HomeMy WebLinkAbout11436 (9) .�...-_--------•--. -----.,_,--.--•---___._. ..._. _.__�._._----__.�_._.._ .._�_._.r_._.. _._..�_._ _. _.._.._��._.___._._._._�....�_.._-_�..,�
�---�1� ---• CITY OF DIAMOND BAR ' • �i
� COMMUNITY DEVELOPMENT DEPAR7`h4ENT ' ' �
21660 E.Copley Drive Suite 190 . � PRESS
� , (909)860-3195 Fax(909)861•3117 � '
""' BUILDING PLRhtIT APPLICATION FI R M LY
N JOBSITE - � ' ' ' • APPLICATION •-2 PERMIT P/C
o ADDRESS � � � DATE NUMBEF� ��
� ISSUE TYPE OCC
APN L T TRACT DATE CONST. GROUP
p OWNE� _
" ADDRESS ZONING SETBACKS
oCIN ZIP TEL. ' � FRONT RW ❑
APPLICANT TEL. REAR ❑
� SIDE/SIDESTREET RW p
� CONTRACTOR �/I- SIDE ❑
Q ADDRESS - t�r (�►•L ,
� CIN ZIP TEL. PROPOSED USE
oARCH/EN /
� DESIGNER NO.DWEL. NO. NO.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
�
OOWNER-BL'ILDER DECLARATION SFR/ADD�'REM �
p I HEHEBY AFFIRM UNOER PENNLTY OF PERJURY THAT I IVA E%EMaT iROM THE COrtTRNCTORS ll• GarOgB/CerpOrt . �
W CENSEUWFORTHEfOLLOWINOREASON(SEG7071.SBUS:NESSIINDPFDFESSiONSCODEANYCITYOR (n
U COUNfYWHIfS/REWIRESAPER1AliTOCONSTqUCT.ALTER.IM7ROVE,DEMOl15H2ORR[PRIRANYSTRUC• W Paiio/Dack �
' � TURE,GRbR TO li<ISSUANCE,AL50 REd11qE5 THE APPLMJIYT LOR SUCM VERMIT TO FILE A SIGNED W
� S7ATEMENT THA7 HE OR SHE IS UCENSED PURSUMIT TO TNE FROVISIONS OF TN[CONTRACTORS U- .
- � CENSE LAW(CH�PTEp 0(GOMMENCINC WITH SECTbN 7000)OF DIV1510N 7 OF THE BUSINESS Ml7 VRO� LL Fool/Spa
FESSpN5CO0E)OR7H�THEORSHEISE%EMPTTHEREFROMANDTMEBASISFORTHE�LLECEDE%EMa-
. � V TION.MIY VIOLATION OF SECTION 7D71.5 BYANYAPPLICAN7 FOR A PEfiMIT SUBJEGTS THE APPLIGANT TO Z Re-Rao1
� ACMLVEKhLTYOFNOTMOf1EiHANFIYEHUNDREDDOLURS(f5oo).):
0 OlASON�NEHOF7HEPROPEflTY,ORMYEMPLOYEESWITHWAGF5A5THEIR50LECOMPENSATIDN, � COf11rt1BfCi�I
Z WILL DO THE WORK.AND THE STRUCTURE IS NOT IMENOED OH OFFERED FOR Sl�LE(SEC.70u.BU51� J
NESS M7�PROFESSIONS CODE:THE CONTMCTORS LICENSE UW DOES NOT APPLV TO AN OW NER OF
' N PROVERiYWIqBUILD50RIAAVROVESTMfREON.ANDW11000ES5UCHWORKHIMSCLFORHEfiSELFOR � '
CL THfi0l1GHWSORMEROWNEMPLOYEES.PROVIDEDTHATSUCNWPROVEMENTSARENOTMENDE�OR m
QO�FEfiEDFOHSALE.IF,HOWEVER7HEBULDINCORIMPROVEM[MISSOLDWITXINOhEYFAROFCOIAGLE�
Z TION,TNE CJVJN[R�BNtDER YnLL HRVE TME BURDEN OF PR01nNQ THAT HE OA SHE DID NOT BUIID Oq
� IMPROVE FORTME PURPOSE OF SALE).
w 04ASOWNEROFTHEVROPERTY,AMEXGLUSIVEIYCONTMCTINGWITHLICENSEDCONTMGi0F5 ,
' ['[ TO CONSiRUCT THE PRQIECT(SEC.70��,BUSINESS M1D PHOFESSIDNS WOE:TME GONTMCTORS LI• V01U8ti0f1 A0.1.AREA
W CENSEUWDOESNOiAPPLYTOANOVMEHOFAPROPERTYN7108U1LD50RMPROVESTNEREON,MA
� WHOCOMMCiSFORSUCHDRO,IECTSWITHACONTMCfOR(5)LICENSEDPURSUANTTOTHECONTMC- QUANTITY �ESCRIPTION FEE
� TORS UCENSE UW).
