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HomeMy WebLinkAbout11252 ----...,__.. . ._.... ._... ._._.... _. - - - -- . .._.... -- -- - �— -------- -- - --- _� - J� --� CITY OF DIAMOND BAR • � :. • // COMMUNITY DEVELOPMENT DEPARTMENT // ' 21660 E.Copley Drivc Suitc 190 . � •• ( PRESS � (909)860-3195 Fax(909)861-3117 '�^' BUILDING PERMIT APPLICATION FI R M LY ¢ ADDRIESS__ 2�2 I DU�L I�Wp{'l DATE CATION � � NUMBER / �s2- q�C ' 0 .��- 9,!� � APN LOT� TRACT �S S I ISSUE f � '� J " TYPE OCC DATE CONST. GROUP p OWNER _ ��.G {� ADDRESS 3�L' �O 'T�[��1�'CA'M�� '� V •• ZONING SETBACKS ; z CITY�a�('I7LA.L�� ZIP,�,3 TEL'�C/� S�D��}^ FRONT RW ❑ o APPLICANT TEL. SIDE/SIDE STREET RW ❑ . z ¢ CONTRACTOR G -_ SIDE ❑ � ADDRESS � PROPOSED USE � CITY� ZIP 9�,3 TEL.5`_3�J D/iS w ARCH/ENG/ + �z DESIGNER OJ�d � NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP� TEL.gjD�fj'�� ' cn OESCRIPTION� SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BL'ILDER DECLAFATION . � SFR/ADD�'REM ID � � . � � 1 HEHEBY AFFIRM UNDEH PENALTY OF OEiUURV THAT I AM EXEMPT fROA1 TME CONTRnCTORS ll-� � _- ���''. � W CENSEUWFOFTHEFOLLOWiNGRfASON(SEC70�1.6BUS:NESSA�DPROFESSIONSCODE:IWVCfT`IOR � Garage/Carport � �- � •. U �p�JryTyWHICHREOUIRE5A0ERMITTOCONSRiUCT,ALTER,IMPROVE,OEMOl15H2ORREPAIqANYSTRUG•' W Patio/Dack � w TURE.PRIDR TO RS ISSUANCE,AL50 REWIRES THE AiPLICANT FOR SUd1 PERMIT TO flLE�SiGNCD ' W STRTEMEM THA7 ME OR SME IS LICENSEO PURSVANT TO TNE GROVISIONS OF iHE COMMCT01i5 l4 S CENSE LAW(pUPTER i(COMMENdNO WITH SECTION 70�0)OF DIYISqN 7 0F TNE BUSINESS ANO PR0- � POOUSp3 � � FESSIONSCODE)ORTI4VHEORSHEISEXEMPTTHEREFROMMlDTHEBASISFORTHEQLEGEDE%EMa- C7 ' V TION.AN`fVqlAT10NOF5ECTION7071.6BYA4VAPPLICANiFORAPEHYITSUBlECTSTHEAPPUCANTTO z Re-Rool . � A CINL VfNAL7Y OF NOT MOpL iHAN�IVE HUNORED DOLLARS(f5oo�.1: � OI.ASOWNEROFTHEPROPERTV,ORMYEMPLOYEESWITMWAG[SASTHEIRSOLECOMPENSATION, 0 �mmercial . � N^LL DO ME WORK,AND THE STRUCNFE IS NOT IMENDED OR OFfERED fOR SALE(SEC.7w1.BU51- J � NE55 ANU PROFESSIONS COOE:7HE CONTRACTOPS LICENSE UW DOES NOT 117PLV TO AN OWNEfl OF � � y PROPERTYWHOBU0.DSORIMPROVESTHEREON.M1�NRiODOESSUCHWOFKHIMSELFORHEHSELFOR � TNRWCHMISOqHfROWNEMVLOYEES.P1iON0EDTHAT5Up11MPqOVEMENTSMENOTNTFNDEDOR m � OFFEREDFORS.LLEIF,NOWEVERTMLBUILUINGORIMPIiOVEA1ENTISSdDWITMNONEYEAROFCOMPLE- � ' Z TION,THE OwNER-BUILDER WILL HAVE TF1E BURDEN OF PRONNC hIAT NE OR SME D�D NO7 BURD OR � OAPROVEFORTHEPURPOSEOFSALE} � �y,� O1�50NMEROFTHEPROPERTV,AMEXCLU511lElYCONTMCiWGWRHIICEN5E000NTMGTORS . ¢ TO CONSTRUCT TNE PROlECT(SLG 7ou.BUSINLSS IwD PFOFESSIONS CODE:i7�E CONTMCTORS LI• V3N2Ii0f1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOW!JEROFAPROPERTYNMOBUILDSORIAAPROVEStHEH[ON.AND � N'FIOCONTMCTSFORSUq1Pp0.1ECfSWITHACONTHACTOR(S)LICENSEDPUHSUANTTOTH[CONTMG OUANTITY ' DESCRIPTION � FEE . � � TORS UCENSE Uw.