HomeMy WebLinkAbout12886 CITY OF DIAMOND BAR EXP�RED
--1��-— DEPARTMENT OF COMMUIVITY&DEVELOPMENT SERVICES
�;.� z�6�oE.c��eynr;��s����o NOU 21 2000
(909)860-3195 Faa(909)661-3117 PRESS
�%�'� auu,nnvG r��rr nprt.tcATTON " � FIRMLY
4 AO RIESS DATE CATiON 1_S�9 9 NU B R I 2 g�� #'�
t
� ISSUE r""�� TYPE OCC
APN LOT TRACT pATE `—7 CONST. GROUP
S OWNER • L L �
ADD� � ZONING SETBACKS
�� CfTY ZIP TEI,. REARr RW ❑❑
APPU TEL. SIDE/SIDE STREET RW O
CONTRACT R E L .� SIOE ❑
� ADDR S '
PROPOSED USE E'S
CITY 21P _ TEL.
� ARC NG!
�� DESIGNER
AD�RESS NO.DWEL. NO. NO. c"'�
C�T'( Z�p �� UNITS � STORIES � BEDROOMS J
y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
fJ!
� OWNER•BUILDER DECIAHATION SFR/ADO/REM
0
� I MEREBV AFFlRM UNDEH PENAL7Y OF PERJURY THAT I AM EXEMPT FiIOM iHE CON�MCTORS L6 G81AgBlCfllpOR
CENSEUWWRTFIEFOLLOWINOREA60N�SEC.70.9f.68U51NESSANOPROFE5510NSCODE:ANYCI7YOFi (�
ppUNfVMRiICMREONRESAPERMRit)L+DN37FVCT,ALTER�P�E.�EM041SH,ORREPAIRANY37RUC- w P��Q��
TUiIE,PRfOR TO RS R9UMICE,ALSO RC-0UIRES THE APPLN.`AHT FOR Sl1CH PERMIT TO FlLE A 61ONED
� BiATBdENT 11Y1T NE ON 9ME IS UCENSED PURSUMR f07NE Pf10Y1910H5 OF THE CONTMCTOHS Lb
CENSE lAW(f�lA7'TER/(COGIMENCINO WITtI tECTION 7000)pF qIVI310N�pF THE BUSMESS MID PR6 �LL �VSpB
FESSIONS COoq Oft iTUT NE OR SHE IS E7(EMP7 iHEREFHdA AND TME BASIS FOR TNEALLEGED ENEMP•
TqN.ANYVqlhT10NOF6EC7WN7091.6BYANVAPPLICAN7FORAPERMITSUBJFCTSTMEAPf'LICANTTO Z Re-Root
�,_, AdHLVENAL7VOFNOTYORETHANFIVENUNOREDDOLU1A51�'+�)•h
� 04�3�EROFTHEPROPEFRI:CRMYEMPIAYEESWITHWA0ESA5THEli160LECOMPENSATIpN, � COmmBfGiel �
WILL 00 THE WOAN.AND 7HE STAUCTURE IS NOT IMEN�ED OP qFFEREO FOR SALE(SEC.7WL B�51- J
NESS M1O iiiOFES510N6 ODGE:T/1E OONTfiACTOR3 LICENSE UW DOE9 NOT MPLY TO MI OWNER OF
y pppP6ltiYNhIp9U0.0SORMIPROVESiHERFAN.IWDN'FIOOOESSUCHWOPNFtl4SELFWiMER3ELFOH �
� TNNOIWXHI50RFIEHOYMEMPLOYEE9,PROYIDEDTHAT9UGHiMPROVEMENTBARENOTMTENOE�OR m
� OFFEREpPORSALE1F,FqYYEVERTMEeULDINOORMIPRO�EMEIJTIS80LDYYITH�NONEVEAROFCOMP4E
iION.iXE OWNER�U0.DER WILL IiAYE 7HE BURDEN OF PRW WQ THAT H@ OR SME DID HOT BUILO OR
MAPAOYE FOR TNE PUNP09E OF BAI.E).
