HomeMy WebLinkAbout13104 (22) CITY OF DIAMOND BAR /`�
" - DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ���-1
21660 E.Copley Drtve Suitc i 90 U
(909)860-3195 Fax(909)8fi1-3117 PRESS
$UQ.DING PEItM1T APPLICATION FIRMLY
� JOBSITE ��Sa hire �ile APPLICATiON PERMR p/C
o ADDRESS__ Pt'� pATE 03/12/99 NUMBER � �'O �
$ ` ISSUE 1 /� TYPE pCC
APN LOT '� TRACT 32400 DATE �12-^"Iq
� CONST. GROUP
OWNER ��q�ard Pac�f�c Corporat�on
p ADDRESS ��� < < � ZONING SETBACKS
W C17y Costa �esa Z�p '� TE�.____�,- � FRONT qyy p
� APPUCANT TEL. REAR p
SIDEISIDE STREET RW p
� CONTRACTOR 00 Llll101il�� IlC. SIDE p
ADDRE5S�2� ('ract t�lvPnnP
� C�Ty PROPOSED USE
�?,,.�vg�g��,g ZIPC�-��- TEL. QC1Q_-�--���=�
ARCHIENG!
DESIGNER NO.DWEL. NO. NO.
ADDRESS
� CITY Z�p �� UNITS STORIES BEDROOMS
ti
rn DESCRIPTION SQ.FT. FACTOR PSF ADJ.ARENVALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
1 YffREBY AFRRM UHDER PENALN OF PERIURY THAT 1 AM EXEMPT FRqA TIE CONTRACTOFiS LI- G8f6 9/CB fl
� CENSEUWfORTHEFOILOWINOREASON�SEC.7031.6BUSINE331WDPROFE3510N9CO�PANYCI7YOF (n 9 � �
Cd1NTYM/HIOi REOLIIRESA PER�IRTOODNSTRUCT,µ7ER MVROVE,DEMOLISH,OR REPAIRMIV STRUC-
TURE,iRiOq TO RS 169UANCE.ALBO REOUIRES 7N6 MPLICAM FOR SUCH PERMIT TO FILE A BIGNED � W Patio/Deck
BTATFMEM TIA7 ME OR 8NE IB UCENSEO MJA6UANT TO THE PROHISIONS OF THE QONTMCTORS LL
� CD15E LAW(dMPTER Y�COMMENCWO WI7H BECTION 7000)OF DIVISqN]OF TNE lU91NE5$qND PR6 V" POOVSPB
FES9IDNSOODEjORiHATHEORSHEISEXEMPT7HEREFI�MANDiNEBASISFORTXEALLEOEDIXEMP- (�
iION.MlYVqUR10NOFSECT10N7087.6BYANYAPPUCANTFOFl�PEWAITBU&IECT9TNEAPPLICMlTTO Z RB-ROOI
� I1CML/EN+LLTT OF NOT MORE TIAN FNE NUNDRED DOIURS(i50�)J:
p ❑IABOWIJEROfTHEPROPER7Y,ORMYEMPLOYEESWITFIW�0ESA3h1EIRSOLECOMPENSATION, 0 COr1lfnBrolel -
Z WILL 00 THE WOWC AND THE STFlIIC�UHE IS NOT INTENOED OR OFFERED FOR SALE(SEC.7a.1,BU56 J
y NESS ANO PR�FE5510N5 CDDE 1HE CONTRACTOq3 LICEN9E UW DOES NO7 APPLY TO MF OWNER OF �
PROPERfY WFIO BIMDS OR�./PRDVES TMEREON,AND WHO DOES SUCH NlORK HIMSEIF OA HERSELF OR
� TMROUGH1A60RHEROYMpIPLOYEES,MW�9DEDTiiAT8Up1�.PROVEMEM9MENOTINTENDE00R m
OFFEHEO FORB�LE IF,FN7WEYER7}IE BUILdNCl ORIMPROVEMENT IS SOLD MATNIN ONEYEAR OF CpAdPIE-
TqN,7XE OMRJEIi-0UItDER WILL INYE h1E BURDEN OF PROVINO MAT ME OR SHE UID NOT B1111D OR
IMPNOVEFORTNEPURPOSEOFSALE). �
� OI,ASONMEROFTHEPROPERTY,AMIXCLUSNELYCONTFUCTINONATHUCENSEDOONTMCTDN3
