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HomeMy WebLinkAbout10162 CITY OF D[AMOND BAR /� COMMUNTfY DEVF,LOPMENT DEPARTMENT 2I660 E.Copley Drive Suite 19D PRESS � (909)860�3195 Pax(909)861-3117 �'""'i BUILDING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION PERMIT /C o ADDRESS � � DATE • NUMBER 1_ N��,� � 1SSUE TYPE OCC APN LOT� TRACT �-�� � DATE CONST. GROUP � OWNER ��J/� T�f�C� _ _ __ � ADDRES w /� C�J 20N1NG SETBACKS CITY ZIP r1 I1 �1 G C TEL. FRONT RW O APPLICANT � TEL. R�A O SIDFISIDE STREET RW ❑ � CONTRACTOR nf 51DE ❑ ADDAESS � G � CITY � ZIP�(,y TEL. PROPOSED USE o ARCWENG! ' � DESIGNER �-����1.c..— NO.DWEL. , NO. . NO. ADDfiESS UNITS STORIES BE�ROOMS � CITY IP TEL. N DESCRIPTION SQ.fT. FACTOR PSF ADJ.AREANALUATION Q OWNEH-BI:ILDER DECLAFiA770N SFWADDIREM O p I HEREBY AFFIf�A UNDEF PENALlY OF PEFW RY THA71 MI EXEMPT Fi10M 7HE CONTMCTOIIS LL G6IlQBfG81POR W CENSELAWFOR7l1EFOLLOVlINOREASON(SEC.7G71.6WSINESSANDPROFE9910NBCOOE:ANYCRYDR (n C.7 CO1AlTl'YYHIp1REWIRESl1PERMRTOCONSTRUCT,KTE1t,w1PF10VE,0EM01.I5M.ORREPAIRANVaTRUG W Pg� Z IURE,PRIOR TD ITS 165UANCE,ALSO RECUIRES TME MPLICMIf FOH SUCII PERMIT TO FlLE A 61pNE� «� STATEMENT iHA7 NE OR 8HE IS UCENSED PUNSUMIT TO THE PpOVIS10NS OF 1NE CONTMCTORS lL W � CENSE LAW(l71APTER Y(004YENCINO WITM sECT10N 7000)OF DIVISION�OF TNElUSINESS AND P110- LL POOVSpi FESSIWA CADEj ORINAT ME OR BHE IS E](EYPT TIEREFNd1 AND TME 9ASIS PoR 1HE ALLEOFA El�A1P- TpN.ANYVKK.�710NOFBELTION7W1.6aVANVMPLICANTF011APEHMIT8U8JEMS7MEAPPI.IGNT�O Z Re-Roof � A CML►ENKTY OF NOT A/OqE THAH FNE HUNORED DOUMS({500).�: � 04+�3�NEROFTNE►ROPERTY.ORMYEMPLOYEESWITHWAOE9ASTHEIRBOLECOMPENSATION, Cpry�T9(C19I N7LL 00 iHE WORK ANO T�£S7RUCil1RE IS NOT MITENDED OR OFFERED f-0H SALE(BEG 7W�,BU64 � � P�ROPERTYPWHOB IDSOHN.IP�ROVE9�ERE0H.ANDVIFiODOESSUCHWORKMIMSELFORHEN ELF011 � � hIRIX1GHNISORMEROWNEYPl.OYEES.VRDNOEDTHAT8UCH61PROVEMENTBARENOTr1TENDEDON m OFFERED FOR 611LE.K IIDWEVER TME 9UMMaOR IEIPROVEIAENT IS&OI.D YN7HINONEYFViOFCOYPLE � TION.TNE OWNEA-0UILOER WILL MAVE THE BURDEN OF PRWINO 111AT NE O(t WE D�D NOT BUILD OR MFROVE FOIi h1E PVRPOSE OF iALE} �yJ ❑4�3 CN'NER Of 1NE PROPERTY,J1M E%0.USIVEIY COMpACTINO MATH LICENSED CON�MC70R9 � 70 CONSTiIUCT TME PROJECT(BEC.7oN,BUSWESS AN�PROFE8510NS COOE:TFIE CONrRAGTOPS L4 ViIUHSI011 AW.AREA J CEIBELAWDOE8NOTMiLY70ANONMEROF/1PROPERTYWMD8URA40RMPROYEBTMEREdIY,M1D F YVFpCONTRACTSFORBUCNPFpJEC76WITNACON7MCfOfy6�LICENSEDPURSUMlT1DTXECONTRAG pUANTRY ESCRIPTION FEE � TORSUCENSELAN!1. ❑1 A4 ExEMPT UNOER BEC. B.a P.C.FOq TVNS pEASON � � � LL WTE OWNER � . � LICENSED CONTRACTORS DECIARATION W � 1HEREBYAFFIRMUNOERVENAL7YOFPERttIRYTHATIAMLICENSEDUNDERiHON51dJ5OFCHAPTER �. p„ �(OOMMENCNJO WITM 5EC71DN 7000�OF DIVISION�OF 7HE BU91NE39 AIA P1pFESSqN5 OODE.11N0 Z X MY LICENSE B W FUII FORCE MID EFFECT. � 11J � � � UCENSE CLASS LIC.NO. � !: on� 3 coNrancra+ � I �' s � WORKEFIS'COMPENSATION DECLARATION � � � I