Loading...
HomeMy WebLinkAbout11292 � . _�. . .. . . . _ -. .. - -. ._ ... .. . _ - --- - ---------...._... ---�� � CITY OF DIAh10ND BAR ' COMMUNITY DEVELOPMEN'I'DEPARTh7ENT ,'�.,,.0 21660 E.Copley Drive Suite 190 PRESS (909)8643195 Fax(909)861-3117 '"' B UILDING PERMIT APPLICATION FI R M LY o ADDRESS �j'7 3 OvEP_L dUlS �f17GG Qb OATE'CATION � �1 CE NUMB R�I�� ��/C (/ � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNEfl��/.LG� ✓Cl��;�nLl/lf�� p ADDRESS ►lLr3 Q(/Ea -. � ZONING SETBACKS oCITI' n1A/YD/�/Db'AiPIP�(a.�TEL. .3 � (f FROPfT RW ❑ APPLICANT TEL. REAR ❑ � SIDEISIDE STREET RW ❑ � CONTRACTO /f/'' L SIDE ❑ • Q ADDRESS � • � � .CITY ' ZIPQ°�Q TEL. c� '- / ROPOSED USE�E/yDvE EXI ST/�✓G �p �Nr� o �¢ic 'v � o ARCH/ENG/ n/A/L" QESfbEN/'T/�L �LAS SNI� W DESIGNER NO.�WEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. c�i� OESCRIPTION SQ.Fi: FACTOR PSF ADJ.AREANALUATION p� OWNER-BI;ILDER DECLARA710N SFR/ADDlREM O � p 1 HEREBY AFFlRM UN�ER PENALN OF DENAIRY 7HAi I AM E%EMPT iROM 7HE CONTRACTOHS LI• G818gB/CafpOR W CENSEUWFORTHEFOLLOWWCREASON�SEG7Wt.58U51N[SSANDPiiOfE55qNSCODE:ANYGTYOR (n U LOUN7YNmIpIREWiRESAVEFMRTOCONSTPUCT.ILLTERP.IPROVE.OEMOl15H2ORHEPAIqANYSTRUC• W Patidpock w NpE,GRiOH TO ITS ISSUIWCE,AL50 REOUIqES THE ADVL�CANT FOR SUCH PER+AIT TO FlLE A SIGNED W � STATEMENT 7FL17 ME OR SHE IS LIGENSEO WNSVANT TO TNE PROVLSIONS OF TME CONTRACiOR3 L4 � CENSEUW�fSfAVTER9I�MENCINGWITHSECfION7oo070FDIN510N�OFiHEBUSINESSAN�7R0• � PooVSpa � � � p FESSiONSCODE)ORTHATHEORSNEISEXEMPTTMENEFROMANDTHEB/SISFORTHEALLEGEDEXEMP- (� V TION,AN7VIOUITIONOFSECTION70T.SBYIWYADPLIG�`lTFORAVERMITSU&IEG'�Sh1E�PPUCANTiO Z fl0-FOOI Q(, I1 dNL VENALTY OF NO7 MORE THAN FIVE HUN�RED DOLURS(f Sao).)� � OI.ASOYrt1EROFTFIEVROPERTY,ORMVEMPLOYEESWITHWAGCSASTHEIR50LECOMPENSATION, O COrtIR10fCla1 NALL 00 iHE WONK M10 THE STRt1CTURE IS NOT INTENDED OR OFFERED FOR SALE(SEG 70aI.BUSI. J � NESS AND VROFESSIONS ODDE:THE CONiRACTORS LICENSE UW DOES NOTAPPLV 70 AN OWNER OF = • FROPEHTYWMOBUrtD50RIMVROVESiMEREON,ANDVI110DOES5UCHWORKMIMSELFORMENSEIFOR CC TMROUCHNISORNEROWNEAIPLOVEES,PFOV�DEDTHATSUCHWPROVE4ENTSAREAbTIN7ENDEDOR m w OFFERE�FOflSALE.IF,FIDWEVERTMEBULDINCORIMPROVEMENTI550lDWITHINON[YEAROFQOM7lE � iION.THE OlVNER-9UILUER 1YLL HAVE THE BURDEN OF PftONNG THA7 ME OR SME DID NOT BV:ID OR � pAVFlpVEFOATHEPURPOSEOFSAtE). W �OLASOwNEROF7MEPROPERtY,AMEXCWSNEL�COMRACTINGN7THLIGENSEDCONTMCfORS � TO CONS7RUCT THE PRnIECT(SEC.)ou,BUSINE55 AND PROiESSiONS COOE:hIE CONTRAC70RS lb V21u8�i0� O ADJ.AREA W CENSEUWOOESNOTAPPLYTOANOWNEROfAVqOPERTYW/qBU1LD50RMPROVESh1EREON,AND � MhqCANTMCi5FOR5UCHPq0.1ECT5WI7H�GONTMCTONIS�LICENSEDPURSUANTiOTHECONTMG