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HomeMy WebLinkAbout17686 (1335) f� CITY OF DIAMOND BAR ? DEPARTMENT OF COMMUNiTY&DEVELOPMENT SERVICES 21825 E,Coplcy Drivc (909)860-3195 Fax(909)861-3117 PRESS ����� BUILDING PERMIT APPLICATION • FIRMLY o� JOBSITE � ��/� Z S(/ _ Y�� APPLICATION ����.���1 MBER.�` N p/C ADDRESS ( Y DATE ����C l�'1 $ ISSUE TYPE OCC APN LOT � TRACT OATE CONST. GROUP p OWNER +r l. E f�l � ADDRESS � S ! ZONING SETBACKS 0 gCIN . ZIP TEL.,�� � FRONT RW • O APPLICANT TEL. � REAR ❑ .�d SIDE/SIDE STREET RW ❑ � CONTRACTOR .�� T�E7k SIDE p ADDRESS � CITY ZIP,��'� TEL , PROPOSED USE o ARC �z DESIGNER NO.DWEL N0. NO. a. ADDRESS = CITY ZIP TEL UNITS STORIES BEDROOMS � � OESCRIPTION SQ.FT. 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W ❑4�OMrtJEROFTHEPROPEHTY,N.1E%CLUSIVELYCOMMCTW6WI7HLICENSEOCONTMCTORS [L TO CONSTRUCT 7NE PHOJECT(SEG 70�1,BUSINESS AND FROFESSIONS COOE:THE CONTMCTORS LI• V8IU8110fl ADJ.ARE/1 W �NSEUWDOESNOTAPPLYTOANOWNEROFAPROPERiY1M108Ut�D50RUAPROVESTMEREON.MlO � YRIOCONTMCTSFOFi5Up1PR0.1ECT5MATHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTMG QUANTITY DESCRIPTION �E Y TORSLICENSELAw.). , � O IAM EXEIAPT UNOER SEC. B.t P.C.FORTHIS REASON Q ?j • U U.. � DATE OYMER F- ZO U � LICENSED CONTRACTORS OECLARATION w � IHEREBYAFFIRMUNOERPENILTYOFPEMIRYTIIATIAMLICENSEOUNDERVROW510NSOFCMAPTER � � Y�WMMENCPIOWRM5ECTION7000�OFDMSION�OFiHEBU5INE SANOPROFESSIONSCOOE,AND Z 11J MYLICENSE IS IN FULL FORCEAND EFFECT. � m � LICENSE CLASS� `�''� LIC.NO. � V DATE"''7 �- Z- ���L� CONTRACTOR_¢ n. 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PLUMBING Z ICERTIFY'M�TNTMEPERFORA/ANCEOFTHEN+DRKiORWHICHTI15VERMITI5ISSUEO.I MECHANICAL C7 SMALLNOTEMPLOYANYVERSONNIWYMANNERSOISTOBECAMESU&IEGTTOTHE (/� WORKERS'WMPENSATIDNUWSOFCALIFORNUTANpAGREETHATIFISHOULDBECOME INSPECTIONFEE SUBJECTTO THE WORKERS'COMPENSATqN VROVISIONS OF SECTION 37000F THE UBOH � ` OCOOE,I SHALL FOpTIN I7H COAAPLY WITH THOSE PROVISIONS. ISSUANCE p OATE:—/�Z APPLICAN� SMIP W �� - � WARNINC:FAILURETOSEWREWOiiKERS'COMVENSATIONCOVERAGEISUNUWFUL.ANOSHALLBE ENERGYP/C �y„ SU&IECTANEMPLOYERTOCRIMINALPENALTIESANOCMLFINESU7TOONEHUNDRED7HIXIS/W� ENERGYPERNIT OOl1AR5(f I0o,0001.Ml ADOITION TO iHE fAST OF COMPENSATION.D�IAAGES�5 VROVIDEO FOfl IN � SECTION7)OeOFTHEUBORCODE,M7TEREST,ANDATTORNEY5FEE5. RETENTIONFEE: oCONSTRUCTION LEND�NG AGENCY PREALT FEE: � IHEREBVAFFINM UNDERVENALT/OFVE0.NRYTHATTHEREISACONSTRUCTIONLENDIN6AGENCV z FOR TME PERFORMANCE OF THE WORK FOR WMlp1 THIS PERMIT�S ISSUED ISEG 1oB7,CIV.G). G.7 � LENDER'S NAME � LENDER'SADORE55 W TOTAL FEES ��(5 I CERTIFY iMAT 1 HAVE READ THIS APPIICATION M10 STATETHATTME ABOVE WFOWAA710N IS CORRECT. � I1IGREE TO COMPLV MATM ALL LITY AND COUNTY ORDINANCES AND STATE Uw5 RELATING TO BUILDING � CONSTRUCTION.ANDHEREBVAIITNOflIIEREGRESENTATNESOFTH�SCOUNTYTOENTERUPONTNE Z ABOVE�MEMIONED OROPER R INSPECTION Pl1RGOSES. COMMENTS � J � � PER TEE NUA Nr . Q �J_ y � �l ti� (n SIGN�T E YERMITT � OATE � RECPT.NO. 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BOND BEA�.9 FRAMINGNENTILIATION I I FINAL EiOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADIP�G ROUGH PLUMBItJG FINISH GRADING SHOWEF�/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING � V�lALL INSULATI�N POO�FINAL . CEILING IN�ULATi�N OFF SITE IP�1PS. DRYWALL NAILING DEDICATIONS SEU'JER FINAL ENG. I SEPTIC TANK LANDSCAPE/IRRIG. � SEEP P!T/L.L. - ON SITE IMPS. � GAS AIR TEST FINAL ZONING FINAL CONST. � F!RE DEPT. FIN!','_ FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY I t��.r'"T e 1- �.l:.r-: _. COMFJIENTS SEPTIC TANK SIZE SEEP PIT/U SIZE .�._ ���. _. ��� m II � _ ��i � i � � � �,