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Home My WebLink About15473 (16) �.� — --- —� — -- �� r�"J� CITY OF DIAMOND BAR '' � DEPARTMEPIT OF COMMUNITY&DEVELOPMENT SERVICES �' � 21660 E.Copley Drive Suite 190 (409)860-3195 Faz(909)861-3117 � PRESS �'��"� BUII.DING PERMIT APPLICATION FIRMLY o� JOBSITE�/S Q _ �-P�JL��'"� APPLICATION IQ PERMIT 1�L / P/C ADDRES F1 /1(��711� DATE 0 NUMBER ( �► g ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER � p ADDFESS ZONING SETBACKS W CITY � ZIP TEL. REAR RW p APPLICANT TEL. SIDE/SIDE STREE7 RW ❑ CONTRACTO SIDE p ADD S � C L.r ZIP TEL. - PROPOSED US � � � , � ARCWENG/ • DESIGNER NO.D�VEL NO. N . = C�DRESS ZIP TEL. UNITS STORIES �_BEDFi00MS � �n OESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADDlREM O p 1 HEREBY AFFli1AA UNDER VENALTY OF VERIUR7 TUT i M1 E%EMPT FROu THE CONTMGTpqS�4 Garega/Cerport lL CENSEUWFORiNEFOLIOWNOREASON(SEG70.71.68USINESSMI�VROFE5510N500DE.ANYCRYOH (J� L7 COIAtfYWHIG111E0UqE5AVERAIRTOCON5IRUCT,ALTEFl61PR0YE,DEM�USH,ORRE7AIRANYSTRUG W Z NRE VNqR TO R9ISSUANCE ALSO REOUIRES THE APfLIGWT WA SuSf VERMITTO FILE A SiGNED Pati0ID9Ck � STATE4ENT iHAT HE Oq SNE IS IICENSED Nl0.5UMIT TO THE PROVISId15 OF TNE LYkfiRACT00.514 � � CFNSEUw(CHAMERY(COIAMENClWWfT115ECTqN/000)OFDMi10N70FTHEBU51NES5IWDPRO- POOVSpO FESSqN5C00[)ORTIATMEORSMEISIXEMPTiHEflEFi10MANDTHE8Ai15FOF1HEALLEOEDEXEMP• (� 710N.ANYVIOlAT10NOFSEGTON70]l.lBYANYAiFIKAHiFORAYERAlIT5U8JEGT5TMEAPVULANTTO Z Re-Roof �,,,� A GIVIL VENALT'OF NOT GORE 7HAN iIYE MUNDRED DOL111R5�i5oa)): O ❑I�aMNEROFTHEPfiOPFR7Y,ORMYEMPLOYEESWITHWAGESASTHEIRSOIECOMPfNSATqN, � COmm0fCL71 - Z 1MLL00 TME WORK.AND TME STRUCTURE 6 NOT INTENOED OR OFFERED FOR SAIE ISEG)0lt.&154 J N NESS AND PROFESSIONS COOE 7ME CONTRACTO0.5 LICENSf LAw�OES NOT AVVLV TO AN OMMER OF ? VROPER[Y WHO BU0..OS OQ MPROVE4 7NEREON,JWD W/q DOES SUCHMURIC NIMSELF OR NERSEIF OR � TMROU011HISDRHEAONMFMPLOVEES.PROY�DEDTFMTSUCH�APROVEI.IENTSM[NOTINTENDmOR m OFFER�iORS/1EF,NOWEVER7NEBUlDINODRIMPROVpAQR1S� )WRHNONEYEAROFCOMPLE• Z TION,TME CM/EREIAIDER N'ILL MAVE TNE BURDEN OF PROVNO huT ME Ofi SNE DD NOT BUIID pR W PRDVE FOq TNE PUNP0.5E OF SKE} w OlIISOVMEROFiHEPiIOPERiY,WIEXCLUSNELYCOMMCfINOWRHLICENSEDCONTMCTOR3 2 TO CONSTRUCT iHE PRQIECT(SEC.)OM.BUSINE55 M10 PROFESSIONS CODE TNE CONTRACT00.S L4 V81Uetial