HomeMy WebLinkAbout12845 (6) CITY OF DIAMOND BAht �
DEPARTMENT OF COMMUNITY d�DEVELOPMENT SERVICES `
21660 E.Copley Drive Suite 190
(909)860-3195 Fax(909)661-3317 P ESS
`'�'�� SUII.DIIVG PERMIT APPLICATION IRMLY
o ADDRESS �S�S SI�--V�cr L�J DATE��ON L��ZZ�II yUMBER v #�/C
$ ISSUE 7YPE. OCC
APN LOT TRACT 3 i� DATE CONST. GROUP
�j OWNER l
ADDRESS ZONING SETBACKS • .
CITY I TEL. FRONT pyy ❑
APPI.ICANT _ TEL. REAR • ❑
SIDE/SIDE STREET RW ❑
CONTRACTOR�'!��_ O SIDE ❑
g CDDRESS ZIP TEL. PROPOSED USE � P � . .
� ARCFUENG! ��,��VIf4IV U"t'�'OIV 1 .
DESIGNER NO.DWEL NO. NO.
ADDR S UNITS STORIES BEDROOMS
� CIn - ZIP TEL.
DESCRIPTION 5a.`FT. � +�ACTOR FSF AW.AREANALUATIDN
� OWNER-BUILDER DECLARATION gFR/A�O/REM Z
I MEtiEBY AFF6W UN�ER PENALTY OF P6iR1RY 1}IAT I AM EXEMYT Ff10M THE CONTRAGTOHS U- �e�Q��� •
CdSEUWWRTMEFOLLOWINfiREA90N(9EG7037.6BUSMESSANDPROFESSIONSCODE:M1YqTYOR (n
COUIRV WHICFI RFOUIRESA PERMIT70 CON6TRUCT,A�TEfl.IMPFpVE,DEApLISH.OR REPAIRANY3TRUC•
111HF.PRIOIt TO R6166UMJCE,K80 REOUIRES THE MPLICMf7 FOR BUCH GEAMIT TO FllE A BIONED � ... . ,�+ •
BTATEMENT THAT NE 011 SME IB UCENSED PURSW Wi TO T11E PROVISIONS OF TME CONTMCTORS tl• .
CFNSE U1W(GfI1VTER Y(COMMENqNCi WITM SECTION 7000)OF DIVISION 70FTNE BUSINE55 MID PFW- u' POOVSpe ��L�,�, �'�.���;.,,,` ' �
FESSqN5000k�OqT1UTMEORSHE1SElfE61PTiMEREFFlOMANDiHEM313FORTHEALLEQE�E%EMP• (�
TIDN.ANYVIJLATIONOFBECTION7001.6BYANYMVLICANTFORAPEW.IIT6UB1ECT8TMEAPVUCAN7TO Z Re-Raof �
� AtlVIL iENAI.TY OFNOT MOpE TNAN FNE XINORED DOlUR3It5a%J: , ^ '
04��M�NEROF711EPHOPERTY.ORMYEMPIOVEESNAlHWAOESASTHEIR50LECOMPENSA7IDN, Q Commerdel ' 'F 'Y s .yy,
WLLl DO TiE WOFtK,AND TME STRUCIURE IS NOT IMENDED OR OFFEREU FOR 611LE(SEC.70N,BUSI� J
NE68 AND VHOFESSION8 OODE hiE CONTRACTORS LICENSE LAW OOE9 NOT MPLV 70 IV/qNNER OF �]/.�� � �*,
� ►110PEHfYWFIOBt/1l.DSORMPROVEETXEREON,ANDNM1lO00E99UCH1WRIfMIMSELFORNER3ELFOR � �7�''I ' "
� Tl410UGHNISORMEROWNFAAVLOYEES.VROVIOED7FN78lICNM1PROVEMENTSIUiENOTMTENOEDOR m ,
OFFEREOfOFleALE�.lpVVEVERTNEBUL0IM�ORIMPNOVEMFMIBSOLDWITNINONEYEAROFCOMPLE• � �,
TION.THE GWWER�UILDEH WILL MAYE 111E BURDFN OF PROVMN]TNAT HE OH 8HE DI�NOT BLIID Oq
61VfWVE FOiiTHE fURPOSE OF BALE). '
� 04��N�NEROFifiEPROPEiRV,AA1EYd.u31VELY00NIHACiWOWRHLICENSE�CON'IRACiORS
TO OONSTIKkT TME PNOJECT(BEC.7a41,BUBINESS ANO PROFESSIDNS CODE:tHE CONTMCTORS U- VelUe�b11 A�J,AREq
