HomeMy WebLinkAbout16537 (32) �� CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ��
TC . 21660 E.Copley Drive Suite 190
(909)860.3195 Fax(909)861-3117 PRESS
�•�A BUII.DING PERMIT APPLICATTON . � FIRMLY
o ADDRESS�'�f' T�I 3�f.11.(.illl.C: �L. r1t.Ll4;!C�.(t � DATECATION� � NUMB R_� M!C
� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER Jlf� �fl
"' ADDRESS � ^ ZONING SETBACKS
� CITY Y ZIP TEL. 1� FRONT RW ❑
APPLICANT TEL.��3 REAR ❑
� SIDEISIDE STREET RW ❑
CONTRACTOR SIDE p
� ADDRESS PROPOSED USE ' - 1 Y �
CfTY ZIP TEL.
o ARCHlENG/ • -.
� DESIGNER NO.DWEL- - " ' -� -:NO. � =:� ,;• NO.
ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
N DESCFiIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
�
� OWNER-BUILDEFI DECLARATION SFR/ADD,'REM �
O
� 111EREBY AFi7RM UNCER iENILTY OF GERNRY MAT 1 M1 E%EYPT Pi101A iHE CONTMCTOR$LI• GBfBQB/CB�OR
W CENSEUWFOHiHEFOILOW�N4REA50N�5EG7N1.68U5NE55ANDVROFE5510N5COOE:ANYCIttOR (f�
� COU!lSYM41101REWIIIESAVERlAITTOWNSTRUCT,PLTEfl,11AVROVE,CEMOLISH,ORREPNFlANYSTRUG � W patio/Dock �
TURE.GRIDR TO R41SSUANCE/�LSO R[WIRES iHE APP�IC+INT FOR SUCH VERMIT TO FILE A SIGNED w
� ETATEYEM TUT HE OR SNE IS UCENSED PU0.51JI1R TO THE GROVISIONS OF TNE CONTMCTORS L��
� CENSE U�M�CNAPTFR i(COA�A�ENCMO VATH SECTIDN 7000)OF OIVISION]OF TNE BUSINCSS AN�PRO� LL' PooVSpa
iE551ON5 COOEI�TMT NE OR SHE IS EXE�Pi THERCFR0IA AND THE BA515 FOR TME ALIECE�E%E�P�
TION.ANYVIOIAiqNOFSECTION7W1.68YANYMFLIGNTFORAPERMITSUBJECTSiMEMPLICANTTO Z Re-Roof UO
� AGVIl7ENALi70FNOTMORElT4WMEMUNORCDDOUAR5�i5o0).): Q
� OI,Il50Y�NEFOFiHEVqOPERTY,ORAIYEMP�OYEESWITNWAGE5A5TMEIR50lECOMPENSATqN, `(,�m�7BfCld� '
YALLDD THE WONC AND TME STRUCTURC IS NOT IHTENDED OR OFFERED FON SKE fSEC.7DN,BU51� J
lff55 A!D VROFESSIONS COOE:ME CONTMCTORS UCENSE UW DOES NOT APPLY TO�N OWNER OF
N OFOGERTYWIpBUILOSORYPROVESTMEREON,AN�WHODOE55UCMN'ORKNIMSEIFORHEflSCLFOfl �
Q TW10UC,HF45011HERONTIEA�ROYEES,PRONDEOTMATSUCJ/iYPROVEUENTSAREHOTWTENOEDOR L�
� OFFEREDFORS/LE6,F10WEYCRTIEBU4DPIOOR4PROVEMENTISSOIDWRHINONEVEAROFCOYPIG
TqN,TFIE OWNER�BUIIDER VA1 HAVE TME BUADEN OF VflOVNO THAT HE Ofi SNE D�D NOT BUM1D OR
W PFqYE FORTNE PURP0.SE OF SILLEI.
� TO CONSTItUC'T iNG PROJECT SEG 7 a�,BU NESS/�W�OFE SIONS CODE'THE CONi�MrC70R5 LI•
LLl CENSELAW�OESNOTMPLYTO/NONMEROFA7pOGERTYMMOBUILDSOAWPR0�E51HCHCON.ANO �aWation _� �d Q ADJ.AREA
� N'IqCONTMCT5FOR5UCMDR61ECT5WI7HACONfRACTOR(S�LICENSEOPURSUANTTOTHECONTMG OUANTITY DESCRIPTION FEE
� IORS UCENSEUW.} " -"-- '
0 OIAAIE%EIAPTUNDFRSEC. B. P.C.FORiHI5REA50N U • �
3 I �
DATE ' � OWNGR ' ' y� U .
