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HomeMy WebLinkAbout14748 (877) % '" " .. . , _.._ ' .. _�� CITY OF DIAMOND BAR EX P I F'��D DEPART?.4ENT OF COMMUNITY&DEVELOPMENT SERVICES �,� ' Zi�oE.c�iey���s��i90 SEP 1 D 2002 (909)860-3195 Faz(909)861-3117 PR ESS ��`'*"�. BUILDING PERMIT APPLICATION FJRMLY � JOBSITE � 1 APPLICATION� Z PERMff � P/C o ADDRESS I3IJr SO. YA 11�1� V1S'f"[� VP. DATE NUMBER II � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER - Vl O �` ADDRESS'7- � ✓1 � , ' k �F ZONING SETBACKS z CITY r' ZIP TEL. — 1 o FRONT RW ❑ g APPLICANT C .TEL /�.. REAR ❑ � SIDElSIDESTREET RW ❑ CONTRACTOR E L � SIDE ❑ � ADDRE55 � PROPOSED USE CffY -. Y'av ZIP�, TEL. - - 8 ARCHlENG! • � DESIGNER NO.OWEL. , NO. NO. ADDRESS UNfTS ' ' STORIES BEDROOMS = CITY ZIP TEL. -- N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFFVADDlREM O Q 1 HEREBY AFFIRM UNDEF PENALTY OF iEM1RY TMAT 1 MI EXEYPT fFiOM TME CON7MCTORS L4 G818ge/Ce�pOA W CENSEU�MfORT/ffFOLLOYYIN�REti50N(SEG7D71.6BUSv1E53AN0iROfE55lONSCODEMfYCtTTOR (n � COIMiYWFM]1f1E0U1HE3AVEMIRTOCON57RUCf,/llTEftM7ROVE.DEUIXJ5/IORFEPAIRANYSTRUG W PBShIDBCk 7URE.VRqR TO RS ISSVANCE.AL50 REIXIIRES THE APVLICAHT FOR SUCH VEfiMiT TO FIIE A SIGNED W 8TA7EMHdf THAT HE Op 31/E IS LICENSED PURS W WT TO THE PROVISIONS OF THE CONiMCTORS L4 � CFHSE LAW(CHAPTfR 0(CCMMENCINU WITH SECTION 7000)OF OIVLSiON 7 OF THE BUSINESS MID PRO� � PooVSpa FES810M5 COOE)OR THAT HE OR SNE IS EXEUPT iHEREFROM AND TNE BA515 FOR iHE ALlE�EO E%EMP• iqH.N1YV101AT10NOF5ECTION1m7.6BYNJYMPIJCNfTFORAPERMITSUBJECTSTMEMPL1CANfTO Z Re-Roof � ACMIVENALTYOFHOTMOi1ElT7ANFNEHUrAREODOLIMS1i5ooIJ: O ❑4��NEROFiMEFROPERTY.ORMYEMPLOYEE4WITHWA0E5A5TMEIR50LECOMPEN5�7qN, ❑ �mmercial - Z YALL 00 T11E WORK,MIO THE STRUCiURE IS NDT IHTENOEO OR OFFERED FOR SILE(SEC.70a�,BUSM J NE58/1D VROFE5610NS COOE:THE CONTMCT00.4 UCENSE UW DOES NOT MPLY TO IW OWNCR OF N iROVERT71M10BURD30RMCiqVESiHEREON.M7DN510DOE55UCHWORKHIMSELFORHERSELFOR = iFiR0U0HHBdiNERONMEMPLOYEES.PROVIDEDTHATbUp11A1PROVE4ENTSARENOTNTEPDEDOFi m � OffFEt�D PDR SALE IF,IIOWEVE0.THE BUIDW OOR YOROVENEHT 5 SOIL WfiHN ONE VEAROF CdAOLE ��710N,h1E OMn1ER�8UILDER W1LL HAVE THE BURDEN OF FROVUM TXAT NE OR SNE DID NOT BUILD