HomeMy WebLinkAbout15024 (1098) �� CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES
: � .s 2��o E.c�i�y nri��s�u t90
(909)860-3195 Fax(909)861-3117 PRESS
�'�'��� BUII,DING PERMIT APPLiCATION FIRMLY
� JOBSITE � ,�C APPlICA710N ��/� PEFiMiT 1� PI�C
o ADDRESS � + � t DATE '+"' NUMBER G G #t°
� ISSUE ,/ TYPE OCC
APN LOT TRACT DATE /V CONST. GROUP
g OWNER � L�
" ADDRESS 'f /.o.�?��d1 C� ZONING SETBACKS ,
e CIT'f�2J2/5'��(JCe� ZI �, �TEL�/�S���`!� REART � ❑
APPLICANT TEL. SIDE/SIDE STREET RW ❑
CONTRACTOR — �v SIDE �
� AODRESS
CfTY 21 / TEL � 1 5' PROPOSED USE
� ARCHJENG/
DESIGNER NO.DWEL. NO. NO.
ADDRESS UNlTS STORIES BEDROOMS
�y CITY 21P TEL.
DESCRIPTION SQ.Fi: FACTOR PSF ADJ.AREANALUATION
¢ OWNER•BUILDER pECLARATION SFR/AOD/REM
O
I NER�Y AFFlqM UNOER PENALTY OF PERR1qV TMAT I AAA EXEAIM Fp01A TV1E COHf RAC70R5 U- OBfagB/C9fpOR �
CElSEIAWFOFTMEFOLLAWWOREPSON�3EG7091.68U51NE5SMAiROFE5510N5COGE:ANYCITYOR (f�
OOIRJTYNI-0piRE0U1RESAFENYR7000NSiRUCi,ALTERM7PROYE.OEMOL131,ORREPNRANYSTRUC-., . �J 9tlp/D6Ck
7URE,PRqR TO ITS 199UANCE,A190 IIEW IRES TFIE APPLICAM FOR BUCH PERMIT TO FILE A BIGNED � P
BTAiEMENT TXAT NE OR SXE 6 LICENSED PURSUANf TO T1E PR041310N5 OF T1E CONTMCTOflb L4 .
CENSE LI1W(CNMTER Y(COMMENCINO WI7M SECTION 7000]OF OMSION 9 OF TME BUSINESS M1O PRO- � POO�SPfi ' �
FESSpNS COOE1 ORIHAT HE OR 6HE IS IXEMPf TMEREFROM MI�TNE BA513 FOR THE ALLEOFD El(EMP•
TqN.ANYYIOURIDNOFSECTI0N7081.6BYANVAiPLICAMfFORAPERMIT3UBJECT9iHE�PPIICANTTO . z Re-Root
� ACNIL PENAL7Y OF NOT MORE TNAN FIVE NUNONEO OOLLARS K+[ol): .
04+�+�EROFTHEPROPERTY,ORIAYEMPIaYEESNATN'NAGESASTHEIRSOlE00MPENSATION, I' COI1V119fClel
1111LL 00 THE WDN(MO TNE BTAUC�URE IS NOT INTEN�ED OR OFFEFiEO fOR SAIE(BEC.7oN,BU31- J
NE85 N7D PiiOFE9910N5 OODE:TiE CONTMCTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF �
� PFqPERIY 1AR10 BUILDS OR IMPFpYES 7FIEREON,N�O NR1000ES SUCX WOFK MIMSELF OR MEflbELF OR � �
Q 7XFqU0HHSORNEROWNEMPLOYEES,PfiOV10ED7NATSUCNMPpOVEAIEMSMENOTINTENDEOOR m
� OFFENEDFORSALEIFlpVYEYER7NEBUlDINOORIMVROVEMENT650lDWITNMONEYEAROFCpAPLE- �
TqN,THE GWNEH�BUNDER YALL/NVE THE BUROEN OF PROVINO TWQ HE OR iHE 01�NOT BUILD OR
MAPFqYE PDR TME VIJRPOSE OF MLq.
