HomeMy WebLinkAbout15543 (28) l
� J� CITY OF DIAMOND BAR � r�
� i DEPARTMENT OF COMMUNITY 8c DEVELOPMENT SER S
Zi�o E.c�i�y nri�o swc�i90 � PRESS
��*"��w BUII.DING PERMTT APPLICATION ' � FIRMLY
o D RESS v-� �d� DATEICATION a'� � NUMB R'` � ` M,C V`�' �
� APN � LOT TRACT 3���� DA EE �l CONST. GROUP
� A DR SS 3 Co � T C� � v / ZOP�ING SETBACKS
w CfTY F�I FDK'T���CN ZIP ' TEL FRONT RW ❑
� APPUCANT S/MON � N TEL,��`��^ -�p SDE/SIDESTREET RW ❑
� CONTRACTOR SIDE ❑
� ADDRESS - ` - PROPOSED USE
o cmr I,.Ia L�(u'� ziPC� i e� �
� ARCFUENG/ �
DESIGNER NO.DWEL. NO. NO.
ADDRESS UNITS STORIES E3EDROOMS
� CITY ZIP TEL.
� DESCFiIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�
� OWNER-BUILDER DECLARATION SFR/ADDlREt�A
O
p 1 HEREBY AFFlWA UN�ER PFWLLTY OF 7ERJUNY TU71 AA1 EXEUCT Fiq11 ME CdJTMCTO0.5 L6 G0f8g0/C9fpOR
LL CQ/SEUWFORTHEiQ10WNORFJ150N(SEQ7W1.68VSNESSANDPROFESSIONSCOOE:IWVCITYOF (n
� COI,Hf`lWNICNREOUNiESAGERMR7000N5TRUCi.ALTERMPROVE.DEN0U5�-LORREVMRANVSTRUC• W PatialDeck �
TURE.VRDR TO ff5 65UANCE.ALSO NEOU�RES TME APPLIGVaT FOR SUCH iERMIT TO FIIE�SIGNED w
� 6UTE4EHT TMAT HE OR SME iS LICENSED YUHSUNR iO iNE PROYiSIONS OF TNE CON7MROR5 U•
� CENSE UW�0/APTER Y(COMMENCIN�WITH SECf10N 7000)OF DIVISqN]OF THE BUSINESS IUl�PRO• � P��Pa
iE55iON9 COOE)OR T1UT HE OR 5/1E IS EXEMPT iHEREFR04 MO THE BI�SIS FOR THE AILEGED E%EIIP•
iqN,J1NYVIOIATIONOFSECTqN7071.68YANYAP7l4'JWTFORAGENYRSUBIECTSTHEAPVLIGNTTO Z R0•RO01
� 11CMLiENALTYOFNOTMOi1[TNJWFNENUNDREDDOlURS(f500�.�: -
� OlA90WNEROfTHEPROVER7Y.ORMYE�7LOYEESWITHWAGEStiSTHEIqSOLEC0IAPENSATqN, 0 COrt1rtlBfCi31
WRL DO iHE WORK AND 7HE STRUClUR[45 NO7IMENOED OR OFiERED FOR SALE(SEG 704,BUSi- J
NE53 Ai�iROFE5510N9 WOE i11E CONTMCTORS LICEHSE Uw DOES NOTAPPLY i0 AN ONR/ER OF
N pqppEIRYWF10BUlD50NMOA0�E5TNERE0N.M1DYV11000E55UQ1YVOHKHIYSELFORNEiLSEIFOR m
Q T11NOlkJ/NISOFtlIENOYMEMPIOYEE4.DFpNDEOTHATSWIMPROVEAIENTSANENOTMTENDEDOR
�l1 OfFEAm FOR SALE 611DWEVER 7HE BULdNO OR IMVROVEMQJT IS SOID'MTTUN ONE YEAROF WA�PLE-
� TqM,TME OWMER-BURDER MALL HJ1VE 1NE BURDEN OF PHOVINO iMAT HE OR SHE UID NOT BUIID OR
IMPHOVE FOF THE PURPOSE OF bALF).
W OI.ti40NNEROFTHEFRDPEfiTY,/WE%QUS:VELYWMMCTWOWRMUCENSEDCOHTMCTORS
� To ca+sTaucr n��vr�cr tsec.�osa,eusiness u+o vnoc¢ssior+s cooE:n+E co'+tnncroas u- Valuatian ADJ.AR[A
� CENSEUWOOESNQTAPPL7TOANOWNEROFAiROiER7YNTIOBURD90RYA7AOV[STMEREON.AND
wHowrrrrucrsroasucNara�crsvnrr+�oorrrw�cron(siucENsmvuruuurtron+eoonrrue p�p,�p7y DESCFi1PTION FEE
� TdiS LICENSE UW.).