TO CONSTIiUCT THE VHOJECT($EC.10N,BUSINESS MI�PROFE3310N5 CO�E:T7E CONTqACTORS U• VBIU0110n ADJ.AREA
CENSE UW DDE9 NOT AI+PLY TO AN OMMER OF A PROPERTV WFI�BUIlDS OR IMVROVE9 TNEREON,AND
WI�OQON�iWCT3WRSUCNVRO.lECT3WIlHACONiAACTOR(9)l�C6NSEDPURSUANTTOTHEOONTMG QUANTITY DESCRIPTION
� rauucEnsEuw.y FEE
❑I AA1 EXENPT UNOEN bEC. B.�P.C.FOq 7MIS REA60N Q
U
�= DATE OMMER F-
� LICENSED CONTAACTORS DECLARATION W
� IHEREBYAFFIRAUNDERPENALNOFPERAIRI'hIA71AGLICENSEDUNDERPROYiSIONSOFCMAP?Eq Ur 19 Fixtures �O/�VO
� Y�COGM[NCIH01VlT}ISECTqN70W)OFDIVI910N�OFTFIEBUSINESSMIOPflOFE5510N5CA0E,AND Z
MY LICENSE IS W FlJLL FORCE AN�EFFECf. m 1 Disizwasher lo•90
� LICENSECLASS C36 �,�.,�. 260324 � � 6 Gas ��utlets 13.90
� w� b�/�f 99 oor,Ta,�oA Nnn Pl t tmi�_i'nT� �'
1 Water Heater 10.90
WORKERS'COMPENSATION DECLARATION a
NI MEREBY AFFIRM UNpER PENALTY OF PERIURY ONE Of 7HE FOLLOWIN�DEQAMTIONS: � Z
� _IHAVE/NDWILLWINTNNACERTIFICATEOFCONSENfMSELF-INSUREFOHNlORIfERS' _ '
COMPENSATqN,A9 PHOVIDED BV EECTION I/oo OF 7HE LABOR CODE,FOR TfE PERPDRMIWCE U
Q OF TNE WOPo(FOR NMICX 1F113 PEHMIT IS ISSUED. �
� _I HAVE AND WILL MAMTAM NADqKERS COM7ENSATIOOJ INSURANCE,AS REd11RED BV SECTqN
Q l7000FTHELABORCO�E,FORTHEPERFORMMICEOFTHEYVORKFORWMICH7HISPERMITIS
145Um.MY WOHKERS'GOMPENSATION INSURANCE CARRIEH AND VWACY NUMBER N1E: CONSTRUCTION
� CMRIER w 7�J/ PLAN REVIEW
� POLICY NUMBER
ELECTRIC
� (nass�nur�rroreEaor.wErFnaFn�rEw�rswaaaeHuwr�ooau�sRi�la��ss� PLUMBING
w
Z 1 CERTI%THA71N TNE VERFORMNVCE OF 7HE YYOWC FOR WMICH TNIS PEHMR IS ISSUEO,1 MECHANICAL
6H+1LL NOT EMPLOY MIY PER50N N ANY MANNER 50 AS TO BECOME SUBJEC7 TO THE
� WORKER3'COMFENSIlTION LAWS OF GLLIFORNIti ANOAfiREE THAT IF I SFIDUL�BECOME INSPECTION FEE
� 6UB.IECT TO THE WORKEHS'COMPENSATqN PROVISIONS OF SECTION a7oo OF TME LABOR �i ^,�
COOE.1 SMALL FORTNYIIITH CdAPLY MATH TFIOSE PROVISIONS. ISSUANCE Y' � W
p DATE: APPL�CnNT. SMIP
W
� WMNINO:FA0.URE TO SECURE 1MORKERS'COMPENSA710N COVEMOE IS UNUWFIK,AN�SHALL9E ENERGY P/C _
� SUBlECTANEYPLOYEHTOCRIMINALPENALTIESAN�CIYILFWESUPTOONENUNOREDTHWSAND ENERGVPERMIT
DOLLARS�f10D.000),N ADDITION TOTHE COSTOF COMPENSATqN,OAMAGES AS PROVIOEO FOR IN �(
� 6ECfpN37000FiHELABORCODE.NTEREST,ANDATTORNEYSFEE3. RETENTIONFEE: __ !:� ' �`�i '
CONSTHUCTIONLENDINGAGENCY PRE-ALTFEE: � ����I�
� IHEREBYAFFIRMUNOEqPENALTYOFPEFLUR7TNATTHEREISACONSTRVCTIONIENDINpAOENCY
Z FOH TFIE PERWRMANCE OiTHE WOFlK WR NMICH TNIS PERMITIS 16SUED�SEG 30a�,CIY.C.).
