HomeMy WebLinkAbout12385 (14) . i, _�\ CITY OF DIAMOND BAR DEPARTMENT OF COMMUrTITY&DEVELOPMENT SERVICES r � 3 21660 E.Copley Drivo Suite 190 ` (909)860-3195 Fax(909)661-3117 PRESS �"�'��� BUII.DING PERMIT APPLICATION FIRMLY a ADDRESS �s v I �"7 PI'�I l�..i U'�7'�� APPLICATION b''S� PERMIT ^L3 P/C a DATE NUMBER ! � APN LOT TRACT �. (9 ISSUE TYPE , OCC Q DATE CpNST. ' GROUP p OWNER L "' ADDRESS W• �1 9 ZONING SETHACKS :'. � CITY P �I�7fEL, Q�' FRONT ... � RW O APPLICANT � TEL.T REAR p � SIDElSIDE STREET RW ❑ CONTRACTOR „�� ��V SIDE p ADDRESS PflOPOSED USE � �r � CITY ZIP TEL. , � ARChUENGJ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � bESCRIPTION 5Q.Fi' FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/A�WFiEM �, O 1 XER�Y AFFIRM UNCER PENILL7V OF PERIURY TWtT I AM E%EMVT FqoA1 TNE CaMMCYORS lF GBfflSJBK�OR 5 � CENSEIAWFORTHE►OLLOWRKlREA60N(6EC.70.11.6BUSINESSANDPROFES510NSCODE:ANYCITYOR (n GOIXdTYY1T11CMRE0U1itE5APEHMRTOGONBTRUCT,ALiER�MFRDVE.DEMOl19H2ORREPAIRANYlI7RUG W ��� � ;,.^f j NRE,rR10R TD R8 1&9UANCE,i1L80 IIEW IRE9 7NE MP�.MANf fOR BUCM PERMIT TO FILE I1810NED W . i.� ' STATEMENT TI1AT ME OR SME IS UCENSED RXI3UPNT TO TNE PfqYIS101i5 OF THE CQliW�CiORS LF ' CENSE LAW(qIMTER i(COIAMENCWO YAiH SECTION 70aD)�DIVISION S OF THE BUSMlE55 AMJ PRO� � POOYSPp -• �'� ' ' � FESSIONSCOOE)OR1fiATXEOR5HE13FXEMPTMEREFROMAN07HEBASI3FORiHEALLE6EDEXEMV- (' � TION.ANV NOLATION OF SECTION 70J7.6 BY ANY APPLICANT FOR 11 PERNR SUBJECiS THE APPtICANT T0 Z pa-q�f � � ACML PEIW.TY OF NOT IAORE 1HAN FIVE HUNDR�DOIIJ�RS(i50o�.1: ., OLti:�NEROFTHEPHOPERTY,ORAIVEMPlWEESWITHWAGESASTHEIRSOLECOMPENSATION, (�pmmB�Cl91 WLLDD TFIE WORIf,AND 7}1E�TR11C7URE 19 NOT INTENDED OH OFFERE�FOR 9ALE(SEC.7oN,BUSI- O � NESS MD VROFES&ONS CODE:THE CONTR�CTORS LICENSE LAW DOES NO7 AGPLY TO M!OWNER OF = .�f1 w�1 • PROPERiY1N10BULD30RINPROVESilIEREON,AN�YMHODOESSUCXYYORKNIMSELFORXEfiSELfOP ��Ywf � TFf10UOMMI50RFIEHOWNpAPlOVE6.GROYlOE�THATSUCNIMPROVEMENTSMENOTINTEN0E00R m � OFFEREU ROR SALE IF,HOYVEVER'�MEBUILDING OR MIPROVEMfM18 SOLD WRHIN ONE Y6AROF COMPLE• TION,iHE OWNER�BUIIDER NIILL MAYE lilE BURDEN OF PpOVIN(3 THAT HE OR SNE 010 NOT Bl11ID ON NAVfqVE WH TNF PURPOSE OF SALEI. : : . � 04���NIEROF7HEA10PEH7Y,AME1fCLU51VELYCOMMCiINOWRFILtCENSEDCONTRACTOqS TO OONSTRUCT 1HE PROJECT(8EG 7oa1,BUSINESS AND P110FE3310N5 OOUE:THE GW7qACSORS 4- VeIUi11O11 V ADJ.AREA GENSE LAW DDE9 NOT APPLY TO AN OMMEfl OF A PflOPER7Y YYFW BUIID6 OH N7PR9VE9 i}SEFlEON.ANO NTpOOMfUCTSFOR3UCHPRQIECTSWfTHAC01iTRACTOR(8)L1GBISEDPURSUAMT07NEGONTRAG- QUAKfITY DESCRIPTION FEE � iORS 4CENSE I.AW.). ❑1 AM EXEYPT IMVOEH SEG B.i P.C.FOR THIS REASON � U � ¢ UATE ONMEH V . � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRN UNDER PENALTY OF PERJURY TiAT I AM UCENSEU UNDER PNOVISiONS OF CHAPTER � i�L�WIMENCWOWIM3ECTION7000��DMSIDN70FTHEBUSINESSAN�PR�FE55qNSCODE.AND z W LICENSE tSIN FULL FOHCE AND EFFECT. m � LICENS LIC.NO.