OIAMIXENPTUNOEN4EG B.IV.G.FORTHISREA50N U
K
LL' O�TE OVMER U
Z W
F4 LICENSED CONTFiACTORS DECLARATION w
CL 1 NEHEBYAFFGiA1 UNDER GENALTV OF 7ERAIRV THAT IAA1 LICENSED UMJER PRONSIONS OF C7IADTER Vr
s •�WIMENCNONnT115ECT�ON70o010FDM5�ON]OFINEBUS:NESSANOPROFESSqNSCDDE.AND Z
W lKENSE IS N FLl1 FORCE Iw0 EFFECT. m
�
� LICENSE CU1SS LJC.NO. �� v � �
V DATE��� O COI�fiRACTORSIM� a �
c6 WORKERS'COMPENSATIONDECLARATION .. . a
� U
N INEREBYPFFIiiMUNDERPENALTYOFGER1Uf1YONEOFTMEFOLL0IMNGDECLARAilONS:
N Z
Q
� _INAVEANDWiLLW�NTAMIICERTIFIGTEOFCDNSCNTTOSfIFaNSUREfORWOi1KER5' S
CCAIPENSATION,ASGROVDEDBYSECT10N7'1000FTNEUBORCOOEFORTMEPEHFORAIANCE �U
OF T11E WORK iOR WNICN TXIS VENMIT I$ISSUED. �
�
_I HAVE ANO N^LL MARRAtN M'ORKERS'COMPENSATION P7SURANCE.AS RE�VIRED BY 5[CTqN ^�n
Q 970oOFiNELABORCOOE,FORTMEVERFORUANCEOFTMEWORKFOFWMIdiiHISPERMITIS � �1(J
ISSUED.MV RKERS'COMPENSATIONWSUfiANCEGWR�EN}qv vaicruuuneau+c: CONSTRUCTION ��'�
� G3VilER � • �`�Sl� � �CEC� PLAN REVIEW
� vacr r�uneen L¢ � ' " ELECTRIC � _
� �sSEcicHn[mwrecoo�a�a�n���T�s�������la�lEssl PLUMBING r r� �)
Z ILEHTIFl711ATNTNEPERFORM�NLEOFTMEWORKFOflWHiCHTWSPEAMRI5155UED,1 MECHANICAL •'''�' � "'�y
(� $HAL�lqT EMPLOYANY VERSpi N ANY MANN[R SO�S TO BECOME SV[iJECi TO THE
�y 1MORKERS'CAYPENSATIONUYlSOFCALIFONNIA,MID�GRE M�TffISnOUIDBECOME INSPECTIONFEE .
S SUB.IECTTOTILV10fiKER5COMPCNSAT ROVISIONSOF �ON77000FTNEUBON iSSUANCE ^ � ���
COOE,1511N.L FORTMw�71�Cd�PLv vnTMTND VRO 'ANS. � 1 V U
O /J SMIP ��r
DATE:�(�J 1 lCb APPIICANT: �
►�i.� ENERGYPIC CTTV(ii�1�i�;�.V�) '�:1Jl:.iIC
� WARNINO:fA1LUREiOSECUPEWORKERS'COMPENSATION VEMGEISUNLA'NNL�NDSMKLBE � {�
SUBJFCTANEMPLOVERTOCiVUMAIVENALTIESANOCMLFWESUP700NEHUNOREDT�DUSANO ENERGYPERMIT ��jf: T�TA�f; AT�rTI��-.l L'1 Y
ppLLARS(Sta0,000),IN ADD�TION TO 7HE COS7 OF C041PENSATION,OAAIAGES AS iHONDED FOR IN ,
J 6ECTIDN770EOF7HEUBOHCO�E,RlTEHEST,ANDATTOiWEY5FEE5. RETENTIONFEE:
�
W CONSTRUCTION LENDING AGENCY pRE•ALT FEE:
[i.
O
C= 1 HEHCBV AFFIRAI UNDER PENALiV OF PERNRV 1M�T THERE IS ACONSTRUCTION lFND41C AGENGY
dZ FOR T1+E PERFORMANCE OF THE WORN FOR WH1CN TIIS VFiUAIT IS 155UED(SEC.�oV1.CN.G).