� O I AM EXEMPT UNOER SEC. B.f P.C.FOR THIS REI150N , U
• � ¢
DATE OwNEP V .. ; � . . . , , .. ,
W
�Q LICENSED CONTRACTORS DECLARATION W
CL IMEREBVAFFlFMUN�ERPEN�LTYOFPERIURVTNATIAAIUCENSEDUNDEROqOV15iONSOFCHAPTfR U,
p„ Y�COMMENqNOYnTH5EC710Nt000)OFDIVISION70FTME0USINESSANJPROfESSqNSCODE.ANO Z ` ,
X MY t10EN5E IS IN FUIL FORCE AND EiFEGT.
LLI C m �' `�
� LICENSECUSS IIC.NO. Zv J . . .. i'•.•.�•, • •
V DATE� CONTRACTOF � a .;�` •
W � "y
� WORKERS'COMPENSATION DECLARATION � �
J
�, G � `� ,
� I HEREBY AFFIFUA UNOER PENALTY OF 7ERJUq'f ONE OF TME FOLLOwING OECLARATqNS. Z �"" ,
4
� �IHAVE/NIDWILLMAIN7NNACER7Ii1CATEOFCONSENTTOSELF�INSUREFORV/ORNERS' S '� ' , - ••%
COMPENSATqN,A9 PfiOViDED BY SECTON 770o OF THE LABOR CODE,FOR T1E PERFpRAIANCE U ^�•�
j7FTMEWORI(FORNM1IICHTHISPEflMITISI55UED. L � _ '.`iC J
W ��IHAVE/WDWILL4AIN7AINWORKENS'COIAPENSATIONINSUfUNCE,A5RE0UIREDBYSECTION LJ .•1'-`
4� 370o OFTHE UIBOH COOE,FOR THE PERFORIAANCE OF 7HE WORK�OR WHtCH THIS PfiUAIT IS �. ;��-'��,
ISSUEO.MY WO ERS' P SATION INSU ANCE CAq R FND PoUCY NUMOERAAE: � CONSTRUCTION ' �
¢ ^✓ .�
> CAFRIER Y PLAN REVIEN! _ •--
0 POIICYNUM6ER ELECT � �'✓
¢
' � (fN55ECKNNEmNOTBECO6TL£fEDOfREPEfiA'6FORONEHJ�I7CDDOLLAiLSR��IORLE..�i M ^ �!. `�.
Z ICERTifYTFUTPlTMEPERFORMANCEOFiHEWORKFORWNip17MI5VEFMITI5155UE0,1 MECHANICAL � � '�
U` SHALL NOT EIlPLOY ANY VERSON IN ANY M�NNER SO AS TO BECOME SU6JECT TO TNE
� WORKERS'COMPENS�TIONLAWSOFC�LIFORN10.�NOAGREETMATIfISHDUlDBECOME INSPECTIONFEE
� `- SU0.IECT TO THE WORNERS'CO�APENSATION PRONSIONS OF SECiION 7)OD OF TNE UBOR
� CODE,1 H� TNfAMPLY WITH TH�1$�o'+s. ISSUANCE ��� �I
� �11—� SMIP �
. p DATE: APPLICANt �/ � �99R
� WARNIN�:FAiU1RE TO SECIIRE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL AND SHALLB[ ENERGY P/C
�y SUDJECiANEUVLAYERTOCRIMiNAI�[NALTIESANOCNiLFWESUPTOONEHUNDRED7MOUSANU ENERGYPERh11T
DOl1AR5(SI00.000).IH ADORION TO iHE COST OF C04FENS�TION,�AAIAGES AS GRONDED FOR IN
� SECTIDN7TDeOFT1EU00RCODE,INTEREST,ANDATfORNEY'SFEES. ' RETENTIONFEE:
a '- CONSTRUCTION LENDING AGENCY PRE-ALT FEE: '
O . . ,
� IHEREBVAiFIi7MUNDERPENALTVOFPERNRVTMAT7NERE15ACON5TRUCTIONLENDINCACENCY
� FOR THE IERFOfiMANCE OF THE WORK FOH WHICH TMIS PENM1715155UED(SFC.7097,CIV.C.).