� — J � o�� conrtFucroa _ a w � WORKERS'COMPENSATION DECLARATION Q � IHEREBYAFFlRMUNDERPENALNOFiEiUURYONEOFiHEiOLLOWINODECLARATIONS: Z G _INAVEANDWILLMARlTNNACERTIFlCATEOFCONSENTTOSELF•INSUREFOHN/OFKERS' � OOYPENSATqN,Il4 DqOV10E0 BV BECTION nooOF iHE LABOR COOE,FOR THE PERWRMANCE W OFTHE WORK FOilMhlldl THI9 PERMIT IS ISSUED. � � �MJNEANDWILLMAIHIYIINYYOHKERS'fAMPENSATqNINSURANCE,ASREWIREDBY9ECT10N QQ 9700 OF iHE LABOR COOE.FOR THE PENFORMANCE DF THE WORN FOR WHICH THIS PERMIT IS � ISSUEO.MY WORKERS'COMPENSATION INSLIMNCE CARRIER AN�POLICV NUMBERARE: CONSTRUCTION �O�� � v � c�nAiEa.. . . PLAN REVIEW I .. . .. � POLICYNUMBER �?",� ELECTRIC `S�O„ad� p (IF166ECI10NNE�No7BEo�FPLE7maFnEPEFMrsWaar�EHM7RE000UNasRtao)aqtE55G PLUMBING I S�V�/M�D�yO� Z I CERTIFY THAT M THE PERFORMANCE OF TNE NORK FOR WMICH TNIS PERMIT IS ISSUEU,I MECHANICAL I J V a w � SHALLNOTEMPLOYANVPERSONINANVMIWNERSOA6TDBECOME6UBJECT70THE � 1MORKER3'COMPEN9ATIONLAWSOFCALIFORNIl1,ANOA�REETHATIFISHOUL�BECOME INSPECTIONFEE SVBJECT70 THE N'ORKERS'COMPENS�TION PROVISIONSOF SEC710N 970o OF THE LABOR cap isHu1 qTHWfiHCOMPLVNAlHTF105E is s. iSSUANCE O ^ �p DA7E:`,�,�APPLICANT. �V��� SMIP V � WARNING:iAILURE TO SECURE WOFlKERS'COMPENSATpN COVERAGE IS UNU1WFUL,AND Sf7pLl BE ENERGY�/C l � 6UBJECTAN EMPLOYER TO CRIMINAL VENALTIESAND CIVIL FMES 11D IOONE NUNDIiED TFM7USAfJD ENEROY PERMIT �� Y OOUM3(i100,000),INAUUITIONTOTHECOSTOFCOMPENSRTKKJ,DNMGESA&PROVIOEDFORIN � sEcr�a7oeoFniEueoRcooe.iNreaEstuao�rroANErs�Es. RETEN710NFEE: "+ � (� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE y�'�� .� `' '� IMEREBYAFFIRMLINDERPENALTYOFPERJURYrH1UTHEHEISACONSTRUCTIONI.ENDWGAGENCV FOR TNE PEHWRAAANCE OF TFiE WORK FOR WHICH THIS PERM�T IS ISSUED(SEC.70i7,CIY.CJ. Z W � LENUEN'S NAME � LENDER'SADDNESS � 1 CERTIFY iNlR I HAVE READ Til3 APPLICATqN MIO STATE THATTHEABOVE INFOIiMATION t3 OORRECT. TOTAL FEES (r� {�I�� ������ � 1 A(iREE TO COMPIY YYITM ALL CT'ANU COUNfY OROWANCES ANO ST�TE LAVIS i�U1TIN(3 TO BUMAINO � . � Cd1S7RlICTION.ANUHEREeV1Wh10R2EREGHESENTATNE50FTHI5COUNTYTOENfERUPONTHF ABOVE.GEIRIONEO vqOPERTY iOR INSPECTbN PUR06SE5. 9 n - COMMENTS = I�L�.6ls/� m PER NAM PNI (� . . a �{.r y (/� 8qlU REOFPERAlI7TEE OAiE � RECPT.NO. PAID BY VALIDATION � VVHITE—DepeRment Copy.YELLOW—FNence Copy,PINK—Assessa Copy.GOLDENROD—File Copy.GFEEN—Appli�nPs Copy , _ . . . `�--- . . . ,. .. .. , . CITY OF DIAMONQ B�4R � lNSPECTiC1N RECORD � � � e - e � � - e - SET BACK ; FLOOR JOIST�,, , < i , i �,,� ; �-� , ; C: ; FTGS/FORMS/STEEL O FHA REQMTS ; , `V ELECTRIC GROUND Lrf' UNDER FLOpR.C}UGT ' "" _ . ____�:—__� GROUND PLUMBING UND�R��UOR C��IDU1T :: :� _ : .��� . ..; _•'; SLAB GRADE FIflEPL'AC�'f�0lJNDATION' ' - ` • • ' ' �° � = ' ' TEMP PUWER FIREPLACE B�ND BEAM � � " • WATER SERVICE D z MID NT.BOND BEAM � R(70F SHEATHIN� '' �l t� 8 FT.BOND BEAM FRAMINGNEIVTILIATION }- / FINAt,BOND BEAM ROOF COVER PRE-GRADING ROUGH HERTING 9- BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH P�UMBiNG , !�� FINISH GRADING ....... SHOWERITUB TES7 l . , .. .••._. ... ... PO�L ELECTRIC EXT. LATH/51DING � � � POOL FENCING WA�L INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING � �� '•':� � DEDICATIONS BEWER FINAL ENG. SEPTtC TANK . LANDSCAPE/IRRIG. � � SEEP PIT/L.L. - ' ' ON SITE IMPS. � GAS AIR TEST: FINAL ZONiNG � FtNAL CC?NST. (, i FIRE DEPT. FINAL � FINAL HEATING HEALTH DEPT. 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