�. . . � . 0 O IAM EXEMPT UNDER SEC. B.8 P.G.FOR TilS REASON . Q OD V L�i 0 a7 � � 0 Z OATE OWNER V , , _ , � O � LICENSED CONTRACTORS D[CLARATION W � v c.c.�.. _ F o IMEREBYAFFIRMUNDERPENAITYOFPERJUAYTHATIAMLICENSEDUNO[NPPOVISIONSOFCHAFTER Vi 6 � �� � 2p,2 � � Y(COMMENCING WITH SECTION 7000)OF DIYIS�ON 7 0F TME BUSINESS AND PROFESSiONS 00DE,M!D Z 1 X UY LICENSE IS W FULL FORCE AND EFFECT. , � m `! .. . lL � UCENSE CLASS G LIG.N0.������l�/��,�1�, j (.V�/' � V DATE Z���CONTiLlGTOfI��+�{,dyl a `X . W . �'J LAJ� -� �� � �� . WOFlKERS'COMPENSATION DECLAFiATION . a � IHEREBYAFflRMUNOERPENALTYOFVE0.1URY0NEOFTNEFOLIAWINGDECUMTqNS Z � _IHAVEANDWRLMAINTAINACERiIFICA7EOFCONSENTTOSELFaNSUR[FORWORKERS' _ � � COM7ENSATION,ASPROVIOEUBYSECTION]7000F7NEL�BOHCODE,FORTHEVERFORMANCE tU OF THE WORK FOR WHICH THIS FERMIT IS ISSUED. � G •/ . w ✓ IHAVEANDWKLMNNTAINWOFKERS'COMPENSATqNINSURIWCE,ASREOUIREDBYSECTION � ]70o OF TME U1BOR CODE.iORTHE FERFORMANCE OF THE WORK WR WNlp/TXIS DER611T IS ISSUED.MYYVORKER'CO�IONINSURMlC�RRIERANDPOLICYNUMBERARE: CONSTRUCT�ON Q �e � ] CARRiEH � ri��� PLAN REVIEW � POLICY NUMDER 7_Zcr�9�_ 0 13 1.�� � - Z ELECTRIC ¢ , � (M1IISSECT�ONN�NDTBEWMPLETEDOFMPERMT6fORONEVMDf1EDDOLLIfLSpf00)OqLE55} PLUMBING Z ICERTIFYTHATINTHEPERFORMANCEOFTHEWORKFOHWHILTITHISPERMiTI5155UED,l MECHANICAL (.'3 SHALLNOTEMPLOYANYPERSONplANYMANNERSOASTOB[C0IAESUBJECTTOTHE � WORKERS'COMPENSA710NUWSOFCALIFORNIAANDAGREE7HATIFISHOULDB[COME INSPECTIONFEE - " SUBJECT TO i11E WORKERS COUPEN5A7iON GROVISiONS OF SECTION]700 OF THE UBOR . rj ,COOE,I SHALL FOR7HJJITM CW.�PLY YAM hpSE PROVI5lON5. �SSUANCE i� � � SMIP p DATE: APPLICANL ' �� J WARNW(i:FAtIURETOSECUREWORNERS'CdAPENSATqNCOVERAGEISUNUWFULANDSHALLBE ENERGYP/C. � �, '-/� � SUBIECTANEMPLOYERTOCR7MWALPENALTIESANOCMLFWESUPTOCNENUNOREOTHOUSANO ENERGYPERMIT '�� DOIURS(f I Oo,a00).IN ADDRIOH TO 7HE COST OF COMPENSATpN,DMAAGES AS PROVIDED FOR IN � SECTpN]7080F1HEUBOFCO�E.IMEREST,ANDATTORNEY5FEE5. � � {'{E7ENTIONFEE: � �' � � a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: ��� � � � IHEHEBVAFFIRMUNOERPENILLTYOFPE0.ri1RYTHATTHEREISACONSTRUCTIONlEN01NGAGENCY � FOR TH[PERFORIAANCE OF THE WORK FON WHICH THIS PERAIIT IS ISSUE7(SEC.9007,CIV.41. , w • , ' . . , - .,�\; . " . - � . .. . • Z� LENDER'SNAME - � � ' t .. ti�. - .. . . ' � F-- •LENDER5h70RES5 y' ¢' ICERTIFVTHAi1HAVEREADiN15APPLICAT10N/�NOSTATETMATTHE�80VEWFORM�TqNISCORPECL TOTAL FEES � � � • � IAGREETOCOM7LYWITiiP1LCRYANDCOVNTVOR0INANCESANDSfATEU'NSRFUTWGTOBUI.DII:C- � •� � ' � " � �'.CONSTRUCTION,MIDHEREBVAUf110RqEREPRESENTATNE50FiHISCOUNTYTDEMERUPONTHE ' "" . z ABOVE�MEMqNEDiAOPEflTYFORINSPECTIONVURPO5E4. COMMENTS' � ' 0 � ` .. - � � � �_.Yw,e.s -L, b � � m PERAIITTEE NAME fUNn ' � � � ' ., .