q(,�C,A��,TEL — R�R RW D APPLICANT ' TEL SIDE/SIDE STREET RW O � CONTRACTOR =���.G• �I�t A.�)SCi' SIDE ❑ . g AODRESS �� � M u" CITY ZIP TEL PROPOSED USE w ARCH/ENG/ n r _ p_ _ __t t� �� DESIGNER K- GKO��O� d'Y�1 ADDRESS Q�._ _ M,�,.�� NO.DWEL. NO. _ . NO. • � CIN ZIP TEL. UNITS STORIES BEDROOMS • N DESCRIPTION SQ.FT. •FACTOR PSF ADJ.AREANALUATION Q ONMER-BL'ILDER DECLARATION �q/qpp�pEM ' 0 p 1 HEREBV AFiIHM UNDER PEW�LTY OF PEiWRY TNAT 1 AM E%EMPT FtWM iNE CONT11ACf011514 G�np�R',aryort � W CENSEUWF0117NEFOLLOM/wONEA50N(SEG70.71.6BUSNESSJlOiROFE5510NSCODE:ANYCrtYON (f) , C2 COUNTlN'MICNREOUWESAVERMITMCONSiRUCf,ALTERM�PROVE,DEMOl157LOqPEGM�RANVSTRUC. � P���� Z TURE,YPIOR TO I7S ISSUANLE,ALSO NEOUIRES THE MPLICMlf FOiI SUCF1/ERMIi TO i1LE A SIGHED �L STATEMENT THAT NF di SNE IS LICENSE�PUR9UMlT TO THE VfqVISIONS OF TNE CONTNACTORS ll• w � CENSEUN'(CMAPiERO(COMYENCNOWITHSECTIDN7o0o)OFDIVt6iON70FiHEBU51NE8SAN�PRO- LL P��W �' � � � FESSIONSOODE)ORMA7XEORSHEISIXEMPTTMEREFROMANDTIIEB�3iSiOR7MEAlLEUEDE%EMP• (7 TION.ANYVIOLATIONO�SECTION707t.6BYANYAPVL1fi1NTFDR�VEIWITSUBIECTSTHEAPPLIGWTTO Z R�.Rpp� � ACMLVENALTYOFNOTMONEITiANFNEMINDREDOaLURS�i50o).): o ❑IASOMMEROFTMEPRDPERTY,ORMYEMPtAYEESWITHWWES1LSiHEtRSOLECOYPEN6AT10N, � (`,qr�Rf9fGlpl - � � ���' • L MnLL DO 7NE WOFK.AND THE STRUCTUPE 6 NOT INTENDED OR OFFERED LOq 8�U.E(SEC.7ou,BU54 J � NES9 ANO VROFESSIONS CODE:THE COHTMCT0119 UCENSE UW DOES NOT APPLY TO AH OVMER OF ? . , , iROVERTY YYFq BULDS OR IYPiqVES TMEFEON.AND NM11D DOES SULII WORK NILISELF qi MER9ElFOR � THHOUGHMSOqHEqqNJFYPLOYfES.PROVIDEDiMATSUCHWPqOVEMENTSMENOTMENDEDOR m , � OFfEAEDFOR9ALEIF,MOWEVERTME&LIDNGOROAPRO'JEMEMISSOlDW1TWNONEYEAROF00A1PLE- 2. Z TqN.TME OWNEREUILDEH WILL HAVE TNE&JRDEN OF VROVIHO iHAT NE OR SHE DD NOT Bt11Lfl OR = IMPRDVEFORiHEVURPOSEOFSALEI _w ❑4ASONMEROFTNEYROPENiY,AMEXCLU5IVELYCOMMCTPlOWITHLIGENSEDCONiMCTORS � TO CONSTRUCT THE iROJECT(SEC.7M�.BUSINE55�1N0 iROFES5qN5 CODE:111E CONTMCTORS LL VlIW�IOff ADJ.AREA W CENSEUWD�ESNOTAFPLYTOAN0IN�EROFAPROPERTYYVFqBUMSORMPROVE4iNEREq{ANO Z YAqCONTRACfSiOq9UG�7NWECf3WIi11ACONiMCTOR�S)LICENSEDPURSUMITIOTMEWNifUG pUANTITY DESCRIPTION FEE � TORS LICENSE LAw.