� �1,AS OWNEii OF T/IE PROPEfiiY,AM E%CLUSIYELV CONTRACTW O NATM IICENSED OON7RACTOqS
TO CONSTPUCi THE PROJECT(SEC.7oW,BUSINE39 AND P110FE391oN9 CODE TNE COMMCiORS LI- V91uatlOR ADJ.AREA
CENSE IAW OOES NOT MPLY TOAN OWNEH OF A PROPER7V WFIO BULDS OR MAPROVE9 THEREON.AND
MM1IOOONI'AA�T8FORBUG1PFiOJECT5N7TMACONTMCTOR�S�LICENSEDPUR6UlWTTOTMECONfFlAG QUANTITY DESCRIPTION FEE
� TOAB LICENBE tAWa.
O 1 AM E%EI.�T UNDER SEC. B.i P.G FOR TFHS HEASCN � ��O
LL � 2� 7 •,3D
CATE ONMER V
� IICENSED CONTRACTOHS DECIARATION � s- i 7D
� IMEREBYAFFlRMUNOERPEWLLTYOFPERIUtiYTFUTINALICENSEDUNDERPROVI510NSOFCNAPTER � �D+�
s i(COWAENGNO N11T}15ECTpN 7000)OF CIVISpN J OF THE BU5INESS ANO PROiESSIONS COOE,AND Z � • �/V
AIY UCENSE IS IN FULL F E AND EFFECT. .�s -�s n
f� y7 � /IL.
m
� UCENSECLASS `+' UC.NO.� �! � r!
� o�� c�rt�nGro " .' . � �
WOHKERS'COMPENSATION DECLARATON 4 /�` , `O
� /ci+�7`r'7 � l,
� IMEREBYAFFIRMUNDERPENALTVOFPERIURYONEOFTMEPoLLOIMNGDECLAMTqN4: Z iGC1t /f
/�Y �i/
� �IF4IVEIN6MAllMAINTANAC6RTIFICIITEGFCONSENT?O$�LFdNSUREFDRIYORICERS' , _
COMPFHSAiION,AS PROVIDED BY SEC710N 97000F THE LABOR CDOE,FON THE PERFOHMANCE C� D
Q OF TME WORN fbR NMltll TMI9 PERMIT IS ISSUED. , Z
t
Q �I HAVE MD MALLMWNTNN WOAKE175'COMPENSATION INSUAANCE,AS REOUIREG BY BECTPON
9700OF�l/E IABOR CODE,FOR TNE PERFOfNANICE OF 1FE WORK FOR WHICN iH15 PEWdIT IS
� ISSUEO.AIYYVOR COMPyENgATIONINSU ECARHIEH DPOLICYNUMBERARE: CONSTRUCTION
� CARRIER ��'//C _ �G7� PLAN REVIEW
� POUCVMIM6ER �" ELECTRIC
pp (nassEs�arir�Ho78Ead�tFiFnaFiHEr�rsFnnaNe�o0aLv3sR��lota�5s? PLUMBINO
Z 1 CERTIFVTHAT M hIE PERFORMIWCE Of 7HE WORN FOR WHipi TF95 PERMIT IS ISSUE�.I MECHANICAL
C� SNALL NOT ENPLOY ANV PERSON IN ANY MIINNER 60 AS TO BECOIAE SUBJECT TO THE
N VYORKERS'COMPENSATIONUWSOFCAL,IFORN10.�NDA(iREETHATIFIBHOULDBECOME INSPECTIONFEE
� 6U&IECT TO TIE WORKERS COMPENSATIDN PHONSIDNS OF SECTION J700 OF h1E LABOfl SC'11 �� �S OD
000e,�aruu Fomrrvvin�cane�r wirn e vwovisia�s. y 1, iSSUANCE BT�
p DATE: APPLICANT. �/L/C��N'�iV��Y SMIP
� WARNINO:FMURETO SECURE WaRKERS'COMPENSATION COVEAAGE IS I1IAAWFVL,IWD SHALL BE ENERGY P/C
�y BUBJECfIWEMPIAYERTOCRIMWNLPENALTIESAPOCMLFWE5UPTOONEHUNDREDT/qUuMl� ENEFiGYPERMITM
Y WUMS(i100,000�,W ADOITpN TO TMECOSTOF CONPENSATION,DAM�OES AS PROVIDEO FOF IN
� 8ECT1ON870eOFTF/EUBORCODE.NTEREST,�lNDA7TORNEY'SFEES. RETENTION f�V A T����'�R�
CONSTRUCTION LENDING AC�ENCY PRE-ALT FE yS 1 i����r
� INEREBYAFFIRMUNDERPENALTYOFPERIURYlMAT1HEREISACON5TRIICTIONIENDINOM#ENGY `��������
POR TNE PERFORMANCE OF T/1EMlORK PoR WHICH 7MI5 PERMIT IS ISSUED�SEG 70Y7,CIV.C.�. � �.�, n
� F f..