� LICENSED CONTRACTOFiS DECLARA ON W
F J
� W
IMENEBYAFFIfiNUNDERPENALTYOFPERA1RYhUfIMILICENScDUNDERPRO�'ISIONSOFCHAPTER �
(� Y�COYM[NCWc]W17T15EGTIDN7000�OFOM510N]OFTHEOUSiNE$SANDPROfE55qN5CO0E.11ND Z
X W LICENSE IS N FLAA FORGEM:D EFiECL m
LLJ
O �
� LICENSE CLA55 LIC.NO. j
V DATE CAMMCTOR d
LU
� WORKERS'COMPENSATION DECLARATION a
N U
N 1 MEREBv AFi�M1 NvDER DENALTV OF PE0.ri1RY ONE OF iHE FOLLON7NG DECLARATqNS: �.
Q
� �IMAVEAHDWILLMMNT�:NACERTifICATEOFCONSENTTOSElF�NSUREF0/1WOFIKERC = -
�pYPENSATqN,�SPFiOVI�CJBYSECiIONJ7000�TNELAflONCCDE.FORTT/EiERFORMANCE �U
Q Of iNE YY�RN iORMn11CH iHIS VERA/IT iS IS5UE0. �
�I HAYE INO YVILL MAIHTAN WOFV(CRS'COMPENSATqN INSUiWKE,AS REOU�RED BY SECTION
Q1700 OF TME U80R LOOE.FORTHC PERPOfLAwCE OF ME WOHJC iOR WMiCMT�iS PENMiT IS
� ISSUED.W W�RNERS'GOMPENSATpN INSURANCE CARR:ERMID POIICY NUM�ERARE: CONSTRUCTION �I O
� ��pqi[q PLAN REVIEW
� PoLIC'lM1MBER ELECTRIC
0 (f1t55CCICNNC�NOTBE07.i1E1'EDOF71[PEPA�TBfOROnClu�piFDDOl1AiGIS+aO)ORIF'S) PLUMOING
Z 1 CEp�'I7MAT CJ iliE FERFORMMICE OF iHE N9N(FOR WN�CH iH:S PENIAIT IS ISSUED.I MECHANICAL
(yry SwLLINOTFMVLOVANYVEH50NWANYuaNhEF50A5iOBECOMESUBJELTiOTHE
Uj WOiU(ERS'COA�PENSATqNUWSOFCAtIFOW+IqANDl1GREE7MAiIFISMOULDBcCdAE INSPECTIONFEE
S SUBIECT TO T1:E wOHNERS'OO�.�PENSATqN FRONSqNS Of SECTqrv 1�0o OF TME UBOR
000�,i sH�u ro�tnw�rn caeP�r wirH nas[artovisar+s. ISSUANCE
� SMIP
p DATE: A7PLICAN7: _ .
W ENERGY P/C
WARNING fAILURE N SECURE VAFL<ERS'CAMPENSATION COVEMCE IS UNUW�VL.AND SNKL BE
�y SU0.IECTMlEMPLOYER70CWMINILLPENAlT1E5ANDpVILFWESUPTOONEMMDFCOTHd15AND ENERGYPERMIT
DOlUAS(f 100.Oo0�.IN FODITION TO TME COST OF COMCENS�TqN,DAMACES AS Pf10Y10E0 FOR IN
J SECTION970eOFiHEUBORCOOE,INTERLST,ANDATTORNET5iEE5. RE7ENTIONFEE:
2
R CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� IHEREBYAFFIRYUNDERVENALTYDFPEiWRYTHATTNEREISACONSTRVCi10NLENDINQAGENCY - " ���'?
__—....—._..._ . ....._ .__... ""'
Z FOR THE PERPoiUAAl�ICE OF THE WOFK fOH WHKa1 TMIS PERNI7151SSUED(SEG�DYI,GV.G).
