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HomeMy WebLinkAbout11407 (9) \ �--�`--� CITY OF DIAMOND BAR , � � COMMUNITY DEVELOPMENT DEPARThSENT x•,•C 21660E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 • • ' PRESS ^"` BUILDING PERMITAPPLICATION FIRMLY o� 'JOBSITE'.� c� ' APPLICATION PERMIT Lp P!C ADDRESS '1���/ ��IIH��i� �UU�I• DATE NUMBER �7 � 7t � ISSUE�����TYPE OCC ' � APN LOT TRACT DATE CONST. GROUP p OWNER t�/9/LtrN L,fFi�1.�/%Yh0 a ADDRESS ?.7�.?�/ ���ff�.t.Fs O/�. • ZONING SEfE3ACKS . gCITY �l/�/!i}'IR.(O ��l/7ZIP�TEL.�I�f'C/-f"�I FRONT RW ❑ APPLICANT TEL. REAR ❑ Z SIDEJSIDE STREET flW ❑ ¢ CONTRACTOR /fff/CJr /�COTir/t • • SIDE -❑ � ADDRESS ��/ �' -.rit�t_1 .G�it.��4_..��y�,�/!_ll. � � CITY Ct.�J�/�✓L !'� ZIP��fEL.fjCX) Zlf Gy'y PROPOSED USE /� � f' _'^/f o AFiCH/�NG/ ' ' �+*iic.r w DESIGNER ' NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn �ESCRIPTION SQ.FT. FACTOR PSF - ADJ.AREANALUATION Q OWNER-BL'ILDER DECLARA710N _ . SFFUADD/REM O p t HERE9Y AFFIRM UNDER PENALTY OF PERJURY THAT I AM ExEMPT FROM iHE COHTRACTORS Lb Gdf2gB/C�rpOR � W CENSEUWFORTMEFOLLOWINGREASON(SEC.70J1.50USINESSANUPROFESSIONSCODEMIYCT'OR (n U COUNTYWHICHREOUIRESAPERMITTOCONSTRUGLALTERIMPROVE,DEIAOl15H.ORRCPAIpANYSTRUG (L w TURE,PRIOR TO RS ISSUANCE.ALSO REOUIRES THE AVPLIGW7 FOR SUpi PERMIT TO fllE A SIGNED W PatidDeck ' . STATEMEM THA7 FIE OR SHE IS LICENSED PURSUMlT TO THE GPOYSIONS OF THE CONIMCTORS LH � GENSEUW�dUPTERY�COMMENqNOYniHSECTKKi7000JOFDIV1510N30FTNEBU51NC55ANDPRO- �- PooUSpa ' .. . FESSIONS GODE)OR iHAT HE OR SME IS ExEMPT THEREFROM IWO TME BA515 FOR TME ILLlEGEO ExEMP- . V TION.ANYVIOLATIONOFSECiIqJ7071.58YANYAPPLICAN7FOfiA7ERMITSUBJEGTSTHEAPPLICANTTO Z RB.Root ' � � A CIVIL PENALTY OF NOT MORE THAN FNE HUh'DRED DOLURS�55001): • � Ol��'NEROFTHEPROPEfiTY.ORAIYEMPIOYEESWITHWAGESASTHEIRSOIECDAlOENSA710N, � `(qmmBfCi01 �� � WILL DO T1E WORK.AND TNE STRUCTURE IS NO71N7ENDED OR OFFERED FOq SALE(SEC.7ou,BUSi- � NESS AND PROFESSIONS CODE:THE CONTHACTOpS LICENSL LAW DO[S NOT MPLV TO AN OWNER OF ? _ PROPERTY NRiO BU0.DS Oq IMPROVES THEREON,AND WHO DOES SUpi WORK HIMSEIF OR HENSELF OR ' � THRWCHHISOHHEHONMEMVLOYEES,PflOV10E01HAT5Ud1WPROVEMENTSAflENOiW1ENDEDOR m ' QOFFEflE0FOR5ALE1F,FpNlEVER7H[BUILDINGORIMPROVEMENTI550LD1MTHINONEYEAROF�OMPLE- � Z