HomeMy WebLinkAbout14773 (51) ,��C l,.p� �� D
�_ _ CITY OF DIAMOND BAR 1
', �"' ��-- DEPARTMENT UF COMMUrTITY&DEVELOPMENT SERVICES
' 21660 E.Copley Drive Suitc 190
(909)86Q-3195 Fax(909)861-3117 PRESS
`'�'�� BUQ.DING PERiVIIT APPLICATION FIRMLY
� JOBSITE APPLICATION ~� � PERMIT � P/C
o ADORESS DATE NUMBER N
� ISSUE��TYPE OCC
APN LOT ,_ TRACT DATE CONST. GRDUP
� OWNER �
ADDRESS ZONtNG SETBACKS
CITY � Z, TEL. � FRONT RW ❑
APPLICANT TEL. -, REAR ❑
SIDFJSIDE STREET RW ❑
CONTRA R SIDE ❑
� ADQRES • � pqpppSED USE
CITY ZIP ' TEL.
u9 ARCH/ENG/
DE5IGNER N�.�WEL. NO. NO.
ADDRESS UNITS STORIES BEDROOMS
� CI7Y ZIP TEL
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�y OWNER-BUILDER DECLARATION SFR/ADD/REM
O
p 1 HEREBY AFFlFiA UNDEH PENALTY OF PERA/PY TFIAT I AM DfEMPT FRW1 THE CONTMCTORS Lb GefflgelC81pof1
p CENSELAWFORTHEFOLLOWINOREASON(SEC.70.91.68USINE55lWDPROFESSION9COOE:ANYCITYOR
C� CaIMiYW1iCHRE0U1RE5APERMRTOCONSTRUCf,AL7ER�PRWE.OEMOI.ISH,OqREPAIRANv6TqUG W P9:ION@Ck
Z T1RE,PRIIXi TO IT9 ISSUANCE,A150 REW IRES THE MPLICN�i'FOR SUCH PERMIT TO FlLE A SIGNED
� BTATBAFNT 7HAT NE Ofi SHE 44 LICEN9E0 PUR9UANT TO iHE PRON910N5 OF THE CONTRtiC70N5 ll� W
CENSE LAW(CHAPTER Y(COI+idENCINO WITH SECTIDN 1000)OF UIVISION!OF TNE 9USINE55 ANO PRO- � POOVSP9
PESSqNS(bDFJ ORTIAT HE OR SNE IS E%EMiT TYIEREFROM AN�TNE BA319 FOR 7NE ALLEOEO EXEMP-
TpN.ANYVIOIATqNOFSECTlON7091.6BYANVMVIICANTFORAPENMI75UBJECT3THEAPPLICAT/TT0 Z q�qap{
� ACML YENALTY OF NOT MORE TIMN FIVE INNDRED DOLLhR3(SSo�.):
� OI.AGOVMEROFTHEPROPEHTY.ORMYEMPLDYEESWITHWApESASTHEIqSOLECOMOENSATqN, � COrtiRierCi01
MIILL U�iNE MfOi1K,ANO 7ME STRUCNRE IS NOT INTEN�ED qi OfFERED fOR SALE(SEC.704�,8US1� J
NESS NiD P7iOFES510N5 WDE:THE O�NTIIACTOR9 LICENSE UW DOES NOT�7PLV TO IW OWNER aF
� WY]PENTYYNIOBl1LLASORMPqOVESiMEREON./JiDYY/q00E55UCF11YORKNINSELFORMERSEIfOIi =
� 7FYIOUGHHI3OqMEROWNEYPLOVEE9,PFOVIDEDTIMTSUCHINPRWEMEMSAREN�TMTEN�EOOR m
OR�pm POq SA6E IF.NON�FVER 711EBULOING OR M17ROYENENf IS sOI.D WRM�N ONE YEAR OFCOMPLF
� TqN,T}IE OV/NEiidULDER N7LL MAVE TWE BURDEN OF PROVINO hiAT HE OR BHE OID NDT BULD OR
MPRDVE FOR TNE PUpPOSE OF SA1�.