W
� IENDEN'S NAME
� LENDERS/DORESS , v I I �
WICERTiFYiHATIMAVEREADTHISAPPLJGTIONAND57ATEhU7T1EABOVEMiORM�TqN�SCORnECT. TOTAL FEES �
� IAGPEETOCOAIDLVWITHAtLC7ttANDCOUNTYORDiNMlCESANDST�TEUNSREUTc1G70BULDINO
CONSTHUCTION,AND MEREBV 0.UT110liRE REiRESENTATIVES OF TMIS COUNTY TO ENTER UPON THE
S� ABOVE MENTIOHEO GROVERTY FOR INSVECT�ON 7URFOSES. COMMENTS
� V C�
= r
m GERuiTTEE [(PflIM) �
�a„ ,� i � Z( p
N SIGIUTURE OF GL OATE
� RECPT.NO. ! PAID BY VALIDATION
WHIT —0epartmentCopy,YELLOW—Finence Copy.PINK�Assessa Copy.GOLDENROD—FileCopy,GREEN—ApplicanYc Copy
r---._,
CITY OF DIAMOND BAR .
� - � '��. • , :�� . IPtiSP�CTi l���.REC03?C �
. __ . �; � .
;j;+�,�;:i��`'rl"-_}�°f ,���.r� 1►'}-�;a�f�'�f�_�',!r{ � ,. w i►`�1:';e:GI�'��� �):,��'= Ai►�F-'i�]�.c�;rc).� �
,._�,.:.:...�.___..._.,,..._--____._________.Y.__......__..v._..__.._...___--_-.--�._.......__..._._.�....._�.____..._,_....._....._.....,..,..,...._.... ...:... ... .. ........... . .. . --
:SET F�ACt: _�_ I � I I FLOOR JOIST • • �� , _
FTGSlFOR'^.�•`STEEL j ' � :FHA R=GP.",TS. _ --
"ELECTRIC GROUPJQ . _ � l � U�!DER FLOOR DUCT �_ ___
GR�UND PLU�ABI^:G I I �I UNDER FLOOR CUi�!DUIT ; � ___ __
.SLAE Gf?AD� i I I FIREPLACE FOU�JD.ATIO�: 1 . I __ _
�TEh1P POWER I FIREPLACE BOPd�EEAti': �_�
VJATER SERVICE • � _ ITr�nID HT. �OND BEAP,1 I �
ROOFSHEATNIPdG _�,�-2'.�-A(_I �-I F F?. EOND BEf1D�1 I _ �
FR/1D�!ItdGNcNTIL1ATIOPJ� � �- --� � FINI',L�E30PJD BEAM �
�ROC)F CU�/�R _ �•�-a�� . �i PRE-GRADING
R�U3H N�r",TIPJG - BENCHItJG
R3UUH ELECTRIC ' � ` I � . ROUGH GRAD�NG
RJ:)�H f LUSJ�iSING � � - ' � ! FINISH uRADIPJG
SHOfJER,TUB TEST-: � � � 1� PCOL ELECTRIC � __
E};T. LhTi i!Si�JIPdG - POOL FEPdCING I I
;lh'fiLL INSU�ATION POOL FIPlAL � _
rC�iLiP;3 1;v�ULATlO�v � I O�F SITE IisPS. _ ; _
�D=,1�"v'dAL�NAILI�dG � DEDICATIO�dS
;Sc1�;LR ! FINAL E�:G. �
S�PTIC TANK LF,NDSCF.P�lIRRIG.
���? i-!T/!.L. � � 0;�:S!TF ID.1?S. _ � ---�— --
�_:',S f,i�TEST � �_ _ �_� FI;vAt ZO^1iP:G ; j
',Fl�'�,L�.OiJST. �.�"�-v`_� � I FIP.E DEPT FiNl.L � `
f;f=i::�:L!I�f,TI�;..: ! . . —�� H /',__ - —
r- r_ I � � i Z H UEPT. �I^:AL ,� � "
1 :'i:'t.,:. [=LECiF31C I I j � DEV. FE�S �r"�In-----j--i --
•.i�.i u� tr• . l I--- �-
-- ---- PL� . �f�.0 � � I � E�:JERGY '----..- _ __.
: -- . . . � —1-- � !-� � ,.,.,� �--- ^__ _.�� !_ ---- –—__--
1_ t...•��`. .......'."'�.......:'�-- ._ . ......... .. ' --
�, -:— _. . - ---.. _... _.._ : . I
���:J��i�v1Ei�J i S — — — -
�.
, ,., - -- - --1
- ---�
SEr�TIC TAf�1K S!Z� � -------...-- --- ------------
SEEP PIT;ii S17_E __ . _ -- -- ------ -- —
�.. ._._._. - _:�R..... -.,___ ' -. ��- ------- --------
i I. . _; -----
::'1�`F` . . ^I. . -- --
t
� - � - --------------------
�.. ... _ . . . . ---_ - ------- — . - -----
�---.___.........'1_......... . .. . . .. � — 1 - --=-� — --