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HomeMy WebLinkAbout16363 _.,:.� ._ . --�-� _._. .._ . _ . __._ �. � � - _ — ,r: ;,�� ' CITY OF DIAMOND BAR �� :� — DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �' ;, 21660 E.Copley Drive Suitc 190 � '�' (909)860-3195 Fax(909)861-3117 -A�ss r, �''"'� BUII.DING PERMIT APPLICATION FlRMLY � J SfiE �OO S���j��� / APPLICATION � � v PERMIT �r^ P/C o A RESS_ I�' OATE NUMBER lY 0 � � A� LOT ;TRACT ISSUE /`� 7yPE �C � OIA�NER ti DATE D v CONST. GROUP ;p A �' RESS � ZONING SEfBACKS � C ZIP r TEL ; FRONT Ryy p A LICANT � TEL. REAR p � C TRACTOR S G7/ SIDE SIDE STREET FiW O A HE D � � C � ZIP ' jTEL! PROPOSED USE � A H/ENG/ DESIGNER NO.DWEL NO. NO. AQbRESS UNITS STORIES �_BEDROOMS� � CITY ZIP � TEL. a N s DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � �:� OWNER•BUIIDER DECLARATION SFR/ADDlREM O : p :�1 HEREBY AFFlRM UNDER PFNALTY OF iEiWH`ATrU7 I AM E%EMPT FROM TNE WNTMCTORS l4 '- Gef8gB/Ce1p011 . �L C��EUWFORTHEFOLLOWNOR£A.rON(SEF70.71.6BUSMESSANOGROFESS�ONSCODEANYCITYOR '/ (n �••� COSlfT'/YMAC,7IREOUIRESA7ERMRTOCONSTRUCT,/�LTER�MPqOVE.DElAOUSH.OqREPNRMlYS7iR1G P0'�� VRqfi TO R9159UANCE.ALSO qEWiqES THE APPIICfl1T FOR SUp1 PEIiMIT TO FILE A SIGNED w � ETA 7HAT NE OFI SME IS LICENSm PU0.5UANT TD iHE PROVISIONS OF tHE CONTRACTORS LI•� ' W � E UW(O/APTER Y(COMA1ENdNO WITN SECTION 7000)OF DMSqN!OF THE BUSMESS ANO PRO-; V" PooVSpa � F�E�ONSODO�ORTHATNEOHSHEISEXEUPTTHEREFiqMANDTNEBA5I5FORTHEALLEOEOE%EMP•� (� 710N.AN'/VIOLAiIONOF5ECT10N70.tI.68YANYMPlM.M1TFOflAPERAlITSUBJEC75THEAPFLICANTTO Z Re-Roof .�� AC�11,PEw1TV OF NOT MORE 711AN FIVE HUNDRED DOLIIWS(i5o%.F i ' � yOI.A501NIEROfiMEPROPERTY,ORMYEMVLOYEESMAiHWAOESASTNEIRSOLECOMPEN5A7qN, Q (`,pmmBfCldl Nnl�DO THE WORK,AND i1fE STRUC7URE IS NOT WTENDED Ofi OFiENED fOR SALE(SEC.T01�,BU51- J NE05 NID YROFE5610NS COOE:TME CONTRACTORS UCENSE UW DOES N07 AGPLY TO AN OWNER OF ►ROPEHfYYIH�BUlD50RN/PROVESTHEREOH,IUIOW/qD0ES4UCHWORKHIMSELFOqHERSELFOR � 7)YIDUGHNI40RHEROWNEIIPLOYEES.PiqVIDEDiHATSUdiWPROVEMENTSARENOTMENDEDOR C� OFf CAED iOR SILE IF,IIDWEVE0.TME BULDWf1IXi M7idOVEYEN7 45 SOLD WITHMONEYEAR OFCOMP�E- 'TION.111E OWNERBUILDER NnLL HAVE iHE BURDEN OF VROVING T11Ai ME OR SME DID NOT BlntD IX1 MPROVE FOq TNE RIRPOSE OF SALE} � ' 7❑��4�A."WNMEROFiMEPROPEHTY,M/EXCLUSNELVCOMMCTWOWIT}1LICENSEDCONTRACTOii3 TO qoNSTAtlCTTNE PROJECT(SEQ 7as,BUSINESS AND PRDFE5510N5 CODE:IHE CONTMCTOf13 LI•� �� V81U0I10f1 ADJ.AFiEA CEf�E UW DOES HOTAPPLY TO AN OIMaER OFA iPOPERTY NTfO BUILDS OR IMPROYES 711EREON,AND MR�D CONTMCiS F01tSUp1 Pq4JECTS WIiN A CqffMCTOfySj LICENSED fURSUANTTO THE CONTMG ourinrrnrr DESCRIPTION � �duc�seuw.