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CITY OF DIAMOND BAR ` --�� --� DEPARTMENT,OF COMMUNITY&DEVELOPMENT SERVICES 'i 21660E.CopleyDriveSuite190 � � (909)860-3195 Fax(909)861-3117 PRESS ' ����� � �. BUII.DING PERMIT APPLICATION � " .. . FIRMLY � JOBSITE I OATE CATION � � NUMB R 1 I O Z �/C ' o ADDRESS ���� ��..KNOI �� � APN LOT 3� TRACT 7 D TEE G G TMPE • OCC CONST.- GROUP p OWNER � ADDR�S 3Y' O �Sj : % ZONING SETBACKS � CITY 1�fY'AVLCL_ ZIP��� TEL5�0' , fl�R RW ❑ APPLICANT TEL. SIDE/SIDE STREET RW D � CONTRACTOR L ( G� � SIDE p Q ADDRESS PROPOSED USE . � CfTY ZIP TEL - / o ARCH/ENG/ . ! � DESIGNER�_ ��► �SS,�G� NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDRaOMS � CITY ZIP TEL Nn . .. DESCRIPTION SQ.Fr FACTOR PSF ADJ.AREANALUATION � Q ONRJER-BUILDER D�CIARATION SFR/ADD/REM ' O ' Q 1 MEREBY AFFlRY UNOER DENAITV OF GEMIRY TMAi 1 AM E%EMPT FROA/THE Od�RMCT00.S LI. Ga�egB/CBf�On � , W C£NSEUWFORiHEFOILOwNOREA50N(SEG7071.6BUSINESSMIDGI10FE5510NSCODEANYCT'OR � (� COUITYWHILHREOlIME9l1VENMRTOCON57RUCLALTERMPRpVE.pEMOLISM.ORNEP�iRANYSTRUG W PatblDedc NRE,Pi110A TO RS ISSUIINCE ILLSO REOUIRES THE MPLICANT FOH SUCN VERAIIY TO FILE A SIGNED W 8iATEMEM TIUT NE OR SME IS UCENSED PUFtSUMlT TO TME YipY1510N5 OF TME CONTMCTORS U• .� CENSE UW(duPTER 0(COMMENdNO WIhI SECf�ON 7000l OF 01VI5iON]OF iHE BUSMESS AND PqO. u- PooVSpa � � � . iE39qN3 COD�OR iffAT HE Oi15HE�9 E%EMPT iHEREFROM IW D iNE BA515 FOR THE FLLEGED EXEA�P• TION.ANYYIOLATIONOFSECTION1W1.69'IN7YAPPLICANLFORAPERMITSUBJECTSTMEMPlIGW7T0 Z RB•R001 � ACIYILiENALTYOFNOTMOREh4WFNEHUNDNED0011M5(lSODI.T . . � OlA90M�NEROFiHEPROPERTSORMYEYPLOYEESVATMWACESh4i1�EIRSOtE00MPEN5ATqN, � Q CpmrtlBfCi01 � . 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B.IP.C.FOliTHISR[ASON� a .O � SO 3 [L ' '� 5 1 S�� u' OATE ON'NER �j '/ , -. p.AD 1 n W L � D V LICENSED COMRACTORS DECLAFiATION -� � � W � . � 9.s� O �HEREBYAFFIRMUNDENOENKTYOFPEMJRYTHATIAAILICENSEDUNOERPRONSIONSOFCIUPTER � � f(GOMNENCN�YlfiHSECTM�N700D10FOM510N70FTHL8U51NE55AN�7ROFE5510NSCODE,A.^1D Z � ��� W UCENSE IS W F'ULL FORCEANO EFFER. m � UCENSE CUSS �••-[ LIC.NO. _' J V � J �j DATE CONTMCTOR�_�r � 6. W � WORKERS'GOMPENSATION DECLAMTION -r U � IHENEBYAFF6WUNDERVENALfYOGFERIURNONEOFTHEFOLLOWw6�ECLARAilONS: - - � � � Z Q � �IIUVEANDWILI.WM/1NACERTIFlG7EOFCONSENTTOSELF-INSUREFORWORKERS' 2 � COAIPENSATqN,ASPfiOVIDEDBYSECTION]7o00FTFIEL�eOiiCODE,FORIHEPERiORMANCE � U Q OF7HEVNOPoCFORWNIGITM�SPEiu11TI5155UED. � � „�,�IHAVEANDW�LLIMMAIHWORNEItS'CdaVENSATqNINSURANCE.ASREWIREDBYSEC'��ON. . . . . . . ... '� .