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�� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES '—' ' 21660 E.Copley Drive Suiu 190 (909)860�3195 Fax(409)861-3117 PRES$ ���� BUII..DING PERMIT APPLICATION FIRMLY � JOBSITE /}�� APPLICATION ! o ADDRESS �0 • ��-I) � DATE � � � NUMBE � k� � ISSUE TYPE OCC APN LOT T CT DATE CONST. GROUP p OWNER o ADDRESS ZONING SETBACKS � CITY ZIP TEL REART RW ❑ APPLICANT TEL. SIDE/SIDE STREET FiW ❑ � CONTRACTOR �S�,�C—s�"�� SIDE ❑ AODRESS � � C(TY ZIP T���� PROPOSED USE .P�+ ARCHlENG/ � '' �S� � DESIGNER NO.DV'!EL NO. NO. ADDRESS UNITS STORIES BEDROOMS � CIN ZIP TEL. N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER•BUILDER OECLARATION SFiUADO/REM Q � 1 HEREBY AFFliM1 UNDER iEN�1TY OF VEiWRY THAT 1 M1 E%CMo7 FfiOM 7NE COI.TMCTORS U� GOfHQB/C81pOR W CEHSEUWfORiMEFOLIOWWORFASON�5EG.70.71.69U5WE55iW9PHOFE55qN5CODE:M7YqTYOR (n � COUNiYWHICHREOUIRESAVERMRTOCONSlRtlCT.ALTER�MPNO�E.00AIOLISH,OfiFCCNRMlYSTRUC• W patiO/Ded( TURE.PPqH TO rt5 65UA4CE./�150 R[WIRES THE AFPUClJR FOR SUCH iERMIT TO FlLF A SIGNE'J w � ETATEMEM THAT HE OR SHE IS LICENSED VURSUAM TO 1HE DROVISIONS OF iNE CONTRACTORS LL � CENSE U�M�CHAPTER Y(CdAA1ENCMU VATN SECTION 7000)OC pIVIS�ON f OF TH[BUSiNE55 AN�VM u- PooVSOa FEuuNN5CO0E70RTH�THEOR5MEI5EXEMPTiMEREfF10A.lANDTHE8tiSI5FORTMEAI.LF�EDE%EIAP- � T10N.NIYVIOlAT10NOF5CGTION70]7.6BYNIYMVLIG�RfORAPERMITSU&IECTSTHEAPP�ICANTTO Z Re-Roof F,,, A(�LVENALiY OF NO7 MOf7E 11UW ME MUNDRCD DOLURS(t5o0).): � OI,ASOWNEROFTMEVROPERTY,ONMYEUPLOYEESWITMWAGE5A5T1�EIR50LECOM7CN5ATqN, Q (�`pTrtl0fLi8I ' WILL DO iNE WORK AND THE STRUCiURE IS NOT INTENDED OR OFFERED fOR S�LE(SEG)0�1.BU51� J N ME53 AND VROCE5510N5 CO�E ME COHTMCTOiLS LICENSE UW DOES NO7 APPLY TO AN OWNER OF = PROVERTYVIIqBVRDSORM7ROVE5THEREON./WDNSqDOE55UCHNCIRKNIYSELFORMERSEIFOq m Q TNNOU�IIWSORHEROWNEMPIOYEES,PFIOVIDEOTHAT5UC+11�+PROVEAIEMSARENOTWTEHOEDOR � OFFENEDfORSKEIF.FIOWEVER7NEBV4DMOOHUAPi10V[MEHi1550L�VniHYONEYFAROFCOMPLE Z 'T10N,ME OWNER�BIAIDER MALL NAVE TNE BVRDEN OF PROVP10 THAT HE Oq SHE DID NOT BUILD OR = p1VipYEFORiHEPURPOSEOFSLLE�. W ❑4��EROF7HEPROPE1iTY,AME%ClUSNELVCOMMCTiNOWRTILICENSEDCONTMCiORS Q' TO CONSTRUCT THE PRO.IECT ISEG 70w,BUSINESS AHD iROFESSiONS CODE:THE CONTMCTORS L4 V�:u3ti0f1 ADJ.AREA IlJ CENSEUWDOCSNOTAPVLYTO/NONNEROFAPPOPEH7YW11DBUMSORYAVROV[STHCREON.AHD � YAIOCOHTMf:TSFORSUCHGPOJECiSMA7HACOMRACTOR(S�LICENSEDCURSUAHTTOTMEOONTRA4 OUANTITY D[SCRIPTION FEE � toasuccNSEuw.