TION.THE OWNER�OUILDER W�LL NAVE THE BUROEN OF PROV'NG TMAT ME OR SNE OID NOT BUIID O(i , , = N�PROVE FORTHE PURPOSE OF SALE} � • W -OI,ASDWN[ROFTNEPROPEHiV.AME%CLUSNELYCOMMCTINGWITNLICEKSEDCONTMCTORS . � TO fANSTRUCTTHE DROJEGT(SEL.7W�,fiUSINESSAN7 PROFESSIONS CDDE:TME CON7MCTOR9 LI• V81U�1i0f1 ADJ.AREA W CENSEUWDOESNOTAPCLVTOANONNEHOFAVROPERTVWHOBUILDSORIMPROYESTl1EREOf1AND Z MM1qCONTRACTSFORSUCHORpJECTSWITHAODNTRACTOR(S�UCENSE'JPURSUANTTOTNECONiMG QUANTITY DESCRIPTION �E Y TORS UCENSE Uw). , , � O IAM E%EMPT UNDER SEC. B.d P.C.FOR TMIS NEASON J - O a � ' U � . ¢ DATE OWNER U Z W � LICENSED CONTRACTORS DECLARATION ' W � IHEREBYAFFIRMUNDERPENAL7YOFPEHJUMTNATIAMLICENSEDUNDEROFOVISIONSOFCHMTER � , � � 9(COMMENCING W17H SECTION 7000)OF DMSION 70F TME BUSINE55 AND PROFE5510N5 CODE.AND Z W MY LIGENSE IS Pi Fl1LL FORCEAND EFFECL m - . , � UCENSE CUSS � y LIC.NO. �ry�Y�� j , - v onre corrrRacTOR�f fl����!ll.�eL a w � WORKERS'COMPENSATION DECLARATION a , N IHEREBYAFFIRMUNOERPENAITYOFGEHJUMONEOFTHEFOLLOWINGDECUMT10N5: Z � � �IHAVEANOWILLMAINTAINACERTIFlCATEOFCONSENTTOSELF-INSUREFORWORI(ERS' _ ' Q COMPENS�7ION,ASPROVIDEDBvSECTI0N�7ooOFTHELABORCODE,FORTHEPERFORMANCE W OF TH� RK FOit WHIp17HIS PEPMI715ISSUED. � 0 W IHAVEANDMALLMAINTAINWORNERS'CdnPENSATIDNWSURANCE.ASREWIREDBYSECTION ,_ Q 77000FTHEUBORCODEFORTHEPERFORIA�VlCEOFTHEWORKFORWHICNTNISPERMIilS � ISSVED.MYNqRKERS'COMPENSRTpNINSURANCELARRIERANDPOIICYNUMOERME: CONSTRUCTION Q � CARRIEN � /� � l/.�1/1�LZ PLANREVIEW � POLICYNUM�ERI� `7{'J�S-[�JO .7C��� ELECTRIC Q , p (fFUSSECTIONNEmNOTBE00f.�PLEfmOFTtiEPEfV.R6Po(iOnEHIIDRED00LWtS(570CIOHLE55F PLUMBM� ... . . 2 0 Z 1 CERTIFY TXAT PI TME PERFORMANCE OF THE WORN FOR WHICH THIS PERNIT IS ISSUE�,I MECHANICAL _U' SHALLNOTEMPLOYANYPERSONINANYAIANNLq50AST08ECOMESV0.JECTTOTFiE � MqRKERS'COMPENSATIONUN'SOFCALIFORtdAANDAGREETMATIFISMOUDBECOME INSPECTIONFEE � ' � SIl[iIECT 10 THE WORKERS'COMPENSATION PROVISIDNS OF SECTION 7700 OF iHE IABOR � CODE,ISHALLFORTMWITHGOM�LVW OSEP NSIONS. +J ISSUANCE _ /r• r'� 0 oa�•�/z,��r APPLIG `� / SMIP �\ , J WARNINO:FA0.l1RE TO SEGURE WOIiKERS'COMPENSA710N CDVE GE IS UNLAWFUL.AND SHALL 9E ENERGY P!C � �y SIAJECTANEUPIAYEHTOCRIUINALPENALTIESAN'�dVILFWESU7700NEHUNOREDTMdJSANJ ENERGYPERMIT DOLURS(f�00.000),IN/�DDITION TO THE COST OF COMPENSATqN,DMA�GES AS PROVIDED FOR IN � SECTIONa10eOFTF1ELABORCOOE,NTEREST,ANOATTORNEY'SFEES. RETENTIONFEE: ' � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: �A���_'O��R O � � .. . . . . , � INEREBVAFFI0.IAUNDERPENALTYOFPf0.tt1RVTNATTMEREISACONSTRUCTIONLEN�INGACENCY � " �- fONTHEPERFORMANCEOFTMEWORKFORWHICHTMISPERM:TISISSUED(SEG709�,CIV.C.). w .