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HomeMy WebLinkAbout17790 �� CITY OF DIAMOND BAR . � DEPAR'TMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21825 E.Copley Drive � '" (909)860-3195Fau(909)861-3117 i. ` PRESS .�%�� BUI IN�',i PERMIT APPLICATION ; ;,. ; FIRMLY , � JOBSITE Y1 � ' APPLICATIO PERMIT q P/C o AODRESS' � � DATE���2— NUMBER/77<a # � ISSUE �—TYPE OCC � APN LOT TRACT DATE CONST. GROUP p OWNER ''C73� _�2i�1�A1 ADDRESS��,�� -�� L.4'n�.��r1 ZONING SETBACKS gCITY[�0.v+cn /�✓�+2- ZIP�-s� TEL --�}" . REART RW ❑❑ APPLICANT TEL. SI�E/SIDE STREET RW ❑ � CONTRACTOR �' 1 � !' SIDE ❑ ADDRESSL3 �'��'� � �����'"_' PROPOSED USE � o fr� � � ,.� ., � CITYS��:.dL+�?U� IP y1�1"� TEL 1��� �—fi �--G'c�t.r--�I�i ct o ARCH/ENG/ .11e ta 4�T. � �r S':'7 —,-,S t� � DESIGNER NO.DWEL. NO. NO��io� o., ADDRESS UNITS STORIES BEDROOMS a � CITY ' ZIP TEL. rvSYc N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER DECLARATION SFFVADD/REM O p I HEREBY AFFIRAI IMDER VElULTV Of PE0.NRY THAT I AM EXEYM FRdA THE CONTMCTORS LL Gdr8Q0/CBryOR W CENSEUWFORTMEFOLLO'MNf3REA50N(SEC.70.1t.SBU5WE931WOPPOFESSIONSWDE:I�M'CRYOR (f� C3 CWHTYWHICNREOUIRESAPERMRTOWNSTRUCiALTER�PROVE,DEMOLISH.ORREPAIRANYSTflUG W P8L0/DBCI( �V TURE.PRIOH TO fi5 ISSUANCE,AL50 REOUIRES THE AOPLICANT FOA SUCM PER/AIT TO FILE A SiCNED W � STATEIAEM TNAT NE OR SME IS LICENSED YUFi5UAN7 TO TME PfqYIS10NS OF THE CONiFiACTORS lh $ CENSE UW(CMAVTER Y(OOMMENGNO WITH SECTION 7000)OF OIVI5ION 70F TXE BUS�NESS M!D VRb � P��Pa � FESSIONS�E)ORTHA7NEORSHEISEXEMVTTMEREFROMANDTMEB�5i5FORTHEALLEOEDE%EMP• TION.ANVVKKATIONOF6EMION7W1.6BYANYI1CVlICANTFOHAVERMITSUBJECTSTHEAVPLICANTTO Z Re-Roo( ���� � AGVR.PENALTYOFNOTIMMETYIANFIVEHUNDREDDOlUR5�f5oo).): 0 01ASCWNEROFTHE7ROPERTY.OR4YEMVLDVEESWITMWA0ESA5T11EIRSOlEC040ENS�TqN. ❑ (`,pmm0fCi81 Z WILL DD iHE WORIC IWD THE STRUCTUPE IS NOT INTENOED OR OFfEHED FOR SALE(SEG)Ou,BUSI• J NE55 AND PROFESSIONS GOOE:iHE tONTRACTORS UCENSE UW DOES NOi AFOLY TO AN OWNER OF � DR07ERi1'VMOBURDSORMPROVESTMEREON.MIDYMODOESSUCNWORKHIMSELFORHERSEIFOH m � THqOUGNHI50RHEROWNEAIPLOVEES,PROVIDEDiHAiSUCHN/PROVEMEMSARENOTINTENDEDOH . . U,1 OFFERED FOR ShLE IF,HON'EVER7ME BUILDINOOR IMPROVEMENT IS SOLD WITHIN ONE YE+�R OF COMPLE� 0 710N,THE O\NNER-BUILDER WILL HAVE TME BURDEN OF iROVINO THAT ME OR 6NE DID NOT BUILD OFi Z MPi1pVEFORTHEPURPO5EOF6A�E�. W 