�. J � ❑IIW EIIEuvT UNOCRSEC. B.f P.C.FOR TMIS PEASON Q 3 � � "-- o�re cvmen � � LICENSED CONTRACTOFlS OECLAAATION � � w IHEHEOYAiFYiYUNDERPEWLL7YOFGE0.NMhUT1AMLIGENSEDN�OERPROV15�ON50FCNMTER � /l 1 � �(COYYENCWOri17N5ECTION70o010FOM5lON�OFTMEW5:NE55�kDVROFE551DN5CODE,M10 Z V W UCENSE L^N FIAl FOHCEAND EFfECL � Z /� � � LICENSG CU55.�_y.��(LIC.N0. � � �j UATE ��II�O I GONTMCTOR _� �- W � WORKEFiS'COMPENSATION DECLARATION a � U N IHEREBVAFFIRMUNDERPENALTYOFPEiUUNYONLOFiNEfOLLOWINGOEUJlRAT10NS: N Z Q O �I NAVE IV1D MnLL 1AAMTAIN A CERTIFICATE OF CONSENT TO SELFaNSUPE Fpi vNNKCRS' S � � COYPENSA7pN.A5 VROVIOED BY SECTON 710o OF TME UDOH C�CE,FCR THE VER�OfUAANCE W OF iME Y✓ORN(OR VA1!CH iM15 DERuIT IS ISSUED. � 2 �I MAVE/�ND WILL IM�MAVI WOP�(ERS'CO�+PENSATqN WSURANCE,AS REOUIRED BY SECTqN O �700 OFTME LADOR COOE.FOH TNE PERFO�M�J+CE OF iHE WOPX fOfl WHICMiHIS PERM111S — LSSUED.IAYW0/1%ERS' FENSATIONINSURANCEGARIER/WDPOUCYNUMOERME: GONSTRUCTION � ��Eq� � -S' PLAN REVIEW > — - .. o va�crNuuoEa �J l� ELECTRIC d fn+ssxcna+u[IDr+oreemn��re�aFneacw.Rswr+as�ooaUr�sa+m7a+icssF „p11161II+aG— • � Z 1 CERTI�V THAT N THC OERFOiiWNCE OF TNE KORN FOR WHICM iM15 VERMIT LS ISSUE0.1 ME-CHANICAI ��} SrtALINOTEMPI.OY/wvPER50NINANvuMNEnSOASTOBECOAlE5U0.1ECTTOTHE � WORKERSGOMVENSATpNUw50FCALIFORhItiANDAGRiETNwi1F15F1oULDBECOME INSPECTIONFEE S " JELi TO TME M/ORNERS'COM�ENSA710N PiYJV'SIONS OF SECTION�1o00F iH[IABOR cooE,isiuLLconnnvirnca�r�rmrntN s¢rRrnnsar+s. ISSUANCE O p OATE:� APPLICANi: ' 'h) SMIP � ENERGY P/C WARNINO:fAILURETOSELLREY+ORKERS'GOMPENSATIONCOVEMGEISU ..�wFl/4AND5HALLBE �y SUOJECTANEMPLOYERTOCR:MIN/�LPENALTIESMlDCIVILFWESUPTOONENUNDRfDTHIX15AND ENERGYPERMiT DOLLIIRS(1100.Oa0L�N�DOIiION TO iHE COSTOF�pMPENSAlION,DNdAGES AS VHOWED FOR IN ¢ SECTION]]OeOFi1+ELABOf1CO0E,INTEREST.ANDATTOiL4EY5fEE5. RETENTIONFEE: pw„ CONSTRUCTION LENDING AG[NCY PRE•ALT FEE: O � IM[REOVAFFlMIUNDERVENALTYOFPERNRYTHATIHER[ISACONSTRUCTIONLENDWGAGENCY Z FOR TNE GERiORAUNCE OF iHE WORN FOR N7/1CM THIS PERMiT IS ISSUED�SEC.bY7,CIV.C.