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HomeMy WebLinkAbout11772 � _ _ -- -___ --- �//��'d !__.-� � EXPIRED --�� CITY OF DIAMOND BAR' � • � COMMUNITY DEVELOPMENT DEPARTMENT ' ' E p( �.,,,.0 2(660E.CopleyDriveSuite190 .' �UL 19 ZO�1 pRESS (909)860-3I95 Fax(9D9)861-3117 . . '� BUILDING PERMIT APPLICATION FIRMLY , o ADDRESS��`�D /� / S�/�3 DATEICATION ''� '� ' NUMB R �!C ISSUE TYPE OCC ' ' � � APN . .. LOT ' TRACT _ . DATE - ` - - CONST. GROUP_ � . ; _ �p -0WNE_R ��.<�/E�j Gt,�{�r , � ADDRESS /S�7D /"�J��,L l! � ' ZONING SETBACKS ; �,. . , • - - -- ' - � z CITY �,/�r17/�ii�3�ZIP 9.l�fi�TEL. /�� � FRONT RW - ❑ ,. p APPLICANT «/�r .TI�J _FJ.'�F"I TEL7�5�L -DA�7 REAR_ ❑ ' o SIDE/SIDE STREET RW -O � . _ ; � CONTRACTOR. �. � , . __ -- - - SIDE __ . _ _ - O � � ADDRESS - �_ ' -_ . __. . _ . ._ . __ - - - _ , _ _ _.. ..- - _ . CITY. i /�.� ZIP 'fEL7� � ' PROPOSED USE i 0 � ,.._-o . _ --- .----- i wo ARCH/ENG/ . N0. ,. .. _. _- . •- - - --._ ' ; z DESIGNER _ _ . _ __ __ . DWEL NO. , _ NO. i _a _ADDRESS � ' � � CITY Z�p , UNITS -STORIES ' BEDROOMS � TEL. � � - __-_ ._. .. _-•__ - -- -_._. _ _. _ -pESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � '--� -- ---- .. ._ _ .OWNEFi-BC�LDER DECLARATION-_ ____. ' _ _.. -SFR/ADD/pEM ---- - � _ _ _. . •-- t _p . ..I HEREBY AFFIRM UNOER PENALN OF PEFLAIRY THAT I AM EXEMPT FPOM THE COMMCTORS L6 " Gaf2 0/C8 � -� - � � ' W GENSEUWFOR7HEFOLLOWINCREASON(SEC.70.71.SB115WE55ANDPROFE5510N5CODEANVCITYOR (n 9 �rt �� �- � � 1 Z CWNTYNMICHNEOUIRESAVERMITTOGONSTRUCT,ALTER�PROVE.DEMOLISH.ORREC/'RANY9TRUG' _ W Pdil0/DOCk... � � � ' TURE.PRIOR T01T5 ISSUANCE,AL50 RE�UiRES THE APPLICM7 FOR SUq1 VERMIi TO FILE A S�CNE� � w - - � - � - - -�- �-. ... .. . . � �' �� � - , . w STATEMENT i}UT HE Oq SHE IS UCENSED PURSUMIT TO iHE PROVISIONS OF 7HE CONTMCTORS L4 � �CENSE UW(CHAPTER O(COAIMENCING WITM SECTION IOOOI OF DIVISION 3 0F 7HE BUSINESS AhD PRO� � � PooVSpa �•- � � � - � � � � � � FESSiONSCODE�OHTNATHEOR5NEI5E%EUPTTMEREFROMANOTHE8A515FORTHE/LLLEGEDEXEMP- _� TION.ANYVIOLATIONOFSECTION70�t.6BYANYAPPLICAMFORAPERAIITSU&lECTSTME�PPL�CANiTO �� Z AB•ROOI � � � • _ ' A CML FEN/LLTY OF NOT MORE THPN FNE HUNDREO COLLARS�SSoo).): � ' j O ❑4�1$pNMEqpFTMEPROPERTY,ORMVEMPLOVEESYATNWACESASTHEIRSOLECOMPENSATKKJ, � COfi1RIBfCIBi � � � � -"Z 'N'ILL DO TME WOFiK,M70 iME STRUC7URE IS NOT INiENDED OR OFFEREO FOR SALE(SEC.7oN,BU56 J NE55 AND PROFESSIONS COOE:THE CON7HACTORS LICENSE UW OOES NOT APPLY TO AN OWNER OF � i - ' � .PROPERTYWMOBUILDSORIMGROVESTHEREON.ANUWHODOESSUCMVlORNHIAISEIFORHEfiSELFOR = ' � 2 THHWGHHiSORHEROWNEMPLOVEES.PROVIDEDTHATSUCMIAIPROVEMEMSARENOTWTENDFD00., m . j W pFFEREDFORSALEIF,HOVIEVERIMEBUItDIN00HIMPRDVEMENTIS50lDWITMNONEYEAHOFCOMPLE, �� ' '��� TION,TFIE OwNERSUILDER YnLL HAVE TME BUROEN OF VROVINO T1UT HE OR SNE 010 NOT BUItD OH . . . . . _ .... . . ' = WPROVEFORTHEWRPOSEOFSALEL � � ' I '� , . '�. .. .,,. •� ��-w� � -OI,ASOWNENOF7HEiROPERTY.AAAEXGWSNELYCONTMCTINCWRHLICENSEDCONTMCTORS ' .. , . ... .... . . . .. . � Q TO CONSTRUCT TME PR0.1ECt�SEG 7014,CUSINE33 AND PROiE551pNS CODE:THE CONTMCiORS U� V2IU8lI0f1 /�Q�.AR� � • W CENSEUWDOESNOTAPPLYTOMlOWNEROFAVHOPERTYNTqBURD50RIMPROVESTHEREON.AND -�� WHOCANTRACTSFORSUCHCR0.IECTSWITHACONTMCTOH(5)UCENSEDPURSUNNTTOiMECONTfUC• OUANTIIY �� DESCHIPTION �� � - -�-�- ",- �'- "" "FEE' ,- � - - � Y TORSUCENSEUW.). _ ._'_i. .