04�OWNEROFTHEPROPER7Y.AME%CLUSIVEIYLOMMC7INOVATT7LIGENSEDCONTMCTORS fG TO CONSTRUCT THE PRQIECT(SEG 7ou,BUSINESSINO 7ROFESSIONS CODf:TNE CONTMCTORS U� VelUetl011 ADJ.AREA LL] CENSEUWDOESNOTAPPIYTOANOWNEROFAPROPERttN'FpBVILD90RWPROVESTNEREDN,AND � N51000NTMCTSFORSUCM7R0.1ECTSN�THACOMRACTOR�S�LICENSEOVU0.SUANTTOh1ECONTMG pUANTITY DESCRIPTION FEE � TORSLICENSEUWJ. � � O I AM E%EMPT UNDER SE0. B.i P.Q FOR TMIS REASON � u' DATE OMMER � � Z W F4 LICENSED CONTRACTORS DECLARATION W CC INEHEBVAFFIRMUNDERPENAIiYOFGERIl1fiY7NATIA/ALICEN5EOl1NDERVROVI510N50FCIN7TER V. p, ��COAAMENCIN�YA7H SECiqN 1000)OF Di�iSqN]OF THE BVSMESS AND PROFESSIONS CODE,M1D Z X �W LICENSE IS N FUIL FORCE AND EFFECL � llJ m � UCENSE CUSS C� �� LIC.NO. ��� I�n � � � V DATE D��^� .Uy�_ CONTRACTOR TIIl� yh�'f f CC� d , . . W . . . _ .. . - . . .. � WORKERS'COMPENSATION OECLARATION a = U � IHEREBYAFFIRAIUNDERPENALTYOFPEfiIUAYONEOFTHEFOLIOW'NGDECUM7qN5: y Z 4 0 �IHAYEANDWILLRIAiNTA1NACERTIFICATEOFCONSFMTOSELF-WSUREFORYVOPJ(ERS' _ � CdAPENSA71dJ,ASiROVIOE�BYSECTION77000FTHElABORCOOE.fORTMEPERFORMANCE W OFTME WOFK FOftMMlp1 iH13 iERMiT IS i55UED. � � /�- O =�HAVE AND MALL MARfTNN WORKERS'COMPENSATqN INSURANCE,AS flEOUIRED BY SECTION �.p �7ooOFhIEIABORCO�E,FOitTHEPERFORMANCEOFTNEWORKFDRN1tlCMTM�SPERMRI3 ��3'a' � ISSUEO.NYWORKERS'COMPENSATIONINSURANCECARRIERANDiOLICYNUMBERAflE: CONSTRUCTION ] CAFRIER TU.4l� PLANREVIEW � � POIICYNUMBER ��� 7 3'3— �/ ELE(�.TRI('. (MsSECfbNr�No'tBEO�I£tmOFiIEFEiiMi5�0a0NE��lrDnEDDatARSR�aolaiLE55). PLUMBING W i l._�.,:� ;:'� �7 � � I____1 Z I CEHTIFY TNAT IN TME PERFORMANCE OF TME WON(FORYmICH iH15 PEFMIT I5155UE0,1; MECHANICAL _ _ (} SHALL NOT ErAPLOYANY VER50N W M1V WUNNEH SOAS TO BECOME 5U61EC7 TOTME � -� � N NKIRKER3'COMPENSATqNLAW50FGlLL�FORNIA�NOAOREETUTIFIS/qULCBECOME INSPECTIONFEE jjj��� � � S 6UBJECTTOTHEWOPoCERS'CdADENS�T10N7ROVI510N50F5ECiqN77000FTMEUBOR �SSUANCE I ���� � WDE,I SHALL!iORTMMTM LOMPLV WITH THOSE FROVISIONS. � OATE:O 3�'�V'�� APPLICANT. ���S �G r7 SMIP . �.. �•-,� �W WMNINO�FAILURETOSECUREN'ORNER5COMPENSATIONCOVEMGEISUNUWFUL,ANDSHALLBE ENERGYP/C � �1��•�� � SU(lJECTANEMPLOYERTOCPIMPULPEWLLT�ESANDqVILFWESUVMdJEHUNOREDiMOUSANO ENERGYPERMIT Lj • • ' OOLlAR5p100.0oo1.INADDITIONTOTHEt0.ttOFCOMPENSATqN,DNAA0ESA5iROVIDEDFORIN `� �•� � SECTION 77oE OF 7HE LABOR CODE,WTEpEST,AND ATTORNEV'S FEES. RETENTION FEE: � d ' CONSTRUCTION LENDING AGENCY pRE-ALT FEE: � � INEREBYAFFIRMUNOERPENALTYDFPE�IRYTHATTHEREISACONSTAUCT�ONIENDW0A0ENCV d FORTME7ERFORMANCEOFTHEWOHKFORWHIp1TMI5YERMIiISI55UED�5EG�0Y7,CIV.G.