MEREBYl1FfIRM UNDER YENALTV OF iERJURY ONE OF 7NE iOLLOWING DECLAMTqNS: Z � _I NAVE AND W1LL 4AIN7AIH A CERTIFICATE OF CONSENT TO SELF�NSURE FOR MIORKFRS' _ ODMPENSATqN.A9PROVICE0BY9fiCTION47aoOFTM6WORC00E,FORTIEVFRFOiWMICE 1U OF TIiE WORK FOR WMdi THIS PERMIT IS 189UED. � � _I NAVE AND WILL NAINTA7J WORKERS'COMGEN9ATqN INSURANCE,A5 REOUIqEO BY BECTION Qs7ao OF 1NE UBOH COOE.FOR THE PERFORMANCE OF 7ME YYORK�OF WMICM THIS PERYrt IS � 186UED.YY WOFtlCERS'OOMPEN6ATION MISURANCE GRRIERAlq POLICY NUMBERME: CONSTRUCTION ' � CARRIER PLAN FiEVIEW � P«��wwB� e�crwc Q (nassEcnoNr�wteem.at�oct�n�urswan�Kia�noouutspiml�+�ss4 PLUMB�NG � t CERTIFY 1HlR W iME PERFOIiMNNCE Of iHE K FOR NM171CH THIS PERMR IS ISSUED,I MECHANICAL (�' SH MOTEMPIAYANYPER50NINANYN RSOASTOBECOMESUBJEGiTOTME y ERS' AENSIHqN UWS OF CALIFO I IU,ANO AOREE TNAT K I SHWID BECONE INSPECTION FEE S ECTTO WOFiKERS'COMPENSATIO R�VISIONSOFBECTpN77 �G.�OG� � .i sHUL oarHvnrH cana�r wrn� E PROYISION ISSUANCE O ' � DATE APPUC � SMIP = f WApNI :FAILURE SECURE 5'COMPE SATION RAf3EISUNUWFUI,MIDSMALLBE ENERGYP/C � SIAIE AN EY ER TO CRIYI iENAlilE3 �dVIL flNES UP TOONE HUNDREO THdJSAND 1� ����_� oou�0.sle+m. ).e+�oorcaN nrecosr CdAPEN3ATqN.OAYA(1ESASVROVIDEDFOHIN ENEROYPERMIT J oECTIONJ7000FTHEUIBOF E.WTERE9T DATTDRNEM6fEFA. RETENTIONFEE: � NSTRU ION LENDING AGENCY PRE•ALT FEE: ��, �,_ ¢ INEREBVAFFIRMUNDERPEN EiUURYTMATTNENEIBACCNSTpUCi1dJLENDWOAOENCY �+• FOR iME PERFORRNHCE OF TNE WORK iOR WNICH TNIS iFRMIT IS ISSUED(SEC.7007.CIV.C.). b � LENDER'8 NAME . C LEPDEN'9ADDNESS � 1 CERTIFV 7HAT 1 WNE READ iN1$APPLICATION ANO STATE TIATTNE PBOVE NFGWATqN IS CORqECT. TOTAL FE ES � i AOREE TO COIAPLY YVITH ALL GTY AND COIMTY ORDPIANCEB NA iTATE LAWS REU71N0 70 9U0.AING � OONSTRUCT ,ANDMEREBY/WT1qRRERE7fiESEMAiNF30FTH19COtMTYTOEMEqUVONTHE • ABOVE-MEM EOPROPERTYWRINSPECTIONPURPOBES. 9 ` �+_ -�� COMMENTS � �� �/4—,V/��YI'L � m �Ei41t NNAE(VNWTI � y � � N IO EE . DA � R[CPT.NO. PND 8V va.�anor� WHITE—Dopartment Copy.YELLOW--Flnancs Copy,PINK—Aasaswr Capy.QOLDENROD-flle Copy,OHEEN—ApqlceM'a Copy � . � . '. . . . . . • ' . _ . ' , " ., . : ' �. . . .. � r ... , ..�� ..P'n.<'7'":�. .. . .. •.p: . . -'^ . ' . . ... � � � GITY Q� DI�.fi+tC�P�lD BAR " . 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I-- - ROOF COVER � ; PRE-GRADING _ i ---�- ------;-- -------- --- ��-- --------------------- --------�----�----------�---__.__,_..,_,_ FiOUGH HEATING ; BENC;HING ----------------- -------------- -�-----....._.. .._.�--•- --.•-.--•..._.. ..--�---...--� -----------�-�- ------------�---�---... ---- - -- - � - ROUGH ELECTRIC : ROUGH GRADING ; ----.—_....-._..--�- - �---- ----•- �- � - ;------- ---------'----._..._...----•----.._.�._._ ROVGH PLUMSING .----�.-------I'-------_-------;_�-- -Fi�t-SI-I GRr�t�ING ----------- � ` -- 1--.-----.;�___---_—____ -------�-- �----- SHOWERJTUEiTEST - � - : POI�I;ELECTRIC----------- ----�--- , .