- O4 ]7oa OF 7HE LABO�COOE,Fqi i11E PERFORYANCE OF iME YVORK FOR WHILH THIS►EPN�T IS '. � � �ssuEo.r.+rvNaue s�vJcns���{�LIy,su�wwc cuwiEau+avoucrNurae�au+¢: CONSTRUCTION ��:�• �'�•�C'' CAqRIER � �T'� � V� Pl�'1� _ � oaicrr+uueEa Z�b � Q�� LECTRI ' •� . � 0 (MssEcm�MCEDrqiBE00MtEiIDOF1FEPEaMt6FOF+aNeM.t�Ofim00t1/JLSR+�101+LESS] PLUM6ING . Z ICERT�FYTNATCI7MEPERFONMANCEOFT/IEN'ORKFOAWMICMtHI3PERA11TI5135UED,� � MECHANICAL (,�} SMALLNOTFUCLOVANYVER50NWMnY.WNER50ASTOBECOME5U0JECTTOTHE � YlOPo(ERS'CDIAPENSATIONUN50FCALIFORNIAANDACREETM�TIfISMO1hCBECOME INSPECTIONFEE S SUBJECT707HEWOPI�RS'G��PENSATIONVROVISbN50F5ELi�ON7T00pFTMEIABOR ' ' - � - - - - ' cooEie�uu�ortn�wrtHca.'a�rwin�nascvnrnnsiows. ISSUANCE / � � SMIP p DATE: APPLIGtNT: - � - . � ENEFiGY P/C WI1ANiN4 FAILURE TO SEIXJRE MV/7KER5'COAIPENSATiON COVERACE IS UNUwFUL,MID 6MALL BE � SUBJLCfANEMPLpYERTOCWAIINALPENALTIESANDCNILFINESUPTOONEMUNDREDTH0U5AND. ENERGYPERMR pOLLMS(f 100,000).IN ADDITION TO TNE COST Oi WMDENSAiION.D�1.U�ES AS PROYIDED FOR W J 6ECT�ON1TOeOF7NEU1[i0RLO0E,NTEAEST,ANDA7TOHNET5FEE4. RETENTIONFEE: � � � SCONSTRUCTION LENDING AGENCY pRE-ALT FEE: � � �� � INEREBYAiFlRMIMDERFENALTYOFPERRIMTMAT7HEREISACONSTRUCTION(ENOPlGAOENCY � � FOR TME OEHFOR4ANCE OF iME WOi1K FOR WHIGM 7M�5 PERMi715155UFD ISEC.]097,CIV.C.). � � � � LENOERSWWE � � � LfN0ER5ADDRE55 W ILEiRIFViIUTIMAYEREAUTHISAVVUC�7qNM105UTE7WRTNEIIBOVEWFOWA�TqNISCqNECT. TO7AL FEES . � � � � � IACREET000I.�PLYM7MALlCRY/�NOCOVNTYOROINANCESANDSTATEUWSREIIN�(iTO8U4DING J i /��t�� CONSiRUCT10N.M1DHEfi[BYAUiHOWZEREPRESENTATIVESOFTHISCOU1fTY70EMERUPONTHE . . I���/ S� ABOVEJAE1fT10NFDGiqPERT`/FOqINSPECTIDNVUflPO5E5. COMM[NTS L � �1 GWK..S C_ �1c� m Q aenu NAMElVR11ln . � y EO PEFWITi OAtE � �. RECPT.NO. PAID BY VAUDATION SL g_— WHITE--0epartment Copy,YELLOW—Flnance Copy,PINK—Assessor Copy,GOLOENROD—File Coq,GREEN—AppicanYa Copy � CITY OF DIAMOND BAR : : .;,, •,� ;_, �.-. . .... . _. _... . . _. . . + ,::.. �;��. :,�,_INSPECTION RECORD' "�:;,.�-��:., ' � � � . . ..,� . . . . . . . . . . . : � � • - • � � � - SETBACK ' , �'�'`'. ' � .' �� i•`� ' �� � FLOORJOIST �'•,`.I � � ,�� '. 'x,:_,. ,_. , . ' FTGS/FORMS/STEEL -. . ;,\ ,` FHA REQMTS •-: �, ,-_ , ; -- - --- - .- - ELECTRIC GROUND�:::�"- - - '.. . _.. _.