�. • . � . � � LENUERSNAAIE ' � IEN�ER'SADDRE55 �� 10ERTIiYTMATIHAVEREAOTHISAPPUGTIONANDSTATETHATTHEABOVEWFORIIATIONISfARRECT. TOTAL FEES � ' �. , j�('� �� W IAGREETOCOAIPLYWITMILLLCITYANDCOUNT'OFDINANGESANDSTATEUWSRELATWCTOBU0.DtNG �`�1 � � CONS7RUCTION,ANOHEREBYAUTHORIIEREPRESEMAINESOFTMISCDUN7Y70EMERUPONTNE ., .. ' �y ABOVE�MEMqNEDPROPERTVFORINSPECTpNCUHPO5E5. COMMENTS ' = V VO m CERMITTEEN Hn � �� � SIGNATUfiE F PERMITiEE � , DATE RECPT.NO. PAID BY VALIDATION ��� WHITE—Depanment Copy.YELLOW—Finance Copy.PINK—A9sessa Copy,GOLDENROD—File Copy.GREEN—Applicant's Copy �. � . .. .. .... . !,4�1' ...r ., . ..i.��... v . ... ..;Y^�....•� .. v br'ri�a�. . �.'"��Y...�.• .. . ^tR' :\! .,:. _� . ._ . .,.. �' .. �cr .. . ..r. . �- • . . CITY QF DIAMO{�l�A B�,R li'vSPEC g IOfrl RECURD ...�....._...,_,�..�..._._.�.__._.-.-. .rH.r ..�. - . �� 'i �� o r �� � � , ` �r E a � , '. ,i . �c e � - o I i � n _ � _-ll�����:�1��J .__. �'T'��_ '.i��--�� ,.�� �.� �. : _- i�, �.����[ ►� . �w� � ...� _. _._.. �...._�..��..___W y_.. __..- -- �! - �' ____._ _ � _.�.______.._..� _.__. _ �, SET BACK FLOGR JOIST FTGS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING I ` I UPlDER FLOOR CU(�IDUIT • SLAB GRADE ; I FIREPLACE FOUNDATION TEMP POWER � I FIREPLACE BOPJD BEAM WATER SERVICE ! ~ MID HT. BOND BEAM . ROOF SHEATHING ��Z �� I $�. BOND BEAM FRAMINGNENTILIATION � i FINAL BOND BEAM Fi00F COVER I �Z��p��� / � PRE-GRADING ROUGH HEATING I � BENCHING ROUGH ELECTRIC I ROUGH GRADING ROUGH PLUMBING � FINISN GRADING SH�WER/TUB TEST I � POOL ELECTRIC EXT. LATH/SIDING j I I POOL FENCING WALL INSULATION I POOL FINAL CEILING INBULATION � i OFF SITE IMPS. DRYWALL NAILING � I DEDICATIONS SEWER � ' ; FINAL ENG. SEPTIC TANK j � LANDSCAPEIIRRIG. • SEEP PITlL.L. � I ; ON SITE IMPS. GAS AIR TEST I i ; FINAL ZONING FINAL CONST. � � , ' �IRE DEPT, FINAL . FINAL HEATING � � HEALTH DEPT. FINAL FINAL ELECTRIC , I DEV. FEES PAID FINAL PLUMBING ; ENERGY' I •�•�@i it�jR'0 t �� _ „�. � �- � ---- COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE ���--�-----�------� i ..__ : ' ; -�-,� ,,��� i�� _ i ..�...�.�....r.�...._.�+ _� _ . ,