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HomeMy WebLinkAbout16864 (32) __ .. _ .. ._�_._. ._ _._ � , .� .. . �� CITY OF DIAMOND BAR'� � 1 � --�� -- DEPARTMENT OF,COMMUNITY&DEVELOPMENT SERVICES i �� 2i�o E.Copley Drive 5uiu 190 ��G ,�S� C-S ` ` �� PRESS • (909)860-3195 Faa(909)861-3117 , ��.. � BUII.DING PERMIT.APPLICATION i ; k ° � FIRMLY N JOBSITE � APPLICATION �� O PERMfT P!Q'�J �' � � o ADDRESS DATE NUMBER 7t C/ ISSUE . TYPE OCC � APN LOT � TRACT DATE CONST. GROUP pOWNER � . _._. �, , t � �+- ZONING SETBACKS' �-::—�. �•-''� ._"� ADDRESS � CITY � ZIP TEL � `�FAO�```-�• )t '• ',r a.,RW O � FEAR ❑ � APPUCANT TEL SIDE/SIDE STREEf ~r • RW ❑ CONTRACTOR SIDE ❑ � ADDRESS � PROPOSED USE" '"' "'" �''<`• ' -' ' ^ �- � CITY p � �i TEL ARCH/ENG/ /� � DESIGNER �J N0.DWEL NO. � . NO. AD� UNITS �� STORIES y� • BEDROOMS � CITY ZIP TEL � 2 N DESCRIPTION �SQ�FT. � 'FACTOR PSF ADJ.AREANALUATION � OWNER-BU�tDER DECLARATION SFWADD/REM Z^ � �� � cerooarceroon ` G� ' p 1 NEREBY AFFlRM UNDER VENALTY OF iEfWRY THAT I AM p(EMPT FROM THE COf�ffRAGTOf13 L4 LI,J CEHSEUWFONI}IEFOLLOMfNORFA50N�5EC.70.71.6BU5INE55IW�PROFES510N5LODE:INVCITYOR (n U COUNSYMI4CHRECUWESAVERMRNCONSTRUCT,l�ITERWPROVE,DEAIDUSH.OHREPAIRANYSTRUG W P8t10/DBdC �� TURE,CRIDR TO R9 i34UANCE ALSO REOUIRES THE MVLICANT FOR SUCH VERMIT TO F�LE A SIONEO W . BTATfMEHT 7HAT HE OR SME IS UCENSED VURSUANi TO T/E PHOVlSIDNS OF TME CONTRACTORS LI• � CEN9E UW(CHAP7ER C(COA/MENCl1a MATII SECTWN M�Oj OFDMSION]OF 7HE BUSINESSAN�DRO� � PooVSPa FESSIONS OODE)OFi TIAT HE OR SHE IS E%EAIPTiNEREipOM ANDTHE BASIS FORTHE ALLEOfD E%EMP• T1DN.NNV�OLATiONDFSECT10N7W1.6BYANYAPPLICANTFORAPERMITSIRJECTSTHElWPLM1l1iT0 - Z Ra-Rool � � A CML PENALTY OF NOT MORE T14N FNE HUNORED DOLURS(=�I�k . � O�ASOWNEROFTHEiROPER7Y,ORMYEMPLOYEE9W1T11WAGESA57HEIRSOLECOMPENSATqN, � (`,pmm8fC181 r _ W0.1 DO 1HE N10FiK,11N0 iME STRUCTURE t5 NOi INTENDED OR OiFENED FOR SI1LE(SEG 7GN,BUSb J y NESS ANO PROFESSIONS CODE:THE CDNTMCTORS IICENSE LAw DOES NOT APPL1'TO AN OWNER OF = �.' !.-,;! :t i PROPEHTYMFqBUlD30R�A0ROVESTIIEREON.ANDWHOD0E5SUQ1Wp11(HIMSElFO11HER5ELFOq m � T�qU011WSORNERONT1ElAMOYEES,VHOWOmTHAT6UdIMPROVEMEMSMENOTMENDEDOR� � OFFEREDFOA SALE IF.HOWEYERINE BUILpNO OH W PROVEMENTiS50lD WITNM ONEYEMOFOCAIPLE• � �TION.7HE OWNER�URDER WRL HAVE THE BUROEN Of VRONNO iW1T ME OR SHE DiD NOT BU0.D Ofi MPROYEFOR7HEPUPPOSEOFSALEI. � W 04�3�WNEROFTHEPROPERTY.IA�O(CLUSNELYCONTiUCTN1�N7R�UCENSEDCONTRACTOR� � 7V CONSTRUCT h1E PIIQIECT(SEC.10N.BUSINESS AND PROFESSIONS CODE TME CONTMCTOR4 LF VelUeti0fl ADJ.AFlEJ1 CENSE Uri DOES tqTMP�Y TOAN ONNER OF A PROPERTY VniO BUILDS OR IIAPROVES 7HEPEON.AND � vn/ocartw�crsconsuairraa�crswnrn�cartn��croncs�uc�swvuasuurtron+eoartnnc QUANTITY DESCRIPTON FEE � TORS LICENSE UW.). i, . (� Q �1 AM E%EMPT UNDER SE0. � B.