HomeMy WebLinkAbout17692 (32) .�..,. ,. . � . . - .. _._:.. :......... .. .__� ..._ ..____--_1_.--�----• - .. ._ . . . .. _ ._ .__ . _. . . . .
�� CITY OF DIAMOND BAR '
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
Z 1825 E.Copley Drive
(909)860-3195 Fax(909)861-3117 PRESS
"�•�' BUILDING PERMIT APPLICATION ' FIRMLY
oN JOBSITE � � C-�1(� DATE CATION��^��(^(1 NUMBER���#/C
ADDRESS tJJ Vd�
c� ISSUE TYPE OCC
APN LOT T ACT DATE CONST. GROUP
p OWNER
" ADDRES ZONING SETBACKS
SC ZIP TEL. REAR RW O
APPL TEL. SIDFJSIDE STREET RW ❑
� CONTRACT R SIDE ❑
� ADDRE�S PROPOSED USE
� CITY�e ZIPQ� TEL ^
o ARCH/ENG/ � �
iz DESIGNER NO.DWEL. NO. O.
a ADDRESS UNITS STORIES ' BEDROOMS
� CITY ZIP TEL
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECUWATION SFR/ADDlREM
O
p 1 HEREBY AFFIHM UNDER PENALN OF PERRIRY THAT 1 AM E%EMPT FROM THE CONTNACTORS�I• G0f8g0/C8(pOR
W CENSEUWfOR7HEFOLLOWINGREA50N(SECJ001.68USWESSANDVROFESSIONSCODE:ANYd7YOR (�
U CGt1NTyYMICHREOUIRESAVEFMITTOCONSTRUCT.ALTEiLIMPROVE,DEMOUSM,OHREPNRAN'/ST(tUC• W P8110/DBCk
� 7UHE.FRIOq TO fT4 ISSUANCE,AL50 fiEd11RES TME ADPLICANT FOR SIKH GEiUAI7 TO FILE A 61GNED W
STATEMENf THAT ME OR SME IS L/CENSED PURSUANT TO THE PROVISiONS OF THE CONTMCTOR9 tl•
� CENSE UW�dU�TER Y(COYAIENCIN�WITH SECTION 7000�Of OMSION]OF iME BUSINESS AND PRO- � POOUSp8
fE5S1ON3 COOE)OFi THAT HE OR SHE IS EXEMPT THEREFfiOM ANDTHE BA515 FOq THEALLEGED EXEMV•
� 710N.11NYVIOUITIONOFSECTION70]1.66YANY1IPPLICANTFOflA7ERMITSU&IECiSTHEAPPLIC/NiTO Z Ra-Roof �
A CML iENAL7Y OF NOT MORE THUJ FNE MUN�HED DOLURS{fsoD).�:
ZD�ASOWNEROFTNEPHO�ERiY.ORMVEMVLOYEESWITHWACE5A57NEIp5plECOMPENSATION. 0 Commercial -
WILL DO iHE WORK IVlD THE SIRUCTURE IS NOT INTENOfO OR OFFEREO FOR SALE(SEC.70N,BUSI- J
N NESSAND VROFESSIONS WDE:i)7E CON7MCiORS LICENSE lAW DOES NOT APPLY T0 IW OWNER OF �
PROPEHTYW/peU4DSOFlAUPROVESTHEREON,MIDNnqDOESSUCMWORKHIMSELFORNERSELFOq m
� TIROUGHHISORHEROYMEMVLOYEES.iROVWEDIMATBUq/MPROVEMEMSMENOiINTENDEDOR
� OFFEREDiOq5ALE1F,11GWEVERTNEBUlDiN60NWGROVEYEMLSSOLDWITIdNOJEVEAROFCOMPLE•
Z TION.TNE O'�NNER�UILDER VALL HAVE TME OUROEN OF PROVINO 1T1AT ME OR SHE DiD NOT BUILD OR
� IMPNOVEFORTMEPURPOSEOFSALE}
❑�AS ONMER OF THE PROPERTY,M7 EXCIUSNELY CDNiMCTINO Mn711 LICENSED CONTMCTORS
� TO CONSTRUCT TME VRQIECT(5EC.7N1.B1151NE5S AND PROFESSIONS CODE:TXE CONTRIICTORS LF V8�U8lipl � AQI.AREA
� CENSE UW DOES NOTMPLV TOAN ONMEH OFA PROPERTY W1108UILDS OR IMPROVE4 TMEREON,ANO
MRpCONTAACTSFOfi5UCH7ROJECT5W1iMACOMMCTOR(5)LICENSEOGURSUANTTOTMECONTMP pUAN717Y OESCRIP710N FEE
� TOpStJCENSEUW.}
� OIAAIFIff1APTUNDERSEC. B.IP.GFOR7HiSREA50N Q
� U
li. �
D�� owr�ea V
z w
� LICENSED CONTRACTORS DECLARATION W
� IHEREBYAFflRMUNDERPEWLLTYOFiEfWRYTHATIAMLICENSEDUN�ERPRON510N50FdiAiTER Vr
d Y(COAIMENCINO WRH SECT�ON 70001 OF OMSION]OF T11E BUSINESS ANO PROFESSIONS CO�E,AN� Z
�f MY UCENSE 61N FULL FORCEAND EFfECT. .