} J �' � O I W EXE4PT UNDEN SEG &�O.G FOR TWS REASON Q � V . LL DATE OWNER � � � � • � • � W � UCENSED CONTRACTORS DECUIRATION W � . � IHENEBVAFFlRAIUJDERPENALTYOfVEfWRYTHATIAMLICETISEDUfOENPRONSIONSOFGHAPTER V. . , . . p. 0(COA�.1ENdN0 VNTM SECTION l000)OF DMSION]Of THE BUSINESS AND VROFE5510NS CODE,Mq Z X W UCENSE IS IN FULL FORCE�Nb EFiEGL m • , . . , • . LLJ Q .� !�'-..//� 0 LICENSE CLASS •./ LIC.N0. ��Y�l_�l V � � ; , , , � �+ � V DATE � CANTMCTOR,_/'l�riC_ �.t�'� � W . . � � WORKERS'CAMPENSATION DECIAAATION � � IHEREBYAFfIRMUNDE11PfNALTVOFiERIUMONEOFTHEiOILOWWODECLMATqNS: Z , � �IHAVEAN�MALLMAIN7ANACERTIFlGTEOFCONSEMTOSELF-WSUiiEFOqWORIfERS' _ � � COMPENSATqN,ASPROVDED9YbECTqN77000FTNEU180HO0DE.iORTNEPENFORMiWCE W . OF iHE WORK FOR WH1CM MI3 PERYIT IS I55UE0. � � . .. . , . . . � C _I HAVE AN�W1LL MAINTAiN WORNERS'COMPENSATION INSUMNCE,AS REOUIRED BY 3ECTqN ` � ]700 OF iHE IABOR COUE.FOR iHE PERFOqMANCE Oi iHE WORC FOR WHICFI THIS PERMIT IS O ISSVED,MYWl7RKER5 uPE SAT WSURAN CARRIERANOPOLICYMMBERARF: CONSTRUCTION • � CARRIER �� PUW REVIEW e • � vaicwNuueEa ` •� �1�_ ELECTRIC � �sEcrcN��Ho7eeoa,qEhvoFtreperwrsroqa�Kaa�oat�sa+oqoratFss� PLUMBING Z IGERTIFY7MATNTMEFENFORAIWCEOfTHEY�GiiKFORWHICHTNtSiERAYTt5155VED,l MECHANICAL ��lD . dII (') SNALLHOTEMPLOYANYPE0.50NWANYYANNERSOASTOBEWMESUBJECTTOTHE �vj 1MORNERS'COMPENSAiqH UWS�F GWFORNI�,AND�GHEE�t IF I SNOUD BECOME INSPECTION FEE � � . SUBJECTTOTNEWOfiKERS'COMPENSATIONiRDViSqNSOFSECT10N�7ooOFTHEIABOR o cooE.�s�uucoannvm�couv�rNnn�nas¢vao�nsaws. ISSUANCE p OATE: AFPLICAHf: SMIP " O � W�p1pN0;iM.URETOSEd1REWOqKERS'tONPENSAT�OH�OVEiUOEISUN.AWFUL,ANOSHAt1BE ENERGYP/C � SUBIECTANEMPIOVERTOCW4�NALPENALTIESMmCMLFWESUPTOONEHUNDREOTCUSANO ENERGYPERMIT 1 D OOLIARS(i100.OW�.N AUD�T�ON i0 THE CAST OF COMVENSAiION,DAMAGES AS YROYDED FOR IN � 6ECTIONl7aOFTHEUBORCODE,NTfRESi�NDATTORNEYSFEES � � RETENTIONFEE: - � � W CONSTRUCTION LENDING AGENCY t� PRE-ALT FEE: � INEREBYALFIRMUMDERVENALTYOFPERNR`/TMRIMEREISACONSTRUCTIONIENOWaAOENCY Z FOR THE iERFO WAANCE�1HE WORK fOR YMIp/7N15 OERMIT IS ISSUED(SEG]a7,GIV.G�. W � LENDER'4 WwE C LEAOER'SADDRE54 � � C q � I CERT�FY iNAT I fuVE REM TIIS APPLIGTqN MA S?