. Z
W
� IENDER'SNAME �
C LENDER'SADDRE55 �
� ICERTIFYTHATIMAVEREADTHISAPVUCATqNANOST�lETNATTHEA80VEWFORM�TIONISCORRECT. TOTALFEES
� IACREETOCOMPLYWITrIALLCI7YANDCAUNT'ORDINANCESANDSTATEUWSREIATINCTOBUiLDING ' � I��
� CONSTflULTION,ANDMEREBYAUTHORREREPRESENTATIVE50FTH15COVNTVTOENTERUVONTHE �J.'�S
Z ABOVE�MENTIONEDVROPERT/FORINSPEG7qNPURPOSES. COMMENTS
� ��""���
4 PERMiTTEEN /—j'/,. _ // �^ty /�� - .
cn `7�/I ii w�� ��� 7
y SIGNATUREOF E MITTEE OATE �
� RECPT.NO. �� PAID BY �VAUDATIO
� � WHITE—Department Copy,YELLOW—Financa Copy,PINK—Assessor Copy,GOLDENROD—Filo Copy,GFiEEN—Appliwnt's Copy
� > � '.�. _ . .� , • .�- ..� .�--..R' ^ �.�,� .�..... �..T' - ,��..,w..�. •,ry..r.,��..�.. ...���..;'
, .- _ . - . .. .. _ , . .. -. . . , .�.. . . . � r � •'T , r.\ . . . ' " . . . . . , -
I� I _ .
I �\ � . �
I ) CITY OF DIAMO�ID BAR ; �.� ;.'. . .:.�' - ' .
- ���__% 1NSPECTION RECORD ' �
. � � , .. , . . � .
• � � � • - • � � • '
SET BACK FLOOR JOIST - � - -- - �
FTGS/FORMSlSTEEL FHA REQMTS - � � ,
ELECTRIC GROUN� UNDER FLOOR DUCT � �
GROUND PLUMBING UNDER FLbOR CO�IDUIT ' • .� .��
SLAB GRADE FIREPLACE FOUNDATION . ___" •
TEMP POWER � t FIREPLAC�BOfVD BEAM• �� • • • ' • " � '
WATER SERVICE - � �- � � • �• `� i - MID HT.BOND BEAM � • � � � '
ROOF SHEATHING � 8 FL BOND BEAM � ' ' � �
FRAMINGNENTILIATION FINAL BOND BEAM - � �
ROOFCOVER -- -- - PRE-GRADING ' ��•`
ROUGH HEATING - - ' BENCHING
ROUGH ELECTRIC - - ROUGH GRADING '
ROUGH PLUMBING � � FINISH GRADING _ .
' SHOWERITUB TEST � � � - POOL ELECTRIC • '
EXT.LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL ' . '
CEILING INSULATION OFF SITE IMPS. .
DRYWALL NAILING DEDICATIONS �
SEWER ... __ _ FINAL ENG.
SEPTIC TANK .. __ LANDSCAPEIIRRIG.
SEEP PIT/L.L. - ' ON SITE IMPS.
GAS AIR TEST - - FINAL Z�NING ,
FlNAL CONST.- - S- -9� FIRE DEPT.FINAL .
FINAL HEATING � � HEALTH DEPT. FiNAL - � - -- ; ,
FINAL ELECTRIC - -= , . DEV.FEES PAID . .
FINAL PLUMBING - -Q,� rJ � �- ENERGY
� �'r��h'y f.�. � , � . . _
�- . •
�, . � .. -
COMMENTS - .;�. ' ' �
; � � . , , :
;-- i � ' - _.�'�', i "► �,�` - , � , . .. _ . , _
' . �. . .
_ _ � *
L 4
l ,` �
SIN'JI C � ��1�4 � . : - -... . .._ - _ . . . � , ,
SEPTIC TANK SIZE � . - - - .
;
SEEP PIT/U SIZE
• . :.� . , _ .. . _ . _..
. , j � '�� ,
. - r , . • .. � -
� � � , . ,' .
�',, � , �- .