> LENOERS NAME S ,a+ � !-� lEN0Efi511DOFE55 � � � �- _^ � w ICERTIFY7HATIH�VEREADT115�PPLICATqN/WD57ATETHATTNEA[iOVENFORMATIDNISCORR[CL TOTAL FEES ' 3O •` — � IAGREETOCAMVLYWITr/ALLCITYANDCDUNTYORDINANCESAN�STATEUWSRELATINGTOBURDING " � CONSiRUCTION,ANDHEREBYAUTHORIZEREPpESENTATIVESOFTN15COUNTYTOENTEflUPONTHE � • Z ABOVE�MEMqNEDVROPERTYFORIN57ECT10NPUNPOSES. , COMMENTS ' 0 � aa�Tit,�f;��r.�.t:r2� � m PERMiT7EE YTI J -. . . , _ '/ �' ���7.s�t 1� -L .-oF pEaMiirEE ;� 'r . oaTE � � - � , : RECPT NO. � PP� VALIDATION - � WHITE-0epaAment Capy.YELLOW-Finance Copy,PINK-Assassor Copy,GOLDENROD-Fila Copy,GREEN-Appliwnt's Gopy • . . ' • r ' . � .. . � ,.. . � • � .' 1"•, . -' - ' 1 ,r• . . . . ! ..�n . . ' ' � . • � CITY OF DIAMOND BAR ... �, � . = � � INSPECTION RECORD � ' � � � . • - • � � � - SET BACK - � ` ' �� FLOOR JOIST - �� - ' FTGS/FORMS/STEEL :. � FHA REQMTS " ELECTRIC GROUND • � UNDER FLOOR DUCT . • ,` . _ � GROUND PLUMBING • UNDER�FLaOR�CU�IDUIT ' • ' • SLAB GRADE - � ' - ' FIREPLACE FOUNDATION . � � TEMP POWER -- - - FIREPLACE BOND BEAM ' • ' �• WATER SERVICE �• - - • -- ' MID HT:BOND BEAM � � � ROOF SHEATHING �'� � •�� � 8 FT.BOND BEAM � FRAMINGNENTILIATION - FINAL BOND BEADA " ROOF COVER - - - - � -- - PRE-GRADING ROUGH HEATING - - -� BENCHWG - ROUGH ELECTRIC '"- - ROUGH GRADING ROUGH PLUMBING . - - FINISH GRADING SHOWER/TUBTEST � "' POOL ELECTRIC EXT.LATH/SIDING , POOL FENCING WALL INSUTATION ' POOL'FINAL CEILING INSULATION OFF SITE IMPS. �� DRYWALL NAILING DEDICATIONS SEWER _ _. _ j Z�" � FINAL ENG. SEPTIC 7ANK - LANDSCAPE/iRRIG. ' SEEP PIT/L.L. -- � - - � ON SITE IMPS. • GAS AIR TEST ; � - - - FINAL ZONING � • FINAL CONST. - - FIRE DEPT.FINAL • FINAL HEATING - - - HEALTH DEPT. FINAL � � FINAL ELECTRIC -- - - � DEV. FEES PAID � . FINAL PLUMBING 1d ENERGY • _ �., .. _ . . . • • " - . COMMENTS ' � ' . • , . . • � ' . . - ^y� . . , • I SEPTIC TANK SIZ�_�� .': ' SEEP PITJU SIZE " . . , . _ - i � ' ' '�� � - ' � ' � . 1 , • •