�TE T1AT 7/1E ABWE INFORMATION IS CORRECt TOTAL FE ES 7 J' � I ( 1� . � IAGREETOCOMVL'/YATHALLC7fYANDWlMTY010NAHCE511NDSiATEUNSREUTNGTOBU0.DIN0 , � CONSTW/CTIOH,AWNEPEBYAUi11ORIZEREORESENTATNFSOFTN15C0UNTYTOEMENU00N7NE ABOVE•YE EDPROPERTYFOR ECiqN WMOSES. COMMENT$ a ' � J � " m WAIREE ryRMIf) . . . .. � . / • � ' tA � � / �tti I//�l � N , 7URE IT7EE-, OATE _ � . • ' RECP7.NO. PND 6Y VALIDATION NR11TE Nnrfl Copy.YELL Capy.PINK�11tNnOf COpy.GOLDENROG-FlM COpy.GREEN—MWlanfs�ADY .}.•...,>. . .. ..:;.�...... . ...,.�...} . Y tr�.<�. y.� � . . . . . .� , . . , . . .� . . ,.. .... .ti._..�. . .... . . . . '.t.'. � M'� . , . ...., . ,'''�.';..-......iy"'�A.. • ��•�T.:N..."•1.. . ..y1Y:'.� er��:�...�re.. . , . . � ^ . � , CITY OF DlAtlf OiSD.::Gl�R,� ;`�'� �- , ..._ ,.., , r;:l:,.: ,, . � , ,., : .. ���,.��� . , . .. _ :__.., : �� � INSPECT�IOf�! RECC�RD,�;,':;=-�;';', �� , , ; � : �`� ' . ., �.•.�� . '=: �' . . •;: '� . . ... ,'�'... . ._ .., r. . 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I `:- TEMP POVVER.=:..- .. -- =-�-_-=_ -- ----- - ----.._.-_..,..._. ,. - •_ .__ WATER SERVICE .,..�. ,_,;'_•;' � - .= � - � MID F�T. BOND BEAM _ ---.�. .._.. .;�.-;. �;i,, i �= i• �c: , -- ROOF SHEATHIN(�3�iL�.° �' � - ---- e FT.bOND BEA�r1 , ,. =, �, , '. -�'�:�'-'�'^: ' ` . . . � , FRAMINGNENTILIATION z- yd. _ .'�,.,, . - '�INAL E30ND BEAM •.•.-.�-_:.; , ;�.- -_ ., :- ..:'-�:�..�=;•;, 1 ; -- - - --- --.. _...--- -ROOF�COVER --- -- --_: _ - • - - -PRE-GRADING._ ...---.-i._.: ' , �'�,�� i ;;. -- �-- --...- ----- -•- -- ,.. ROl1GHHEATING. ,-- 9� !'�- • �- '-` .,',.. .,.;`. _. .... ._.._...._._.. ._ _ l -- -- BEFJOHING _ - _ I., ' � , � . .. , ROUGH ELEG7RIC� :-- - .�> _- RO CH GRADING ,. ,., . ,.. ..•... :. ... .. . .... ,,.. : .. . t <: : .ROUGH PLUMBING �---- --�`---- %'��-- '�-•-- --.!__ .. -FINISH GRADING �:. . .. :;. ��,' ' '� ; � ; � - . ,� SH0INEHlrUBTEST.; . l. y � _ _ .. --- � . "PODL ELECTRIC . � '. , ._., , , ; , , � ,� - H ��� . . . . � , ... 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