HomeMy WebLinkAbout18131 (17) ,�` CTTY�F DIAMOND BAR
1 1#E�A1C['1�NT OF COMMUNTIY&DEVELOPMENT SERVICES
21 i25 E.C�pI cY�ive
� '�"` p0�)�fOT3l'fSFax(909)861-3117 PR�$$
��'%�»" IIUIi.��NG PERMITAPPLICATION FIRMLY
� JOBSITE p APPLICATI PERMIT �? P!C
o A�DRESS ��b� �A.(��1c�o dd � DATE 3 NUMBER � ✓�
�
� APN ��! TRACT ISSUE TYPE OCC
Q _ DATE CONST. GFIOUP
p OWNER O
" ADORESS U oi- ��ilJGf�L.7 od�, ZONING SETBACKS
z CITY�/.O/S9trsL.A IP��TEL. FRONT RW O
g APPLICANT TEL. R�A �
� . SIDE/SIDESTREET RW O
� CONTRACTOR �� ��� SIDE p
s A�ORESS-38 G L L �0 _ A- �
� CITY ANf;NSf� ZIP AG �tv �'23-0`��� PROPOSED USE �� -�7H l ���
� ARCH/ENG/
� DESIGNER NO.DWEL. N0. NO.
n. ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
� DESCRIPTIpN SO.FT. FACTOR PSF ADJ.AREANALUATION
� OYVNEH-9UILDER�ECLARATION SFR/AD0/REM �
O
(, 1 HERE9V AFFIRY IJNDER PENALTY OF PERAIRY TMAT I 11A1 E%EMPT FROM iT1E CONTMCTORS LL G8f8QB/C81�OR
W CENSELAWFORTNEFCILOWINOHEA50N(SEG7W7.60USWFSS/N�VPOFESSIONSCOOE:ANYCITYOR (J�
U COUNTNWHIpIRE�UIRESAFERAIRTOCDNSTRUCLAlTE0.MVROVE,DEUOlISH.ORREPAIRANVSTRUG W pgtidDetk
� NRE,PNOR TO RS ISSUANGE.AL50 REW�RES TFIE AVPLIGNT FOR SUCH PENMR TO flLE A SIGNED W
6TATEIAEM THAT HE OR SH6 IS LICENSED VURSV�NT TO iHE PROVISI�NS OF THE CONTMCfOR4 L4
� GENSEUIW(CMAPTEHV(COIAMENqNOWITHSECiqN7000)OFDNISIONiOFTMEBU51NE55�NOPilO� V" POOVSPB
FESSqN5000E)ORTWIT HE OR SH[IS EXEMPTTHEREFROM AND THE&t515 FOR THE+4lEGE0 EXEMP•
� T�ON.AM'VKKATIONOFSECTION)091.6BVANYAPPLICMITFONAPEfiMIT5l161ECf5THEINPLICANTTO Z Re•Rool
A CML PENAITV OF NOT MOFE TMAN FIYE HUNDRED OOl1AR5(fsa0).):
� OL��fROFiHEPROPERTY,ORA1vEMMOYEESWffHWACE5�5THEIqSOIECOMFENSATiON, � CORIm0fGl01 �-
WILL 00 THE WORK.AND TME STqUCTUHE 6 NOT INTENDED OR OFFEREO FON S�LE(SEC.7W�,BU54 J
� NESS AND GROfE55qNS CODE THE CONTMCTOHS UCENSE UW DOES NOT APPIYTO AN OWNER OF ?
PNOPERT7 NRiO 8V0.O5 OR MVROVES THEREON.IIND WNO DOES SUp1 WORK NIMSELF OR NERSELF ON
[C THROU6MHISORHEROVlNEMPLDYEES,PROYIDE��TSUd1IMPROVElAEMSAREHOTINTENOE�OR m
0 OFFENEOFORSAI.EIF,HOWEVE0.7HEBULDINCORIYGPAVEYENTISSOIDWITMWONEVEAROFCOMME
y TION.THE OV/NEN�BUILDER N�LL HAVE TME BURDEN OF iROVIN6 iMAT NE OR SHE DID NOT BUILD 011
� IMPpOVEF00.THEPURP0.5EOFSALE�.
