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HomeMy WebLinkAbout13463 (24) �,� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� 21660 E.Copley Ihive Suite 190 (909)860-3195 Faz(909)861-3117 PRESS '��^'� BUILDING PERMIT APPLICATION FIRMLY o DDRESS ` '��"I `,f �vP_r (�[�/tfi DATECATION �Z � NUMB R � 3 �3 ��C � ISSUE TYPE OCC ¢ APN LOT TRACj Z DATE ��1 �� CONST. GFiOUP p OWNER 4 " ADDRESS . ZONING SETBACKS 0 � CITY L-cS ZIP�2�Zl- TEL ' Q FRONT RW ❑ APPLICANT TEL REAR • ❑ � SIDE/SIDESTREET RW O CONTRACTOR � 'l.0 SIDE ❑ ADDR S rc� - � CfTY r � � ZIP� • TEL PROPOSED USE N-L" ` l � � ARCH/ENG/ DESIGNER NO.�WEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION � OWN[R-BUILDER DECLARATION SFR/ADD,'REM O p I NEREBY AFFlF4.1 UNDEA FETALTY OF PEiWM iHAi 1 AM EXEMPT FRqA THE CONTRACTORS iF GaragolCarport '' W CENSEUWFOftiMEFOLLOWNOR[ASON�SEG7al�.SBUSPlESSAWGROFE5510NSCOD[:ANYCITVOR (n WIMttWFnCNREOUIfiESAFERMRTOCOxSTRUCT,ALTER����EDE►�OLIS�tORRCPNR/WYSTRUG W paGdDeck �� iUi1E iR10R TO RS IS5UANCE,AL50 REQJIRES THC 11➢R�CMlT FOR SI1CH PEWA�T TO FILE A 51GNED ETAiEYENT TlUT HE OR SHE IS IICEN5E0 PURSUANT TO THF.PROVISiONS OF TM[CONTMC70R3 LI� � CEHSE UW(OUP7ER Y(COMYiNCIN�MiH SELTION 7D00)OF DIVISION 7 OF THC BUSINC55 MPJ GRO� V" PooUSpa FESSqNSCODE)ORTIIATMEORSHEISE%EuvTTHEaEFROUAhDTNEBA5i5FOqTMEALLEGEDEXEua. (� 770N.ANY VIOLAiiON OF SECTiON 7mt.6 BY/VJNAPPL�CJM FOR�PERA1iT SUB.lECTS TNE MPLIGwT TO Z Re-Roal F A CIV0.PENAL7Y OF NO7 MORE T11FN FNE HUNDRED OOlLMS psoo)r � O��ONT�EROFTHEYROPERTY,ORYYEMI'LOYEESVATHWIGESAShIEIfl50LECOMPEN�ATION, O Cammercial � YMIL DD 7ME YIOftK IWO TH[57RUC7UFlE IS NOT N7TENDED OR OFFERED FOR SKE(SEG.7DN.BU51� J ' � NE55 ANO VROFESSIONS OOOE:THE CDHffUCTONS UCENS[UW DOES NOT AaPLY TO FN CrNNER OF = iROPEHiY 1M70 BULDS Ofi NPROYES THEREOH,ANO WNO DOES Sl1CH VIORK HiMSELF OR MEHSELF OH Q TMNOl1GNH140RNEROWNEwPIOVEES,VROVDEDTHATSUtl/WopOVFMENTSARENOTMEN�C00R C� OOFFENEDWRSALEIF,NDVYEYERTNEBlAOPI�OqYPHOVEMEHTISSOIDWITNINONCYEAROFCOYPLE� Z TqN,THE OWHER-BUIIDEN NnLL HAK TME BUROEN OF PRpV WQ TMAT MF OR SME DID NOT BUIID OH = MPiqYEFORIHEPURPO^EOFSAL[) W 04A30NTJEROFTNEifpPEfiTY,A/AE%0.USNELYCGfTMLTPlOWTILICG'SEDCOf.TMCTOFl7 . ¢ TO CON5IRUCT T+E VN0.IECT�SEG 70N,BUSINE55 AND iROFE55iON5 CODC:THE CONTMCTOf15 ll• VOluaticn ADJ.AREA lu CENSEUWWESHOTMPLYTOIW0IYNEHDFAPHOPERTYNT10BUlD50RIMPpOVESTNCRCOf7.AN0 � YMIOCOMMCTSFOASUp1GNO.1ECT5VnTHACDflTMCTORl51LICENSEDPURSUIMTOTNECONTMG QUANTITY DESCRIPTION FEE � TOil5l10EN5E LAW.). J Q ❑I AM EXEMPT U�DfR SEG B.i V.C.iORTMIS RCASON Q 3 � � ¢ o�T¢ owr�a F- z w F LICEhSED CONTRACTORS DECLANATION W � INEHfBVAFFlWIUNDERPENPLTYOFP[NURV7MA71AAAL�CENS[DU:DEAOROVI510NSOCCHAv7ER ' � ��C0IAMENCMqNfiiHSECT10N1o00�OFDM510N70F!YEBVSINCSSANDPHOFESSiONSCWE,/.ND � l�r� ' � ,) oX MYUCENSEISNFULLFORCEANDEFFEGT. � i `S�{�C..S�\�� -�v u��E�us/$� C 3 fv ��.No. ZIa b�2 � �'j DATE�/��-�Q�{ canaaeror�� • � �T'1� a _ t O 6 � WORKERS'COMPENSATIOPI DECLARATION J Q ^ = U N IHEi1EBYAFi1i1MUtAERVEWLL7YO�VEtWRYDNEOFTHEFq1OW�NG�ECU1M710N5: � Z Q � �INAVEIUAW!LLMAINTANAC£RTIFIGiEOFCONSENTTOSEIF-INS'JREiOqWORKERS' _ '��- COIIPENSATKKI,ASPROVIDEDBY9ECTION7�OOOFTHEUBORCODE.FORiNEPCi1FORMJ11iCE `U OFTHE WORK FOf1 WM�PITMIS PEFMiT IS ISSUED. � � �I MAV6 AND VfLL►IANTIUN WORNCRi'Cd.'7ENSATION INSURANCE.�5 REOURED 6V SCCTION Q �7000F 1ME U80fl CODE,FOR TNE PER�OPMANCE Of THC WOf�K fORNnr.CN THIS PEMAIT IS � ISSUED.AfYWOHKERS'COMPE �SATIONINSVNANCECARfiER/JR7VOL:CYNUMOCRA/1L: CONSTFUCTION � CARNIER J � � . PLAN REVIEYJ � V0.ICYNUABCR A i'�'• IG'� ELECTRIC 0 (tHsstenair�mr+�Te[ca.s�[�acn[v[a.�Tsc�a+c�a�c�oaUns�s�a�a+tessy PLUMB�NG — - - Z s Z ICERTIfYTUTNTHEVERFORMANCEOFTHEWOfU(FORwMQ1Tni5PEFlM�7IS65VED.1 MECHANICAL , •�`'�` • (•} 5lU:LNOTEMPLOVIWYPERSONINANYYANNERSOASi08[CG.�LSUBJECTTOTHE `� tv�� G.� N WORKE0.5'Gd1PENSA7qNUw5OFCAL60iiNIA,AhDAGREE7IUTIF15110ULDB[COu[ INSPEGTIONFEE � w -�'`i _.f SUBJEMiOTHEM/ORKERS'Cd�7ENSATIONORON510NSOF5ECT10N]7o00FTHCUE�OR � '�t`��-;..;vy',�1.�j1 ' COOE,ISHALLFORTl1WITHCOMPLVWIhIT1105[PFOVISIONS. ISSUANCE �� d � • •�'� S _ �,. p DATE: APPLICANT: SMIP \, .�-�•1�'•�•� . W ENERGY P/C �^`a U� <!