OR MPi1DVE iOR THE PURi'OSE OF SALEI. ❑1,A4 OWNEH OF TIE VROPERiY,11M E%CLUSNELY COtdTMCTNO YlfTH LICENSED COMTMCTORS � - TO CONSTRUCT TNE PROJEGT(SEG toN,BUSME55 NJ�iROiE5310NS CODE TiE CONTMCTOFi3 U• V81UelI0f1 AD,I,AREA CENSE UW DOE9 NOTAPPLI'TOIW OWNER OF A PHOVERTY WNO BULDS OF IYPROYE9 TMEREON,MA � N?1000NTRACTSFORSUCMPFiOJECTSWIiHAGONiMCTOR�S�I�CENSEDPURSUANTTOTMECONTMG QUANTITY DESCRIPTION FEE � lORBUCEN6EUW,� �J OI/WEJtEMPTUN0ER5EG B.IP.GFORTNISPEASON q , � U U- F¢- DATF OWNER V � IICENSED CONTRACTORS DECLARATION —� � w IHENEBYAFFYUIUhDEt1iENAlTY0FGE0.N1itYiHATIIUAIICENSEDUNDERVROVI510N50FCHAPTER Ur � �(COYYENCMI(iMTiH5ECT10N7o00)OfDMSION]OFT11E&1SINESSMIDPROFESSIONSCOOE.AND Z X W 1,ICENSE tS W fUl FORCEMIO EFFECT. m � ucE►+sE cuss - �� ��c.r+o. SS O I S . � —a -ao �«��oR -' � o�re ' = WORKERS'COMPENSATIONDECLARATION �j� ! a I �j.p-t'� F�y�.� M • � 1 � U � INEREBYAFFlRAIUNDERPENALTYOFPERRIMONEOFTHEFOILAWiNODECUMT10N5! Z 9 5'•p"rQ1J �� �� v Q � _IWIVEIWDWILLMIUMAINACEHiIFlG1TEOFCONSEHTTOSELHNSUREFORNOfiKERS' $ COMPENSATION.ASPROVI�EDBYSECilONT000FTHElABORtODE,FORTHEVERFORIAMICE W OF 1HE WORK fON WHiCH TMS VEiWIT IS ISSUED. � � �IHAVEANDWM1IYAINTAINWORKERS'COMVENSATIONINSURANCE,ASREWIREOBYSECfIDN Q77000FTHEUBORCODE,FOfiTNEPERFORMMICEOFTHEWOPoCFOHYlHiQ1i/1i5VERMRIS � LSSt1ED.WWORKERS'CdAPEN4�+NSURANCECAHy�ERINDPOUCYNUABERME: CONSTRUCTION �, cu,q�ER l)r�'�-�-Q U Pcx C�'c��l C. PLAN REVIEW � POIICY M1M9EN nLu/A �'l R�Ls`S c�.�O O ELECTRIC �ssEcrqr�r�rooTgemr.n�rmoFnEpFantraror�ar+EruanmoawsR�aqaatEss} PLUMBING 8 ICERTIFNTHATNTHEGERFIXWANCEOFTHEYNRKFORWHICHTHISVERMITISISSUED.1 MECHANICAL � () SNALLNOT EMPLOYANY VERSON W ANY Il.WNER SOAS TO BECOAIE SUBIECT TO tHE � WORNERSCOMPENSATICNUWSOFCALIFORNV�ANDIICREETNATiISNOULOBECOEIE INSPECTIONFEE S SUOJECTTOTHEWORKERSCOMPENSATIONPHOVISIONSOFSECTION77o00FTXEUBOR � 000e,is roaTHwrn+ea,�v�rwm�nasevnrnnsia+s. ISSUANCE � � SMIP p DA?E: APPLICA : �1 _ � WMNINO:FAiLURETOSECUREV.OiiKER4'COAIPENSATIONCOYERAGEISU wFl1L.ANOSHALIBE ENERGYP/C �Ay � SUB.lECfANEMPLOYERTOCAlA1WALPENALTESANOCMLFNESUPTOONEHUNDREDi�IOUSANO ENERGYPERMIT r��� C011AR4(itoD,Ooo),W AODITION TO 7HE COST OF COMPENSATION,D�LudES AS Ff WVIDEO FOR IN J