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HomeMy WebLinkAbout15410 (222) J _C� ., �> c �� CITY OF DIAMOND BAR E�PIRED DEPARTMENT OF COMMiJNITY 8c DEVELOPMENT SERVICES 2i�o�.c�i�yna��s�c�i90 AUG O1 2002 PRESS � (909)860-3195 Fax(909)861-3117 `'�'��� BUII.DING PERMIT APPLICATION • FIRMLY � JOBSITE ` / APPUCATION � PERMR P1C o ADDRESS 2 v ��� DATE � NUMBER� ��it � ISSUE TYPE OCC -- APN LOT TRAC DATE CONST. GROUP � OWNER O � AODRESS . p ZONING RO�CKS RW ❑ � CITY IP . o O APPLICANT EL. REAR p � SIDEISIDESTREET RW O CONTRACTOR SIDE ❑ g ADDRESS PROPOSED USE CITY ZIP TEL � ARCHIENG/ • DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STO IES EDROOMS � CITY ZIP TEL y DESCRIPTION SQ.FT. 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TION.MNVI0LAT10NOF6ECTION)aa1.68YANYAPiL1CANTFORAVER4R5UeJECT57HEAVVLICANTTO Z Re-Rool � ACMLPENALTYOFNOTMOf1EhNNFIVEHUNDRE000LLM5(iSDo).k � OLASOVMEROFTHEPROPERTY,OHMYEMPIAYEESVATHWMESASTHEIRSOLECOMPENS�TICN, � �mmereial . - WILL DO THE riORK AND TNE STRUCNRE IS NOT�NTENOED OR OFFERED FOR SALE(SEC.t0a�,BUSI• J NFSS MD PROFESSqNS WOE:THE CONiMCTORS LICENSE Uw�OES NO7APPLY TO AN OWNER OF y VROPERiYMAiDBURD90RMPqOVESTHEREON.ANDN1iODOESSUCHWOIiNHIMSELFORHERSELFOR = [L TYIOUGHNSOHHEROMMEMVLOVEES.VNOYIOEDTHATSUCH�I7ROVEMENTSARENOTINTENDmOR m � ,OFFEREOiORSAlEF,11�WEYE0.7HEBtAD�NU0i1WPi10VElABJTIS50lDMrtiHNONEYEAROFCOMPIE �TqN,T/1E 01VHER�BLM.OER WILL NAVE THE BURDEN OF OROVPIa 71uT NE OR SHE DD AIDT BUILD Oii W PHDVE FOR T1E PUHPOSE OF SALEI W Ot,A90wMEROFTIEPROPEifTY.AMEXCLUSN[IYCOMMCTINdWRl/IICENSEOCONTMC70RS [t TO CUf15711UCT THE►RO.IECT(SEC.7as.BUSME53 FNO FROFESSION^.a CODE:THE CONTMCTORS LI• V81U8IIOf1 AQI.AREA 11J �ENSELAWDOESNOTMPLYTOANOYRIEROFAPPAPEPTYMRIO&11D30RMPROVESINEREON.AND T�- YRqCONTRACfSFORSUCMPROJECfSWIi/1ACONTMCTOH(5)LICENSEDPURSU/JfTTOMECOHTMG QUANTITY DESCRIPTION FEE � TOfiSIICENSEUW.} OI/JAEXEIAPTUNDFASEC. 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J t, DATE COMRACTOR a Si � WORKERS'COMPENSATION DECLARATION a � IMEREBYAFFIRMUNDERiEN.LLTYOFVEiWRYONEOFTHEFOIIOWIN�DEGAMTIONS: U f/) ZQ � _IMAVEANDWILLWUNTAINACERTiFICATEOFCONSENTTOSELFaNSUREFORMOfiKERS' 2 COMPENSATION,AS VROVDED BY SECTdJ 570o OF ME LIBOR CO�E,FORTHE PEHFORYANCE U Q OFT/EYlOitKFORWNICNTHISVEHIdRqISSVE�. � 0 Q _I NAVE AND M9LL LWMAM WORKERS'CDl1VEN5A710N INSURANCE,AS REOUIREO BV SECTqN ]7DOOFTHEUIBORCOOE.iORTHEGERFORMINCEOfTHEWORKFOFWM�CHTN�SPERMITIS � ISSUm.GVWCNi1fER5COMPEN5AT10F1WSURANCECAiiNiERINDVdJCYNUMeERAAE: CONSTRUCTION � �qEq PLAN REVIEW � voucv�uueEA ELECTRIC Q (I4C65ECfIpNN�bTgE�71,�PL£TEppFTIEpEp.Tf6fOqpJEHMNImpotuRs(S�m)Oq1E551 PLUMBING Z ILERTIFYTHATNTNEPERFORMANCFOFTIEVfONCFORNM1IICHTHtSPERMITI5iS5UED,1 MECHANICAL (} SWILLNOTEMPLOYANY►ERSONNANYIAANNERSOASTOBEC0IAESVOJECTTOTHE � WORI(ERSCOMPENSATqNUW50FCAlIFORNItiAND�GREETHATIFI5/qULDOECAME INSPECTIONFEE S SUB.IECTTOTHEWORKEIi5COM7EN5ATI0NPROVI510N50F5ECT10N7TvoOFTHEIABOR ISSUANCE COOE t SHAt1 FORT1iWfTH WA1PlY WITH THOSE GFIOVISIONS. 