�' ��� � WARNINO:FMURE705ECUREWORKERS'COMPENSATqNfAVERAGEISUNUW�UL.ANDSHALIBE � �y SU0.IECT/WEMPLOYERTOCR:MIlULPENALTIESMIDCNILFM+fSVPi00NENUNDRED71qU5AND ENERGYPERMIT �` '�1 ���1 DOlURS(f t00.0o0�.IN ADDITHXa 10 THE COST OF CpAPENSATIDN,DAMAGES AS PROVIDCD FOH IN � SECTI�N7700DFiNEUBDRCODE,WTENEST,AYDATTORNEY5FEE5. RETENTIONFEE: ��v a CONSTRUCTION LENDItvGAGENCY PR[-ALT FEE: CC IHEREBYAFFIRAIIAaOERVENALTYOFPEitNRVTFUTTHEREISACONSTPVCTIONLENDiNCAGENCY nZ- FORTl1EPERFORAW�CEOFMEWONCFORWHiCNMiSVERMITI5155VEO�5EFDoi7,CIV.C.). W � LENDER'S NN.1E � IENDER511U0RE55 ^Q W I CERTIFY i1Ni I NAVE READ T115ACPUGTqN MIO STATE TMATTHE ABOVE INFORNATION IS CORRECT. TOTAL FEES � G�` Y ��� � IAGREETOCOMiLYWIiHN.LCITYANDCAUNT/OROfWWCE5ANO5TATEUWSREUTNOTOBVILDING CONSTRUCiqN.M1D HEREBY AURIORIZE flEPRE5EN7ATIVES OF iH15 COVHiY TO EMEfl UPON THE Z AOOVE�MENTqNEOVROOERTYFORINSVECTIONVURPOSES. COMMENTS 9 r � .�1"P`'C� Cc .^ i�l. . � �N m PERIAI E�iN.�(VP' y � JfZrl � SK.NATUREOF PCRMI EE D TE � FlECPT.NO. PAID f1Y VALIDATION WF11TE-0eDariment Ccpy,YELLOW—Finance Copy,PINK—,Aaaessor Capy,GOLD[NROD--File Copy,GREEN—ApplKsnCa Capy � CITY OF DI�rfJIOP�D BAR - � If�lSPECTIOt�l�RECORD '� * �'j��+•�..�at�.r����! 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BOND BEAPA ' • • 'FR/�P,11fvG,NENTILIATIOPd FIidAL BO�JD BEAh4 � � ( T ;ROUF COVF_R - ' PRE-GRADING ' �ROUGH H�ATING - - 1 BENCHING _ ROUaF: E�CCTRIC � f�OUGH GRADING �RGIJi,!-i PLUM,BING �j�23 FIPdISN GRADING � SHrJ''�"J�.R,TUB TEST . - - POOL ELECTRIC �XT, LAi ri;'SIDIfJG POOL FENCING i :^!F-.LL INSULEITION POOL FIfJAL ' C�II_iNa I�d�UL.AT10iJ + OFF SITE IP,1PS. � DRY'+'JALL NAILING � DEDICATIO��S 5E's",lcR FI"JAL EPdG- � ! :�EPTI:,TANK � Lf�FJDSCAPE/IRRIG. � , j.SEE:'P�3/L.L. OP�SITE Iti1PS. � .?;,�_E,I:ti i�ST � FIPJAL ZOtJING � � �•�-. �'��yST. _ FIRE DEFT. FINF,L F-�•'=�-��AT1NG . � H�ALTH DEPT. FIhAL � � .". . ... {�� . •�:ELECTRK� � � DEV. FcES PAID .__;..- _.:E.�ur.4BING a- -� L� '� � Et•:ERGY I i ---- , . .- (--�- (- . � f �-�---- --- - i , ; i. . _ :.�..._':t�►'_;:1,4_��.__...---:-.._.,.__. — ; ---- -- .. . . : ' ' ' � ::._, :. . ._ � . 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