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HomeMy WebLinkAbout12985 � CITY OF DIAMUND BAR � � DEPARTMENT OF COMMiJNITY&DEVELOPMENT SERVICES � , 21660 E.Copley Drive Suite]90 (909)860-3195 Fax(909)861-3117 PRESS ��`^��� BUII.DING PERMIT APPLICATION - FIRMLY QADDRESS �SOD S(I V�('" �q 11 e. ACPLICATION 2.-C.�-r,{� PERMIT I ��GL._ p/C p DATE � NUMBER ��l It � V� ISSUE TYPE OCC APN �OT�—,S�;— TRACT DATE � CONST. GROUP SOWNER S'�erncta Pd O�t c: ' c � ADDRE S � ZONING SETHACKS CITY P 21P 9Yf, - TEL( � FRONT RW ❑ APPUCANT 7EL. REAR ❑ � SIDE/SIQE STREET RW ❑ � CONTRACTOR N� h1 SI�E ❑ p� ADDRESS p . � / PRDPOSED USE CITY ZIP 0 719�_TEL. p ARCH/ENG/ ` � � DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIE8 BEDROOMS CITY ZIP TEL. c,g DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECIARATION SFRlADD/REM O I NEREBY AFFlRM UNDER PBLILTV OF PERAIRY 7MI17 I M1 E%EMPT FROM THE OOflIAACTORS LI• G8fflQ0IC81p011 CEtIfiEUWWAhIEFOLIDWINOpEA,40N(SEC.7m1.6BU91NESS1IN�PROFE5510N5CO0E:ANVCITVOR' (n COUN�YWI11Q1REWWESAPEAMITTOCONSTRUCi,KTEF�MPAOVE,DEA10l1SH.ORREPAIflANY9TRUF W pBtq/DBCk NRE.PRIOA 10 RB 185UANCE.ALSO REQUIRES TME APPLICANT YOR BUQI PERMIT TO FlLE A SIONEO W STA7EYENT THAT NE OR SHE IS UCENSm VURSUMIT TO THE PROVISIONS Of T11E OONTRACTORS LI- CENSE lAW(GiMTER i(COMMENCINO WIh18ECTION 7a0o)OF 61VISION 9 OF iHE BUSINE99 AND PA6 u' PooUSpa FESSqNSOODE)ORTWITMEORSNE19E7CEMPTTHEREFfiOMANDT1E9A615FORTNEALLEQEDIXEMP- (� TION.MIYVIOL�TIONOFSECTION7011.68YMIVMPLICMITFOFACERMITSU&IECT$THEMPLICANTTO z Re-Roof � ACML/ENALTYOFNOTMORETiJWFNEHUNDi1EDDqUfl9�iGo0)��: � OLIISONRIEROFTHEPROPERTY.ORMYEAIPLOYEESWITHWAGESASTHEIRSOLECOMPENS�TpN„ � COf1irtlBfClel MN.L 00 TNE WOi11C,AND THE STRUCNRF IS NOT INTErDE�OR OFFERED FOR SILLE IBEC.704{,BU51- J � NESSAND PROFESSBDNS COOE:THE CONiMCTOHS LICENSE lAW DOES NOT APP�Y 70 Ml pWNER OF ? P110PERTY WIID BUMS OR RIPHOYES THEHEONI,ANO WHOOOES 6UCH WORK NIMSELFOR HERSELFpR� T1ilOUGHWSORNEROWNBJPLOYEES,PIqN��TNATfUCHIMPROVEMENTSMENOTINTENDEDOR' � � OFFEqEDiOR3AlEF,l10M'EYER7MEBUl�IfJ�ORIMPROVEMENT1660lDWITXWONEYEAROFCOMP�E- ' TpN.THE ONfNER�UILUEH NALL MIWE THE BUR�EN OF PROVINO TW�T XE OR SHE DI�NO7 Bl11LD OR � IMPROVEFOR7HEPURPOSEOFBALE). ❑I.A6 OWIiER DF iME►ROPERTY,AM E%CLUSIYELYCONTMCTMO WI7H UCENSED OONTMCTORS� TO CGNSTAUCT 7HE PFbJECI(8EC.70M.B1131NE551WD PNOFESSIONS COOE:THE CONTRACTORS LI� VeIY9110f1 qpJ.AREA l�J CENSEIAWDOE9NOTMPLYTOANOWNEROFAPqOPEHNWFIOBUILD50RIMPROVE8TIEREON,AND s WWDODHTRqCfSFORSUpiPRqIEGf5WIT1+.A00NTRACT011�9)LiGENSEDPURSUMITTOiHECOHTMG QUANTITY DESCRIPTION FEE � 70RS LICENSE LAW.7. ❑I AM E7(ENPT UNDER SEC. B.E P.C.FpR iN15 REASON q U � DA7E OYYNER � � W ` LICENSED CONTRACTORS DECLARATION W LL IHEREBYAFFlRA1lRJDERPENAL1YOFpEFWMTWITIAMIfCENSEDVNDEHVROVISION90FCHAPTEq , � ��OOMMENCWOYYITMSEC710N7ooD)OFDMSIONJOFTMEBUSINESSIWOPHOFESSIONSCOOE.AND Z � �G �0"►1 O W LK:ENSE 16 N R1LL WPCEANO EFFECT. Q�[� m � LICENSE CLASS LIC.NO.,� L O T�� J _, � � � WITE � - CANTRACTOR a � WORKERS'CAMPENSATION DECLARATION a � 1 HEREBYAFFIRM UNDER PENALN OF PE0.IUHY ONE OF iHE FOLLAWING�ELUMTIONS: Z � �_INAVEAN01YILlMAWTNNACERTIFlCA7EOFCONSENiTD6ELF•INSUREFdiVNORKER9' _ CpADENSATION.115PFWVIDEUBYBEC710N77000FTMELABORCODE,FORTHEVERFORMANCE W OF THE WORK iON WHICFI THIS PERMIT 1815SUED. � � �I HAVEAND WILL NAIMAIN WOfiKERB'COMPENBATION INSUFiANCE,AS REOUIRED 8V SECTION Q 97000FTMELIIBORCOOE.WR7NEPEAFOqMANCFOFTHEMNRRFORWHICMTHISPERMITI3 Q �SSUED.MY VYDRKERS'c/q�,e ENSATqN INSU E CARRIEfl Mlp POLICV NUMBEH ARE: CONSTF�UCTION � CARRIER / ����� _ PLANREYIEW � POLICVNUM6ER � e�ecrRic � (nassEcnowr�npreEoowr�tFrmoF7�rEm.srswr+orae�oalMsa�oo�at�ss} PLUMBING ICERTIFY THAT tlJ TIE PERFORMANC�OFTNE YYORK FOR WHICH THIS PEHMIT 151SSUED,1 MECHANICAL SHALL NOT EMPLAY ANY iER50N IN ANY MANNEH SO AS TO BECOME Sl10JECT TO THE (q WORKERS'COMPEN3ATIONLAWSOFCALIFORNIA.ANDAGREETMA7IFISHWL08ECOME INSPECTIONFEE S SUBJECfT01HEWORIfERS'CdAPENS�iIONPROVISqN50FSECTION]laoafTHEIABOR e.`swu.tw in�caaa�rwin+n+o�rr+rnisron� s. ,.M,! j' ISSUANCE � p OA1E: �PPLICANT: �. ///�� P/71_ SMIP � ENEROY P/C WIIRNINO:fAILl1RE TO SECURE WORKEflS'COMFEN3ATpN�OYERAGE IS UNIAY7FUL,�WD 5HALLBE SU&IECTANEMPLOYEFTOCPIMINALPENALTIESANDpYILFINESUPTOONENUNDNE�THW5AN0 ENERGYPERMIT } DOUAFiS�t100,000).p1ADDITIONTOTHECOSTOFCOMPEN4ATpN,DAMAdESAE71iOVDE�FORIN � SECTION77080FT7ELABORCOOE,INTEREST,AND�TTORNEY'SPEES RETENTION FEEQ�_����q,������ CONSTRUCTION LENDINGAGENCY PREALT FEE: *rv+.r� .��o e t�cmV � B V iLTJIP�7ei���—x t HEREBY AFFIRM UNDER PENALTY OF PERAIRY THATTHERE 18�CONSTRUCTpN LENOINO AOENCY Z FOR THE iERFOHMANCE aF TME WORK Wfl WHIOi THIS FERMIT IS ISSUED(SEC.70W,qV.C.7. W � lENOER'SNAME � LfNOER'SADDRESS � ICEi1TIFYT1iATIFUVEpEMTiISMPIICATIONANDBTATETHATIHEABOVEWfORMATqNtSCORRECT. TOTALFEES �{,(7• � � IAOREETOCOMP�1'WITHAlLC7TYANOCOUNtYORDINANCESANDBTATEUWSRELATINGTOBUIL�INO � � CONSTRUCTION,ANDMERFHYAUTIIORIZEREPRESENTATIVESOFTWSCIXMTVTOEMERUPONTHE /1BOVE-MEMIONEO iROPEHTY FOR INSPECTqN Pl1RPO6E5. 9 COMMENTS = G F'iyl °O re e�vw • � � '��' / y SH3/M E fTTE DATE � RECPT.NO, pAID BY �VALIDATION YJHITE--0epahment Copy,YELLOVY—flnence Copy,PINK—Asseesa Copy,GOLDENROD—File Copy,GREEN—Appllcant's Copy CiTY OF DIA1611tOND BAR INSPECTION RECQRD ' k` � ' E ' ' � i � ■ � - SET BACK FLOOR J015T ,, , � ' FfGS/FORMS/STEEL FHA REQMTS ; , ELECTRIC GROUND UfVDER FLOOR DUCT� - , • GROUND PL11MBtNG UNDER FLQOR�U�IDUIT, , ' SLAB GRADE FIREPLACE�fOUNOATION - � � • . TEMP POWER FIREPLACE BOND BEAM WATER SEFtVICE MID HT. BOND BEAM - ' ROOF SHEATHING 8 Ff.80ND,8EAM � � � � � FRAMINGNENTILIATION FINAL 80ND BEAM ROOF COVER PRE-GRAQING ROUGli HEA7ING BENCHING � ROUGH ELECTRIC RQUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERIfUB TEST POOL ELECTRIC EXT. LATN/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSl1LATION OFF SITE 1MPS. DRYWALL NAI�ING DEDICATIONS SEWER L-11� '�l�y FlNAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. � ` GAS AIR TEST FINAL ZONING FINAL CQNST. ; FIRE DEPT. FINAL FINAL HEATING ' � HEALTW DEPT. FINALY -'� FINAL ELEGTRIC DEV. FEES PAID ( FINAL PLUMBING � ENERGY � � I �. � � I '._ '_-�_ COPJlMENTS SEPTiC TANK SIZE . SEEP PiTlU SIZE --- - �:. - r � _: - . . , -- i