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EXPIRED ---�� -- CITY OF DIAMOND BAR � CO:t4MUNITY DEVELOPMENT DEPARTMENT " �+ ,x.,.� 21660 E.Copley Drive Suite 190 • O C T 2 u �OOQ PRESS (909)86a3195 Fax(909)861-3117 � '""� B UILDING PERMIT APPLICATION FI R M LY ¢ ADDRESS Z`3�� �A IL (�DL�' (.�L , APPLICATION – PERMIT I � P!C ��7 , o DATE NUMBEp k � � APN LOT L��_ TRAC� � NI �SSUE TYPE OCC � DAT� _CONST.� GROUP p OWNER 714�n�N.� ���r. <i.. V ••T/�2..5 �` AODRESS �� '�U(1-tJ1s�JL� � . 4Tt�p� ZONING SETBACKS Z CITY 1'v�+�L�^1CF� 21�t750��L. '3►��rl� FRONT RW p , o APPLICANT ' �q P J��C[QF.1�� 'TEL � REAR ❑ • � '—� SIDE/SIDE STREET RW ❑ � CONTRACTOR VnT GoNG�T"s . SIDE ❑ o AODRESS � PROPOSED USE ���►S C,cw.�r F�cGr , Lj(��.}.�S � CIN�W�i �[� ZIP�%�],�I-.� TEL � w ARCH/ENG/ 2���p �vUTj z DESIGNER � a ApDRESS � �J,'✓+a.� 1.v, T � NO.DWEL. NO. NO.. N CITY TZ�+nwGt ZIP� TEL. p UNITS STORIES DEDROOMS cn DESCRIPTION SQ.F7. FACTOR PSF ADJ.AREANALUATION � p� -OWNER•BCILDER DECLARATION SFWADD,'REM - O 1 HEREBY AFFlRM UNDER PEYAL7Y OF PERJURV TFNT 1 MI EXCMPT FROM TN[GONTRACi0ii5 LI- G3f292/CefpOrt W CENSEUWFORTHEFq10WINCREA50N�5EC.70J1.5BU51NE55M1DPROFE5510NSO0DE:ANYCiTYOR (n C.� CWNTYWHICNREOI➢RE511PERMITTOCON57RUCT,ALTER�MPROVE EMOL191.ORREVA:fiANYSTRUG W Patio/Deck� TURE PR10H TO RS ISSUANCE.AL50 REOUIqES THE APPIICANT q SUCM PERUI7 TO Fl�E 115IGN[0 S STAiEMENT THAT HE OR SH 5 UCENSEO PURSUANT TO TH iOV15lON5 OF TME CONTMCTOAS LI•' � � CENSE UW(CHAPTER i(COM 'CWC NATH SECTqN 7000 'O�VISION 70F THC BUSINESS ANJ Pq0- POOVSPB - - � 0 FESSqNSC00E)ORTMATHEOR �ISE%EA�PTTHERE� fAAN�TNEBA5IS�OHTHEALLEG[DE%E4P- C7 , V TION.ANYVIOLATqNOFSECTIONld SBYIWYAPPI .TFOqA�EHMIT5l18JECT57MEAPV�ICANTTO Z qe-qpp� A CML 7ENALTY OF NOT MORE THAN F �NUNDRE OLURS�f 5o07.k ~ OIASOYMEROFTHEPROPERTY,O ��EMP OYEESWiTHWAGCSA9THEIR50lECOMPEN3AT10N, - Z � Commerciai W�LL DO THE WORK AND THE SiRUCTURE ' INTENOED OR OFFERED FOR S/LLE(SEG 7oH.BU56 J ��/ N NESS ANO PROFESSIONS CODE THE COM JRS LICENSE UW DOES NOT AVDLY TO/W OWNER OF � TQ�I���S -✓✓ x � VROVERTYNM1qBUd.D50RILIPROVESTME ON, vDNT10DOE55UpiWOPKNIYSEIFORH[RSELFpR (t THRWGNI9SORXEROVAJEMPLOYEES. iOVIDCD UTSUp11MVROVEMEMSARENOTIN7ENDE00R m � OFFEREDFOq3AlEIF,MOVlEYERTME .LDINGOHpAP MENTISSdDWITHINONEYEAROF�OMP�E• z TION,7HE OWNER�BVILDER WiLL HA .THE BUADEN OF P� NG TIUT ME OA SHE DiD NOT BUiLO OR . � IMPpOVEFOF1iHEPURPOSEOFS )., . 