0 SMIP � p DATE: APPLICAI7T: . W ENERGY P1C W�fWINQ FNLURE TO SECURE WORKERS'COMVENSATION COVERACiE IS UNUN'Ftri.AND SHALL BE � 51161ECTANEMPLOYERTOCRNABULPEIULTIESANDCINlFNESUPTOONEMINDNEDTIqUS/w0 ENERGYPERMIT DOLLARS(f 10o,Dm),W/�OITION TO THE COST OF COMPENSATION,DAGAGES AS PROVIOED FOR IN f� !� /� ¢ SECT10Nf1oeOFlHEU180f1CO0E.MTEREST,ANDATTORNEYSFEES. RETENTIONFEE: ��I1. 11 � 711�� OCONSTRUCTION LENDING AGENCY PRE•ALT FEE: �r cC IHEREBVAFFIRIIUrDERVENALTYOFPERNRYTW�TTHEREISACONSTRUCTIONIENDWOACENCY 1 a• FORTHEPERFORMAIJCEOFTIEWORKFORWFIICNTM4SPERMITISISSUED(SEG70i7.pV.G� I1,DINGANDSAFE LLI � LENDER'S WUAE � � LENDER'SADDRESS . {'�J q/� � ICERTIFYTHATIWIVEREADiHISAPPLIGTtlNANDSTAlETMA7iHEABOVENFORMATIONISCORiIECT. TOTAL F ES � . . � /.✓/�D� W IAOREETOCOMRYH7T11ALLCrtYANDCOIMivORDIWWCESANDSTATEUNSREUTWOT00U1LDIN0 �� � COHSTHUCTION.ANONEREBVAUT710RREREPFESENU7NESOFTHiSCOUN7VTOENTERUVONTNE 5�7. ABOVE�AIEHTIONEDPNOPERTYFORINSPECTIONPURPOSfS. COMMENTS � G J � '''''� ` m FEIWfTTEENAME�a�w.�— . � � � _ ��) uJ 81(7NATUREOFPERMITTEE �TE � RECPT.NO. PND BY VALIDATION WHITE—Depanment CApy,YELLOW—FnanCe CApy,P�NK—Assessor COpy,GO ENROD—File Copy.GREEN—ApqicanYs Copy . �y..• :� �. ... � � ...�,.�r ; -i'r�'�,-�t'. .� . " . •.re� r- . . . '0 . . , . , ru^� . ., � .. ;�� .�.r. , E•'y-r� CITY OF DIA«iOtJD BAR _ . . . R�lSPECTIOtV�•RECO . . �� , RQ ; . �.�����?�i�'1 _ ��r'�.�= ll.�;�...��;�� : (e�,�• �'^���►; � '�=': ���.��c''�a�,��� SET BACI: - �� . � FLOOR JOIST ' . _ r y��"� .. � y ;FTGS/FORMS/STEEt � , . • � �. �, FHA REQMTS ` ELECTRIC GROUND ' � _` -' UNDER FLOOR DUCT ' GROUND PLUh4BING UNDER FLOOR COP�IDUiT � -- �SLABGRADE- FIREPLACEFOUNDATIOf�I '� ' . .� `TEMP POWER FIREPL'ACE BOND BEAM ' ~ WATER SERVICE � • P�11D HT. BOND BEAM �RO�F SHEATHING � • ` ' � • 8 FT.BOND BEAM ;FRAMINGNENTILIATION , - -- FINAL'BOND BEAM �ROOF COVER .` ' ' ' PRE-GRADiNG - _ ROLIGH HEATING ` ' '. �_ BENCHING ,• ; �ROUGH ELEGTRIC . _ •' ROUGH GRADING - iROUGH PLUMBING FINISH GRADING 'SHOWER/TUBTEST- -- - POOL ELECTRIC ' ,EXT:tATH/SIDING - - POOL'FENCING !WALL iNSULATION , - POOL FRJAL CEILING ITdSUL!',TION OFF SITE IMPS. ' � :DRYWALC NAILING DEDICATIONS iSEWER FINAt ENG. ;SEPTIC TANK LANDSCAPE/IRRIG. 'SEEP PIT/L.L. ON SITE IMPS. . , ;GASF�IR_.TEST FINAL'ZONING :FINAL CONSL_;_ __. . FIRE DEPT. FINAL fFlA1.AL HEATIhdG _ HEALTH QEPT. FINAL - ;FINAL ELECTFiIC DEV. FEES PAID - f=lP1A,L:PLUT.4BiNG - - EtJERGY. ( __ . I ' —� _ _. _ . • . _ I�'��r:�r�,.'i_ �+'^"i�'e'.__....._.��_..��.� � "__ i �cor�nMEr�7s , � . _ _ � ; _ ; . _ .. . J �C�:.��f�• 1 . . _ . � SEP�IC TANK SIZE ' ;SEEP PIT/U SIZE_ �����`���� - _. # ':1�`�) . -:�4�[�.Vi(?I1��I' =r' •'�'t' , _rti.. _ ''i��/-.f�(.!`,/,�'.� �ll�'��' �i�' , , . . . i . 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