� UCENSE CUSS�'�_UC.NO. �� �
V DATE CONTMGTO a
W
� WORKERS'COMPENSATION DECLAHATION Q
NIHEREBYAFFIRMIMDERVENALTYOFFE0.NHYONEOFTMEFOLLOYVINGDE0.AM7qN5: Z
4
� �IHAVEANDWILLMAMiA1NACENTIFICATEOFCONSENTTOSEIF-INSUREFORWOHKERS' 2
, COIdPENSATION,ASPRONDEDBYSECTON71oaOFTMELABORtOOE,FORTHEFERFORMANCE U
Q Of THE WORK iOR WNiCN THIS VEM1tT IS ISSUEO. �
�
W IHAYEANDIMLLIM�MNNWORKERSCOIACENSATqNINSURANCE.ASRE0U1RED8VSECTqN /+�.
� J7000FTHELABORCWE.FORTHEPERFORMNICEOFiNEWOfIKFORWMICH7HISPERAIITIS a.yyL.3O
� ISSUED.MY WOCR1(E_19s,., PENSATION INS NCEcM.1 RIER AN�FOLICY NUMBER ARE: CONSTRUCTION � ��
y c+wwEa ��[.��'� �Y1l71 _ _ 1 PLANHEVIEW
� GOIICYNUMBER � �O ELECTRIC
0 (I5l;sECIY�NNE�NOfBE00AA0.£IIDOFTEPEP1.fTBRIRONEH1Fl%�EDDOl1MSR�0�lORLES�. PLUMBING
Z (CERTIFY7HATNTHEGERFOqMANCEOFiHEWONKiORWHICHTHISGE{WITISISSUED,I MECHANICAL
C7 S/ULLNOTEMVLOYANYPERSONINM7YMANNERSOASTOBECOMESU&IEGTTOTNE
y WONNERS'COIdFENSAT10NUWSOFCALIF NIqA DAGNEETHATIF HOULD9ECOIAE INSPECTIONFEE
S SUBJE TOTH WORNERS'COMVENSA P SOFSECT 7000FiHElABOR
C�e �u an�wirHcaattr iswNs. ISSUANCE a
� �J SMIP
`p pA?E:�^ AVRICA : -
J WMNINO:FAILUHE TO SEWRE WORI( ENSATION COVEM6E IS UNUWFUL,AND SNALLBE ENEFGY P!C
�y SUBJECTAHEMFIAYERTOCFiMWA�VEN �SANOCMLFWESUPTOONEMINDHED7YrDU5AN0 ENERGYPERMIT
W6UR5(f100,000),IN�DDITIONTOTNEC TOFCOIAPENSATION,DMIAGESASPROVIDEDFORIN
¢ SEGT�DN]loe OF iNE LABOH COOE,INTEREST,ANDATTOIiNE`I'S FEES. RETENTION FEE: .�O
nw. CONSTHUCTION IENDING AGENCY PRE-ALT FEE:
O
� IHfilEBV11FFIRMI/NDERCENALT OFPERNRVTHATTHERElSACONSTRUCTKKJIENDINaACENCY
FORiHEPERFORIA.WCEQF�(i�KFORWHICNTHISPERMITISISSUED(SEC.�oY7,CiV.C�.
