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HomeMy WebLinkAbout13434 (29) �� J� CITY OF DIAMOND BAR . � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drivc Suite 190 (909)8603195 Faa(909)861-3117 PRESS '�'� BUQ.DING PERMIT APPLICATION FIRMLY a DDRIESS�i7�C'J 1 /�'Y _ APPLICATION PEHMIT �2 �/C o �f� � �� DATE NUMBER �3 J� � APN LOT T T ISSUE�r� I��^, 7ypE pCC � DATE "� CONST. GROUP p OWNER p ADDRE�S ZONING SEf�ACKS � CITY LC') ZIP TE-L�/ FRONT qyy p APPLICANT T�+a� SIDE/SIDE STREET RW O � CONTRACT Fi —' � � SIDE • p ADDR �J � O Cm, Z� � �,U�n PROPOSEDUSE L o _#�, 0 ARC G/ � DESIGNER N0.DWEL NO. NO. N ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. N �n DESCRIPTION SO.Fi. FACTOR PSF ADJ.AREANALUATION Q OWNEiI-BUILDER DECLAFiATION SFR/ADD/REM O . p 1 HEREBY AFFlMI UNDER VENALTY OF VE0.AIRY TUT I AM E%CMPT FROA1 THE CONTRACTO(Ls LL Garepe'Carport W CF)JS[UWFOiIiHEFOl1OWNORftiSON(SEC.7LL'It.68U5WE55WDOROFESSIONSCOOE/UJYCITYOR (f� �•J COlR1TYWMd1RE0U1R[SA7ERA/RTOCONSTHUCT,/LLTERMPROVE,pEI,1p�J$H2ORREPAIRMlYSTRUG W �Z TURE.ORiOR 701T9155U�NCE,A4S0 REOUIRES THE MPUCANT FOR Sud1 PERMR TD FIIE A SiGNED W Patiol�eck � STATEMENT TNAT HE OR SME IS UCENSED GUiLSUANT i0 THE PROVISIONS OF h1E CONTRACTORu LL � � CENSE�Aw(QIAP7ER Y(CqAMENCINO WfM SECTION 7ao0)Oi OMSION]OF THE Bu5ME5511N0 if1O POOVSpO FES510NSCOOE)ORTMATHEORSnEISEXEMP7TNEflEFRpAANDiHL8�1515FORiN[ALIEGEDEXEMP• (� 7qN.AN'IVIOlA71DNOFSECT10N10]1.EBYIWYAPPLICANTFORAVERIIITSUBfiCiSTNEAPPLICAN7T0 Z Re-Roof �„_, ACML7EIULTYOFNOTLIORETWIi1VEHUNDREDD011AR51=`+�1.1: � ❑4�.:a'�NERO�TMEVROPERTY.ORYVE�7LOYEESWITHWACESIlSTM[IR50LECpMoENSATpN, (`qmmef�lBl - W0.1 DO THE WOPoC ANO THE STRUCiL1RE lS NOT IMENOEO OR OFFER[D FOH S�LE(SEG loN,BU56 � N NE55 AND P110FESSION3 COOE:T11E CONTMCT00.5 LICCNSE Uw DOES N07 APPLY TO IW OWNER OF � , PROPEHTY N'HO BUIlD9 OR MPRpy'S iMEREON.IW D Vh10 DOES SVCHN'O(iK HIMiELF OR MERSELF OR [= TYiOUCIiH50qXERON?IE)APLOVEES,PROVIDCOMATSUpIMPROVEMEHTSAF[NOiWTEN�EDOfI C� � OFFEREDFORSALEF,MOWEVERT�BV0.LNNODNA/R10VEAAEMISSOIDWITHINONEYEAROFCOMPIE� Z �TqN.TNE OWNER�BUILDER NALL MAVE TNE BUIL�EN OF PROVPIG THAT HE OR&1E DiD NOT BUiID OR = MVRDVEFORiHEPURPOSEOFSILLEI. �y,� 04�40MMEROFT1EOi10PEKIY,/WEXCLUSNELYCOMRACTNQWRHLICENSEDCONiMCTORS � TO CONSTRUCT THE PRO.IECT(SfC.70a�,BUSINESS/W�PROiES5iON5 COD[:THE CONTRACTOf15ll- VOIUUIiOn ADJ.AREA CENSE UW DOES NOT AVPLV TO/W OWNER OF A PpOPEFTY Mnp 8URD5 OR 14PROYES TMER[ON.AND � YAIOCONfMCTSFORSUp/FRp1ECTSMnTHACONTMCTOR(5)LICENSEDVlJRSUANTTOTHECONTMG QUANTITY DESCRIPTION FEE TOfiS UCENSE LAW j. � ❑I IlM IXEIAPTUNDER SLG B.l V.C.FOR 7M15 REASON � � , ' �� ' � � � )c �• � � LL' OAiE ONrt:ER U �¢ LICENSED CONTRACTORS DECLAAATION W , �... � CL IHERE81'AFFWAIVIDERPENAI.7YOFpEiWqY7HATIAMLICENSEDUNDERPROV�5lON50FCNAPTER V, p., i(COAMFNCWON7MSECTqN70oalOFOMSION70FTHEBU5IN[SSAhVPROFE55qNSCOOE,ANO Z X W 110EN5E IS N FUII FO cEAND FFFECf. llJ / /Y �/ C� � UCENSE S �. LIC.N0._% ��, _ j � V DATE�' ��� CONiRACTOR' .(L� � W � WORKERS'COMPENSATION DECLAFiATION a � INCREBYAFFIRMUNDERiENALlYOFVE0.RIRYONEOFTF1Ei0UOWINGDECLARATqNS: � Z � _IHAVEAHDW:LL►WNTARIACERfIFIGTEOFCONSEMTOSELi-INSURC(ORN9RKERS' 2 � COMPENSATION,ASVROVIOEDBVSECTIONl7o00FTHELA60RCO�C,FORTHEDERFORAIANCE U Q OFTHEWORKFORWHIp1TH15PFRMIi19155UED. � � �IHAVEANON'ILLMARfTAP1Y/Of7KER5'COMVENSATIONPlSUWINCE,l1SRE0UtREDBYSECf10N ' � O �7000FiH[UBORCOOE.FORiHE7ERFORIIANLEOFTH[WOPJ(FORW111CHTHISVERMITIS � ISSUED.YYY.ViL(f,ji6;Cp1VENSATqNINSU _�GNRIERANOPOLICYNU1.18ERARE: _ CONSTRUCTION ] GRRIER��T �� PLlw REVIEVI � POIICYNUM�ER 7-7 ELECT . . , i � Q 0 (Il0.;SCCf1JNKmNOTBEO]MlEfDOFhEPEMR6f�ilOhLlAf�DiIEDDOLL�flSR�OMORLF55} PLUM�ING �_ '� W Z ICEqTFYT/UTPITIEFERFOqMANCEOFiHEWORKFORWHIp1TNI57ERNITt5155UED,1 MECHANICAL C7 SwLLLNOTEMPLOY/WYiENSONNAM'NINNERSOASTOBECOMCSUOJECTTOTHE (n WOPo(ERS'COMPENSATION UWS OF GAL60FNIA,AND AGREE TNAT li I 511QhD BCCOME INSP N FEE SU0.1ECT707H[NORKERS'W�.�vEN5AT10N PPOVISIONS OF SEGTqN f70a OF THE IABOR � A I '�J U �_/ �j CODE.IS�WIFORTMY17HCdAPLYWITHTM05[PROV1510N5._�____JL� SSUAN Il-f JN I�/7 p DATE:�-(-6�i/APPLICANL ��l�F�L SMIP . ��'T��' �T'+'' . • 1' '�Y� W - .._ ........ _ .�i. _ � ENERGYP/C Uinr .� . . .