QUANTITY DESCRIPTION FEE Y TORSLIGENSEUW.). ' � O I MI EXEUPT UNDER SEC. 8.l V.C.FOR TNIS REASON 4 � V � � DATE OWNER V � � ZW . . . . , . .. � LICENSED CONTRACTORS�ECLARATION ' W � IHfR[BVAFFIRMUNOEFOENALTVOFVERNRYTNATIAULICENSEDUNDERDRON510NSOFCMA7iER � p_ Y(COMMCNCWGWITTfSECTION70oc)OF�IVISqN70FTNE0U51NES5AN�PROFE55iON5CODE,IND Z X YYLICENSEISNFULLFORCEANDfFFECL ' tlJ ^/ �1 � LICENSE CU15S �� LIC.NO.�tS G S�j� j V pATE � ' CONTRACTOR d W ��fi'�C�✓ � - WORKERS'COMPENSATION DECLAFATION ^ � a = /' U � I HEREBYAFFIiiM UNDER VENAITY OF PE0.IURV OflE OF THE FOLLOWING DECLARATpNs I Z � Q � �IHAVEANDWILl1MINiAINACERTIFICATEOFCONSEMTOSELfaNSUHEFORWOAKERS' _ COMPENSATqN,ASiROVIpED8Y3EGT�ON]TooOFTHEUBONCODE,FORTHEPERFORMANCE `U . OF THE WORK FOR WHiCH iN15 VERAUT IS ISSUED. . � � � w �INAVE�NDWILLIAA�NTAINWORNERS'C01J�PENSATIONINSURANCE,A4qEWIREDBYSECT10N �� � Q 97ooOFiIiEUBORCODE,FORTMEPENFONMMICEOFiMEWOAKFORWMICH7Mi5PENAiT15 � ISSUED.MVVpRKERS'COMPENSATIONINSUMNCECANNERANDPOLICYNUAI�ERARE: CONSTRUCTION �' J —,/ j caaaiea �b f'n/ r /A X PLAN FEVIEW o va�crNUMOEA <-!'iCS,�'�� A �� ' z y ELECTRIC ¢ � (IHSSECiICNNEEDNOT8E07A�'IETEDOFhEPEq'.R6FIXi0NEM1�OREDOQI�SR��)��} PLUMBING Z IGERTIFYTHATMTHEPERFOMLWCEOFiMEWOPKFOflWHIp1THI5PENMIT�5155UED,l MECHANICAL �' 1 (7 Sw1LLNOTEUPLOYANYDEP50NWANYMANNERSOASTOBE00►�ESUBJfCTTOTHL •^'l� ��•6! � N+ORKERS'COMPENSATIONUN50FCALIFpRNIA,ANDAGREETHATIFI5N0ULDBECOME INSPECTIONFEE � �r � SUBJECf TO THE WORKERS'COMPENS�TiON PROVISIONS OF SECTION 7700 OF 7ME UBOR � � CADE.1 SFLLLL FORTHMATN COIAPLY WITH hpSE P/RONqSIONS/. � /��� �SSUANCE p DATE: �"� � � APPLICANT: I`"IS�) 4(�/v�//i.�/�u!/�N �� SMIP _ � � WARNINO:LAILURETOSECUREWORKERS'COMPENSATIONCOVERAGEISUNUWFUL.ANOSHALLBE ENERGYPlC � _ � �j„ SU0.IECTMIEMPIOYERTOCRIMINALPEWLLT1E5/1a�CIVILFINESUPTOONEMUNDREDTMOUS�ND ENERGYPERMIT DOILAFlS�S 100.000).N ADDITON TO TME COST OF COAIPENSATqN,DNAAGES AS PNOVi0E0 FOH IN � SECT10N770lOFTHELA[fORWOE,WTERE5TM10ATTORNEI"SFEES. RETENTIONFEE: � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: ' O Q IHEREBYAFiIRMUNOENPEN�LTYOFPERIURYTHATTMEAE6AGON5TRUCTIONLENDINGIICENCY �- FORTHEVERFOiUA�NCEOFTHEWOFKFORWHICHTH15VENMiTI5155UE��5EC.�09�,CtVG). . Z w � LENDER'SNAME F– LENDERSAOORESS w� TOTAL FEES ICERTIFYTHATIHAVEqEAD 7VUCATION STATETNATTHEABOVENiFORMATqNISCORRECT. � IAGREETOCd.1GlYWITN CIT'AND YORDINANCESANOS7 SRELA7INCNBUILDING � , U, CONSTHUCTION.AND EOYA ,EREPRESENTATNESOF :,GOU YTOENTERUPONTHE � MEMIONE � FOq INSPECT s. COMMENTS Q\� ' � E NAAIE(OHINT) � N �R�� E Kr 2�zy-9� f • �� SiGNATUHE OF DEWAiTTEE � DATE ,�,, � . - RECPT.N0. v PfL'D BY VAL�DAT10 � WHITE—DepaKment Copy.YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanCs Copy . � . � .. . . � . . . • . . �,. - . , .....i,...