�P.G FOR THIS REASON � AC � �L- �+ 3 � � u" DATE OWNER � � V - " G 'r'a � UCENSED CONTRACTORS DECLARATION W ^� ��..� � � t �HEREEYAFFWM UNOER VEtU1TYOF iEiUURY T11Ai INd IICEN3E0 UNDEH PRONSqNS OF CHAPTER Z ,�� ., �� ��C0IAMENCN(iWITHbECTIDN100o�OFDM510N]OfTHEBUSiNESSANDGROFESSIDN5CO0E,AND X W UCENSE IS N FULL FORCE AND EFFECT. . m •� � ^ LLI � 110EN5E CUSS� LIC.NO. , � �— 1 k � cr ~ DATE � coNrrucror� n- � G p � Vc WORKERS'COMPENSATION i ECLARATION � 1 V � �HERE�1'�FFIRNUNDERiENALTYOFVEiWF7YONEOFTHEfOIIOWINGDECURAT10N5: �„ ��J- , ZQ I L � �IMAVEANDN9LLAWNLYNACERTIflGTEOFO0N5ENTTOSEIFaNSUREFORNOiU(ERS' 2 � � � � OOMPENSATION,AS PPOVIDED BYBECTION 770o Of THE LABOF CODE.FOR7HE DERiOfUAANCE W OF7NEWORKFOitWM:CHTMSVEPMITIS159VE0. � , � 0 _I NAYE AND WiL1IAAMAtN WORKERS COMOENSATqN INSURANCE,AS REOUIREO BY SECTION Q 970oOFiHEUBORCODf,FORTNEOERWiWANCEOFiHEYfOPKFORWHICHtHISiERM1T15 � SSUW.Ff1 fA/5� ENSATION INSURN�CE URiUERAND POLICY NUMBER ME: CONSTRUCTION � W1RR:ER�[�� � ��ni�P/����'��� GO• PUW REVIEW � ICYMIMB[H ,SI t'�►N/ IL'JT - ELECTRIC -�� r1 ����� ' � BEOp�FLFIEDOFTFEPEPMi6faRohEF�i�Df1EDDOtUF6(i�ao)oNtEssF PLUMBING �1 O• , }7 � ICERTIFYTHATNTHEPERFORMMICEOFiHEWONKCORWHICHTHI50EiUUT6LSSUEO,I MECHANICAL _ ��] GMALL NOT EMPLOYMlV PERSON IN IWV MANNER 50 AS TO BECOME SUBIEM TO TME lf y WORKER5GOMPENSATqNUWSOFCAL�FORN4�AND116REETHATIFI5N0UlD0[COME INSPECTIONFEE r(� S SUBIECTTOTNEWORKERS'C01.1PENSATIONPROVISqNSOF5ECT10N�7000FT1ElABOR �/ � e,iswuicaar�nnn�cowv�rvn ttas� Eqnovisbr+s�� ISSUANCE � O ��q� il A 1�•,o SMIP � p wrE: _(�11/�. avvticu�r _aL]_LL� � ENERGY P/C 1 WARNINO:iA4URE TO SECURE WOFKERS'COMPENSATION COVERAfiE IS UNLAWFUL,AND SH/J.L BE � � SU&7ECTANEMPLOYERTOLRiMWALGEIULTIE5N10CMLFINESUPTOONEINNDREDTqUSAND ENERGYPERMIT OOlLARS(f l00.000).N ADDrt10N iO7/1E COST Of COMGENSATION,DAMAGES AS FROYIOED FOR W (� ¢ SECTqN�)OeOFiHEUBORCODE.NiEREST,ANDAT70RNEYSFEE3. RETENTIONFEE: w d CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � O i , � 111EREBYAFFlPMUNCEROENALTYOFDERttIlh'TN�TiHEPEISACONSTPUCTIONIENOMCiAOENCV - n- FORTMEVERFORAIANC O/F�i/H�EWpONKFq/R