AQI.AFlC-A llJ CENSEUWOOESN07MVLYTOI710'.VNEROFACHOPEqTYYA1OWlDSORI�IP{iOVEShIEREON,AND W1q WNTMCTS FW15UG1 pROJECT3 WITHACONTRACTOii�S)L�CENSED WRSUAHTTO7HECOHTMG roasuc�sEuw} OUANTITY DESCRIPTION �E � OIAMD(EAIPTUNDERSEG B.1PGiORiH15REA50N Q ' � � U � � DATE OWNER U � W LICENSED CONTRACTORS DECLARATION —� � w IMEREBYAFFlMIUNDERPENALTYOfVE0.1URYTMATIMILICENSEDUNDERVRJYI5qN50FC1uPTER �r s �(CqAMEHCINOK7TMSECTION)OOO�OFpIViSqN70FT11EBUSIhE55/WCVHOFE55pN5CODE,AND Z X MYLICENSE6P7 FO CEIWDE E�A � UCENSE GUSS / �,`'�,�.No. .� �7� � V DA � CONT/ a � WORKERS'COMPENSATION DECLARATION a NIHEREBYAFF'JWUN�EROENKTYOFCEfUVRYOHEOFTMEFOILOYNNGDECIARAT10N5 Z � _IHAVEANDWILLMAINTAINACERTIFIGTEOFCONSENTTOSELFaNSUREFORYVORNERS' 2 [OYVENSATION,ASCROVIDEOBYSECTION71000FiMEUBORCODE,FORTHEPERFORIAANCE W Q OFiHEWOpKFOHYMICHTHISPERUITI5ISSUE� � � �_IHAVEANDN1LLMUNTAWWORKERS'COMCENSA7qNIN5UFLWCE,ASHEWREDBYSELTIDN 4� ]7DOOFThELABORO00E.FORTMEPERfORMANCEOFTHEWORI(Fql}WHId1TH15PERMITIS f � LSSUED.W,1' KEAS' FNSATIONINSURANCECA7�EHANDV�"VaUA18ERARE CONSTRUCTION 1 �� C.�(J Z Paicr ruueEn�i J � �-�—aL- ELEG'fRIC� Q 0 �s[cnoaecmNoreEm.RtrmoFnfP[an�rsra�aFFummmuasRioc)«+�ssi PLUMBING Z ICERTIFYTNATMTHEFERFONA/�NCEOFTMEWOPHFORYMId/TH15FE�7Mi71$ISSUED,I MECHANICAL (J SMALLNOT EMPIOYAN'I PERSCN IN Mil/MANNER SOAS TO BECOME Su&IECT TO iME (/j YVOW(ERSCOMPENSATIONUWSOFCALIFORNIA�DAGREEiMAi1FI5HIX1LD8ECOME INSPECTIONFEE S SUBJECTTOTHEWOFKERSCpAaENSATpN7ROV15qN50FSECT10N�70oOFTHElA80R CdOE.ISMA:LFORTMNRHCOM7LYVAT/THOSEPROVI510NS ISSUANCE _yy1(� � O DATE: AVPLICANL SMIP rtiU U W ENERGY P/C _LIF I� � � WAANINQFARURETOSEWREWOFlKERS'CO�A�ENSATpNCOVEMGEISUNUWFUl.M105HALtBE �� -- '^i� � SUfl1ECfM1EMPLOYERTOCiUl1WALVENALTESAMJdVIIFINESUPTOONENUN�REOTtlUS�ND ENERGYPERMIT nui�7TT,��N� AND� � DOl1AR5(f f oo.0aoj,W ADDITION TO TME COST OF COUPENSATION,D1u1ACE5 AS iROV10ED FOR IN � � SECTqN710lOF1HELABOROWE,NTERESi,ANDATTORNEY5FEE5. RETENTIONFEE: OCONSTRLICTION LENDING AGENCY pRE-ALT FEE: � IHEREBVAFFIRMUNOERPFNALTYOFPERIURYTHATTMEREISACONSiRUM10N�EN0IN�ACENCY FOR THE PEii WRMANCE OF TME WORK FOR WMIp1 TNIS VERAIIT IS ISSUE�(SEG]OW,CIV G). � � LENDER'SNAME - C LENOERSADDRESS ,� TOTAL FEES f y��3� � I CERTIFY THAi I HAVE READ THIS AFPLILA710N hND STATE TMAT TME A80\'E NFORMAT%k!IS CORRELT. � IAGREETOCOMPLYN7MALLCRTANOCOUNTIOROIWWCESANDST�TEUWSRELATWOTOBUILDINO � CDNSTRUCTqN,ANDHERE9Y UTTqFQERE7RE5ENTATNE50FTHISLOJfiTYTDENTFNUPONTHE -4EMqNEDPROVE FOfi WSPECTION PURPOSES. COMMENTS � � � � m E EE N/J�E(vRlrfn /� Q N � IGNAiUREOFVERMITTE D� � REGPT.NO. PAID BY _ VAUDATION WH —Depanment Copy,YELLOW—Fnnnce Copy,PINK—Assessa Copy,GOLDENROD—File Copy,GREEN—ApphcanCs Copy - CITY OF DIAMOND.BAR . _ . ` � -� �� . .: . i ,_, �l :'�-, ��.. �. . 1NSPECTlO�J'RECORD � " _ � �'' ��i�=, '"��,.,�_l�� `\ J�.�1•= '1 G`� .��' .:4 P" . m�.� �i ��. _�.__._� ....�_A\,� .�� c, � in _ ►� ��-�'�`. ��rk�!►`�`i�!��.._'.!._.��._.. '�F'= (�`.E-�:� �"��►. ISET BACf: ,�y . y� . � � FLOOF JD15T � __ � _ . . - � � ' � ' ;FTGS/FORP�IS,`STEEL' ' � �- - ' "� FHA REQAATS - _ ' - - � ' - _ - __ �ELECTRIC GROUND__ _ • . __ � UNDER FLOOR DUCT - - I - � _ 'GROUND PLUNIBING I - UNDER FLOOR CUid�UIT - ' � ______ �SLAB GRADE- - - � �' FIREPLAC�FOU;JDATIOtJ -• " � I __ iTEh1P POWER • � FIREPLACE BOND BEAP.9 � I - - - � ' �WATER SERVICE- -- / � Pv11D HT. BOND BEAF�1 _ � �ROOF SHEA7HING� •. �I� �U� `` 8 FT. BOND BEAb1 . -� � ' � � � . • � F NAL BOND�BEAM �FRAMINGNE�JSILIATION I I 'ROOFCOVF_R .�- � PRE-GRADING - - - • �ROJGH NEA7ING - -,� 6ENCHING � • � � • 1ROUG!-i'ELECTRIC - � ROUGH GRADING - - - � " � 'ROUGH PLUl�1BING� I- - - - FINISH GRADING 'SHO��iERrfUB TEST - - -� - � POOL�ELECTRIC EXT.I_ATH!S4DIN� - - -- - - POOLFEPdCING I � •WALL-INSULATfON - - - -- � � ' POOL FINAL • ;CEItIPJu I�dSULATtON, - ' ' " OFF SITE IFriPS. � ' _ ;DRYLrJALCTdA1t(NG- . -�- OEDIGATI�NS � 'SG�ti'ER - - - - FINAL ENG. � -- ;SEPTIC TANK LANDSCAPEIIRRIG. • SEEP P!T/LL. ` ', ��, ON 51TE IMPS. 'G�5 F,Ir TEST FINAL ZONING � iFii J4t_COidST. ____ _ __8�30-�,,o � FIRE DEPT.FINAL � 'Fli:�.L HEATING ___ _ __ HEALTH DEPT. FINAL ' ::�i'.:•L ELECTRIC DEV. FEES PAID - � �•_�•!^.L-PLUt�A9lNG - ENERGY � --- -- - - -- - - - - � � � , � ��--- -- - ---- - -- - . � - ,-•��:��'�.' c_�¢.e;t� - ' . �_ - - - - ' -�� -, =--�--- ---- . � CCfv1MENTS � � , - - . ; ; ' � �� ., ' - � � " � - � _ , � - - - - - • � ' , - = �' - - i'r , , , . .. _ .. . , . , � , � �SEPTIC TANK S{ZE � � "' � �- -'��-'� � ' � - SEEP PIT/U SIZE . � , - , - - ;��. .��_.....�..._.__..... . ;� � - - � ' ��i�' .� . . - . , � - - - , : ; ' - � � - � '�. �. _ .. . _ � . . � _ : . _ _� , ��, . - ; ______._�_ -�--_--�---- .