SEGfIOqa7DeOFTHELA80RCO0E,INTEREST,ANDATfORNEY'SFEES. � FIETEN7�ONFEE: ��+�. � CONSTRUCTION LENDINO AGENCY PRE-ALT FEE: D St1i'DTY � IHEREBYAiFlR1AUN0E(1PENALTVOFPEiUUMiHiITTHEPE�SAQONSTHUCT10NlENDPl�ACENCY 2 FOR THE PERFOWAANGE OF 7HE VYOPo(FOA WHiCiI iMIS VERMIT IS ISSUED(SEG 3oa7,CN.C.j. W � IENDER'S WWE C IEHDERSADORE55 / W ICERTIFYTMATIIUVEREADhpSAPPLICATIONMlDSTATETUTTHEABOVENFORIIATIONISCDRRELL TOTAL FEES . / � �/ � IAOREE�000IAOLYN7TIi�LLItfTYANDCOUNTYOqDNANCESANOSTATEUWSRELATINOTOBULDIN6 CONSTRUCTION.NW HEREBY AUT110 WZE REPRESENTATNES OF 7HIS COUHfY TO EN7EH UPON iHE S� IBOVE-MENTqNEOVHOVEHTYFORINSPECTIONPURPO5E5. COMMENTS � J � m V fTTEE �11AE(CNNT) 6 ' �d� � 810NANPEOFVEPoNTiEE DATE � RECPi.NO. PAID BY VALIDATION WHITE—Oepartment Copy,YELLOW—Fhence Copy.PINK—Aseessa Copy,GOLDENROD—Flle Copy,GREEN—Applicant'a Copy CITl' OF DIAiViORD �AR � � -, . , . _,_ , ::,� , •�-, IP�iSf'CCi fOh��RECORD: s-. = _-�� ,.: _ .. . ; ---- -- __�_ _ - - . � i_„r C�l�j�l r;���^r= !1►E-7�� r.�`����t � (��'���R-�c'��lc.�►`� J��f!- (�E-'��=�`'I'�;��� .. .1�t _. S c:^� �._���_.---._..�._.___ . .�...._._.�.-...--�-- �-�--.�.�..__._.-- .-...___..__..__.._.. .._..._�_._�,._I�_.—-- �-----------__..-------._. ..---_.�_�._.: .._..� _._.�.____. SET BACK .... , ` � �� .'; I , , ., FLOdR JOIST.� , , ,, - , , - . .. 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POOL FENCiNG � V�JALL INSULf1T10N POOL FINAL CEILING �NSULATION ! �FF SITE IMPS. � • - DRYWALI_NA!LIiJG DEDICATIONS SEVJER _ . . . FIPJAL ENG. � !- � -- -- __ � ___ _- - , . cG�TtC TAr,'r•:__ .- .- -- - ----- .-- __...:__ .. .. __ LAPJDSCAPEa'IRRIG. , , - ---- --__ • -- ------- ---=-- --- SEEP.PITlL..L. . - - - �-- - - -. _ _ ' . ON SiTE.ItI'PS. - . , : -- -GAS F�IR TEST� . .- _____. - ---- --_ '_ :.- FINAL ZOf�iNG ; -�IfJfiL-CQi•;8i:; --__ f _-- - � -- - � _ - F,IRE,DEPT. FINAL � . .FtfJt.L F1�A;i I":C; --- - j .__ _. __ _ __- - fiEP.ITH DFPT. FI'JAL � F1iJAL ELECTRI�„- --- - -_._._ _ _ _ D.�..=V. FEES PAID - - . _ � _____._. FIi�F'�LPLUP1181iJG � __%, - - EP�l�RGY . , , � — , , �{ ..,e ��_: -.._..._..t__, • � � ; -..,.:.� _ - - - � , �-'� _ ..,. _ ," _ .-" ";" _ _ . , . _ _- - — --�-- _. 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