� ❑4�OM�EPOFTMEPROPEflT1:AM�E7(CU131VELYCOHfMCTINOWRHLICEN3E000NTRAC70H9
TO OONSTRUCi TME PH0.16C713EC.7a1,BUSME59 ANO PROFESSIONS CODE:iHE CONTRACTORS LL V81ufit�On ADJ.AREA
C9/SE UW WES NOT MPLY TOJW OWNEROF 11 PFiOPEHTV WHo8UCD5ON IMPROWES TXEHEON.AND
YhqOONiMCf8FOR8UCHPROJECTBWITHA00NTMCTOF�S�LICEN9E0DURSUM1TibT1ECONiMO pUANTITY DESCRIPTION FEE
� TOfiSUCENSEUW.). J
❑I MI E7(EMPf IMDEfl BEC. B.i P.C.FOR THAS RE,�SOIJ a
U
¢
LL o�re ow� V
F �
LICENSED CONiAACTORS DECLARATION W
� Ii1EREBV AFFIRM UNDEA PEN1LLiV Of OER4IRYTHAT IMI LICENSFD UNUER PROVISIONS OF CHAVTEN �
� Y(WMYENCINCrWITFISECT�ONT000)OFDMSIONSOFiHEBU51NE5SlWDPROFE59��NSCOOE,ANO
MY IICENSE 61N FtAlFp(y�E AN9,�,EF m
0 UCENSE CUSS v" LIC.NO. • . j
� on��"�__ corarancroa a
� •7�3,��VORKERS'COAAPENSATION DECLARATION �.
� INEREBY�FFIRAIUNDERPBiALTYOFPEMIMONEOFTHE�OLLOWINliDECLAMT1pNS: U �
tA :. . Z
Q
� ,IWNEANOWILLLWNTAINACERTIFlCATEOFOONSENTTOSE�FiNSUREFORWOFiKER3' 2 �1 I i ' • ,._ � "
CpMQ1$ATION,ABOROVIDEDBY8ECTION7/ooOFT1ELA80RCA0E,FORTHErEFi'OMNNC� U
Q OF 7HE WOAK FOR WHICl11M15 PERMIT IS ISSUED. �
0
�I HAVE/W�WILL MII1MAPl 1WAKEH3'COAIPENSATpN INSURANCE,AS qE0U1RED BY SECiIOH
Q l7000FTNElABORCdOE,FORTHEPERFOfIMANCEOFTHfWORKFORWHICXiHISPERMITIS
ISSUm.MY ERS'O MPENS IONINSl1fl�NnCEUFRIEPANDPOLICYNUMB£RARE: CONSTRUCTION
j �pq�Eq - �(�!+ f _ PLANpEYIEW
� pa�crr�u�eEa I � ELECTRIC �
o �ne6sEclaxr��Noreemtia�moFitErERar�sWaa+eM.ra�ooau�tstsiaolaalF551 PLUMBING �I�.
Z I CEAT�FY 7W�T MJ THE PERFORMANCE OF THE WORN FORN?IICH THIS PERMIT IS L55UE�,I MECHANICAL
(} 6MALLNOTEMPLOYANYVERSONWANYMMNERSOASTOBEGOMESU&IEG'�TOTFIE
� WOPKERS'COAIPENSAiION WNS OF CAl1fOHNIA,ANDAOHEE TI/�T IF I SHOVLD BECOME INSPECTION FEE
S 6UBJECT70TNEWORKENSCOMPENSATIONPROV1510NSOFSECTION9�ODOFTHEUBOfl
GOOE,1 BHALL fORTMMTi COL�PIY WITH 7}fOSE PRONSIONS. ISSUANCE �
� SMIP
p pATE: APPIiCANT:
W ENERGV P!C
W�fNIINO:FNIURE TO&ECURE NAFKERS'COMPFNSATION COVERAOE IS UNLAWFUL,AND SHALL BE
�y SU&IECfANEMVLOYENTOGRIMiNKPENALTIESANDCIVILFINESUPTOONEMUNOHEDiHOUSAN� ENERGYPERMtT
DOLLAFlS(S10o.00D),W MDf710N TO THE CO6T OF COMPFj.ISATIDN.DMUGES AS FROVI�ED FOF IN
J SEC�ION97000FlHELABOHCOOE,liTEfiEST.MlDI1TTORNE'f9FEES. RETENTIONFEE:
Q
�d CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
�
I MEREBYAFFIHM UNDER►EN�LiY OF PERJURY?F1AT TMERE IS A CONSTRUCTION IENOINO AOENCV �
FOH TFff PERFORMMICE OF TNE WORK FOR WHICHTMIS PEFMIT IS ISSUED(SEF�OY1.CIV.CJ.
