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HomeMy WebLinkAbout16837 (40) �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNTfY&DEVELOPMENT SERVICES ��` 21825 E.Copley Drive (909)860-3195 Fax(909)861-31 l7 PRESS ��'-�� BUILDING PERMIT APPLICATION FIRMLY ¢ DDRESS � CSi/�i _� (� 3��� >- b APPLICATION C� � PERMIT !C o DATE NUMBER _5.,��,� � ISSUE O f^1 7yPE pCC APN LOT TRACT DATE V�CONST. GROUP p OWNER — p ADDRESS ZONING SETBACKS z CITY TJf A IP�..��fs�fEL.(Ql Z^dB FRONT RW ❑ p APPUCANT ,�_�4Ga�f��:,a�Afs�^�' TEL.�,�f�-7SS�7 SIDEJSIDESTREET RW p � CONTRACTO l�� SIDE ❑ r o CnDRESS ZIP pQ TEL.'���'S� PROPOSED USE�11� A w ARCFUENG/ z DESIGNER ��✓ �� a ADDRE � S O.DWEL. NO. NO. v� D�ITS STORIES BEDROOMS � CITY ZIPQ���TEL'�= .�•—!�� N DESCRIPTION SQ.Ff. 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Z � �I NAVE M!D MAIL MAiNTAM A CEFTIflWTE OF CONSENT TO SE�F�INSURE FOR WORKERS' _ � COIAPENSIITION,ASPROVIDEDBYSECTION77000FTMEUBORCOOE,FORTMEPERFORMAfrCE w Q OF TH[WORK FOR WHICH iH15 iEfUAIT IS ISSUEO. � �I HAVE/WD MALL MAIMAIN WORKERS'Od.1PEN5ATqN INSVM4LE,AS REal1IRED BV SECTION ///''']�� n.� Q 37000FTHEUBORCODE,FORTNEVERFORMANCEOFTHEWORNFOflWHiGI/THISFERMITIS ��.� ISSUFD.MVWORNERS'COMPENSATIONINSURANCFCARRIERANDPOIICYNUuBERAR[: CONSTRUCTION j GRR;ER �47��Ls�/l�� PLAN REVIEV! 1��n � POLICYNUTABER Z ELECTRIC ¢ 0 (iTe55ECIiONNCmNOTBE[OMtLEfEDOFhEPERMf6fOROhE DouAnS(SiroloqtFssl PLUM�ING Z ICCRTIFYTHATINTHEiERFORIAANCEOFiHEWORKFONWHICHTHIS ERMITLSISSUE�,1 h1ECHANICAL [} SH�LLNOTEMPLOVANVPER50NNAM' 'TR$OAS708ECOME 'JOJECTTOTH[ � WORNERS'COMPENS�TION UWS OF iFORNI ANDAGRE HAi l I SHDULD BECOME INSPECTION FEE S SU&lE T07H RNERS'COMP SATiONiRC ISiON50 SECT �370oOFTHEIABOR COOE, SHALL i.RTMYIM COMPL W17M 7M05 R �q ,. ISSUANCE / O p DATE: APPLICA � _ SMIP � n J WMNINO.FA:LURE OSEWitEWORKERS'Cp.�P NSATpNCAYE 4 _ISUNUWF�,ANDSMALLBE ENERGYP/C �y SUOJECTANEMPLOYERTOCRtMiVALPENALT[SANDCINLFINES ' TODNEMVNORCDTFqUSAND ENERGYPERMIT DOLLARS�f1a0.Om�,IN I10DITION TO TNE COST OF COMPENSAT .OAMAGES AS PROVI�EO FOFl IN ¢ SECTIDN77DeOFTHEUDORCODE,INTERES7,ANDATfORNEYS eEs. RETENTIONFEE: � oCONSTRUCTION LENDING AGENCY PRE•AlT FEE: � IHEREBYIIFFIRMUNDERVENKTYOFVERNRYiMATTHEREISACONSTRUCTIONLENDWCAGENCY FOR iHE FERFORAIMlCE OF 7HE WOfU(FOR WHiCH 7Hi5 VEfUAIT IS ISSUED(SEC.7007,CIV.C.). Z w � LENDEfrSNAME S' F- IENDER'SADDR[SS ¢ TOTAL FEES 3 . W I CERTIiY THAT I HAVE READ THIS APVLICATION AND STATE TMA7 THf A90VE INFORMATqN�S CORRECT. p_ IAGREETOCAMPLYN7TMALLCRVANOCOUNTYORDINANCESANOSTATEUWSRCUTiNCTOBULLDING � CONSTMICTION,ANDMENEBVAUTMOR EREPP ^• ESOFTHISCWNTY70ENTERUPONTNE �i cu�,�,.. �C� D�` �/'� � Z PBOVE�MEMIONEOPROVERTVFOR . VVHVO E5. •� COMMENTS � ! � � � � m PE I EENAME� /� - ¢ n � �� N SIG T . F PER T D fE � RECPT.NO. _PAID BY VALIOATION WHITE—Department Copy,YELLOW—Finance Copy.PINK—Assessor Copy.GOLDENROD—File Copy,GFiEEN—ApplicanYa Copy w I I 3.5(�. , . . . . � ...._ . _.. .-.. •-- . . , , .. ,.,, , .. .,,,......_ .,. ... - . . . . � . , . . , . . . . , ,,.- . ._ . . .. ��i i' f��= 1�(E�f,iG9��'G� �F�{� lF�Si=►=�:"f�i� r�C(1 i�� (►��'-`1��='C.'�lC�►'I'. ^ Ct�l.�'= ---� 1►`I�'1:a:;E' ���:F,, •.-- ----�;����'�'E--'�'�C•1►'�•_•_• _ ___. �r�1;r� __ (',�'7:.l�c�.`.7Cl�i� ' ----......_.:...._�.:__....- --.. - .. .. ...._.._.:.. .... . . .. ... . _ . .... _.. __...___.._.._._.... ._ SET E3F,CY. , � .• � I FLCOR Jv^IS i. � - - - -I--- . . _---- -�--- ---'---- --..-----•-�-- -� ------- — f-TGS/FOR'�1S;5TEEL � � ' ' ' � FH^ �3E=Q'.'T5 _ � _— �----------------�-•-- �' - __�. ELECTRIC Gq�UfJD �__ ---�-� UIJD�P. FLG��R D'JCT --�---.- , . --- _ -- --�---- -- - -------- CROUtJD PLU�•:931P�G I I � � Ut•:D(T, FLOOR CO",!�UIT � --- ;-----_---- SLF�B GRF+D� --� --�- -- _. ! I FIR:f'L'r^�.CE FOU�:!�/ITION --�— � ------ TEP•.1P POVJER I � __�I_I f�IRFP�.F,C:E EiJND_BEF,Ps1 i _ ___ I _ ___._ �ti'ATER SERVICE ' — ----_ ---- i � t:",!D HT EO":���nr:� ---- I I -- ROOF SHEATHIf•1G , ��— .~-I£f-f. 6�0'�'�f7El�!:-- �--- — � FRAP•,11t•dG,NENTILIATION � � FI�dr1!_G�?JU F�EI'�t.t �__ � _ __ ROOF COVEFi � --- -- -- -� F'��-GR!iDI�:G -------_�— I ROUGH HEATING I I I BE�•.CHI^:a ,�• I � l ROUGH ELECTRIC � I I � ROUGfI GRAD!�dG � 1 � ---�1_.----- fiOUGH PLU��"81NG � __ � _ i 1 �C•�ISH GRF,DI"J� �__ � ____ SHO�^:ERITUB TEST _�_ �_ � � F'OOL ELECTRIC _ EXT. LATH!SIDING I I POOL FEfdCi�J�, � 4"JALL RJSULATIOP� � � -�1 POOL FIi�AL i __ CEILIPdG INSULATIOfJ � � OFF 51TE IP:"PS. _� _ DRYVV�LL P�AILI�JG � � DEUICr;TlO'dS � SEl"JER � -- - � FI�JAL EhdG. I � SEPTIC TANK , - -� �_I L!',NDSCF,PE/IRRI�. � � SEEP PITlL.L. � ' j � QPJ SITE I�APS. 1 GAS AIR TEST � � j�1 FI�JAL ZO;JItJG _ FfNAL COhST. � ! � ��RE DEPT. FIFJ/1L FINAL HEATI"JG I ! � HEF,LTH DEPT. FI?J.AL � FINAL ELECTRIC � I I � DEV. FEES P�,ID j FINAL PLUP.IBlPJG � I I EN�RG'r i I _�����,rr�-C9 y(c�-�-�.�- �_I_ . .--T- --._._ _ _.__-____...-_�--- - =-- i r__ .-,., ,- CUPJ�MENTS SEPTIC TAPJK SIZE SEEP PIT/U SIZE -- -----���-._____,__. _ `�_�� - - - -- - � . � . • . � , • , -k • .