"' ❑I,/SOWNEROFTHEPROPEflIY,AMD(CLUSIVELYCONfRACTINOWffHIICEN5E00W�(fMCTORS
oL TO OONS7IRlCT TiE PRO.IEC7(SEG.7o�a,BUSINE63 AN�PROFESSIONS COOE:TIIE CONTMCTDRS L1- Velu9NOf1 ADJ.AREA
�S C@iSELAW00E5NOTMPLYTOANOVMEHOFAPROPeRTYNRiOBU�LD50NIMPq�YE57HEREIXY,AIID
Z YRqCOHTMC78FOR9Ur,HPPWEC7S4A�MA00NTMCTOR(S�LICENSEOPUNSUMIf70THECONTRnG p�p�Ty DESCRIPTION FEE
t' roas uc�uw.�
OO 1 AM DfEIAPTIMOER SEG B.l P.G FOR TNIS REIISON �
3 �
¢.
�=" GATE oWNER V
� LICENSED CONTRACTORS DECLARATION W
� IHEREBYl1FFIRIAUNDENPEWLT'OFPERIURYTHATIAMLICENSEDUNDERPROVISbNSOFCHAViEN V.
� O�WYYENCNK3WItHSECTqN7000)OFOIVISpN]OFTME9VSINESSANOPROFESSIONSCODE,M1� Z
MY LICENSE S NI FVLL FORCE AND EFFECT, �/ m
� UCENSECLASS(.L� LIC.NO.,�_,y�.(,/ I �
� J
� pA7E � CONTRACTOR � a
� WORKERS'COMPENSATION DECLARATIpN ¢ y 3 6 �
N INEREBVIIFFIRMUNDERPEWLLTYOF7EiWRYONEOFTHEFOLLOWIN6DECURA7qNS:
y a 3 a0
O �_III�VEINDWILLMAN7INNACEIITIFlCATEOFCONSENTTOSELF-IN5UREFORM/ORKERS' _
Z CpIPENSAiqN.A4VROVIDEOlYSECTION?7000FTHEUIBORCODE,FOATHEPERFORMANCE U
Q OFfHEWOPo(FORMMICHTlIISPERMRISISSUFA. �
�
_I W1VE AND WILL MAR�ITAIN WOfUCER3'COLIPENSATIOH IN9URANCE,AS REWIRED BY 9ECTIDN
Q �7000F7HELABOROODE,FORTHEPERFORMANCEOFTNEWORKFpRWHICHTNISPERMITIS
� ISSUED.MV WORKERS'COYPENSATION INSUIiAIVCE CARRIER AND POLICl/NUMBER AflE: CONSTRUCTION
� �pqiEq PLAN REVIEW
� Pq,ICYNUMBER ELEC7RIC
0 (nass[t�qNr�IDraTeEaOtis�'rmoFn#newarb�or+aEFa�noamDouAa.SR+oMara�ssl PLUMBING ��.j-j�..;\ ,{.�
� 1 CEA7�FYTHAT MTHE PEHFORMAHCE OF THE WORK FOR WHICH 7HI5 PERMIT lS ISSUED,I MECHANICAL �'�" f v O
SWLLl NOT EMPLOV ANY PEFSQN N ANY N�NNER 50 AS TO 6ECAME SUBJECT i0 THE
� VPOPKERS'COMPENSATqNLAVlSOfGLIiORN1AµDAGREEiH�TIFISFiOULDBE00ME � P TIONFEE
S SUBJECTMTHEWORKERSCOMPENSAT NPROVIS�ONSOF6ECT N37000FT11EUeOR ISSUANC •►1 n ✓ 7000 � / DO
CODE.ISNALLFOf�NWIMCOMPLYWI HOSEPNOVI NS
� !�
p UATE: �J APPLICANT SMIP
ENERGY P/C ..���4�I7 RAR
WMNINO:FAILURE TO SEWRE WORKERS' f'ENS�TIDN COVEfll10E 18 UNI+� ANO SFNLLBE 't7.1 G ���T
� 6UB.IECfANEMDLOYERTOCRIMNALPENAL ESANOGVILFlNESWP100NEHUNDHEDTHOU9AND ENERGYPERMIT �� �y.d�"�■ +
pDI.IMS({100,000),MI PDDITION TO THE COST OF COMPENSATqN,OAMAOES AS PROVIDEO tOR IN
� SEGT�ON]7oaOFT1EU60NCODE,NTEHEST,ANDATTORNEYSFEES. RETENTIONFEE:
� CONSTRUCT�ON LENDING AGENCY PRE•ALT FEE:
�
1 HERE6Y AFFIflM UNDER PENA�TY OF PERNRY THAT TNERE IS A CONSTRUCTION LEN�INC�GENCY
FOR TME PE0.FORAIANCE OF AIE WONK FON MM1IICH 7NI.5 GERMIi IS ISSUED(SEC.�oD7.CIV.G�.