04�OWNEROFTNEVFOC ,AME%0.USNELYCONT INCN7THLICENSEDCONTMCTOHS Q TD CONSTRUC'T 7HE PR0.IECT _G 70��.B1151NE55 AN�PROFESSIONS COOE:TME GONTflACTOfiS W V21U711W1 3c��oon• � ADJ,AREA � � � CENSEUWOOESNOTAPPLY FNOWN[ROFAPROGERiYWHOBUILDSOflIMPROVESTHEREON,AND , WHOCANTMCTSFORSUCHOHOJECTSMAiMACOHTMCiOq(5)LICENSEDPURSV.WTTOTNECONTMG QUANTITY DESCRIPTION �E Y T00.5LICENSEUw.�. . � ❑I AM E%EMPT UN�ER SEC. 8.8 P.L.FOfl THIS RE�SON Q .�.�. 0 � � a —A�� L�'�l�-.�r5 i � � OA7E OWNER U ' z W v n b Q �¢ LICENSED CON7RACTORS DECUIRATION_ w [L I HER[BYAFFtRM UNOER PENAL7Y OF PERIURv THA7IAM LICENSED UNDER PRON510N5OF CHqPTER Ur � , p, i(COUMFNCP1aN7TH5ECilON700o)OFONi5�ON70FTHEBU5ME55ANDDRO�ESSION5C00[,1wD -, X MY�ICENSE IS M FULL FORCE ANO EFFECi. ' m , lll � LICENSE CUSS � LIC.N0. ���� j F--� V OATE � ���COMRACTOti �r'r i S a W � WORKERS'COMPENSATION OECLARATION �3 b'�� a . � IH[REBYAFFIqMUNOERPENALTYOFVENJUfiYONEOFiHEFOLLON1NG0ECUMTION+. � Z . � �IMAYEAN�WILLMtiMAIN�tERTIFIGA7EOFODNSENTTOSELF-INSUREFORWORKERS' _ ' CG.�PENSATION,ASiROVIDEDBVSECTICN]7ooOFTHELABORCODE,fORiHEVERfOMWiC[ W G� ' Q �/ OF iHE M'ORK FOR WHICH THIS PEflM171S ISSUED. � , -- '. .'� � '� � : : ,•, W �Yj�iHAVEPNOWIlLMl11NiNNWORNERS'COIAPENSATqNINSUNANCE,A5RE0U�RE08YSECTION , " ` /� ' 0 9700 OFTHE UBOR COOE.FOR TNE PERFOFMANCE OF THE WORK FOR WHICH THIS PERMIiIS �/� � I �/J ISSUED.MYWORKEflS'COM7EHSATIONINSUiIANCECARRIEAAN'JPOL�CYM1M9ERARE�. CONSTRUCTION�r\�1�� � {�' /✓'r � CARRIEN T'A TG � g PLAN REVIEW ll �� —(��� � VQICYNUM�ER IIZ.(o_�'�l7 �f ELECTFiIC _ 1 /1 v ¢ . �� (MSSECiIONNEmNOTB[OOIMIEfmOF71f�EPMT6iMOhEHR,ORmDOl1AlK,�E707�q1tES5� PLUME3ING w Z I CEATIFV 7HAT N THE PERFOPMANCE OFTHE N�ORN FOR ' THi� 'MITIS ISSUED,I b1ECHANICAL .(.�J SHALLNOT EIAPLO�ANY VERSON W ANY MANNER 50 BE .�SU&IEGT TO THE I (n N'ORKERS'COMVENS�TIONUWSOFGLIFORNIA, �GREE nTIFI51qV�OBECOME INSPECTIONFEE � � � - S SU61ECiTOTNEWORKERS'COMPENSATqNPRO 3qNSOf GTION�7000FTNELAFi ' . COOE,ISHNJ.FOqTFMATMCOMPLYWITHTIpSE �owsro ISSUANCE � 0 p DATE: �� V APPLICANT: SMIP 1 ,: � ENERGY P!C . .