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HomeMy WebLinkAbout12989 (6) _��_ CITY OF DIAMOND BAR � t / DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES `� � 216b0 E.Copley Drive Suite Y90 (909)860-3193 Fax(9�9)861-3117 PRESS $UII.DING PERMIT APPLICATION FIRMLY y JOBSRE ' ` APP��CATION �PERMIT I i'7 nj �/� �1C o ADDRESS �S�� S(I VQ fr L�K N� DATE �' � NUMBER �- � ISSUE / TYPE OCC � APN LOT TRACT V DATE CONST. GROUP g OWNER L� G 1 ; G ADDRES vl t ZONING SETBACKS CITY ' ZIP�.3J,i TEL. I FRONT RW ❑ APPLICANT TEL. REAR ❑ SIOE/SIDE STREEf RW ❑ CONTRACTOR N r Qi►, ' SIpE� ❑ ADDRESS PROPOSED USE g CITY � �M i .`o ZIP 2 TEL � � ARCHlENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDRDOMS � CITY � TEL. y DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFFVADO/REM O I IiEREBY AFFPoA UNDEN PENALTV OF PERIURV THA7 I AM E%E1AP7 FFlCM TNE CDMRAClORS LI- GBf8g6/CBfPOR CENSEMWWRh1EWLLOWINONEA6ON�SEC.703f.sBUSP1E83ANOPROFES510N5CO0E:ANYG7YOR (/� OOUNfYYMIG1REOlMiESAPENMRTOCONSTRUCT.ALTERR.�OROVE,DEMOLISH,ORHEPMRM1Y97RUC- W PBIIOID6Ck il1RE,PRIOFi i0 RS ISSUMICE.KSO REQUIRES Tl1E APPLICANT FOR SUCH PERMIT TO FlLE A&ONED W BTATEMENT 71MT ME OR SHE 14 UCENSE�PUFiSUANf TO TNE PROYISIONS OF TME CONfRACTORS LI- CFNSE MW ICMAPTER i�COMMENCINO WITH BECTIDN 7000)OF ON610N 7 Of TIiE BUSINE53�ND iR0- LL' POOVS�A FESSIONS OODE)DH hIAT ME OR SHE IS O�MDTTHEHEFROM AND TME BASIS FOFi TIIE ALLEOED q(EMP- TqN.ANVVIOlAT10NOFSECT10N7oJ1.6BYMIYAPPLICIYJTFORAGERMITSU&IECTSTHEAPPLICAN7T0 Z Re-Roof � A CML�ENAL7Y OF NOT MORB TlIAN FNE XIIt�DREO DOCUlR3(SSoo).). OtA601NNERpFTHEPROPERTY.ORMYEMP�OYEf9WITHMMflESASTHEIRSOLECOAIPENSATpN, O CofI1f11Bft181 M/CL DO 1HE WDNK,MI�THE SiRUCTURE IS NOT IHTENOFD OR OfFERE�FOR SALE(SEC.7ou,BUSI- J NE83 AA�Pi1DFE8510X5 CODE:T11E CONfMCTWl.4 LICENSE LAW OOES NOT APPLV TO AN OWNER OF � P1qPEqiYYYFqBUIDSOfiIMPROVESiXEREqV,AN�YYF70DOE55UCHVYOHKNIMSEIFONHERSELFOR = Q TNROUGHHISORHENONMEMPLOYEE&PFOYIDE�THAiSUCHIMPROVEMENTSARENOTMTEN0E00R m � OFFEREDPDRSALEIF,IqWEYER�NEBl11LDIN00RMPROYEMENiIS50LDWfTMINONEYEAHOFCOMPLE TION,TME OWNER�BUIL�EH MLL FiAVE lHE BUHDEN OF PHOYINO 1H�T HE OR BHE DW HOi BUILD IXi = IMPROVE FOR THE PURPOSE OF&ALE} � W OI,A60NMEROF7NEPROPEqIV,AMIXClU51V0.YCON7MCTIN�WRFIL�ENSEDCOMMCiOR9 � TO CONSTRUCf 1ME PiIOJECT(6E0.7oM.BUSINE55 AND PROFESSIpJS OO�E:h1E CONTNACTORS U� V01U91iOf1 ADJ.AREJ1 CENSE LAW GOES NOT�PVLV M AN OMINER OF A OROPER7Y VhID BVILD9 OR IMvqOVES THEREON,NID YViqOONTM4TSPDRBVCfiPRQlECTSWITiACONTMCT011(S)�ICENBEDPURBUANT70THEOONTHIIG QUANTITY DESCRIPTION FEE � 100.5UCBYSEUW.�. , ❑I AIA EXFJIPT UN�ER SEC. B.i P.G FOR THIS REASON � � U � � DATE OWNEH � LICENSED COPf�RACTOR5 DECLARATION � � IHEREBVAFflRMUiDERPENALNOFPERIURYTFU1ilAMLICENSEOUN�ERPHOY19pNSOFCHM7EA � !Q � �L���� `1 � •(COMUENCMIOWITHBECTION700DIOFDINSION30FTiEBUSINE55AN�PFOFE5510N5CODE./1N� Z X W LIGENSE l5 N FULL PoRCE M!D EFFECT. m LLJ ��7� � � UCENSE CLA55 LIC.NO. � F � � DATE � ' CONTRACTOR ' a WORKERS'COMPENSATION DECLARATION 4 N I HEREBV AFFIRM UNDER PENALTV OF PE0.1UqV ONE OFTME FOLLOWING DECLAM71ON5: U �j Z Q Q �IYiAVE1W�WILLiMPlTNNACERTIFICATEOFCONSEMTOSELF-INSUREFORwOHNERS' _ Z (ri1PEN5ATION.AS PROVIDED 