� LENDEiYSNAME_ N
C LENOER'SADDRESS
� ICE�FYTIMTIMAVEREADTMISAPPLIGTqNJWDSTATEiHATTMEIIBOVENFORMATqNISCORRECT. TOTAL FEES I ��'V/�
W IACREETOCOy PLYWITHALLCRYANOCOUNTYORDMANCESANDSTATEUWSREUTWOTOBUILDIN6
CONSiRUCT�DN ANDHEREBYAUiF1OR2EREPRESEN7A7NE50FTNI5CDUNTv70EMERUVONTHE 1 v
ZABOVEyc+R7qNED ROPER7YF SPfCTIONVURPOSE COMMENTS
� �
� rc7
m PER NAME i n
Q
N
TUR F V ITTEE DAT
� RECPT.NO. _PAIO BY VAUDATION
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy.GREEN—ApplicanYa Copy
f"1' �.:'h:i.qT -: t�pri,�..��,s n'aTr.l^i.Cr.i...ym•1:1 Fl:_YI�YI����l: r ��y�.lu�•�•q'a:.,o�.ri`++r:.. ...k�AfN.•r,rrw'v.�vr�n!�v��y�..y„w� .� . .. .-�.�........i..r,�a•4q:n�•e�J'yr'r..r�. r.,n . �.- ,..-...
� CIT`�'OF DIAfV10h1D.BAR � �
lf�4SP�GTiON RECORD �
_ _ . . , �.
. _�-
.��
.:a�.►'.�������I�`��. :..: . .��'�d� � =i���:Et���o,l,:�. .--`- ��,l�r:�:a����i�e�'��. ` �"���i�i�!� :.�►:1►r. 'T�.�?..� �� .
SETBACK . _ _ _._.._�.._.�-.. ;,. "'_..'. - FLOORJOIST' 1'i •� � ' ; _.
----��
FTGSlFORMS/STEEL ! FHA REQMTS
ELECTRIC GROUND . � UNDER FLOOR DUCT . , �., - - - '
GROUND PLUMBING UNDER FLOOR•CUNDL117 - � '-� ' _�
SLAB GRADE I FIREPLACE FOUNDATION ' � ' �
TEMP POWER I � i FIREPLACE BOND BEAM � � •
WATER SERVICE I �_ _ � MID HT. BOND�BEAM ' ' • ' - '
ROOF SHEATHING ���Z ' '� 8 FT.BOND BEAM.�� r � I. ,
FRAMINGNENTILIATION j��,/ _� � FINAL BOND BEAR1
• ROOF COVER . �G�LT�O-=z=�-aC%r/ PRE-GRADING
ROUGH HEATiNG � BENCHING
ROUGH ELECTRIC I ROUGH GRADING
ROUGH PLUMBING ; FINISH GRADING
SHOWERffU6 TEST I i POOL ELECTRIC
EXT. LATH/SIDING ( � j I POOL FENCING
WALL INSULATION , � i POOL FINAL
CEILING INSULATIpN OFF S17E IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTICTANK � LANDSCAPE/IRR�G. j
SEEP PIT/L.L. - OfJ SITE IMPS.
GAS AIR TEST � � ! FINAL ZONING
FINAL CONST. ,Z� Z ` � � �lRE DEPT. FINAL
' FINAL HEATING I HEALTH DEPT. FINAL
FINAL ELECTRIC I I DEV. FEES PAID
FINAL PLUMBING I I ENERGY
� I _ .
� fL^�� ICr�:+�t��C, . � ��
COMMENTS
E - _ _ _- ---
, , , - . -
��� �
, .
,�, -
� SEPTIC TANK SIZE
SEEP P1T/U SIZE �
��,� �� •
.._. .. _ -. ... j
'�l�i � '. , , ' 1��
.b.�' . _ . �`�
1
, . � .
.,�.�..:..�...�...=�. ,� ; ` i;�,