❑I,AS OWNEH OFTHE PfiOPERi'I.AM ExCLU51VELY COMMCTINO MrtTN IICENSED CONTMCTOfiS
� TO CONSTFiUCT TME PRQIECT(SEC.70M,WSINESS AND PROfESSIONS COOE:THE CONTMCTORS LI- VONBI�Ofl ADJ.AREA
W CENSEUWDOESNOTAPP�YTOANOWNEROFAVROPEXTYWIOBURDSORIMPROVESTMEREON.AND
� WYqCON7MGTSFOR5Up10RO.lECTSWITHACONTMCTOR�S)L�CENSEDPURSUANTTOTHECON7MP Q�q�JrITY DESCRIPTION FEE
� TORS LICENSE UW.J. I'
O I�D(EMPT UNDER SEC. 8.�V.C.FOR THiS REASON ¢ �dv �N�
� � .� �.'f /� �/ �
u" DATE OWNER
Z W
� LICENSED CONTiihCTORS DECLARATION -�
� w
IMEREBYAFFIRMUNOEHPENALTYDFVERNNYTHATIAAILICENSEDUNDERVROVISqN50FLHAiiER Vr
p. 9(COMAIENCWOWITHSECTION70oo�OFONiSION�OFTHE8U51NESSANDFROFE5510NSCO0E,AND Z
X MV LICENSE IS IN FULL FORCE M1D EFFECT.
LL1 4 m
� LICENSE CU55 �� O LIC.NO. " ��� j
F-
. V DA7E �� S� OZ� CONfRACfOR C AI/G � . . __. . , . . . .. - -- --
W
� WORKERS'COMPENSATION DECLARATION • Q
� 'IHEREBYIIFFIRMUNOEAPENALTYOFVERNRYONEOFTHEfOLlOWW40ECLARATqNS: V � � �
� Z
Q
� �INAVEANDNAU.AWMAMACEfiTIFICATEOFCONSENTTOSELFJNSURfFORYVORKERS' 2
� COMPENSA710N,ASViqVIDED8V5ECTION77000FTMEtwBORCODE,FORTHEiERWRAIANCE W
OF THE WO(1K FOR WHICN THIS pERMiT IS ISSUED. �
�
4 _I HAYE AND WILL MNNTAci WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SELTqN
J7o00F THE LABOR COOE.iOR THE PERFORMANCE OF TNE WORN iOR WHlpi THIS PENAiT IS
� ISSUED.MYNVIU(ERS'COMPENSATIONp,7�S/yp,w C-EICA/p/q ERANDPOLICYNUI�IBERARE: CONSTRUCTION
jC�RRtER S r� W"'T� - — - PLAN REVIEW
� GOLICVNUTABEP ' �S GL�6 Qr ELECTRIC �
p �Ss��rpHr�mrutgeoor�ppFnErer,rrgrtxor,��u+or�ooa.t�g+oo�oa�ss� PLUMBING
w ICERTIFYTHATNTHEpERFO�MlCE�fTHEMM11KPo4 T1115VERMIT1565UEO.1 MECHANICAL
CZr} S+ULL HOT EMiLOY MIY GERSON W ANY M�NNER b��S T E E SUBIECT TO TNE
UJ WORKERS'COMPENSATiW1UN50FCA11i�11NU,1u1 1 EE TIFISMOuIDBECOME INSPECTIONFEE � j�
SUBJELTTOTMEVYORKERS'COMPENSAT�M�II� S�f CTqN77000FTNELABOH ISSUANCE `�
�j CODE,Ir�SHALL FOR7M'M7H COMPLY VA7H il�i Sv� �},J� ��I�
� DA7E:�'✓�Q v APPLIcaN. �^�/✓/�/ SMIP
G
W ENERGY P/C
� WARMNO:FAI�URETOSECUREVlORKERS'CW�ENSIT�1l C�VENAGEISUNLAWFUL,AN�SHALLBE
� SU67ECTANF�IVLOYERTOCWMINALPENALiIES�CIVliNE7WTO0NEMUNOREDTHOUSIWD ENERGYPERMIT �
DOLU1i3(ttGo,oDoJ,N 4DDI710NT0 THE COST OF NSITIDN.DUAA6E5 AS PROVIDED FOR IN
aSECTIONa7oe Of TNE L190R CODE,INTEREST,AND n«w[rs r�es. RETENT�ON FEE: •D�
oCONSTRUCTION 4EN�INOAGENCY PRE•ALT FEE:
a IHEREBVAfFIRAIUNDEAPENALTYOFPE0.NRVTMJRTHEREI3ACON5TRUCTIONIENDINOAGENCY
Z�- FORTt1EPERFORMMICEOFTNEWORKFORwHICNT1uSPE11MR15155UED(SEC.M�7,CN.C).