Z
W
� IENDEH'S W1ME
C LENDEWSA(1DHES5
� ICERTIFYTHATIHAVEREADTiISMPLIGT10NNJDSTATETIUTTMEABOVE1NFpRIJAT10NI5CORRECT. TOTAL FEES `y� 'O O
d 1 MiREE ft)C�OAAPLY WITX N.L G7IY AN�COIMTY ORD�WiNGES AND STATE LAWS RELATINO TO BU0.UIN6 � 7
CON6TNUCTION,ANO HEREBV AUi11DRlac qEPRESENTA71VE5 OF 1HIS OOUNiV TO EMER�PON 7HE �
� ABOVE•MENTIONEO YHOPEHTY FOR WSPECTIpV PUHPOSES. COMMENTS / f `
� J • �-t:'42`
m NRTEENA4IE(PRINf� ,�w -
� V
Q � .\
y EOFPEfW�7'TEE �TE
— RECPT.NO. PAI�BY VALIDAT70N /
wHITE—Department Copy,YELLOW—Fnance Copyt PINK—Assosevr Copy,GOLDENROD--File Copy,GHEEN—Mplicanl's Copy
_... ..�..�+.�.....�...� ---
� cri-�r oF o�an�orv� Ba�
. , � INSPECTION RECORD
* � E ' � ' ' � � � • � '
SET BACK • . � ; . •• • -� FLOOR JOI �.� . � , _�,� - ,. � ` � � 3 c•.
° � � --. �.__
FTGS/FORMS/STEEL , , ._ "; FNA RECIMTS '� �
ELECTRIC GROUND � ' UNDER FLOOR DUCT i . `
_ . -�..�
GROUND PLUMBING UNDER FLOfJA�O�IbF��1' "
SLAB GRADE FIREPLACE FOUNDATION • -ry�:{; ='` '-��•':,°�;
TEMP POWER FIREPLACE BONQB�AM .,
WATER SERVICE MID HT. BOND B�At�A�ti��"' •°'-, �' �`"`'� '"
. , ',=�_
RODF SHEATHING "' -� �,, •'-: �` � � ._.� ' 8 FL 6 ��AM ��• � � � . � � _,..,:�. ,
FRAMINGNENTILIATI�N FINAL BOND BEAM '
RO �FCOVER . '' \ PRE-GRADING
RC?UGH HEATING BENCHING
ROUGH ELECTRIC RDUGH GRADING
RC)UGH PLUMBING ��--V FINISH GRADING
SHOWER/TUB TEST POOL ELECTRlC
� _._
EXT.LATH/SibING POOL FENCING
WALL INSULATION POOL FINAL � �
CEiLING INSULATION OFF SITE IMPS.
DRYWALL NAILING ' DEDICA710NS
SEWER j FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. " ON SITE IMPS.
GAS AIR TEST FINAL ZON(NG �
FtNAL CUNST. FIRE DEPT. FINAC
FINAL HEATING , � HEALTH DEPT. FINAL —,�-- '
FiNAL ELECTRIC � i � ' pEV. FEES PAID ����
FINAL PLUMBING � � ENERGY ^
I , . S
�:�W� � � - t_�� ,:.�': ..�- —___..
. . .... ... .... �V i • i
COM�JfE�VTS ...�:� w•,; : ;; �., ,
• • . .�.. .:� . .�� i... �::
, . b�1� .1,,, , . . . ._.
. �$ "-
,., .. . i.�'k' . ';:ir � �, ,., •�•'� � � . 4 ---
_ , .,t'' .t--;;, — �
� �. .
... . �� y .
SEPTiC TANK SIZE ' - • •� �
SEEP PIT/U SlZE -+'—"
'SP' � i' E�, --
�� " ; � '"'+'�i� '
_. ,', r ,
- - (• .,,.. 1 �4 -y J -' ' •;;'• :t':'';w ___..—