>, � .. .. r .. , ..�.. ... .. . • .. .'. ... "�•� . .�r,� . .. _., .n fl:�...-.. ,.,r�.. ..., ,.i'p• w .. _.. ,. CITY.OF DIAMOND BAR �; . ;:'' .�� . . .� : ; ; - .. , ; ' �= �'- INSPECTION RECORD . �•, - ` ...' ,, , . . . �; �: � � � � , . �al��• a . . =.�_��. I� . ���o � e � . - ' SET BACK . - _ . � FLOOR JOIST -- -- ' _._ . � FTGS/FORMS/STEEL - - -- FNA REQMTS -. - _ - � _• ELECTRIC GROUND ' � : UNDER F100R.DUCT��-�,�, .-- - �� , ' • GROUND PLUMBlNG - -- � UND�R•FLOOR CO�IDUIT •-� `�� '•' '- �' •, � �' SLAB GRADE - -.._.. " _ . _. _ �.. ; �� : FIREPLACE FOUNDATION � , . . , , TEMP POWER - - _ . --: . . � :. . FIREPLACE'BOND BEAM=�--= :.-,�_..'::.^: '. - '-'.��:. . . . • ; VYATER SERVICE. � -_�� � • - ' � `= .' MlD FiT.�BONDBEAM� • - n�,... . ._ . ._ : , . � `- ROOF SHEATNING.i-�•=� 2(,'/�fJ . �•• .n 8 FL BOND BEAM � , 1 FRAMINGNENTILIATION � FINAL BOND BEAM ' -.. ; =�. ROOF COVER -� - -- -._ .._. __ --- - � PRE-GRADING ' ,. �;'.� i : ' . , . . ` ' BENCHING - ROUGH HEATING ---i _ . . . . ROUGH ELECTR(C � , - - ` � ROUGH GRADING . . ROUGH PLUMBlNG� . � - - FINISH GRADING SHOWER/TU6 TEST - � - POOL:ELECTRIC � , EXT.LATHlSIDING , .; �. - POOL'FENCING . ' WALL INSULATION : POOL FINAL• • • ' CEILING INSULATION OFF SITE IMPS. � • .. DRYWALL NAILING � DEDICATIONS " SEWER. _ .. .. . ...__ :_ . .. , FINAL ENG. - - --. .. .. • • , . ; : .� -„-�-.`. LANDSCAPEIiRRIG. , . , EP [ TA K.._.- .-__. •.. -� ._ , . ,. SEEP-PIT/L.L. - _ =-•-. - ON SITE IU1PS. . ; . . GAS AIR TEST--- - -_ _ -- - F1NAL ZD�JING �- . FlNAL CQNST. ;--- - ` FIRE DEPT FINAL - , . F1NAL HEATING -- -- ��� - --�-- -- HEALTH DEPT. FINAL FiNAL ELECTRIC - - . DEV. FEES PA�D . . 1 . FINALPLUMBING - � - �` -ENERGY ! : ; � `: � r. .. •' - -, - • ',� ;.� � m . . � �-t-._- _ - , _ , , . . - - . . .. .... ---- -- --. _._. . _ � : : . COMMENTS - . . _. . _. _ _ . . � , , , . . , . ---- . . . .. _ __ _ . , - - . . ,_. . , . _ � .: - - - ..._ - - --- - - _.. _ _ , _ _....- -- , , � . . . � , . , _. _ � .. , , _ � . � _ - �,- ,,,� �-. _ - . _ . . .� , -- � . . _ < <. �_ , • � . . . i . � .._._ r, ,.._ _ � � , _ , , . �: .. . , . _ . , � � � ; '. ; . _ . ���; ,�. �� ��� � �:•,.; . . '��;; - �-�� �. . '<`; , - . � .; . _ _ . � • - , ! SEPTIC TANK SIZE - - . - ; : ..... _ _ ._ __ _ . _ - ---- - �__ , SEEP PIT/U SIZE - � _ ' � _ . ,,�� i ; , - .\ - � � - _, _� � y�.\_ -� _. - ��' , . i '��. _ ... '� — J��, ,, , ' /I , �. , ,; , - - --- - . � .. . .._ '. .. _ .. ._.... .._ _..._... .. _ ; _ _ _- -- -- - - - _ , _ /