__ .. . . . ._.__.. .'._' ._. __ _.._._... __.... . .___'. _ _. . , � ` O ,J .,__ .__ _. . .._ ._ . ._ . . _ .... . ' ,. . O 1 AM E%EIAPT UNDER SEQ � 8.t P.C.FOR THIS REASON � U � :. _� _..._ . _.__.. ...., ._.. ._. __ .'_".. .. _. ; . ._ .._ ' ____...-_ _ .__. ._ . .. . .. . . _ ._ . . � _ . . . ._. ._ ...._ . . � ;_ LL' DATE OWNER ' �. '. ' _ .. .. . -. H , Z. _ _ . (� ...._ . .._. _. . .. . .... . _ , W ._. ,._._..._ ._. __' __"._ i __� _. _._., UCENSED CONTRACTORS DECLARATION . ' '' -� ¢ _ _ w . . . _ _ ____ CL 1 HGREBYAFLIRM UN7EF PENAL7Y Of OE0.IURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER� Vr • . . �' . �� -�� p_ 'D(COMMENCINGVATHSECTION7000)OFDMSION�OFTHEOUSINESSANDPROFESSqNSCOOE.AN� "� � Z ' �' ' - - � -� � • X MY LICENSE IS W NLL FOPCEAN�EFFECT. j � m � ._..W. . _. . .... . ..._ "7�, _ _ _'__ ._. . 2 ..._. . . � . . •.' . . . � LICENSE CLASS ' �r�✓ UC.NO. � v _ � � ' I. ~ � onrE �t!-,/' //-�n-9.�caarwicroa ' 2 . �' � .w -- _ _ -- ` ���ppp���,,, , f � � WORKERS'COMPENSATIONOECLARATION, rl��o�� U l � _ � � � IHEREBVAFFIRMUNDERPENALTYOFPE0.NRYONEOFh1EFOLLOWINGDECLAMTqNS: ' u, Q �' Lt , f � _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORNERS' S � � ��- �� � COMPENSATqN,AS PPOV�OED BV SEC710N 77ou OFTHE UBOq WDE,fORTF1E PERFORUANCE U I,.. ¢ _ OF WORKFORWHIpfTH15PEHMIT13133UE0. � Q' .. _.. .'" __.. __.. .. . ." ".___.._.. .... . , - . ..... _ _ . . � w _I HAVE AND K7LL AIAIMAIN WORKERS'COAIPENSATION INSURANCE,AS REOUIRED BY SECTION � O 07ooOFTHEU80FCODE,FORTHECERFORAIMICEOFTHEWORNFORWHId1TNI5PERM1T15 � ISSUED.MV WOR RS'COMPENSATION INSURANCE CARRIER AND POLICY NUMOER nARE: � '� � ' ' �CONSTRUCTION��� -- - � --'�-- � . . .. _.. ._ _ �' ��/v/7� � � J PLAN REVIEW � � CARRIEF J 7 _ . . ' _ ._. _ .... .. ._ _ .. _ _. _ . _ .._'._ . _'.._.. . . .. _ ......._ ... . 0 . ._.'PCLICYNUMBER �� .. . _ _.._ _.__. . .... ___.•_". ELECTRIC ¢ o �rr+xsecnour�mraoreE�oFnfvEaMrscoaor,�Krnamoaurs ioo�oa a- . PLUMB w ECHANICA � � Z ICER7IFYTFIATNTHEPERFORMMICEOFTHEWOfi1CFORYlM�CNTMISPERMI7ISISSUED,1 ' - 'U -�- � �SHALLNOTEIAPLOYANYPERSONWANYNAMdERSOASTOBECOMESUBJECTTOTHE _ , � N WORKERS'COMPENSATIONUWSOFCAUFORNIAANOAGREE7l/�71FISHOULABECOME � �INSPECTIONFEE "�-� - " �-"� � � --�" " --"--" � -" '���' � 1 SUQIECTTOTNE RKE0.5'COIdPEN5ATI0NGROVISION50FSECT10N77000FTHEUBOR � � CODE,I IALLF THCOMPl�W�7NTW EP VISI M. ISSUANCE < < i O ._ q .. . . . .. . . .. .. . . _ _. . . _ .. � � DATE: � 3 �� APPLICANT. ••• �'✓ SMIP .. _ . .. _._ _- J _ -ENERGYP/C �1��_�� � WARNiNG:FA�LURETOSECURENORKERS'COAIPENSATION AGEISUNUWFUL.ANDSMALLBE- ,Jy LL SUBIECTANEMPLOVERTOCRIIAIN�LDENALTIESM'DCINLF SUPTOONEHUNORED7HOUSANO ENERGYPERMIT � ?, DOlURS�ft00.000).N AODITION TOIHE COST OF CdAPEN5ATI0N.DNAAGES AS PROVIOED FOR IN ' -� J� SECilON7�OeOFTHEU�BORDO�E,INTERE5T.M7DATTOIWEY'SFEES.'