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HomeMy WebLinkAbout11549 ! _�� C1TY OF DIAMOND BAR � '= �' ` " • � �— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � . 21660 E.Coplcy Drive Suitc 190 . ., • (909)860-3195 Fax(909)861-3117 � � : '�*�'.. . BUILDING PERMIT APPLICATION __ - . . � Flhn.,� N JOBSITE r • APPLICATION �PERMfT P/C ` p ADDRESS l?G /Y. Pa�.o C��R0 DATE NUM6ER �I s�a N . g _ issue � TYPE " OCC . APN - LOT � - -TRACT - - DATE - CONST. ' GROUP g OWNER PAVL ,' 14.NOt'7Qt�G(t. . "" ADDRESS S A.v�t ' 20NING SETBACKS � � w CITY �l/A.H.ow.b Dk�7 ZIP 917LS 9vQ- �G/•c7731 FHONT .. - FtW - ❑ , z TEL. REAR , . ❑ � APPUCANT Sa�+�+t' u�hTEL.9o4�L�P-r1�2 , � SIDFJSIDE STREET RW -p CONTRACTOR N�'�� D�ti t h SIDE � p � ADDRESS �4.D o v t . CITY ZIP TEL PROPOSED USE � ARCHlENG/ • . � . . . DESIGNER - NO.DWEL. NO. NO., ADDRESS UNITS STORIES BEDHOOMS ' NCITY ZIP TEL N 'DESCRIPTION `�•SO.FT. FACTOR PSF ADJ.AREANALUATION Q _ OWNER-BU�LDERD�CURATION '. . . SFR/ADWAEM - O Q 1 HENEeV AFFlR4 UNDER VENALT'OF CEiWRV THAT I Au EXEAIPT FROM THE CDNTRACTORS L4 .Gaf896�CetpOR . � itJ CENSEIAWFORiHEiOILOWMOR ` (SEG70.71.6BUSMESSANOPilOFE5510N5CODE:ANYC1fYOFt (n "'� - � � � COUNTYMRIIpIREqARE511PEMIRYOCONST(RICT.ALTER�PROVE.OEUOLISH.ORREFAIRAN'/STAUC• W P8110ID6Ck _ . . 7URE,PR�OR TO rtS ISSUANCE.AL50 NEOU�RE9 TNE APPLICMIT FOq SUdI PEp4IT TO FlLE►61GNED W �� - � ----� - - �� . .... .� STA7EMENT TfUi ME OR SHE IS 110EN4ED PUR4UANT TO THE PROYISIONS OF iHE CONiMCTORS U• . . ., . � CENSE UW(f]UDTEN�(OOMMENCWO WIiH SECT�ON 700010F D�h510N]OF TME BUSINESS ANO PR0. � P��Pa iESSqNS CODE)OR hNT ME OR SME IS EXEMPT THEREFRpA AND THE&1515 FOi1 THE/LLAEaEO E%EUP- TION.AN'lVIOU1710NOFSEGTqN7W�.6BYANYMPIK'J1NTiORAPERMITSUBJECT37HEMPLICNffTO Z Rg•R001 F ACMLiEtULT/OFItlTMORETHFNFNEMl1NDREDDOl1ARS(iSa01.1: � p4ASOYRIEROFTHEPROVERTY.ORMYEYPLOYEE5W17HWACE5115THEIRSOLECdAPEN5AT10N, � �mmerclai . - � WLL DO 7NE YIORK.ANO TME STRUC7UHE IS NOT MENDED OR OFFERED FOR SAIE�SEG 7Mt.BU51• J NESgµD CIqFE5510N5 COOE T11f CONTRACTORS LICENSE UW O�ES NOT AOPLY TO AN OWNER OF N PiqPERNYMiOBVpD90RIMPROVESh1ERE01(ItAV1�lODOE55UCHNOfiKHIA15ELFORHEM1.ELFOq m ' Q �7HFqUCW11150fiHENOMME1Ml01'EES,VROV�EDiHA75U07MVROVEYEIRS�RENOTNTENOEDOR � OFFERWFORSFLE6HOM/EVE0.IMEBVI.DWQOR4PRDVEUENTiS50lDN1TMNONEYEAROFCOMPIE. • . . . . T10N,TME OwMER-0UIIDER W1LL HAVE THE BURDEN OF GROVUNi TW�7 ME OA SME DtD ND7 BUtID OH YPf10VE FOR iNE PURPOSE OF SALEL W OI�aN�EROFIHEPROPERTY.IWIXCLUSNELYCONiMCTWaWRHIICENSEDCONTMCTOR9' � [t TO