W
� IEN�ER'S NAME
� LENDER'SADDRESS
� I CENTIFY THAT 1 HME PEAO T115 MPL�LATqN AND STATF iHAT TIE ABOYE INFOAUATqN IS CORRECT. TOTAL FE ES �
p� IACqEET0001dPlVWITMALICITYANDCOUNTVORDMANCESANOSTATEUNSREUTNJO706UIlDIN6 � 1
CONS7NUCTION.ANDHEREBYAUTTqR�Z PRESENTATIVESOFTIUSCWNiYTOEMEAUPONTME
Z ABOVE�MEMIONED PROPERiV FOR MS CT Wj7noscs. COMMENTS
� !
�� /�...
/Y••
�
¢ PERMfTTEENAAIE(PRINn
�, 6-3-ov
� SiGNATUREOFVE MITT DATE
� RECPT.NO. _PAID BY VAUDATION
WHITE—Department Copy.YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENflOD—Fila Copy,GREEN—ApDlicanfd Copy
,.... , _,:-., .., ., . . , ..__ .__.
. ... . �.,_ . . .� �7.� . • .F"�.1'.'.:�',�-4�C d "'` � 'y,S .�:+' 1 .j. y a.v�.x..,,... `�:.
..1. . .r�.`�i, � .. , ���� n 4....., �� . � .!-. � w � .K•��...r�. ..�.. ... �. . T
CIZ'�' OF DIANiOPdD B�iR . , .4 ; ..,
•����u �c_
' ifdSP�C�'ION RECOf-�D ,,.� . �a, .
.;, :... ,
,:���'..�.���.�.I�R� _ - ,�:�?x�. _�.1►��--���e,���7r`� . . 'EI►��I,������m`l►�d� �����,�':'�t�° il�� ������ !
SET BACK � '� � � FLOOR JOIS7 ��: � ��, . ._� . ' •
FTGSiFORMS/STEEL �� � FNA REOMTS �
ELECTRIC GROUND �_ j_ I UNDER FLQOR DUCT 4 • �
GRaUND PLUMBING �;•UNDER FLOOR Gf�f�!DUIT' �• ' - � -
SLAB GRADE ; I FIREPLACE FOUNDATION � � ' I` �
TEMP POWER 'I _j_�_FIREPLACE BOND EiEAM
WATER SERVICE I i MID HT.BOND BEAM_� ..
ROOF SHEATHING � � ` I . 8_r FT. 60N-D.BEAPJI:�• .� •
FRAMWGNENTILIATION I FINAL BOND BEAM �
ROOF COVER i � PRE-GRAbINU I
ROUGH HEATING BENCHING
ROUGH EL.ECTRIC ��I�L = ROUGH GRADING I
ROUGH P�UMBING ' :, FINISH GRADING
SHOWER/TUB TEST I � P�OL ELECTRIC
EXT.LATH/SIDING � POOL FENCING
WALL INSULATION PO�L FINAL
CEILING IN�ULATION OFF SITE IMPS.
DRYWALL NAILWG j DEDICATIONS
SEWEF� FINAL ENG. i
SEPTIC TANK . LANDSCAPE/IRRIG. ; �
SEEP PIT/L.L � � ON SITE IMPS.
GASAIRTEST � � FINALZONING
FINAL CONST. -_" //�Zi �,�i.+-7� ,. , F!RE DEPT. FINA!
FINAL HEATING � � HEAL.TH DEPT.FINAL
FINAL ELECTRIC � � DEV. FEES PAID
FINAL PLUMBING , � ENEpGY
� `�¢��W_!F�ejr ic c�,' .
� ,;: �.-�,..d.� ..
�� _._- _ .-_ ,- -=-._v.. , -- �.�..- .� -- - � .
coMnnENTs�o_�.�°► UZ ������P.�-1��.�Gf ���,C'����i�.5_C� �
�
.
. -.-.-,--.....
,,.
. . ;.,.
.=�::�.:.
...... ......
. ... ..
:::.
SEPTIC TANK 51ZE ��•�����•.�'•••�
SEEP PIT/U 51ZE ��•-• �•
___ 1��: :�
_ I
i
:
i
; ��� _ 1�;
��
�
; .
_ ; .
Y�..��._ _- �.�..�__._...._�.� ' _ .� , , ,