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HomeMy WebLinkAbout16948 (33) __._::.._ . _.. ..., . . . 1 _ _ . C1TY OF DIAMOND BAR ��SS 1�"S J� DEPARTMENT OF COMMiJNiTY&DEVELOPIv�NT SERVICES ��w 21825 E.Copley Drivo � (909)860-3195 Fax(909)861-3117 PRESS `%«�'' BUILDINGPERMITAPPLiCATION FIRMLY QJOBSITE � , I ��Cy t��.� �� DATECATION �-��-� �NUMB R �1�5y ��� a ADDRESS � APN LOT SU TRACT "r.�ZZ G� ISSUE TYPE OCC DATE CONST. GROUP p OWNER pv I� D o ADDRESS � H � o �N1t/� ZONING SETBACKS Z CIN 1rv1N� ZIP ( LI T - FRONT RW ❑ $ APPLICANT TE . REAR ❑ SIDE/S�DE STREET RW ❑ � CONTRACTOR SIDE ❑ � ADDRESS � CITY ZIP TEL. PROPOSED USE SCW G{�' LR o ARCH/ENG/ � DESIGNER NO.DWEL NO. NO. . n. ADDRESS � CIN ZIP TEL UNITS STORIES BEDROOMS � cn DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADDIREM O p 1 HEREBY 11FFlPM UNOER PENILTY OF PERRIRY THAT I AM El(EMM FROIA TNE CONiMCTORS LI. 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B.i P.C.FORTHIS REASON Q U � � DATE OWNEH V O w �Q, LICENSED CONTFACTORS DECLARATIDN W CL INEHEBYAiFIRMUNDERPENALTYOFPEiWR'/TMATIAMLICENSEOUNOENPROVISIONSOFCHAMER d. 0(COIA4ENCWON7IHSECTqN700070FDIVISqN70FTHEBUSINESSANDPROFE5510N5CO0E.AND Z � ����� L� X ►IYLICENSEISN1FUlLFORCEANDEFFECT. m � UCENSE CUSS LIC.NO. � V �ATE CONTMCTOR a W � WORKERS'COMPENSATION DECUIRATION � � IHEREBVAFFIRMUINERPENAL7VOFVE0.AIWIONEOFIHEFOLLONANfiDECUMiqNS: Z � _IHAVEANDWILLMAINTAMACEft(IFlGREOFCONSENTT09ELHNSUREFORWORKERS' _ COA/PENSATqN,ASVPONDEDBVSECT10N�70oOFTHEU80RCODE,FORTHECERG'OiU1M10E �U Q OFTIEWORKFORWMIq1THISPERMITI5155UED. � � _IHAVEANDWILLMAINT�INWORKERS'COMPENSATqNINSURANCE,ASRECUIRE0BY5ECTION Q �70oOFTHELl1BORCODE,FORTXEVERFOMIANCEOFTMEWORKFONWHIp1THI5PERMITIS ISSVED.MVNpRNERSCOMPENS�TqNM15URANCfCANRIERANOPOLICVNUAIBERME: CONSTRUCTION j c�aweA PIAN REVIEW � VOLICYMIMBER ELECTRIC � [IFa55ECfqNNEmNDTBER7hpLETEDOF7TEiERMi16fOFCNEFIRDHED00lLW5(S1W)OR1F551 PLUMBING LI I. � I� Z ICERTIFYTHAiNhIEPERFORMANCEOFTHEWONKFORWHICNTHISPERMITI5155UE�,l MECHANICAL C7 SHALL NOT FAIPLOY ANY VERSdJ IN ANV MANNEH 50 AS TO BELOME SUBJECT TO TME � WORKERS'COMPENSATqNLAW50FCALIFOHNU�AN�AGREEIHATiIS11IX1LDBECOME �NSPECTIONFEE S 6U&lECTTOTHEYVORKERS'COMPENSATIONPROVISqN50F5ECT10N77ooOFTHEIAeOR COOEISMALLFORT11WI7HCO�APLVNATHTHOSEVRONSIONS. ISSUANCE 2�.tDC7 0 p DaiE: pFp��caNi: SMIP � WARNiN2 iAILURE TO SEWRE WOHNERS CdAPENSATION COVERAOE IS UNUwA1L