� LEHDER'9 HAME .
� LENDER'SAD�HESS �
I CERTIFY TFMT I W WE READ THIS APPLICATqN MID BTATE T1iAT7HE ABOYE INFORA1ATqN t8 CORRECT. TOTAL FEES �
� IM3flEETOCOMPLYYYfTHALLG7YANDCOUNTYORDINANCESANDbT�TEtAWSREUTINOTOBVILAING I
� CONSTRl1CTI0N,MlDHEREBYAVTHORREREPRESENTATIYE30FTHSCWN7YTOENTERUPONTHE
ABOVE�IAE ED FHOPFRiY FOfl INSPECf10N VUHPOSES.
� COMMENTS
� �J � �
Q n aui �nwr+rl
N � � _ / /
� SNi OFPER EE OATE
�r RECP7 NO. PAIo eY yai�oal�
F 1NF11TE—ae ariment Co YELLOW—finence
p py, Copy,PINK—Aasessw Copy,OOLDENROO—Flle Copy,GREEN—Applicant'e Copy
� CiTY OF D1�4MOND BAR
----i .
� INSPECTiON RECOf�D
i E � i ' ' C� 6 � ' E '
SET BACK , f I� ' � FLOOR JO1ST'_ � - ' _
FTGS/FORMS/STEEL � FHA REQWITS �- '
ELECTRiC GROUND I UND�R FLOOR DUCT'T '
GROUND PLUMBWG I9 fX� I UNDER FLO�R-COt�{DU1T _�!� - �
SLAB GRA�E � ) D FIREPLACE FDUNDA�tON� � � • '
TEMP POWER FIREPLACE B�ND BEAM-
WATER.SERVICE . , MID HT. BZ1ND��AM . : � ' •� -
Rt30F SHEATHING 3-- �J 8 FL BOND BEAM �1 � � " • �
FRAMINGNENTILIATION f a� FINAL BOND BEAM
AOOF COVER PRE-GRADING
ROUGH HEATING �EIVCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISN GRADING
SHOWEFUTUB TEST ' POOL ELECTAIC �
EXT. LATH/SIDING 2 POOL FENCING
WALL INSULATION .� POOI FINAL
CEILING INSULATION (7FF 51TE IMPS.
DRYWALL NAI�ING DEDICATIONS
SEWER Db FINAL ENG.
SEPTIC TA(VK. , LANDSCAPE/IRRIG.
SE�P PIT/L.L. ON SITE IMPS.
GASAIR T�ST rl � Od - � FINAL ZONING �
FINAL'CONS�f. ` " • • , • j FIRE DEPL F1NAL �
FI�AL HEATING �-`�•' , : I HERLTH DEPT. FINAL
Fif�tAl.EL�GTRIC � ' � DEV. FEES PAID
FINA�P4l�MBING � � ENERGY - �---- u
� �+' � �
. .. _. �, � �. . � ---
COftRiVlE�'�TS : - . . • ' . _` .
�'. �'ti DD �-=.��j����L�` S���D -��t-�2d ,�s3-s'T .��?�.�._ e �� ���S_—
�U� �d� ' Se�'7'�im_o�,--��� s 1� � --
�.. �^-- 1� ' ���L � _ ' . ,
• \ . .
� � . �
1�.��'
- -t t-___..,r ----------
s�pTic Tan��c s�z�
SEEP PITlU SIZE �--
�;, --- ---------
��-
i�
, — —
�� ._. . _. , _ --
