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HomeMy WebLinkAbout13127 (16) CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suitc 190 (909)86Q3195 Fax(909)861-3117 PRESS ^�°��� BUILDING PERMIT APPLICATION FIRMLY y JOBSITE APPLICATION PERMIT f 3� P/C �(,( o ADDRESS 2�'��I+� R.�G�c.F �ia�� . OATE �n'�-9S NUMBEFi � M �$— "/�. . � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER ' _ �. " ADDRESS � ZONING SEBACKS " � g CI7Y y{,.31P �TEL. � ' REAA - � 1 ❑ � APPLICAN7 � LL TEL�2-'11{��(��a SIDE/SIQESTREEf \ RW D � CONTRACTOR SIDE ❑ � CITY E� ZIP TEL. PROPOSED USE_ S�I�+- i ��P�ac¢11t �i ARCHIENG! �m— "L"Z/Q � DESIGNER � w � NO.DWEL. NO. NO. ADDRESS UNITS � STORIES Z BEDAOOMS � CITY j�ptBH�lr� ZIP�. TEL? ��j►il►� � DESCRIP710N SQ.FT. 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B.i P.C.FOR iH15 RE�SON Q �' In LL' DATE OWNER � � � � s- . �z, s-D LICENSED CONTRACTORS DECLARATION —� � w I/IEREBYAFFWAUNOERPENILLTYOFPERAIRYTMATIAMUCENSEOUNDERFROVISION90FCHMTER � � O�COMMENCHCJNIRHSECTqN70W)OFOMSION90FTHEBU6INESSMIDPROFESSIONSCAOE,ANO Z _ W LICENSE IS W FUII FORCE AND EFFECT. m O � LICENSE CLA55 LM..NO, j � DA7E CONTAACNR a = WORKERS'COMPENSATION DECLARATION � a � IMEREBYIIFFIRAIUNDERPENALTYOFPERtt1MONEOFTNEPoUAWINODECLAMTIONS — � c � ' Q 4: G _INAVEANDWILLMAINTAINACERTIflG1TEOFCONSElYTT09ELFdNSUREFOHWORKERS' _ , , , �� � Z COMVENSATqN,l1S PROVIOEO BYBECTION 37000F THE LABOR CODE.F9N 1'ME PERFORMIWCE U � OF THE WORK FOR NM1IICN TTIIS PEAMIT IS ISSUEU. � � �I HAVE AND YNLL MlJMAN YYORKER6'CAMPENSATIdV INSUMNCE,AS REQUIRE�BV SECfKKJ QQ , 37000FTHELABOROODE,FORTHEPEHFORMANCEOFTNEWORNFORMMICHTHISPERMITI8 ' � ISSUED.MY WOfi10ER5'CO�IPEN9ATION INSURANCE CAWiIEN ANO POLICY NUM6EH ME: CONSTRUCTION � CARRIER EW � voUCVNUMBER L TR � (M6sEcrorlME�NoreEOOAREfEooFnEP6#NrsPOaaNEtuDaEODalMsli+ODIatLESs} P ING Z I CERTIFV THAT IN 1HE PERFORMANCE OF TiE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICA �7 SHALL NOT ENPLAY ANY VERSON W ANYlMNNER 60AS TO BEC04E SV&IECT iO THE � WORKERS'COMPENSATqNUW30FCALIFORN10.µDAGREETXATIf15HdJLDBECOME IN P CTI NFEE � � SUBJECT TO THE WORKERS'COMPENSATqN VPONSIONS OF SECTION d70o OF 7HE LABOR CODE.1 SHML FOFiRIWITICOGPLY WITM 7F105E PRO IS _� � �� SMIP �� p DATE:�q APPLICANT: � ENERGY P/C WARNINO:FAILURETOSECUREWORKERS'COMPENSATIONCOVETI WFUl.M1O5HALLBE �y SUBJECTM!EMPLOYER TO CRIMMAL PENALTIES AND CML P TOONE NUNDRED THOUSMIO ENERGY PEFMIT OOlLAfl3(�700,000),IN I�D�1710N TO THE COST OF COMPENSATpN,OPMAOES AS PflOVIDED FOR IN J SECTION 9708 OFTHE UBOR COOE.NTEREST,AND ATfORNEY'S FEES. R�ENTION FEE: I � a CONSTRUCTION LENDINO AGENCY PRE-AlT FEE: � I NEREBYAFFIRM UNDER PENALTYOF PERJURY TiATTiENE 19 A OONSTRUCTION IENDINO AOENCY � FOfl THE iERPDRIMNGE OF THE WORK FOR WHlpi THIS PERMIT IS ISSUED 19EC.]097,CIV.C.�. /1 � r v � IENDEFi'9 NAME � LENDEtYS/DDRESS �) � ICERTIFYMATIHAVEREADTIISMPLICATIONNJDSTATETHATTHEABOVEWFORMATqNISCORRECi. TOTAL FEESCy�� ��� � �! �O7 � I ACiREE TO COMPLY NlRYI A11 CITY AND COUNTY ORDINANGES MID 8TATE LAWS REUTNq TO BULDIHG �.�j�� J I.� CON&TRUCTION.MIDMEREBYILL7INORIZERFPRESENTATIVESOFTHISCOU(ITYTOEMERUPONTNE V � ABOVE-MkM10NED GROPERTY PDR INSPECTqN PURPO5E5. COMMENTS � r✓�DG�A vA'U/�a� s�Ah � PERMITTEE NMAE WN�M) p�j ' Cn � I� (� N BKifNTUREOFPERMITTEE WTE , � RECPT.NO. PAID BY VAUDATI VYHITE—Depertment Copy,YELLOW�inenee Copy,PINK—Aseesaor Copy,GOLDENROD—File Copy,GREEN—ApplicaM'a Copy � CITY OF DIAMOND BAf� IIVSPECTION RECOf�D s E � . � . . � � � � s - SET BACK', - <� � • � FLOOR JOIST � -' � ' FTGS/FORMS/STEEL FHA REQMTS ELECYRIG GROUND � UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CUf�IDUIT, . �r SLAB GRADE FIREPLACE FOUNb�,TION ' - • - • - TEMP POWER FIREPLAC�BCJND BEAM WA7ER SERVICE 1fl���Ci ' MID HT. BOND BEAM R�OF SHEATHING . - - - 8 Ff, BOND BEAM FRAMINGNENTILlATION � � ' � � FINAL BUND BEAM ' ' ROOFCOVER PRE-GRADING• - ' "� ROUGH HEATING BENCH4NG •�- - •� � -- - � - . , ROUGH ELECTRIC r� 'J rS - ROUGH GRADING ROUGH PLUMBING ' FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.�ATHISIDING f_�/. , ,�:�' P�OL FENCING � _ WALL INSULATION / POOL FINAL CEI�ING INSULATION . OFF SITE IMPS. ^ DRYWALL NAILING j�-�'..��� �-�sx-.•-•'�-�--..::.,'"� DEDICATIONS � SEWER _� FiNAL ENG. _ SEPTIC TANK I LANDSCAPE/IRRIG. SEEP PIT/L.L. ; • � ON SITE IMPS. 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