V►h�f1lpliFnSGERMIT151 SUED(SEC.Joa7,pV.C.). �- , � LENDER'SNM/E�V' ' v^`�T V`���1 �� , . . � LENOEH'SADDRESS � '� ... ^�[ ��� ' `� � ICERTIiYTUTIWNEREADTIUSAPPLIC�TIONANDSTATE7NATTHEABOVEINFOfUAAT10NIS[ORRECL TOTALFEES � ' �. J�I ��I ��J . � IA6REETOCOMPLYN7THAlLCT'AHDCOUNNONDWANCESINOSTATEUWSREUi1N�TO8UttDIN6 � � - I�1 : , CONSTRUCTION,AN011EREOYAUTHORIZEREPRESENTATIVESOF7HISGOUMYMEMERUPONTME ` " i � ABOVE�MEMpNEDVROGEflTYFOflMSVECT�ONVVflGOSE& COMMENTS � � ��, J � . _.. .. � � , . � � m VERMRTEEWwE(PWNn , i � � ' N �/ j J y .s�csru VERMITf�,F / I D�TE RECPT.NO. PAID BY � VALIDATION � � � WHITE—DepeRment Copy.YELLOW—fhenee Coty.PINK—Assessa CApy.GOLDENROD—Fi�e Capy,OREEN—AppicanYa Copy , `:, .� ' • �.'�"4 h.'`�'., •' �' �� • ;� • � . . � , . � .�. . . . , .._ . � ... .. . . � - � CITY OF DIAMOND BAR i �-. �.e t:t,-: ,: :?,i�(��Ci�.'T1:J '� � �� r�.:;��v:::,�:•r��:iNSPECTION'RECORD 1�,-:,:r�,:i;<<,.�. �a , ^.f -�:�. c: ';:.1 _. �� ; � l,i jL�i�� �J ;��:t:,,�:,:';,�:.:t,•:t: �..+ ..�r^ �. ,:.:��(r� i:�s:;: �= .�,� -:� �''��J;r �i>��..d��i��' ; �!zi`;,. =`' ' o :�'�1 ►�.:�►.� .�� o �, ��-- <1.0�►'.��.�. 'JY� '..���"�`� . ;i _ ,e.....:....�...�.....� � ,.,..,� -- r.�,; `j S •-_ `�� ' (�. � • , . `FLOO JOIST �-.�. �� .� ..r, \ «,.�.,�,,.��._...:. jSET BACK' � . � � '� �.�., �. _I �t� r �, :� i i �' ._ � ('FTGS/FORMS/STEEL�'=- �--,�. :., , . . _- _-.�- - ;_ --- : ,FHA EQMTS_�___.` ' _' __ ___ '. .,_- _.. ._ . �� . . . �� _�_ .._�_.. ..;,. (ELECTRICGROUND---_ --- �. 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WALL-iNSfiL-ATION--.---- -- ------- - -------- - -...---- -- POOL FINAL � , , � „ , : ,. �-,:�,� ;, � fCE1L1NGilVSULATION--- --- -- . . - - -_---. -_ OFFSITEIMPS. , ,., , `, r � ,,:� � •,.:, . - � � � ,, � - � , I DRYINALCNAIGNG----- �1 (o � - - - _ __ - -DEDICATI�NS ' �; . ,• , ;' a ; . � - � ---- - �SEWER ---- ----- _ _ � - - FINAL ENG . . , _ .., , :. -_ � ,SEPTIC7AfVK LANDSCAPEJIRRIG. ' '� ' � "�" � � '-3�'i ;'I �SEEr��'iT/LL.----.------_- ;° .' , " " 'c� '.GI�.i 1'c'�- �- ON SITE IMf'S. � GASAlRTEST •' �' �" � '�� FINALZONING , ;.. �., ' ': .; � --- --�---- -- -- � �_ �_� __ . . . - ��IPJ�`,�._CONST. ;--- - ,.-1' � :1 . _-•i�I v +7 - - -- FIRE DEPT. FINAL . .�. ,, _ . _ _ . FINAL.HEATING - --- _ � :I,` ` _..,•,.� .`; ___-.�.. . HEALTH DEPT.FINAL- - --- ----_ � _ __ .. ..___ -: ; .=�NC,L�FLEGTRIC--,,;•�; '-�-� � ; `-'" ' ---.---� -DEV. 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