-� '-- � "--'-' '�' -' � . RETENTION FEE:_ _. _ ____ .. _ __. _ --- ' w CONSTRUCTIONLENDINGAGENCY PRE•ALTFEE: .. .... �� .��!: . � ,�� �, �-„ .. . ��� �....0. _. _ ._...._._. ----.. . .. ._.___. _.._.. __ . .. _ . , � - .._. __.. .... ._.. . . -- � - -...--. .. _ . . � CL IMEREBYAFFIRMUNDERPENALTYOFPERA1RYhIATTHEREISACONSTRUCTIONlEN01NGAGENCY � � FOPTHEPERFORMANCEOFh1EWORKFORNMId1TH15PEFMITIS155UE��5EC.�097,pV.C.�. . . . - . � Z�' ' '__"'__'__'_.., ..... ." '_' ... ._..._...._. _. _'_.. ..' ."___ _" � � w � � LEN�ER'SNAME � ._S. . F- LENDERSADDRE55 . � � � ICERT�FYiHATIHR'lEflEADT115APPLICATqNANDSTATETHATT1EllBOVENFpRMATIONISCORFECT. TOTAL FEES � � � ' . ' W IAGREE7000MPLYWITHALLCITY/WOGOUNTYORDINANCESAN�STATEUwSHEUTINGTOBUILDING� �� �� -' ��- ��� - -�� � • � � � � � - � � CONSiRUCTION,AND HEREBY AUTHORIZE REPRESENTAi!YES OF TMIS COUNTY i0 ENTER UPON THE . � � ' ' � � � Il80VE�MEMIONEDPROPERTVFORINSPECTIONPURPO5E5. . -COMMENTS � �� � � . . . .. __._ _ . __ -.. ._..___. . _ !_'__Z .._ . . " _ _. _ _ ' . . . � � ��/� � ,/� . � . � . __m _ . ._ _'. . . . . . . .. __ . .._ . . ._ .. . . .. . + ¢ 7ER1.1i7r N.U.�•fDR/INn�� . �' - .' . -" � - N ���1�' . t - ATE � SI4 ATUREOFPER E � � i — RECPT.NO. �� PAID BY VALIDATION i---��- �� �- -- ---- - -- �� -WHITE—DepeRment Copy,YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD--File Copy.GREEN—Applicant's Copy _ ' . .'., , { _ ..... .... .. .. . . . . . . . . , . , . �• . .w .-� .,��r.�� , , .. _ _ . , . �.. ._ , CITY.OF DIAMOND BAR . . . .'. . , � INSPECTION RECORD ' . . ,;. . � • � . • � - � � � • � - SET BACK � FLOOR JOIST � - - - FTGS/FORMS/STEEL . FHA RECIMTS . • : � . . ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT �. - - SLAB GRADE - FIREPLACE FOUNDATION " . '� ' ' ' ' TEMP POWER - - FIREPLACE BOND BEAM '' � ' WATER SERVICE - MID HT�BOND BEAM , • - ROOF.SHEATHING 8 Fr.BOND BEAM FRAMINGNENTILIATION - FINAL BOND BEAM ROOF COVER - PRE-GRADING ROUGH HEATING - ' BENCHING ROUGH ELECTRIC � ROUGH GRADING . ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS -- SEWER - . - ----- - ' __ _ FINAL ENG. SEPTICTANK = - -� - - -' -- - LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST - - _ FINAL ZONING � FINAL CONST. - - - - � - FIRE DEPT.FINAL FINAL HEATING - � HEALTH DEPT.FINAL FINAL ELECTRIC DEV.FEES PAID FINAL PLUMBING ENERGY ' � � - - • :, _ • • \�`' - - . . , , � ,. - -- - - - • - z � - \ ��' i i. �' COMMENTS � ' � ., ,` ' _ . ; — -- _ , � • -. , , _ `,�. ,. — - ._ �'_,�: , _ . � . , .; : .+,, _ ; . _ �� , � . _ . . _.. • , � .� ... �. � .,,. , , SEPTIC TANK SIZE - _ _ SEEP PITN SIZE , .-_ � . '\:�\ '. . , . �- . .,, ; , a:. •