�. W �Z IENDEN'S WUAE � C IENDER'SADDRESS �" d ICERT1GYlHATIHAV'eREADTNISAPPIICAT10NM105UTETHATTNEAAOVENFONAATqNISCAPRECT. TOTALFEES eli�G'�� W IAGREET000IACLY'M!NAILCrtVAN�COUNTVORDINANCESANDST�TEUWSREUIINOTOBUILDING �' CONSTRUCTION,ANDMEREOVAUiHOHiZEREPfICSENTATNE50LT115COUNNTOENTERUPONTME ZABOVE�MEMICNCDiROPERTYFOFtINSPECTIONPVRPO5C5. COMMENTS o ����� _ m PERM�—�PaM, �y � 2 ` Q . N � S�G fUREOFP IUIITTEE OAfE � fiECPT.NO. PAID BY VALJDATION WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessa Copy.GOLDENHOD—Fiie Copy,GFiEEN—�icanl's Copy _ , .�- Ctrux-�a' --- � �, � CITY OF DIAf��fOt�lD BAR , . . , � .. „ � '� - - . .,. ;,�. It4Si�ECTl06� REC�OP,� . -� _,. . . , , . '� T.• ��� '�-'[`-'+ ±(�'1��. 6)n1; � � ;1�e; �,J=� �r+� �� `j.a-'�' l�+l►°1;*'��is.![ ��:1''= � � �1�'d't'r. �--. ., .,, _, . . J► 7� �.�.E .J _.. �'_ (RE-�_ �`iF,_. .• ►4- �.._, � . _i- _. �i►F-y _._, _7c�� �..�^..�....._._.�.............._�,.,._,�.--_...._...._,....�__.__..__....__...____ � �....._ ...,.... . ... �...___._... ... ......_. ._. .. . ..... . . . .. . SCT 6ACK •. . � � ' � ^ FLOO � ' . _. ,. - . � . � . � ' . ( R�tJiST � . , � . • • ' ' ' . --�'-�—�; � � - � ' ---- - :FTGSfFOR�.'S!STEEL� . � . ll FNA R�Q"�"T5 ' . , . � .`,, . ---- 'EL�CTRIC GROUND � _- I � UNDER FLOOR DUC7 l , . _.^ ! . GRDUND PLUt•�BING I I._I UNDER FLOOfl CUP�!DUIT'' i I` ' t' �I '`.� �. � ' ^__ _ 'S!_AB GRA�E I _�_ i�IFiEPLACE•F3UNDATION ___ TEP,�P POVdER � • I I FIREPLf.CE BOND BEA��1 ' �WATFR SERVICF � � MID H7. BOND BEA,P.1 '. . ' .•, � , _—� ROOF SHEATHING � I I I 6 FT. 60PdD BEAh1 - . . ; �. ,.. -. ` ; , ;FRA"Al��a!1,�ENTILIATION I + � FINAL E3��D 6EF,?JI � � � - � 'ROOFCOV�R I I I � PRE-GRF�DING � - �ROUGI-I F?�ATI�G � BENCHING � AOUGf-I E�ECTRIC � _ I� ROUGH GRP.DING _ �R�JGt-� PLUi�"BING - � � � FINISH GRADING _�-- ---- �SHOb'JER:ri'UB TEST . � POOL ELECTRIC � �— • __ i�1;T. LATH.'�IDIlhG - POOL FENCIFJG • � :"JALL iNSUtATlO"t - POOL FINAL �------ C�I�I�JG it•:SULATION ' " OFF SITE IP�1PS. � ;DRl�1"JA.tL NF,IL1idG �� � DEDI�ATIONS ;S�i".'cR I � � FINAL'E(.G. -j �--•---- iSEPTICTANK i IJaNDSCAPr11RRIG. _ � � — ;Sr'E� P;TlLL. _�� � ' O�J SITE IP�1PS. ; � � u�:S 41R TE�i � � FIN�L.'_ONI�:G TF�; �,: t.0`d�i, I I I Flr:E DE?T. 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