� WARNING:iNLURETOSEWREWORNERS'COIAPENSATIQVCOVERAGEIS 'NFUL,lWOSHALLB[ � —, � �y SU&IECTMIEMPLOVERTOCR;�IINALPENALTIESANOCMLFINESUP70WEM 7FqU5IWD £NERGYPERMIT ��,�,�� D�lLARS(5��.00�),INIDDITION TOTNE COSiOF COMPENSATION,pAA1AGE5ll5 PROVIDCO FOR IN R�/� � SEC710N]�aeOFTHEIA�ORGODE,RITEREST,MI�ATiOFWE75FEE5. � RETENTIONFEE: � L � (�(/ � CONSTRUCTION LENDING AGENCY PRGALT FEE: �}�. �- � � iC�1Q � �� I l�i` 1 : I;+J:J IHEREBYAFFIRMUNDEflPENALTYOFiEilM11RYTW1TiHER[ISACANSTRUCTIONLENDUJGAGENCY . Z FOR THE VERFOqNANGE OF THE WORK FOR WHlpl THIS PEHMIT IS ISSUED(SEC.7097,CIV.CJ. W � LENDEFYSIL�ME F_ LENDERSADORESS - W I CERTIfY TIAT I HAVE pEAp 7111SAFPLICA1pN A E T��,T��,�,�aFo��,pH�S��aE�,. TOTAL FEES �� , 3 b i � IAGRfETOLOMPLYWITHALLCITYMIO .�IOHUINAh.. M1�SIATEUWSRELATII:CTO�VLLDINC �� � CON57RUCilON,.WD T �UZEREP0.ESENTATIVES TNISCOUNT7TOENTERUR7ITHE Z ABOVE�MENiIONED OPERTY tINSPECTIONiURP0.5E5. , CO�+IMENTS ' � � ��= 1 m CEPoAITTEENAAAE �N�N7j "7I—f I (,(J . . . � . 4 N _ (q SIGNATUREOfiERMiTTEE DATE i � � � RECPT.N0. PAID BY �ALIDA7I � � � �� ITE—Depanment Copy,YELLOW—Finance Capy,PINK—Assessor Gopy,GOLDENROD—Fita Copy,GREEN—Applitanl's Capy � _.__.. . . ._...._---- --- -- -- - - _._- -- ---. _.. . . -, .,,,• ,. - .. � . ., ,2 . .... . ., : .. . .., ,, ... , ,-.. �,y. _ . .. .. .-_. .. �,o � . .r.i •a..r;.�•`:.,. y -�_lr,l�_��j::: ` __ r'� `-•: � .. � -��. CITY OF DIAMOh1D BAR � ` ''':�"�� `' ` �,��� iNSPECTION RECORD , � � �. '� - . � ti / � � � o - • � • • • SET BACK � _ FLOOR JOIST; , , - - . ' FfGS/FORMS/STEEL FHA REQMTS`" � ELECTRIC GROUND UNDER FLOOR DUCT r.. �. - � GROUND PLUMBING UNDER;�L'OOp CO�IDUIT � � SLABGRADE � FIREPLAC"EFOUNDATION ' �"'` '"' `"-`` "` TEMP POWER FIREPLACE BOND BEAM ` .' ' " � - �� WATEFt SERVICE` l � � � ' � MID HT.BOND BEAM J . �-�. ; � � � J ` ' "' ROOF SHEATHING 8 FT.BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM - ,. . .r. - ROOF COVER - PRE-GRAbING=1� ''=. � � ' •. ' ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRAQING � SHOWER/TUB TES7 POOL ELECTpIC � i EXT.LATH/SIDING POO�FENCING WALL INSULATION � POOL FINAL ' CEILING INSULATION �•��• r��.,�., OFF SITE IMPS. � DRYWALL NAILING DEDICATIONS ` SEWER ;� FINAI ENG. SEPTIC TANK� � � LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. . � GAS AIR TEST FINAL 20NING � FINAL CONST. ' " . - FIRE DEPT.FINAL FINAL HEATING ' � � HEALTH DEPT.FINAL FINAL EL�CTFtIC � DEV.FEES PAID FINAL PLUMBING ENERGY � • , . _ . __. .----- - -- - , � , - _ - __ . . COMMENTS • � ' z. C' ��•rt��ay��t—� .. - •.. . i . . . .... . .. � �t.: !: � ' . . , . . _ . ,. � , i ', . ..._ .._••,��.. `. :... ....:�:`_�.� .`.�-_�_..;.��__.. . . - - . , . . 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