W
� �ENDER'S WWE
� LENDEA'SADDRE55 f f
¢ ICERTIFYMATIIUVENEADTHI4APPLM•ATqNM95TATETWITTNEABOVEF1FpRMATqN15[ORRECf. TOTAL FEES �
W IAGREEl0001Af'L1/N17MALLCT'ANDCWNTYORDWANCESANOSTATEIAWSREU7INOTOBUILDING
� CONSTRUCTqN./J�OMEREBYAUTHORIZEREPRESENTATIYE50FiW5COlR�TYTOENTERUPONTN[
S� ABOVE�MENTIONEDYROPERTYfd11NSPECT�ONFURPO5E5. COMME-NTS
= 1�
¢ OERURTEE �oa ^
C..r
�
y SK1Nn7UftE O PE OA
RECPT.NO. PAID BY VALIDATION
� ' WHITE—DeDBnment Copy,YELLOW--Finanee CoPy,PINK�Assessa Copy.GOLDENROD—File Copy.GREEN—ApplieanYs Copy
� �, CITY OF DIA�OND BAR
= . _ - � � ItdSPECTiON RECORD
�..��.����1�`j��J' , '.�����' ,�a�l►��,�—�;��e.����1►��-�'.���!?l�l� .. _ a t�i';+�/"■Wj�E-�1::��:,s:�r�1;;___..
,
� -- ,+.:.�;_.:-.......`..:r...e___.. ._ - ..�r� �s��a ie R�a � .
SET BACK . � � u FLOOR JOIST1 . .,�,�_ ... ___\ . f I. ., \-1,`,... —
FTGS/FORP�^S/STEEL FHA REaPRTS ' �, ��—�� �
ELECTRIC GROUND UPJDER FLOOR DUCT -
GROUND PLUPABING I UNDER FLOOR CUf•IDUIT � `
SLAB GRAOc FIREPUICE FOUNDATION I
,TEDA? POWER F�IREPLACE BOND BEAh1 ' __I
WATER SFRVICE � MID HT.�OND BEP,h1
ROOF SHEATHING.'••� .. 8 FT BOND BEAP�1 '
FAAh1ING.NENTILIATlO�: � FINAL B�ND BEAM I
:ROOF COVF_R PRE-GRADING
�ROUGH HEATING 6ENCHING '
ROUGH ELECTRIC ' ROUGH GRADING I
ROUGH PLUMBING FIWISH GRADING '
SHOVVER,'TUB TEST I POOL EL�CTRIC •
EXT.LF,TH/SIDI�dG � '� '�•.' POOL FENCIPdG
VVALL tNSULATION POOL FINAL
CEILIVG IfJSULATIO�J � OFF SIT�IMPS. � ^~^
iDRYVVALL PdAiLI�dG � DEDICATIOPJS
SEVVER FINAL ENG. ! �
SEPTIC TANK UINDSCAPE/IFIRIG. 1 I �
SEEP PIT/L.L. � ���L%�=� �_ � O;�51TE I�APS. �
GAS AIR TEST � FINAL ZO"JING �
FI�,SL CO�JST. . � � FIRE DEPT. FINAL _ _�
FI�:P,L HEATING � HE�`+Li N�EPT. FItJAL
FINr,L ELECTRIC � � DEV. FcES Pr",ID � � ___ �
�=!^lA�PLUDABiNG ENERGY I
- — � I ---- - –4—�-----------�------
j_. � � Y_f�^";:•�::,��,e:''.�."-^�----,., �....,. —�_—�.—_---=--
.. . :
: ..
— :.,�._-- -.c...:..,._s,_ .. .:...
Ci��1/�N{ENTS� c`�'c+°'�Om� . .. _ �yt---�,r-r��a 3_� .tr_ T--J._.61� S' I't Als ' -�-l3�=lg-7S�'-C,��
----- �— � _ ---- ----�
� � , �-- ------� -
..,� .
; . •
, • --.� , --------
- -`-t_
- � ' � , __.._..___
SEPTiC TANK SIZE
'SEEP PIT/U SIZE -- ---
�;�: . . . T���.: . ' ^ -= -- ----
, - � � —
��'�� ��',i
;1 T . - ..
�'�� � , ---- . ---
�� • -------
�:�
•---•.'....._•--__=–�:.,__ ....;.. ' _� . ---------—
. .:�.sJ� . .