+,. �•�. r.,^�'V WAANINQ:FAILUR[TO SECURE N'DRKERS'C04PENSATION COVEMCE IS UNLAWFUI,AND SHALL BE -+ �y SUflJECTANEMi'LOYERTOCA:AIIWILCENALTIESM'DpVILFWESUVTOONEMINCREDTN0U5AND � ENERGYPERMIT DOl1AR5(f 100.000).IN ADDITION 70 THE LOST OF LOMVENSI1TqN.DAYAGES AS PNOVIDED FOA IN � SECTION77010FTHEL4BORCOOE,IN7EREST,ANDATTORN[YSFEES. RETENTIONFEE: OCONSTf7UCT10N LENDING AGENCY PRE-ALT FEE: � IHERCBYAFFIRIAUNDERCENALTYOFVEtLUMTHATTNER[L511CONSTRUCTIONLFNDINOAGENCV ' Z FORTME CERFOfU1ANCE OFTME WORK FOR WHIW TMIS VERuIT IS ISSUEO(SEG]oa1,CIV.G). W . � IEN�EfY5NAAIE � LENOER'Sti7ORE55 /� � 1 CERTIFY TIU71 HAVE READ MIS MGL1CATpN AND STATE TM�7 iME/90VE NFOWIATqN IS COR0.ECT. TOTAL FEES .rf��� W IACRE.'-NCOE'FLYN7TI/LLLCR7ANDOOIMTYORDINANCESANDSTATEUwSRFUTWOTOBVILDING �.r � CONoTRVCTICN,N+DHEREUYAUi1qi11ZEREGRc`SENTATNESOFTHLSCqMiVTOEMERUPOHiME S� ABOYE�M�NTqNEDiROPERTYfORINSPEGfqN%JRPOSCS. � �,�����f^ '� r� . COMMENTS _ �a.'I l m P . �wa i ¢ � � N � 8 VR[OF VERMIT7EE DAT R[CPL N0. PAID DY VALIDATION WHITE—Department Copy,YELLOW—Fnence Copy,PINK—AasossorCopy,GOLDENROD—File Copy,GREEN—ApplicenPs Copy � — i .\ ._ i' ' ` ��•`� �� '� CITY OF DIAMOND BAR ' � " - ' �'INSPECTIOt� RECORD . � � � e � • • - • � � • � - SET BACK .- . FLOOR JOIST,-.:; :^., ' - . ,, : ' -. FTGS/FORMS/STEEL , , . .�, , -- FHA REQMTS . � . ELECTRIC GROUND � ' � ' ' � UNDER F�OOR DUCT. ,-:. , .,� � -. �.,-.� - GROUND PLUMBING � UNDER FLOOR CUMDUIT�:'•, ��. �:.,�,`� `.,- ��•,',-'�\ . SLAB GRADE - FIREPLACE FOUNDATION�•=- �'� ��•� -��'.'• �'i� •- ' - TEMP POWER � FIREPLACE B�ND BEAM _ WATER SERVICE - MID HT. BOND�BEAM , �' �='�� ��'^--•' ' :� ROOF SHEATHING��"�' =�� �� � �' ' - ' S FT.BOND BEAP,9 . . . , � � �� � � � � ' ' . � FRAMINGNENTILIATION FINAL BOND BEAh9 ' '• ' � ROOF CdVER PRE-GRADING ROUGH HEATING � - BENCHING ROt1GH ELECTRIC � •6 ROUGH GRADING ROUGH PLUMBING -- � � FINISH GRADING � SHOWER�TUB TEST POOL ELECTRIC � EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION QFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTICTANK _. LANDSCAPE/IRRIG. SEEP PITlL.L. - ON SITE IMPS. , GAS AIR TEST - - , .FINAL ZONING FINAI CONST.- � ' � - - =;`���� ' '•� ' -' ,�• .• - � FIRE DEPT. FINAL FINAL HE!{TING � - � '"' ''; . ., ' �"�" HEALTH DEPT. FINAL FINAL EL'ECTRIC p• o. � �' ' " ' DEV. FEES PAID • FINAL PLUMBING EPdERGY ��{-�.��'. 9F t�� •J COMMENTS - � , ,� _ „• �. . ••\ ,,, . -- . � • - � • � , - -_ ^ __ , , `:, _ , , . • • - . .. . . ,. . ,� � SEPTIC TANK SIZE SEEP PIT/U SIZE .` • �:�� �; ' � � -, ,.•, . . � _ - . _ __ - . . . . .., •. _ . �� • . . .. � ; , , , . � .. . . .