CENSE UW DOEB NOTAVPLYTO AN OWNER OF APROPEHTV WFp BUILDS OR MIPROVES THEREON.MD
WHOOONTRACfSFORBUpIPHOJEC78WITiA00NTFMCTOR(S�LICENBE�PURSl1ANfTOTHECONTHAF pUANTITY DESCPoPTION FEE
� lOM1S LICQI9E IAW.). '
❑I AM O(BAVT UNDER eEC. B.i P.C.FOR TWS REASON �
U
DATE OWNER
� LICENSED CONTAACTORS DECLARATION �
� IlIEREBYAFFIRMUNDEHPEN+LLTYOFPERIURYTFIATIAMLICENSEOIlNOERPHOVISqN90FC11APTEH �
s �I�NENCW6YlITMSECfION7000)OFOMSION70FTME6USINESSAImPROFE5910NSCO0E.AND Z
� W IICENSE IS rl FULL FORCE M1D EFFECT. m
0 UC.NO. � ` �
� UCENSE C •�� 7�-�-7� �J
� DATE ��� CONTMCTOflS f i+� �- �71�/-� a
WORKERS'COMPENSATION DECLARATION �
� I Vi[REBY AFFi1M IAAER 7ENLLTY Of GERIURY ONE OF iHE FOLLOWINU DECLAHATqN9: Z
� �IIUVEANOWILLMNMAINACERfIFIGTEOFQONSENTTOSELF•INSUREfORWORKERS' _
CO4PENSATION,A9 PHOVIOED BY eECT10N t700 OF THE LABOR COOE.FOH 7XE PER WRMANCE w
OF THE WOlUf FOR WHICH 7MIS PEflM1T IB ISSUED. �
� �IHAYE/WOWILLIIWMAP1WOIiKER3'ODUPENSATIONINSUMNCE,ASREIXIIREDBYBECTION !�
77Do OF 7ME LABOR OOOE.FOR71iE PERPORMANCE OF TIE WORK WN WHIGIi TNIS PERMR IS LO S �O
� IS.SUED.MY WDRNERS'CpA♦PEN�S�ATION IN9URANCE CARRIER ANO POLICY NUMBER ME� CONSTRUCTION �
� CNiRIEN C��iV�+T PU1N REVIEW
� POLICY MIMBER Z� C Z ELECTRIC � ��n!OD
0 (n�e[erorar�rareem�a�IDaFn+erere.�r�sro�a+e�oau�s�iaqon�essF PLUMBING �+�D�OZJ
Z I CERTIFYTNAT N TNE VERFORMANCE OF THE WORK FOq WHICH TiI6 PERMIT Ifi 1SSUE0.l MECHANICAL L SD I D�
BHAIL NOT EMPLOY ANY PERSON M AM'4ANNEH 60 AS TO BECOME SU&IECTTO 7HE
y WORKERS'COMPENSATIONUVlSOFCAIAFOHNIA,ANDAOREETHA71F18HOULOBECOME INSPECTIONFEE � �
6UBJECT701HE W�OiY(EAS'OOMPENB�TION PROVISIONS OF SECTION 77 OF 1TIE IABOq
Sp e, sHat rorm�mn�caar�r vnni r s � ISSUANCE D
p DATE�_ APPLICANT: Tµ��� � SMIP
� WAiWING:FAIWRET08EWRENORNER3'COMPENSATIONCOVERAOEISUNUWFI14hW6HALLBE ENEFiGYP/C
� SUBJECTANEMPLOYERTOCRIMPIALPEW4LT1F5ANDCMLFWESUPTOONENUNDREDiFIW9ANG ENERGYPERMIT � ,D�
D�LLN�s(i1a0.000),N ADDITON TO hIE C097 OF COMPENSATION,OAMAOES A4 PROVIDEU FOR IN
� SECfqN 97GlOFiHE LABOR CODE,NTEREST,MIO AT70RNEY'S FEES. RETENTION FEE:
4 CONSTRUCTION LENDINO AGENCY PRE•ALT FEE:
O
� IHEREBYAFFRMUt�ERPENILLT'OFPERJUAVTHATTHEREI9ACONSTRl1CTIONLENDINGAOENCY
FOFiTHE PEFIWRM4WCE OF7HE WORK FOR WHICH TMIS VERMIi15155UED(SEG 9W7,tlV.G).