�
� LENDERB NAME
F- LEN�ER'SADDRE55
� ICENT�FYTNATINAVEREA�7HISAPVLIC�TIONMlOSTATEilUITTMEA90VEINFORMAiIpYiSGOHHECT. TOTAL FEES Cj}�J.y. � �OQ�
� IA6REETOCOMPlYW1h1ALLCT'ANDOOUNTYOROWANCESANDE�IITEUWSRELAtINaTOBNLDING ' • OF
COHSTRUCTION,MID MEREBV AIITHMIZE REPNESENT�iNES OF TMIS COUNTY TO ENfER IFON 7TIE Tf T s� D��O�T�
� /�BOVE-MENfqNWiROiENTYFORINSPECTWNPURPOSES. COMMENTS L���u+ ���J
t
� �
� I E IN � /���—ti
Cn � t\/
�J TUREO PERMIT7EE DATE
� '. RECPT.NO. PAID BY VAtJOATION
NM1iITE-0epertrnent Copy.YELLOVY--Finerwe Copy,PINK—Assesaor Copy,(iOLDENROD—File Copy,GREEN--JVpplipnCe Copy
R ^•
5
+ws...n...�.r.�.wwra. .. ---
CITY OF D{�MONQ BAR .
� IN�PECTiON RECORD� `� _
E E + • � ' � � , • 6 `
SET BACK ' FLOOR JOIST ;
�TGS/FORMS/STEEL ' FHA REQMTS • �
ELECTRIC GROUND ' UNDER FLOOR DUCT - '
GROUND PLUMBING `� � ' UNDER FLOOR CU�IpUIT. ; . + �
SLABGRADE FIREPLACEFOUNOATIOf� - --- '
TEMP POWER FIREPLACE BOND BEAM ' � ' ' ' "
WATER SERVICE • MID HT.BOND BEAM - - - - ' -
ROOF SNEATHING ` - -� � •- ' ' 8 F7. BOND BEAM � � ' `
FRAMINGNENTILIATION � FiNAL BOND BEAM �
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADlNG
ROUGH PLUMBING FINISH GRADING
SHOWER(fUB TEST POOL ELECTRIC
EXT.LATH/SIDlNG POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSUtATION OFF SITE lMPS.
DRYWALL NAILING ' DEDICATIONS
SEWER ; FINAL ENG.
SEP71C TANK � ( LANDSCAPE/IRRIG.
SEEP PI'T/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. { I FIRE DEPT. FINAL �
FfNAL HEATfNG j NEALTH DEPT. FINAL
FINAL ELECTRIC ; 'i DEV. FEES PAID
FINAL PLUMBING � I i ENERGY
----�-+—
• � ' � .
, s i ,
COMMENTS � -- . . , _ ,�`_' -�' � , . -�_
f� ,!�� 1 . �� �� ; , %� .
�. • - ^'�'�--- ��2 �. �--��,r�G�_ . -
�
SEPTIC TANK SIZE i
SEEP PlT/U SIZE
� I �I'' ,
; �� . . . .
� � -
, . . . _ . .. �