} FEE c :�OIAAIE%EIAPTUNDERSEC. B.ti.C.fOqT1115REASCN Q ',� U r.. DAT� OWNER F- � � ` ;,�� !; UCENSED CONTRACTORS D[CLAAATION � • � � w t ' 1 � I�BY/�FFYBJUNDERPENALTYOFPERNRYTNATIAMLICENSEDVNDERFROVISIONSOFCHAPTEq �r i Y(OOMMENCIIqWfiNSECTION7oW10FOM510N70FTMEBUSINESSM70VRdFE55lON5CO0E,AND Z � W YICENSE IS IN RAL FONCE�yp EfFECT. , m ' � L1C8NSEC SS �� UC;NO. O �� • � .- _. _ .... . ...__ _'_._. ,., . . __ . . . . .. __.-. DATE �D� C CONTMCTOR I WORKERS'COMPENSATION DECLARATION -+ � - U ` INF�REBYAFFlRMUNDERPENALTYOF7E0.1URYONEOGT11EiOLLOWW(3DECLAiUT10NS: z �INAYEANDW4LMAMTNNAGERTIFICA7EOFCONSEMTOSELFdNSUHEFOHWORNERS' _ . COMPENSATION,A4GROVIDEDBVSECTIONJ1000FTNEUBORCOOE,FORTNEPERFORMANCE W r OF 1HE WOHK FOR WHICH THIS VEii1AR IS ISSUED. � vT I HAYE AND W7LL MAiMfA�N V/ORKERS'COMPENSATqN INSUMNCE,AS RE W IRED 8V SECTqN �� �7ooOFTHEU80RCO0E,FORTHEPERFORMMICEOFTHEWORKFORWHICHTH15FERMITIS ,{ ISSUED.MYNVPXERS'CdAPENSATIONWSURANCECAARIERANDD0.ICYNUMOERME: CONSTRUCTION � WiRIER NW PUW REVIEW '� VCIICYHUAIBER � r � '�,�' •t, ELECTRIC .� . : (Mss[cm+rlE�wfBEaoM1ET�OfhEPEaMT6PoRu+EIUDPLDOCttA0.sfsiool�tEss1 PLUMBING ,�f�h ICERTIFY7HATNTMEPERFORMM7CEOFTMEWORKFORVMId1THI5PEiWIiISI55UED,l MECHANICAL SWLLLNOT EMPLOYANV VERSON M ANY IAMlNER SOAS TO BECOlAE SU&1EGT TO THE WOi1KE0.5C01APEN5ATqNUW50FCAl1FORNIAAN�AGREE7MATIF15110ULOBECAME INSPECTIONFEE - �� SUBIECTTOTHEWOiiNERS'GpAOENSATIONVROVISION50FSECTION]7000FTMEUDOR OOOE,1 SHALL FORTHK'ITN C01.�PLV W17N TIIOSE PIIOVISIDNS. ISSUANCE • � SMIP DA�: APPLICANT. � • WAfyJtN��FAIIURETOSECUHEWD1iKEFS'COMCENSATIONfAVEMGEISUNLAWFUL.ANOSHALLBE ENERGYP/C 6UqJECTANfMPLOVENTOCPIMWALPENALTIESANDCMLFNESUPTOONENUNDF[OTMOUSAND ENERGYPERMIT �,� OqUR5�f10o.000),INADDITONTOTHFC0.STOFCOUPENSATqN,DAAIAGE5A5PROVIDEDFORIN ,.� SEOTION�7os Of THE LMOR COOE,INTENEST,MlDATfbRN[V5 FEES. RETENTION FEE' . ��±r` CONSTRUCTIONLENDINGAGENCY PRE-ALTFEE: ;,,� IHq1E8VAFFlRIAUNDEROEN.LLTYOFPERttJMTNATTMEREISACONSTRlKT10NLEN�WOACENCY 2 yyq SNE OERFORMANCE OF TME WORK FOR WMICNMIS 7ERIAIT IS ISSUED(SEC.9oo�,dV.G�. ��.W �/"� .