W
� IENDER'SNAME
� LENDER'S�DDRE55
� 10EFTIFYTNATI READ7�1 PGLICATION �5 TTIE�BWEINFORMATIONISODRREC7. TOTAL FEES ��V/�6O
� IMRESTOCOM WITHµ.[ ANOCOUNTY ESNIOSTATEUWSHEUTINOTOBIJRDINO
� OONSTRUCi AND MEqEB REP 7 YES OF THIS COUNfY TO ENTER UPON ME �
ABOVE�AEN �PRf�p Fp EGT q ses. COMMENTS
� e � esident
� P R7EE �I
� 03 12 99 ,
y E pATE
� RECPT,NO. PAID BY YALIDAl70N
� /��l �� WHRE�t Copy,YELLOW-�'�v�nnce Copy,PINK—Assessor Copy,GOLDENRO�Ie Gapy,GREEN—Applicant's Copy
V C✓i \I E
--•��.� _.__..._..
CITY OF DIAMOND BAi�
� INSPECTi�N RECORD �
w " � E � • � . ■ � � � ■ � .
SEi BACK FLOOR JOIST '" �"
FTGS/FORMSlSTEEL FHA REQMTS � � �v
ELECTRIC GROUND UNDER FLOOR DUCT
GpOUNO PLUMBING UNDER FLOOR CGt�IDUIT ��
SLAB GRADE FIREPLACE FOUNDATiON '
TEMP POWER FIREPLACE BOND BEAM
WAT'ER SERVICE MID HT. BOND BEAM
ROOF SHEATHING � 8 FL BOND BEAM
FRAMINGNENTILIATIt�N FINAL BOND BEAM
ROOF C�VER PRE-GRADING
ROUGH FiEATING BENCHING '
ROUGH ELECTRfC RQUGH GRADING
ROUGN PLUMBING ' -�jl�`C FINISH GRADING
SH�WER/TUB TEST P�OL E�ECTRIC
EXT. LATH/SIDING � f PaOL FENCING
WALL INSULATION PC70�FlNAL
CEILING INSULATION QFF 51TE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTiC 7ANK , � LANDSCAPElIRRIG.
SEEP PIT/L.L. � ON SITE lMPS.
GAS AIR TEST �^� FINAL ZONING ;
FINAL CONST. � I i FIRE DEPT. F1NAL +
FINkL HEATING � � ' �HEALTH DEPT. FINAL �_� j
FIt�IAL ELECTRIC � j ; f DEV. FEES PAID t
FINAL PLUMBING , • � i j ENERGY V ; .:
iT � �
I �
i �
I ' I ' � � ��_ I -.�._�
COMMENTS
SEPTIC TANK SIZE � � �
SEEP PIT/U SIZE -- �- � '
�� , � __..��.__ _ —.
,�
� ..
i.