ANO SIULI BE ENERGY P/C � SUBJEGTANEMPLOYERTOCitIMW�LPENALTIESANDGMLFWESUPTOONEMIXiDREDTFqUSAND ENERGYPERMIT DOLURS p100.0001,W ADDITION TO THE CAST OF COMPENS�TION.D�AGES AS PqOVIDED FOR IN ¢ SECTION�70BOFTHELABOqCOOE,INTEREST,AND�770RNEY5FEES AE7ENTIONFEE: a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFINMUNOERPENAL7YOFPERJURVTNATTMEFEISACONSTNUCTION�ENDWCAGENCY d' FORTHEPEPWRMANCEOFTIIEMIORKFORW111f)iTMISiERutTI515SUE��SEG�aa7,CN.C.). Z W � IENDEti'S NMIE � IENDER'SIDORESS w� TOTAL FEES Le�• U 1 CERTIFY TMAT I HAVE READ T1114 MVL�CATqN AND STATE TMAT THE ABOVE MIFORAIATqN IS CARRECT. p� IAGREETOCdAPLYWITNALLCRYANDCOUNTYOPDiNANCESANOSTA7EUW3REUTWOTOBUILD�NO � CONSTRIICTION,/WDMEREBVIIUIFIORIZEREPRE .NTATIVESOFTMISCWNiYTOEMENUPONTNE Z �BOVE•MENTIDNEOPR07ERttGORINSPECTION IIRPOSES. COMMENTS = 7/�l�L-r . m PEPoAiTTEENAME(PRINT) � �/ �O� � S�ONAT ERMITTEE D�7E � RECPT.NO. PAID 9Y WILIDAT�ON WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assassor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy �.�, ' . ..� I. t :Y':'t.'1�'r.'C.,^;"t„""' , - . . r.';-r^-.'r^�N'��'.T::'.r;i:'Y"'y"C+`..:.i.�.'a .,—.�.:-4;s,w-,��,M� ,,c7:'.; � r.,. . .-. r.--.�- � , ..- .._ . _. . .�... •_ ... . �-...� • ' - CI i Y OF DIAMOND BAR � � IEJSPEC i i0N RECORD .. �������� a ��-- ������� ���,�-���z'�'a�,��. . �Ca��-������i����l :��'��� �l�r����� SET BACK � • , � FLOOR J015T. 'i i ' � � �� `' ', r' ; . FTGS/FORMS/STEEL FHA REQMTS j—. ELECTRIC GROUND UNDER FLOOR DUCT • , ,•.� GR�UND PLUMBING UNDER FLOOR.CU�IDUIT ' • `ti" •' ' � - SLAB GRADE FIREPUI�CE FOI�NDATION � "� '" '� '� TEMP P�WER i FIREPLACE BOND BEAM WATER SERVICE i h91D HT.BOND BEAM ROOF SHEATHING � 8 FT. BOND BEAM FRAMINGNENTILIATION I FINAL BOND BEAM FOOF COVER PRE-GRADING ROUGH HEATING BENCHING � ROUGH ELECTRIC I ROUGH GRADING j ROUGH PLUMBING I FINISH GRADING SHOWER�T'UB TEST I i POOL ELECTRIC EXT. LATH/SIDING � POOL FENCING , WALL INSULATION � POOL FINAL CEILING INBULATION OFF SIT�IMPS. DRYWALL NAILING DEDICATIONS SEWER ���iZ i FINAL ENG. SEPTIC TANK • LANDSCAPE/IRRIG. SEEP PITlLL. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. � , FIRE DEPT. FINAL FINAL HEATiNG � HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING • ! ENERGY — .__.._ ic -�K'ico�•�o e;. y COMMENTS � . , ,, SEPTIC TANK SIZE SEEP PIT/U SIZE I�� . 11�1�{' �,�; . . . . � _ . . . _. ` _ _ E . ���;. _ j _ . , , - - •--.!