� ' ::� LEt+i;ER'SNM1E . . �,,,. � LEIiOERSADDRE55 W I'C�R71F`/TNATINAVEPEADTHISAPPLIGTqNIiNDSTATETwlTT1EABOVEINFORIIATIONLSCORRECT. TOTAL FEES . �5�� �� � IAGREETOCOMPLYWRH/�LLCRYANDCOUNTYORDIHWCESINOSTATEUVV5RE41TINaTOBVILDINO ; � Cpl3TRUCTqN,ANDHEREBYALRVqRIZFREPRESENIATVESOFTXISCOVNttTOENTERU�ONT11E - l�BOVf�MENTIONE PROPERTV FOR WSPECTION PURPOSES. o COMMEMS G G /�cl e P n �� . . � � � � (A B PERMIT7EE , DA7E � RECPT.N P/UD BY VAUDATION WHITE-0epartment Copy,YELLOW--Fnence Copy.PINK—Aesessor Copy,GOLDENROD--File Capy,GREEN—ApplicanCa Copy �s - , CITY OF DIAMOND:BAR . , �. . - �: ;:R�SPECTlO��t RECORD _ _ ,.:� � . � � , ° f''�;���������1 ��:��.-�� �l►'��,�.��d�.R. . .�. .� I►��.��„7�.�+tp[e:1���+��i.¢��y•V,,�� _-IR��-i t s r��ce ._�. - --- � . ._ . ......�,. ._,, ,.. �SET BAGk` .,:� �_� I��� 1(' _. I � , � 1 � � i\ FLO�R,Jp15T . _ '� ..: ,.�' -- -- � �--- :.`�.. _-=-r—�_.;. �FTGS/FORMS/STEEL' . ,.; � � , � .� ' � .- _ ^ _ , , ; � . _ FHA REQf�ATS ' _ . + _l_�__.. I ELECTRIC GROUND_ _ . � _. .� �' � `-' l �y UNDER FLOOR DUCT- ' - ` - . -. _ _ ; ' I ;� -- - ^--._�-- GROUND PLUMBING UNDER FLOOR CU��IDUIT - - r ' :. ' -_--___-' - SLAB GRADE - -- - ' ' - ' FIREPLACE FOUNDATION , ; I r TEMP POWER--- —_ r"••I•�?S �'... ,.�.�{-.-... FIREPLACE BOND BEAM _ _ � � ; WATER SERVICE_ _ _ _ �-�" MID HT. B�JND���EAt�°I�'- �_`�'�'' 't -s�. -• �+'� ; � a � I t; _� � r. . � _ r. '.=.�-Y,.1 ��'-_� \ . r ; + i•, -1 �ROOF\SV��TF�If ,1t 1 1��, 1 ,� � 1 8 FT. BOND BEAM.' �' . .�• ,.. , ` . ,�,� +=t-�-�-i-; � ,-• � 'FflAMINGNEN IL'�A71 ,:'1 '•� ,� ",-'1: FINAI bND�BE,�M . , � �.� ' ;ROCIFCOVF_R .�.�. �� � . _ . f . . . � : PRE-GRADING - �'- Y-- _. . ._ - " .[� � ROtJGH NEATING --- -='..� ` ' BENCHING . __ .-- -- .. __ �:i ; 'ROUGH ELE�TRIC ' _ ` .� '� ' ROUGH GRADING `� I . 'ROUGN PLUMBING- - - - ' FINISH GRADING SHO�VERIfUB TEST - - - - POaL ELECTRIC r • ' � , �EXT.Lf,TH/SIDING _ __ __ _ . _ _ . ; __ POOL'FENCING � ` � , � ' f V'JALL INSULATION _; _ . ._ �. _. _.. . _ POOL FINAL � __�_� ?GE►LtNG tNSULATION -� - �� - ' OFE SITE IMPS. . --==-1I------------=---- - DAl'V✓At.t NAILING i -- - - �EDICATIONS � -, i _l__�___.—�_.:,-��._, �SEWER ___- _ _ __ _. ___ _ _ -FINA�'ENG. � I . � -: SEPTI�,TANK LANDSCAPE/IRRIG. I � � SEEPPIT/LL. ON SITE IMPS. � I GAS�,Ifi�EST � ` ' • , FINAL ZONING `� I ` ` � , : FI� — `-____` ' �.-� ^ � -._-_-- �' , � �' ,'t.�.-)� FIRE DEPT. FINAL 'FIt�1,L HEATI G . - .� . , . ,- '. ^. � � ' HEAL.TH DEPT. FINAL - -- -• � - , '- ' ��'��t,l_EIECTF� l. �: . J,�'.�� -�. . �1' DEV. FEES PAID _ � . _. _ _ _. • � --- - - - , :.lr,,t-PLUF.'!BING -- � ENERGY . , , !+�._. -- -- - , �� _ _ . i - � ______, , . - -- - , . . � ,.-- �..- ..�..x..�..�� ..._._. � ____ _. _ .__ - - - - I , , _ ._ _ . 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