HomeMy WebLinkAbout10871 - -._.-- .�._.---.---.._______....__._--
- - -� - --- --
...,....._. . -._�.,._...r----- - __�....._.__._... ...�..,.._.�...W..,........._,.. . �
— CITY OF DIAMOND BAR �
� COMMUNTI'Y DEVELOPMENT DEPARTM�NT �i�
,�=,^,' 21660 E.Copley Drivc Suite 194 � � PR�S�•
(909)860-3195 Fax(9D9)86]-3117 �
'�^"� BUILDING PERMIT APPLICATION %� FI RM LY
QJOBSITE ' ' APPLICATION �/���?— NUMB R v ,I �/C
< ADDRESS ~ '"'_}'II L� ' DATE �
� ISSUE�T— TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER
" ADDRESS �� f�f�L• . ZONING SETBACKS
gCITY LZIP�= TEL ^ FRONT RW _�
APPLI A TEL. FiEAR �;
� SIDFJSIDE STREET FW Ci
m CONTRACTOR o ,o SI�E !�
� ADDRE55 - ' ' �� � pRaPOSED USE �� �L'� v�a�� S p�i-R�'"
� CITY � , u' r. � ZI f` TEL. � –� "
w ARCH/ENG �� L_ •. �b–
�z DESIGNER NO.DWEL. NO —�T�� NO. ����Y•
= CD'�6,RESS Z�P TEL. UNITS STORIES � q0
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BL'ILOER DECLARATION SFR/A�p/REM
O
1 HEREBY AFFIRM UI�AER PENALTY OF PERJURY THAT I AM E%E�PT FROM THE CONTRACTOPS�I- G8f8g0/COfpOfl
W CENSEUWFORTHEFOILOWINGREA50N(SEC.7031.SBUS�NESSANOPROFE5510NSCOpE:ANYqTYOR (n
� COUNTVWHICHREOUIRESAPER611TTOCONSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRAh STquC- W Patia'DBCk
TURE.PR�OR.TO IT:�SSUANCE.AL50 REOUIRES THE APPUCANT FDR SUCM PERMIT i0 FILE A SIGNED W
STATEMENT THAY HE OR SHE IS LICENSED PURSl1AN'TO THE P90VISIONS OF 7HE CC#1TRAC70RS LI-
� CENSE LAW�CHA7TEN 9�COMMENCING WITN 5'eCiION 700a1 OF DIVISION 3 OF 7NE BUSINESS AN6 VkO- �'�' POOVSpd
FESSIONSCODE)ORTHATHEOR6NEISE%EMPTTiEREFROMANOTNEBA5ISFORTNEAILEGEDF%E11R (� .
� TIONANYVIOLATIONOFSECTION7o31.58VANYAPPUCAMFORAPERMITSUBJECTSTHEA°PLICANT�TG ' Z pe•Roof �•
� A CIVIL�ENALTY Of NOT MORE THAN FNE HUNDRED DOLIARS�S50o)): '
� ❑I,RSONTlEflOFTNEPROPERTY.OqMYEMPLOYEESWITNWAGeSASTHEIfl50LECOMPENSATcQN, 0 Commercial
WILL DO TNE WORK,ANO THE STRUCTURE IS NOT INTENDE�OR OFFERED FOR SALE(9EC.7044 BU6i- � �J
NESS ANO PROFESSIONS CODE.THE CONTRACTORS LICENSE LAW DOES NOT MPLY TO AN OWNE R OF
� PROPEH"fYWHO6U�lDSORIMPROVE5THE9EON.AN�WHODDE55UCHWORKH��SELFORHERSFLFbR '
� THRWGHHISORHEROWNEMPL�YEES.VROVI�EDTHAiSUCNIMPqOVEMENTSARENOtINTENGEPbR m
QOFFEHE�FORSALE.IF,NOWEYER'R7E6UILDINGORIMPROVEMENTISSOL�WRHINONEVEAROFC041PLE-'
Z TION,THE OWNER�BUILOEII WILL NAVE TME BUflDEN OF PROYMG 7HAT NE Ofi SHE OIO'NOT HUII.D OR
= IMPROVEFORTHEPURPOSEOFSALE). .'