� . 2 � ,� �. N' �SIGNATUR F P MITTEE � � ,. _, -. .DATE ' _ � � � ` � , RECPT.NO. � PAID DY ' VALIDATION � �- � � � -WHITE—OepaRment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy , . � , .. ,. . • . . . . , .. _•t- � -., . . •ti.ti, ., . ,. . . �. . . . � •-_ , ' - , - � ��, �� CITY.OF DIAMOND BAR " �: �: ,;';, � _', �: � _. -� � � .�' ` iNSPECTION�RECORD � ' : � - : :'' ' ._ .� : . , �. . � . ,, • � , • - • E � . � . ' ��� �� �.�'-. FLOOR JOIST SET BACK ` , � -- ,., - FfGS/FORMSlSTEEL ' - - FHA REQMTS � -��� � ' �� ' � � � - � - -_ ELECTRIC GROUND � � � UNDER FLOOR.DUGT. �, � ;,r,= �,• , ;�"- '•' ;•' GROUND PLUMBING - UNDER•F'LOOFi CO�IDUtT �:�- 1! ' .�� "=�� '.�; �'� �' FIREPLACE FOUNDATION ' SLAB GRADE ' - - - . - . . . FIREPLACE BOND BEAM'_ '•� -� TEPJIP POWER - - - - .- ��` . WATER SERVICE -- MID HT:60ND BEAM: � •- I ��: y� ` .< i ,J.��� .; ' - ROOF SHEATHING � 8 FT.BOND BEAM_ -,'� � - ' � ' FRAMINGNENTILIATION � FINAL BOND BEAM: " � � �� � _' '� �� • ROOF COVER- - . _ PRE-GAADING�.,..,:•, : •:'. :•,. ,. - : _ - . �� _ ROUGH HEAT(NG- �- :� . � BENCHING . . - ' ROUGH ELECTRIC - ROUGH GRADING ROUGH PLUMBING - - FINISH�GRADING SHOWERlTUB TEST -� - �� � - - POOL'ELECTRIC � - EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL'FINAL � CEILING INSULATION OFF SITE IMPS. � � DRYWALL NAILING . DEDICATIONS ' � SEWER _. . ' __ _ _ _ _ ._._ FINALENG. SEPTICTANK: _ ... _ ' LANDSCAPE/IRRIG. , : .. SEEP PITlL:L. � -- = -- • ON SITE IMPS. - GAS AIR TEST �� ' '' ' " �' " • - - � FINAL ZONING • • ; FINAt CONST. - " - , ' ' ' - ^' FIFiE DEPT.FINAL .. FINAL HEATING � - ' '"•J 1 HEALTH DEPT.FINAL - .. � �-- - FINAL ELECTRIC ' '� � DEV. FEES PAID � FINAL PLUMBING ' '.- � .: � ENERGY � � �• , .�, .�� - - �, ' • .. -- . �. _, \• .._ . . •_ - _�. . ... - . �, �� ,,.�� . � _: • • . •� ., ,•., -. � _ — COMMENTS - _ ' � - -- --- - - - .. ._ ._ _. . _ -�---.._ . . ; ; . . .. - -- - --...- - -- - . .. . _-_ _ ; . . ,�;,.�, .. , � _. - - � . .J�,r , �=j ^�,.�,,:yi , -- -. �. , _.. ' • _ . . . . _. 1 . 1 �-.i ... � � '_1 �_- _ ; • � _. _ (.t�.,J� �l � . � � ' � • . .. . . .. . . . . .. �.: � .r.; .. � i � .. . ' , . � ` • SEPTICTANKSIZE��;: ,._ � - . . ._w. . .. . . .... ._ . .._ _.._ .. _. _._ . . .... ' : SEEP PIT/U SIZE - . , ����� , , . . � ; ' i . . .. -Jrm ��r� ��?. � 1 Z . . 0� ; . � • , 6 ? £ � _ , ,. , . , - . , _ . _ _ _ ���0��?��L �c , � � � . _ j : �.'�,,•�: ' t..�j/Y � d� s. ; -.!��• `►`'� ' � ;'' ,� :'; � a d/ £ {���y ! ,� c �'►�• . . .-� � ��' � 1coy , .S �. �