6Y 6ECTION T/o0 OF TNE I.ABOR CODE,FOR THE PEHFORlAANCE V Q OF7HE WOWC FOR WHICH TFIIS PERFIIT IS ISSl1ED. � � �ilMVEMIDWILLMNNrNNWORI�RS'COMPENSATpNINSURANGE,IISREWIREDBY9ECT10N 4 97000F THE LABOR OODE.FOR TFiE PEHFORMANCE OFT/IE YYORK F9R WHICH THIS PERMIT IS � ISSUED.MV NfORKERS'cq/��NSATION INSU CARRIER AND POLIGY NUMBERARE: CONSTRUCTION � CARRIEN /✓�SW`� _ PLAN REVIEW � va�crnuueea A�� i � v �LECTRIC � (tHss[c�qrar�noreEoaYq.E�IDOFnfvEsw�rlSfar+a+ew�uoa�nasR+�1�1�s1 PLUMBING � Z I CERTIFY 7HA71N iHE PEHFORMANCE OFTHE M/ORK FOR WHICH THIS PEPMIT IS ISSUED,I MECHANICAL (,'} SHA4INOT EMPLAYANV VERSON AJ ANY MANNER SOAS TO BECOME 311&IECT TO TNE � NADRKERS'COMPEN6ATION LANlSOF CAIIFORNII�MID AOREE TIUT IF I SFqUID BECOAIE INSPECTION FEE ��nl� •� � SUBJECTTOTHEWORKERS'CONPENSATpNVROVIBqNSOFSECTpN37000FTHEUBOR �7J COOE,�SIMLL PoRM'MTH COMPLY WIT1 THOSE PROVISIONS. I SSUANCE � p DA7E:� APPLICANT: e. a. �r e�'fI� SMIP Q�'��-r-�.j�*�-�Ta�Ct�� F+� � ENERGY P!C +r.r+�."r. ..� G'^�.�+`�'Y WARNINO:FAILl1RE TO SECURE WORKERS'CqMPENSATIDN COVERAGE IS UNUWFW„AND SHALL BE B�a�Tj�'.}. 6UBJECTANEMPLOYERTOGRIMINALPENALTIESANOCIV�LFWESUPTOONEFiUNDREOTFpU3M10 ENERGYPERMIT DOLUFlS(5100,OOOy.IN ADDIiION TO THE COS�OF COMPENSATION.DAMAOES�S PROVIDEO iOR IN � SECTION 970E OF h1E LABOR CODE,INTEREST,ANDATTORNEYS FEES. RETENTION FEE: p„ CONSTRUCTION LENDING AGEMCY PRE-ALT FEE: � I HEREBYAFFIRM UNDER YENILLTY OF PERJUflY TMATTHERE IS ACONSTflUCT10N IENOINO AGENCY Z FORTiiE GERfORMANCE OF iHE WONK FOi1 WH�CH TMIS PERMIT IS ISSUEO(SEG.�oe7.CIV.CJ. W � LENDERSNAME ' � LENDEHSIIDORE55 � ICEfi71FYT1U1TI11AVEREAD7HI5APPLIG�TIONNY�STATETUITTME�BOYEINFORMATIONISOOPRECT. TOTAL FEES � V d IACiREETOCOMPLYWIhIALLCRYANDCOUNTYOR0INANCESANDSTATEUWSRELAT�N�TOBUIL�ING CONSTRUCTqK AND MEHEBY AUiNORQE RE�NESENiATNES OF TMIS C011N7Y 70 ENTER UPON 7HE S� ABOVE-MENTIONEDPROPERTYFOHINSPECTIONWRPOSE5. COMMENTS � - � ' �17 +G � nEro�rtr . w � � _� ` !' cn . � V L/ (n 81ONATUR F E fTTEE DATE � RECPI:NO._,_ . _ PAID BY VALIUATIpN WHITE—Department Copy,YELLOW—Ffnance Coryy,PINK—Aasesaor Copy.GOLDENROO—File Copy,GREEN—ApplicaM's Copy CITY OF DIAIIt�EEOND F3AR � IIoE�PECTiON RECQt�� ' • e � . � - • � e . . � . SET BACK FLOOR J015T • � " FTGS/FORMS/STEEL FHA REGIMTS • ELECTRIC GROUND UNDER FLOOR DUCT ', . GROUND PLUMBING UNDER FLOOR CUNDUIT� SLAB GRADE FIREPLAC�FOUNDATION • � � � • TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BD1VD BEAM • ' - - -• RO�F SHEATHING 8 FT.BOND BEAM � � � � � � ;4� FRAMING!VENTI�fATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGN HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING R�UGH PLUMBfNG FINISH GRADING SHOWER(fU6 TEST POOL ELECTRIC EXI: LATH/SIDING I POOL FENCING WALL INSUtATION POOL FINAL CEILING INSULATIQN �FF SITE IMPS. � DRYWA�L NAILING DEDICATIONS -� SEWER q„- � � FINAL ENG. � SEPTIC TANFC LANDSCAPE/1RRIG. SEEP PITI�.L. ' ON 51TE IMPS. GAS AIR TEST FINAL ZQNING FINAL CONST. � FIRE DEPT. FINAL FIIVAL HEATING � '. HEALTN DEPT. FINAL i FINAL ELECTAIC � DEV. FEES PAID � � � FINAL PLUMBING . � � . � ; ENERGY ' _ �_-...._._ � I I � � � , � � � COMMENTS ;�.;� � � SEPTIC TRN'��. S92E SEEP PITIU SIZE �- I yI I � '� , �•