fi L 115 ONMEH OF 7NE PROPERTV,M1 EXCWSIYELV CONTftACTING WITM UCENSE�CONTAAC7QR5
Q TO CONSTRUCT TNE PR0.IECT(SEC.70ae,BUSINESS AND PROFESSIONS COOE.TNE CONfRACTORS LI- V81118ti011 `� ADJ.AREA
W CENSEUWWESNOTAPPLYTOANOWNEROFAPHOPERTYWH00UILOSOflIMPROYESTHEREON,ANO' -
� WHOCONTRACTSFORSUCHPROJECT6W�THACONTRACTOR(5)LICENSEOPUR6UANiTOTHECONTRAC- QUANTITV DESCAIPTION FEE
Y TOHSLICENSELAWJ. �
� �7 I AM E%EMPT UNOER 5EC B.8 P.C.FOR 7HIS REASDN . Q
� __ U
ti. �
OATE OWNER _ U ,
Z ; W
� LICENSED CONTRACTORS DECLARATION �y
� 1 HEREBYAFFIRM UNDER PENALTV OF PERIURY THAT 1 AM LICENSEO UNOER PROVISIONS OF CHAPfEA U.
� B(COMMENCINOWITHSECTION70D0)OF�IVISION30FTHEBVSINESSANDPROFESSIONSCODE.M'll Z
XL� 1AY LICENSE IS W FULL FORCE AN�EFFECT. m
LLl
� LIGENSE CU55 LIG.NO. ���'���/ _ j
U OATE � �+ �� CONTRACTOR�,r'LL-"'LL���.�'L�� a
w 7 � '- " � u
� WORKERS'COMPENSATION DECLARATION • -�
¢
� IHEXEBYAFFIflMUNOEflPENALiYOFPERJURYONEOFTHEFOLLOWINGDECLAflATIONS: z
� _iHAVEANDWILLMAINTAINACERTIFICATEOFCpNSENTTOSELFANSUREFOqWppKERS' _
� COMPENSATION,ASPROVIDEDBYSECTION370oOF1HELABORGOOE,FOHThIEPEHFORMANGE U
OF THE WOflK FOF WHICH THIS PERMIT IS ISSUED. �
�
W _IMAYEANOWILLMRINTAINWORKERS'COMPENSATIONINSIIFlANCE,A5RE0U�qEDBYSECT�ON
Q 97oa OF THE LABOR C�DE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSllEO.MV WDRNERS'COMPENSATON INSURANC/E1 CAfifilER PNO POLICY NUM9ER ARE CANSTRUCT�ON ��I Qp
� CARRIER IJ PLAN REVIEW
� POLICYNUMBER
Z - —� ELECTRIC _
¢ (1}IU^SECiILM1NE�NOiBE(UM1W_E�EDOF71 rEanarta�cnEHx,onEooal�xsaioo�on�Ess� PLUMBING
O
W
Z �GERTIFY TNAT IN THE PERFORMaNCE OF THE WOiiK FOR WHICH TNIS PERMI7IS 165UED,I MECNANICAL _
U' SHRLLNOTEMPIAYANYPER50NINANYMANNERSOASTDBECOMESIJBJECTTOTHE
Uj WORKERS'COMPENSATIONLAWSOFCAUFOflNIA.ANDAGREETNATIFiSHOULOBECOME INSPECTIONFEE
SUBJECTiOTHEWORKERS'COMPENSATION7qOV151ON50F5ECTqN3�0aOFTHEL4BDR � �Q
� CO�E,I ALL FORTHWITH COMPLY WITN THOSE PROVISIor{,5. ISSUANCE _ �
p OATE:���� APPLICANT: ��I}+/\ SMIP �'G
"'� WARNINO:FAIWRETOSECUREWORKERS'COMPENSATIO YERAGEISUNIAWFl1L,ANDSHALIBE ENERGYP/C �
�`� .LL SUBJECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFMESUPTOONENUNDREDTHOIJSANU ENERGVPERMIT
OOLLARS(f t00.0ao�.IN A�DITION TO THE CAST OF COMPENSATION.DAMAGES AS PFOVIDED FOR IN
� 9ECTION3�OBOFTHEUBOflC�OE,INTERESiAN�ATTORNEY'SFEE3. RETENTIONFEE: _
a GONSTRUCTION LENDING AGENCY PRE-ALT FEE: __�� y�y y
� �'17tl/
� IHEREBVAFFIRGUNDERPENALT/OFPERJURVTHATTNEREISACON57RUCTIONLENDINCAGENCY
FOR THE PEfl WRMANCE OF THE WORK FOR WHICN THIS PERM17 I5195VED(SEC.�MJ7,CIV.CJ.