CONSfNUCTiT1E iR0.1ECT(SE4 7oN.BUSINE55 AND GROfE3310N5 CDOE:TNE CONTMCI'ORS U• ValUefiOn ADJ.AREA � LL1 CENSEUWDOE9NOTMVLYTOiU10Y/NEHOFAVROPERTYWM06URDSORMPROVESIMEREON.M70 � rnaoorrriucrsFonsuwvaaccrsv�nni� iucroacs�ucEuseoruAsuu+rTon+sca+rw�a pUANTIN � DESCRIPTIOY FEE . � lORS LICEHSE UW I. /y�� /�+� - .. '. . . O�MI E7(EYPT UNDER SEC.I�""��" P.C.FOA THiS REASON Q 3 . c' � � DATE `�7 4 a �N'KER � W D.t/'t uo.. .+1 P P�►.vt-L 1 q, o � �4 UCENSEO CONTFiACTORS OECLARATION ��� �_ �yj . ` �' '• � - �L IHEREBYAFFIRIIUNDERPENKTYOfPE1WRYTHATIAMLICENSEDUHD[Rifi0Yi51CN50FCHAFTER � . � �(COIAMENCN(iN7iNSEGTqN7000)OFDMSION]OFTMEBUSiNESSANDPAOFE55pNSCOOE,M'D ' W L10E NSE IS N NLL FORCE AN�EFFECT. � IICENSE CLASS. . . LIC.NO. . . U DATE cONTRACTfM � W � WORKERS'COMPENSATION DECLARATION , � a .. � IMER£BYAFF7RMUNDENPENALTYOFPEiWRYONEDFiHEFOLLOwiNGDEq.ARAT10N5:. .. .. . . .. .. .. . . y Z G �IMIIVEMOYALLMNNiANACERfIFlGTEOFCON5EMT050.F�N$UREFORNOIMEflS' S q CO4PENSATION.ASVROVDED9YSECTION77000FTHElI90RCODE,iORTHEPERFORMANCE Of THEN'ORK FOR WHIp17HIS VERMR19155UED. � ' � Q �I HAVE AND YnLL LURfTAai Y/ORKERS'COAIPENSATqN NSUMHCE.AS REOUIRED BV SEC710N ]7o00fTHELAeORCOOE,FORTHEGENiORYANLE0F7HEYYORRFORWMiCMTNISPEPNfT15 � ISSUED.MYWORI(ERS'COMPENSATqNINSURMrCECARR1ERMiDPOLICYNUu6ERARE: CONSTRUCTION � CARNER PLAN REVIEW � FOLICYNUMBEA ELECTRIC ' � �„ � Q (�"SECfXX1N�NOTBEC01RlElIDOfMPEMfiBiOftWEFIIAORE0Cd1A0.SfSt00�ORlESS? PLUMBING z ICERTIFY TMAT W iHE VERFORMANCE OF iME WOfiK FOR WHICHTH15 VERMIi I5I55UE0.1 MECHANICAL " � (�} SMALLNOTE4PLOYANYVERSONNAMlYANNERSOASTOBECOMESU9JECTTOTME � WOPoCERS'CO�.�PENSATqNUw50FCAl.IFORNItiANDAGAFET1uTIFISMOULDBEC0IAE INSPECTIONFEE - `_ -"- - SUBJECT70TMEWOW(ERSCO�APENSATICN7F10Vi51ON50FSECT�ON]TOOOFMEUBOR ' "' ' - - - � COOE,151W1FORTXWITHCOMPLVN7h171105EPHOVI510NS. ISSUANCE � � � � SMIP �] DATE: APPLMJ.NT.�� . w ENENGY P/C WARNINO:FAILURE TO SECURE MARKERS'COMPENSATION COVERAGE IS UNUV+FUL AND SMI1lL BE +� � �y SUBJEGTANEMPLOYERTOCAIMINUPENALTIESANDCNILFwESUPTOONfMUNOREDTHOUS�ND - ENERC�iYPERNIT j 1 � 1 1�"• � DOLURS(S10o,00a1,W AD�ITION TO 717E CQS70F COMVEN5A7qN,DAMAGES�S PROVIpED FOR IH � � SECTION91oeOFfl1EU80HCWE,INTEREST,ANDATTORNEYSFEES. RETENTIONFEE: � ? �� �" � , pWi, CON5TRUCTION LENDING AGENCY pHE-ALT FEE: . .� .IHEREBVAiF6UAUNOERpENALTYOFPERN1iY7HAT7HERE15AQONSTAUCTIONLENDRIUAOENCY, �L7�� r� •�{_ � FOR TME PERFORMANCE OF THE WORK FOR Yn11CH MIS GERAAIT IS ISSVED�SEC.]OY�,CIV.C.�. \'� .