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HomeMy WebLinkAbout11888 (5) �� CITY OF DIAMOND BAR • / ,� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 � �� (909)86Q3195 Faa(909)861-3117 PRESS ���'"". BUILDING PERA�1'APPLICATION FIRMLY � JOBSITE �23 a ADORESS ��bi'I ��Y1� C��'� APPLICATION PERMfT p� o DATE_ I4 J23�l1��_NUMBER N � APN LOT TRACT �SSU[ TYPE OCC p OWNER WG�'�1���'P,A,. DATE CONST. GROUP p ADDRESS 1.A 1 20NING SETF3ACKS �w CITY _ A4tW1nin0 '�7A�(L ZIP �1(9'S' TEL t - 'U. FRONT qy� � APPUCANT��j�{r�^nT_ TEL. ���,g REAR � � SIDE/SIDE STREET RW O CONTRACTOR SIDE o ADDRESS � o CIN ZIP TEL. ROPOSED USE l.nC�ZsS �� -'`Y'�-�1{1 C���p.(��y '� o AflCH/ENG/ —���,�.� 1L� � DESIGNER t'����mAt�.���- ADDRESS N0.DWEL 'N � N � � C�TY ZIP TEL. UNITS STORIES BEDROOMS N DESCFi1PTION S0.FT. FACTOR PSF ADJ.AREANALUATION ¢ OWNER-BUILDEFi D�CIAAATION p SFR/ADD/REM e 1 HEREBY AFFlRY�1NDER iE1LLLTV OF FERIURY TMAT 1 MI El(EMPT FROM 7HE CONTRACfpf15 U� GOfe 9/C0 � CENSEUwFOHTXEFOILOwiNGRU50N(SEC.70.7i.6BV5WES5AN0YROFE55qNSCODE:ANVCITVOR (n 9 �K OOU1(T�WMK]1REONRESAVERl1R7000N57RUCT,ALTE0.��ROVEDEMOLI51{ORREiNRANYSTRUC• W patiwDeck TURE.PRqfl TO RS ISSUANCE,ALSO REOUIPES THE APVLICM7i FOR SUGI GERMIT TO i1LE A SIGNED W � STATEMEM h1AT HE OR SHE IS UCENSED PURSUAM TO TME DROVLSIONS OF TME CON7RACfORS LI. � CENSE lAW�CNMTER Y(COYUENGRxI WITISECTqN 7000�Of DMS�ON 7 OF THE BUSiNE55 AN�PAO� � PooUSpa FE5510NSCOOE70Ri11ATHE0i15ME1SE7fFlAPTiHCREFRpAAHDiNEBASISFOqTHEALtE6E0E%EMP• (� TION.AHYVqLAT10NOF6ECT10N7071.6BYANVAPGLICANTfOiIAFERMIT5U0JECTSTNE�PVLILANT7p Z Rg-ROOI � ACIVIL NALTYpFfqT►qpEhlANiIVEHUNOREDDOLUPSIt�)l: O tti40WNENOFTMEiROVERTY,ORMYE�7L01'EESVATHWAGESASTHEIRSOLECpMPENSATICH, O Cpmmerciai _ Z WIl1 TNL YYOFBC.ANO 7NE STia1ClUfiE IS NOT INTENDED ON OFFERED FOfi SALE(SEC.70�1 BU51� _I , � I�ffSS IVO 7ROFESSIONS COOE:TNE CONTMCTORS IICENSE UW�OES NOT APPLY TO AN OWNER OF � VROVERTY NR10 BURDS OR MPRpVES iHEREON,ANOIMq DOES Slltl/WOfiN MIMSELF OH HERSCLF OR ' � THROUGHIp40RMEROWNEIIPLOVEES.iRDNDEDTHATSUCHWPRpy[A/FMSM[NOTMENDEDOR m �l� OFFEREOii�RS/lEF,HOWEVERTMEBULDINOONMPROVEMEMISSOLDWITHINONEYFAROF�C4PLE. Z TION.THE OWNEHbU1LDER WILL NAVE THE BURDEN OF VROVINQ TlUT NE OH 511E D�D NOT BUI�p Oq = MPiqVEFORTHEPUi7PO:EOF8ALE1 �y,� ❑I,A4MMIEROFTHEPROPER11/,MAE%CtUSrvELYLOH�RACiNOWITHIICCNSE�CDNTMLTORS � N OOHS7i1UCf TMC FR0.IECT(SEC.70u,BUSINESS AND PROFESSICNS C00[:7ME CONTMCTORS ll• f� CENSEUwDOESNOTMPLYTOANOYMEROFAVROPEHTYVh10BUILD50RIlAPROYE57HER[ON.IUdI �� Y���� ADJ•AREA � 1MNOCOHfRACTSfORSUQ1VfqJECTSMATHACONTiUCTDR�S)UCEHSEDPUNSUAHTTOTNECONTMG pUANTITY DESCFiIPTION 7oRs uc�sE uw�. FEE � O 1 Au IXEMPT UHOER SEG 8.i P.C.FORTMiS REASON Q � 3 � , , . � DA1E � ONMER F- , � U �d LICENSED CONTAACTOFiS DECLARATION W [L IYIEREBYAFFU»JLNOERFEWLLTVOFPERM11RVTU71/WIICENSEDUNUERPl30Vi5qNSOFC1iA➢TER � p� �(COMAICNClNUWITNSECf10Nt00o�OFDMSION70FiHEBUSINE45NiDVROFE5510N5CO0[,AND Z X W�ICENSE IS H FUL�FORCE ANO EFfECL m � LICENSE CLASS IIC.NO.� � �j DATE GONTiUCTOR d W � WORKERS'COMPENSATION DECLARATION a � INEAEBYAFFIRAIUNDERPENAL7YOFPERRIRYONEOFTHEFOIIAW:NGDEClAM710N5- V N Z � �I MA1IE Mp WILL IAAINTAN Il CERTIFlCATE OF CONSCtfi TO SElFaNSUR[FOR VIORKERS' ¢ 2 COMPENSATqN,AS VROVIpED BY 5ECT10N noo OF iT�E 11t30R C00E,FOR TME PEFiFOR4ANCE U Q OF TNE wO�K FORwFnpi T/n5 iERMIT IS ISSUED. � �I HAVE IND WILL MAAMATI N9q7(ERS'CDAIPENSATION MSUMNCE,AS REOUIRED BY SEC7ICN � Q �700 OF 7HE UBOR COD[,FOR TIE CERFOFMANCE OF h1E WORK FOR WNICn Mi5 PERM1715 ISSUED.WNOfV(ERS'COYPENSATIONINSURANCECARfUENANDVOIILYMIMBERME: CONSTRUCTION � / j GANER PLAN REVIEW G � .. � P0.ICYNUMUER ELECTRIC ' � (1Fc:5[Ci10NN[mNOTBECOMlE7IDCFTEPEiMTBfOHOrLH.fpiCDDCl1/1L5(t:oG1�LE55�. PLUM�ING � ICERTIFYTHATNMfVERFOPAIMICEOFTHEriURKFORWMICH7HISPEW.�ITISI55UED,l MECHANICAL 5/W1 NOT EMVLOY ANY PERSON N ANY MNINER SO AS TO eECAME SIAJEC7 70 T71E (n WORKERS'COAIPENSATIONLAN50FCALIFORNi.�11N�AGREE7HATIFISHOVIDBECOME INSPECTIONFEE S SUBJECTT07HEWORKERS'COuvENSATqNVRON510NSOF5ECTqN�7000FTHElABOR / coo�,i sNu1 camivnn�couv�r vnn�n+ose prwhsar+s. ISSUANCE O p �ATE: APPLICANT: SMIP � EN[RGY P/C � WMNM���ALUNCTO SECURE VIOi7NER5'001AVENSATqN COVERACE IS UNUWFVL,AND SMM!BE �y SUBJECTMlEMP�OVEflTOLRIMINA�pENA�TIESANOpVILFWESUPTOONEHUNDRCDTYpUSAND EN[RGYPERMIT � � DO1111R5(f 100,000�,W ADDtTION TO TFIE COST OF�pMPENS�TqN,�AMAGES AS PROVIOED FOfi IN SECTION 770E OF iTtE LABOR COOE,INTEREST,ANO ATTORNEYS FEES. RETENTION FEE: ' 0 CONSTRUCTIONLENDINGAGENCY Pk[•AITFEE: ��9�A � IHEREBVAFFIRMUNDERVENALTYOFPERNMTNATiNEREI5ACp15TAUCTpNtENUINGIIGENCY /'� �- FOfI T1E VERFOfiM�NGE OF TT1E WORK fOR WMIGH TMS GENMiT IS ISSUED�SEC.]09�,pV.G.). `���� �� LLl � LEr0Efl9 NAM€: ��T�+ , �.r L JI"lt•t3 F-� IENDER'91DDRE55 � w ILERTIFYTHATIMAYEREAUTMISMVUGTqNANUSTATETMATiH[ABOVEINFO{lAlAT10NISCORRECT. TOTAL FEES � � � p_, IAGREETOC�DIAPLYN7TMALLClTYANDCOIMTYOROPlANCESAHDSTATEUNSREUTWGTOBU0.DP70 � CONSTNUCf10N,ANDNEREeVAUTIqRIZEREPRESCIf�A71VE50FTM15GOUNTY70ENTERUPONTHE ABOVE�1AEMqNEDVROCERT/FO(11NSPECiIOND E5. �/�.. l�� / COMMENTS � �p�'L �R(� R �.�J�-�_ _ m �` N oE�l/Ih�/�� � ��3,�1� , � � � ,) N sar+�Tu eo��ififfe•'• DA7E _. S RECPT NO. PAIDBY _WWDATI � WH1TE-0epartment Capy.YELLOW—Flnenca Copy.PINIS—Assessor Copy,GOLDENROD--FileCopy,GREEN�I.pplicanl's Cop� .� '�"' ..- . ' ' � . � ��... . r . . �. l . �.. �, r. . ��. ...�t,�y . . ,.�i . .. . .. . .. . . � , �. ,.. .i. .r a i � .. . . � �, _: CtTY OF DIAMOND BAR . . � ' � i ' � ' INSPECTION RECO�iD . � �• . , � � ... - _. • . . . . � . �c�Yer � , . � . . � � , • - SEf BACK �' � • • '� ' FLOOR JOIST " . ' ' ' . FTGSIFORMS/STEEL � FHA REQMTS ELECTRIC GROUND - UNDER fiLOOR DUCT . . GROUND PLUMBING �UNDER FLOOR CO�IDUIT � � SLABGRADE - FIREPLACE�FOUNDATION - -�- TEMP POWER ' � - '� ' FIRE LACE gOND�BEAM � -' '"""` �""""� WA7Efl SERVICE � MID HT.BOND BEAM - -- ' ' ROOF SHEATHRJG � ' � " ' � 8 FT.BOND BEAM - ' FRAMINGNENTILIATIOfV � � ���� � � �� - FINAL 80ND BEAM ! ' ROOF COVER .� � � PRE-GRADING ROUGH HEATING - BENCHING - - ROJGH ELECTRIC -� - ROUGH GRADING ROUGH PLUMBING - - " - � FINISH GRADING SHOWER/TUB TEST. - POOL ELECTRlC . EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL , CEILING INSULATION OFF SITE IMPS. . DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTlC TANK .. LANDSCAPE/IRR1G. � : SEEP PIT/L.L. - -• - -�'-r ON SITE It�,APS. GAS AIR TEST• -- � - FINAL ZONING FINAL CONST. � y-j��jf %/L+1.7r FIRE DEPT.FINAL � �FINAL HEATiNG - HEALTH DEPT.FINAL ' FINAL ELECTRIC DEV. FEES PAID ' FINAL PLUP�181NG ENERGY t���t� ���„��R" I ' - •a.....___..w.�._�c.s.:l.�.-__.' COMMENTS ' - `�� . �;�����'E, , SEPTIC TANK SI���'�� � , � SEEP PITlU SIZE �3r,�,�r��J'� �,, ' . )�_ f OI�t, .•.. ".��: f4:) . . - ?CiL';� 7%!tC1.3i!t:F ,;���� �, � � � .,. � . _ .,-; � �. , . . . �- - .s ��� � p��►aJ�. . 8 �,�-�r l' �