Z
W -
� LENOEF'S NAME �
F- LENDER'SA�DRE55 _ __
¢ ICEHTIFVTHATIHAYEREAUTNISAVPt,ICATIONANDSTATETMNTTHEA80VEINFORMATqNISCOflREGT TOTAL FEES 'Q� . / �
w I AGNEE TO GOMPLV WI7H ALL GTV AND COUNTY OFOINANCES RND STATE LAWS REIATING TO BUI:'JINC
� CON57RUCTION,AN�HEREOY AUTHOfiIZE REPHESENTATIVES OF THIS COUNTV TO ENfER UPON THE
ZABOVE-AIENTIONED PR07ERTV FOq INSPECTION Pl1RPOSES. COMMENTS
Q �,.r,�/A� "____
� --`-�}�l-+- a ___ _"' ' '___
m PERMRT6� . PRI
� �� � r� o��?=--- _— --- —
(n 5� REO E MITTE
= FECPT.NO. O��'�_PAID BY ' VALIDATION_`
~ WMITE-Departmenl Copy,YELLOW--Finance Copy,PINK-Assessor Copy,GOL�ENROD--File Cnpy.GREEN-ApplicanPs Copy
, . „. � , r. . , -. . . . . , .
CITY OF Q{AMOND BAR
IIdSPECTION RECORD
. . � . • � - . E , . � .
SET BACK ' FLOOR JOIST � - � _
FTGS(FORMSlSTEEL ^^ FHA REQMTS !`
ELECTRIC GROUND T UNDER FLOOR�UCT _
GROUND P�UMBING I UNDER FLUOR CGM1IDUIT ���° � ----
SLAB GRADE i ; FiREPLACE FOUNDATION -� ~
TEMP POWER ' FIREPLACE BOND BEANI ' '
WATER SERVICE ' � � MID HT•B04VD BEAM' ��," '
ROO�_SHEATHING G A�l , -- 8 FT. BOND BEAM i �T
FRAMINGNENTILIATION FINAL B�ND BEAM
ROOF EOVER � �� J �`� PRE-GRADING
R�UGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING � -
SHOWERlfUB TEST POOL ELEGTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION PO�L FINAL � ��
CEILING INSULATION QFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANlC � ,� LANDSCAPE/IRRIG. '
SEEP PITJL.L. . QN SITE IMPS.
GAS AIR TEST FINAL ZONING '
FIIVAL CONST. ,�j ¢r —^"'-----• FIRE DEPT. FINAI �
FINAL HEATING HEALTH DEPT. FINAL �
FINAL EI.ECTRIC � DEV. FE6��',41DN'
FINAL PLUMBING ' , ENERGY
, .. » i O . , ,
COMMENTS
��v
J���,��;; - .
SEPT(C TANK SIZE
SEER PiT/U SIZE � `a � — --- --
�;$ , T�F�
�p � � ,�;
` . � -
. _ , , . i�,\•