� . � . �: � �. . � LENOERSNAME � � � � � LENDEWSADONESS . WICERTIFYTUTININEREADTILSAPPLIGTIONANDSTATEiHATTHEABOVEINFONAATpNISC0��IECL TOTAL FEES , p� IAOflEE�COMPLYN7iNALLCRYANDWU1fT'ORDINANCESANDSTATFUWSREUINOTOBUIDIN� ` � � f S O . CONS7RUCfpN,ANDMFREBYAUiNOR�ZEPEPRESEPRATIVE50FTMISCOUNTYTOENTERUPONiHE . S� /19pVE�MEHTqNEDPftOVERTYFORPlSPECTIONRINPOSES. COMMENTS � � 9 Pa v-i� �' -�.rv n c=2 t G G- ' ' � � ' � iEHA1fTTEE NAy[�{P(UHn � � . . . . . =�. i •,,r' •b ��' — � y C i.KJ�, I . bqNA7VREOFPERWrtEE `!C��±�ty� OAfE � _ _ RECPi.NO. � • PAID BY (� G VALIDATION, ���` � � ��WHITE—Department Copy.YELLOW—Flnance Capy.PINK—AseeseorCopy.GOL�ENROD--File Copy,GREEIJ—Applicenfs Capy� � � - � ..;e• . _ ..�r .,�+'�.�t:. 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MID HT.BOND BEAM , �., �,•_, ; , .. .. , � �. _... - - - ROOF SHEATHING . . _._ _. . __.. . .. .. ... -� " 8 FL BOND BEAM � ' � FRAMINGNENTILIATION . FINAL BOND BEAM ' ' - - — � ROOF COVER : ": � " �PRE-GRADING � � .;•;.•. � � ROUGH HEATINCa --:.... _. . . . _ � _. �BENCHING. .. _... _. - _ � ; _ . _. .... . . - '� -� i :�: �ROUGH ELECTRIC .-- 3l -� ' - ROUGH GRADING � ; `.' �ROUGHPLUMBING - - - ' �- - :� .�. -. "FINISHGRADING, , •. . .. . ,. . I :• SHOWERlTUBTEST� - - - - ------ � --- . . . . P.00L ELECTRIC- ... : � -, '. :. :. . ' ;,... EXT.LATH/SIDING .- � �_ . - � - --- - - . . POOL FENCING . ° , , . _ • WALL INSULATION POOL FINAL ' CEILING INSULATION OFF SITE IMPS: � • • DRYWALL NAILING i DEDICATIONS , . • SEWER..........-----�- -'--- .__ FINAL ENG. � ,. � . . � . . . SEPTIC TANK -- .!....-- -.... .. .._ _ . . --- ._'. . . . _ LANDSCAPE/IRRIG. ' -.;�� ! :- � _ . . ... ON SITE IMPS. . .. , ,... SEEP PIT/L;L.-::=._:- :._... _ _ . ... . . . . . � GAS AIR TEST-' __. ._. ... - .- . - .-: . . -. FINAL ZONING � �-. � n r; � , FINAL-CONST. -.... .... .. . ...... ... . . ... .._. .. ..... .. FIRE;DEPT.FINAL\,.` ":. .,.. ,�..'_._.. . � . FINAL-HEATING -- - .-; � c.-, -.. . , .....- �.. .. : ,.. ? HEALTH'D�P.T.�PINAL.k. t.�.,s�1 -� i�-c-�C-�... .� � _�, _. � FINAL"ELECTRIC� ��- � z�- � -�" DEV.'FEES PAID - � - � i - FINAL PLUMBING �NERGY , • ; • -• I ` , . � e � . . . ,_ . . . , _ . _ . _ � - .. .. .. _: : .. - - -.... . ,.._..:._._..._ - -= --_..:—-- . . . __ ,. _._ . ._ _ COMMENTS - - - ----. .. _ ..__. .._ : . .._ _.. j , . I � --��---- --- � - - , .. � •: _ .. _ . ..-� --. . ._ _ .. � ,, . . . . - _ - - -- -�- -- -- . . . , � _..' . ', '. .. i��'.. �' -' . ., � . � - �., f :� . ... .._ _. . . .. ."' . . ...._ ._ . .. . . � '�} . . . 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