� ` `,� _ � .. UNDER FLOOA�DUCT., , � :-- - �_ . GROUND PLUMBING ' UNDER FLOOR COMDUIT.• .',, •�.',�i�' ,- - '-'�''` ' ` ' ..: . . .. , . . ; . . . ... . . \ . � ' 1:!1Y'i .)t . . SCAB GRADE - . ---- � : • FIREPLAC �F�UNbATION '.'. '�'`� -" TEMP POWER -- � ' --- ' � '� �'� � FIREPLACE BOND BEAM � -- � --- � � � ' ` WATER SERVICE -. __�: -: ----.-:-.._:: . :: : . =_. . . .MID HL BON�BEAM '-' �_�-- '- , ' -� - ' ,— .,. . ; ; : : . ._. . . . _. .. . _. . . . .. ___. . __._ � , ROOF SHEATHING . _ -_ . _ ` ' 8 FT.BOND'BEAM'• � '.:f�� ��`,=• ,= �, r,..1 �i.r''. .; ! � . ... ., FRAMINGNENTILIATI�N FINAL BOND BEAM .. _ I: -. � ,� c--; � - • ROOF COVER:' 'PRE-GRADING ' � ' � ' � — '� ' ' ROUGH HEATING --- - - - - - BENCHING ... .. ', . . .- - �� �.- , ROUGN ELECTRIC•-: -- z ��d � �- ROUGH GRADING , ROUGH PLUMBING ; -� � - - �- �� ' ' �� : . FINISH GRADING SHOWER/TUB TEST - POOL ELECTRIC . EXT.LATH/SIDING ' : POOL FENCING " WALL INSULATION ' � POOL FINAL . ' CEILING INSULATION OFF SITE IMPS. � ' - DRYWALL NAILING � DEDICATIONS . . . :. •. � SEWER...__.... _.__..,- � - -. _. .FINAL ENG. • ,.. � - - - - SEPTIC TANK...--.--. � . ... _. . LANDSCAPE/IRRIG.. . , , -SEEP P17/L.L, . .:. -- -- =. -. ON SITE IMPS.-.. �. -GAS AIR TEST;--- �--- _ . ._. _.. `..._ _ _ ... - - . - . ; . FINAL ZONING . - RNAL CONST. -; -' `- ' ; ':; ",' ";` „ ' �•, ; - FIRE DEPT. FINAL � � FINAL'.NFATING ' �'',' ' ' � ;'; , �'� - -� '. HEALTH DEPT. FINAL _ FINAL ELECTRIC :; � ' ' . :,�' .--,' `; DEV.;FEES PAID - -� � �NAL.'FLU�JIBING �>»,!.-•�!,, � ; •. , ,.�� �.,{� � ENERGY . • � _ �� �;�, �.�:ti.. � . ; � — „' �.,� ��� � j • :, �',i, (=• -. ft f _._ , i . . ._ � . . ;;r ♦ � . -..• J .• ' _ � �_ .� '�. _... . ...�...-...�....� �� . ♦ � ) ��1 - : �i � .. '\ � " • . " _.' _ _.. . . . . . . J._ . _ � _ ' ._�.� . . . . � � COMMENTS - - ��"� , , , _ �., . . .. . . �.. , . . -� �.'`S: -. .. . . '� - . . - '� � �•_ - .J ,�..,: '` . .� - . _._ .. _ .... . . , . ; , , . , • 1 ....�; ' - - --. . _.. � ; . ,. - - - i .- -- - .. .- -- .. . .. � , . . , SEPTIC TANK SIZE ' ' . ' SEEP.PITIU SIZE - - � . I , - � � � }' -- -- � � . , . . . � ....- --. ... .._. . , ,,. ...... _ .... - - - - - ; � � 1 ; • . . : . . . .. . . - __ , . . � . t _ . . .. , , ��r �' � — = — — . .. � .�,. 1 . , � .�,c.,,,, , � _J � l��r�!� ..1� . .. i' ��1� ` ii��`i\' . . C� 1 \�,i 1`1 - 1 "� _ ��- �-• - . '�'-__ '� _