� LENDERSWIME�
• I '
C LENDEFiSADORE55 ^
ICERTIFYhNTiWWEREADTqSMPIICATIONANOSTATETMTTIEABWEWFORM�TqNISCORRECT. TOTALFEES (/37�'�� ���Z �?
I M3REE N OOAIPLY WITI Nl CRY ANO COUHf'/ORDwANCES/1NO STATE UM/5 REUTMIO TO BURDINO
� CONSTRUCTIOf�ANO NEREBY/UITHOI;QE REPRESENTATIVES OF TNIS COUNfY 1D ENTEfl I1VON iHE
ABOVEilEM10Nm PNOPERiY FOR INSPECTION PUHPOSES. COMMENTS
a ��.�..�.
� PERMITTE E(PRI 1 Z ) �
N 4�
� t10NATURE F ERMITiE pATE
� RECPT.NO. PAID BY VAL.IOATION
WHITE-0epsrtment Copy,YELLOW-Finance Copy,PINK-,Aasessor Copy,GOLDENROP-Flle Copy,GREEN-ApplicanPe Copy
CITY OF DIAMOND BAR
� � �INSPECTiaDN RECOF�D � , ,
� � , � . . i � , . � .
SEf BACK , FLOOR J015T ; ; � � '
FTGS/FORMS/STEEL FHA REQMTS ,_ , �
ELECTRIG GROUND UNbER FLOOR�UCT .i: .•, :, , „ ,
GROUND PLUMBING UNDER FLOC�R CUriDUIT::'i :� ::_�j : .I ".�:j� '.
SLAB GRADE ,S FIREPLAE£��1UNDATION • � ' • '�� � -'
TEMP POWER � FIREPLACE BOND BEAM ' � ' � `
WATER SERViCE MID HT. 60ND BEAM � ' ' ` ' '-
RDOF SHEATHING �' �' V 8 FT.BOND BEAM
FRAMINGNENTILIATION � �f _ FINAL BOND BEAM
ROOF GOVER PRE-GRADING
ROUGH HEATING � BENCHINC� � =`• � ��� � ' + ' °
ROUGH ELECTRIC 4, . _• • RQUGH GRADING
RDUGH PLUMBfNG �� � i ,. FINISH GRADING
SHOWERlTUB TEST � ��'► -�!' �-' P��L ELECTRlC
EXT. LATH/SIDIIVG Z„ I POOL FENCING '
n � �^"�" r ��
WALL INSUlATION �. POOL FINAL
CEILING INSULATION � OFF S1TE IMPS.
DRYWALL NAILIfz1G �. z, � i ^�" �1�i`, ,' ; DEDICATfONS
SEWER I FINAL ENG.
.-�:-
SEPTIC TANK I � LANDSCAPE/IRRIG.
SEEP PtT/L.L. '? `'' ON SITE IMPS.
GA5 AIR TEST � FINAL ZONING
FfNAL CONS7. '�.t'l.- � E �IRE DEPT. FINA� _ _
FINAL HEATING � � ' ; HEALTH DEPT. FINAL �
FINAL ELECTRIC � ' '; DEV. FEES PAID
FINALPLUMBING �v��:'; - � ENERGY _ _
� � --T-�- --
�„'.. '.. ��., -,.. . y . � ��' ib ��il� �_ ...1
'_'__��,�'.5��-�i,'�,_._. .: ....,_� .. . , . . . . Y
GOh1tM�NTS
� �.# , ,:�,!'�.� .
—^_. K s- , — -- ----, � --._.
.� -; _ � � '_'-__-_-= ' - -
- -- ---j, ;.�:,�
-T": .. . � - .
` ` +. �S i t + , '' _ -.L.-._-�-r-
"!�. t i� �� , --- . �
sE��ic-rar��siz�
SEEP PIT/U SIZE ----- �
- i
-- :;-,-= -
�,4 , 1 4 t, -
�t" � _ f . , �—+� ,1},� ., �!�'�---_.�
�., 1 1 � , .
, � �� . , � .� r ',-----
, , � • .