- ---�--- --- ' EXT LATH/SIDING I ' j � POI�L FEPlCI�1G ' : _.. - - - ---�----------=---- ---- WALL INSULATION t----------------------- r POOL. FiNAI------ j . ---- -------- ------ --�--- ----- - - __----�------•------ =.� CEILING INSULATION � nFF GITE fM('S. � � ` DRYVUALL NAILING � --�-- =. ..-- -- .._.._ . . ------------- -----' . _..--•-------------------f--�- .. ! � DEDICATIC}NS �------- ------:----�------- --- - --...------------------------�._.. � —� �-- SEW E R ---.----�---�. � F I N.A�. E N U. �-- --------------------�-- SEPTIC TANK • ' • LAhIDSCAPE/1RR1 � —�- ----------- ----�-,---------------G=-- � ___:...__._4', ---�-- ----- —- --------,-- 4 SEEP PITlL.L. . ' OnJ SITF= IP�1�'S. ---- --- ---------...-- -------- -�----...- - ---._..._�- - -- -'----- --' GASAIRTEST I FiP�'�L ZONING -�-- - --------------�----... .--- - -...._...----------------�--------._....-�- - ---- ----- - ----._-._..--I -- FINAL CONST: �'j�B -= FIRE DEPT. FlN�L � � � � --- � ---- --- - ---- - -----�---------- --- ----�------....�.-- -----------�----._....---------- _f FINAL HEATING _ : HFQLIFI DEPT. FINAL ! � . I i 1----- -----..------. .. . - ------..... ... . . . ..- ....__ . _...-----•�----..._ ._.�,..._, FINAL ELECTRIC DEV. FEFS PAID . , � ------ ---------- - - -- -------...._.. ..----. _.4------_...__.._.____.----------•---�•----- --- —�--------�-�-- FINAL PLUMBING ! ENE=RGY � — ---------------- - -- -- ------ --- - -- --- ----------- . -�-- -------,----------- ---- —------I-- ---- - -- -,,... � -- ------------- --------- ------------ ..,.. .s . .•�,... . . _ - -- -- - - ,..,,� . � . _ �.. , ---------- _.. .,.... . .. . , _. .. .. ... - ----- ----- ------ -----------� COMMENTS � ` � ---- ---------—�---- - - - ---------- � , • k ---- --�—-- --- ------------- ------- -�------ ---- , - --- - ---- ...- - ------------------- , . � . , � __'_ ____�_��_�.y'_—"._��.�_.�.��._.�__. ._..._"___.""""'__"_"___.....-._'_..,—".____'_'__�___""'_'�___"__�_.._______�"� ____",_— . ' ��, � � .. + � . . . �, ..__'"_'_ '"`__—_"______ ' t"��__ "_ '_'_ _'___. _ ""__ "__-- _"_"'"'__"'_'"—___'_'_____'_____'_____ 1 I _�._"__'_"__'""_""__._._.._.. �..�_"'__'_____'_"_'___'_'__�"'__ ' -I I � ��_"��__1 I I —__ ' ____ —___"__ d �li . ------------ —�------- - ------ --� � - - - � ---...- - -- -------------- - ------- -- —�--� 'I ---' '. : i�: . � . � �� N' 4'.i: ---- --—-------- -----------------— -- � II , e -- - t- - - a - --- ------- -- --------- ---------------------�-----.._..- ----� - -- ----� SEPTIC TANK SIZE ____ ^; i �' � � SEEP PIT1U SIZE � �i'"�--�---� �r=`'-- --..--- . - ---� -- � - - -- - -- -�---- ---------- ---------�-� - j ---- -------�----------- --- �------- - ...-- ---�------....-------------�------- ' ----- -- � ------------------- - ------------- — --- - ------- --------------------- . �I y . --- --- ------ �`� , �6.zz��-� . ._ _ . . _, _�. _._ _._._.__. ...__ _ _�____.__. ______ ---.____ �._ _�-_�.,� �-