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HomeMy WebLinkAbout14508 (661) . . CITY OF DIAMOND BAR • .Q..�� � --�� �- DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES T si�o�.coPi�y��os�c�i90 . •_ 1 PRESS � (909)86Q-3195 Faz(909)861-3117 -��'r�.U 1����� / �'n �i��`,��. _ / � . ���'; BUII.DING PERMIT APPLICATION � !- •.•� - �/�' �I �r� . o �DRI SS , � • •� � DATEICA I � //) _, _ �NU BERI G` / *�`„i ''D ( r � APN LOT '.TRACT DA EE �� CONS7 �� GROUP � OWNER �� U � ADDRES ZONING SETBACKS � CITY TEL�_�/"�&� FROPlT RW ❑ ' APPLICANT � TEL " � REAR ❑ � SIDE/SIDE STREET RW •❑ CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE���D C_.�I/-P�/ CITY ZIP TEL Pou ARCH/ENG/ �. -: , � OESIGNER � ' NO.�WEL NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP �fEL. �' y DESCRIPTION SO.FT. FAC70R PSF ADJ.AREANALUATION OOWNEF-BUIIDER DECLARATION . .� SFR/ADDlREM � p I 11EREBY AFFlRM UNDER PENALTY OF PERAIRY MA7 I AM E%EMVT FNOM TH[tONiMCiORS lb' G8�8g9lC8�p011 - - ' LL COISEUWF01tT11EidlOwsN3NEll50N(SEG)0.7f.6BU51NE55ANOCROFES510N5CO(1E:ANYdTYOR � COUI(T�fWHICMREOUINESAPERMRTOCONSTTWCf,KTER�MFHOVE,DEMOUSM.ORREiNRIM'STRUG• P8tI0ID9Ck � � � TVRE PFIOR TO RS ISSUANC�ILL50 REOUIHES THE APPLICANT FOR SUq1 VERu1T TO i1LE A SiGNED � 6TATEMINT TMAT HE OR SHE IS UCENSED iURSUNR TO 71fE PiqVI5iON5 OF T11E CONTMCTORS LI• � CENSE UW(GU1PiER i ICOAIMENCINO WI7N SECIION 7ao01 OF DINSION 7 OF THE BUSINESS AN'J VR0. � �P��Pa FESS�ONS CODE)OR hN7 HE ON SME IS E%EMPT TMEREFROIA ANO THE BA515 Fqi 7liE ALLEOEO E%EMP• TqN.ANYV10lAT10NOFbECT10H7W1.6BVANVAVPLN:AH1iOqAPEHA1iT5UBJECTST11EA0FLK'1NfT0 Z qa-Rool �„� ACMLPEw1LtYOFNO'TMOfiETMANFIVEIM1INDRED�0.LM5pS0ol.k � � OI�OWNEROFiHEPROPERfY,OA�EMPLOVEESWiTHWACESASiHEIRSOLEtOA1PEN5A710N, O CMIrtI0fCl01 � - N7LL 00 iHE YYORK AND THE STRUCTUNE IS NOT INTENOED Of1 OfFEitED FOR SALE ISEC.7oar.BU51• J NESS ANO VROFESS10N5 COOE:7HE COMMCTM79 LICENS[UW DOES NO7 AVPLY TO Ml OWNER OF � y iROPERiYMhqBUl.O50RI1,IPFiOVE57NERLOfl14DN110DOE55Up7Y101iKM145CLFORMEftSELFOR a � CL iHROUGHMSORHEAC/MEYPLOYEES,PROWEDTHATStKHMPROVEIAENTSARCNOipfTENDEDOR m � OFFERmiORSKE1F,110WEVEfiMEBULUN60RIMPPOVEMEHTI550lDWfMNOf�'EYEAAOFCpAPIE- •TION,TIE OWNEI4BUItDER WILL FNVE TME BUROEN OF PROYWO iHAi HE OR SME OD NOi BUIID OR = YpiIOYE fOR TME R1RP0.5E OF 9ALEl � I W �74�OWNEHOFTHEPROPERTY,A/AEXQUSNELYCOMMCTwQWrtHLICENSfDCONTMCTOfiS _ � MtONSTAUCTiMEVf10.lECT(SEG70N.9USINESSIWOPROFESSIONSCDOE:TNELONiRAG70R514 V81119110I1 A�J.AREA CEttSE UW pOE9 NOT IIPPIY TO AN OMMEf7 OF�PROPERiV NM1q BULDS OR IIAPROVES TiEREON.AND • � 1MUCOHiRAGTSFORSUd1VND.IECTSYVIT/ACONTRACfOH(SILICENSEDRIRSUANTTOTMECONTMG QUANTITY DESCRIPTIOV - FEE � iCR4l10EH5E UW.} � • O IAM IXEIAPT UNDER SEG B.d B0.FORTHIS BEtiSON � / 3 � _ . �. .� .. �=' OATE ONNER � � W LICENSED CONTRACTORS DECLAFiATION W � INERCBYAFFIRNUNDERPENALTYOFVE�IF�YTNATIM7UCENSEOUNOERPROVISIONSOFCFWTER Ur . . ' s 0(CO�M�ENCNUM7TNSECTIONT000)OCUMSqN�OFiMEBUSINE55ANDGROFE5510N5CO0E.AN0 z LLJ ���ERNiUI.LFORCEl1NDEFfECL m � � � LICENSE CUSS LIC.NO. � �"j pATE CON!F7ACTOR a = WORKERS'COMPENSATION DECLARATION � � IMEREBYAFFliWUNDEHPENALTYOFiEM1RYONEOFTHEFOlLO'MNGDECtMATqNS: U � ' C!J � 4 � �111AVEANOWILLMAAfTAMACEHTFIG7EOfCONSEMTOSELFaNSUA[FONY.OR1(ERS' S tOMPENSATqN,ASPHOVIDEDBY5EC7fON77ooOF7HELABORC006FORTFiEPERFOHAUNCE U � OFTHEWORKGOqW111CHTHISCEiWi76155UED_ � G �IHAVEANOWfLLMAR7TNNWOfYCER3'Cd.�PENSATqNIN5Ui1ANCE,/lSREOUREDBY5ER10N � / C (O O 77000FTHEU80RCOOEFONTMEPERWNJANCEOFTNEWORKFORYNiIp1iHI5PERMlTlS ' � r /)� {SSUEO.W WONI(EPS COMVEN9A7qN INSUiW/CE CMRIER M10 POIICY M1M0ERME CONSTRUCTION i__ i ��l i �� � � �iEq PUW REVIEW �L} . � PO�IG1'M1MBEp ELECTRiC B �nss[cronr�rIDrareem�st£rIDCFnEVEmrtswr+or.�Mra+[noaurisR+mt�tEss) PLUM8ING Z 1 CEttT�FY71Ui W T1E VERFORUANCE OF THE WOHK FOR WHICM TMS PERMR 6155UED.1 MECHANICAL �� r � �' SMALLNOTEM7LOYANYVERSONN/WYYANNERSOASTOBEWMESUBJECTTO7HE N MqPo(ERS'CddPENSATIONUYYSOFGLL�F011N1�ANDAGREETMATIFISHOUlOBECOME INSPECTIONFEE �� ~ n ' � SUBJEGTTOTMEYYOPICERSCGIPENSA7�ONVROV�SIONSOfSECilON�7ooOFTNEU80R ' r]��' � eooe.�swui conn�+nn�eae�v�r mn�nas¢vao�ns�oe,s. ISSUANCE � SMIP OATE: � � APF'LIGM: l!1 lp � �ey ry '� . ENERGYP/C � 7n�� WMN�NO:iM.URETOSECUREWOf1KEA5COM0EN5AiqNCOVEMGEISUhUwFUL,MIDSHALLBE rtir—y �–�;,� � SUBJECTANEMPLOYEHTOCWYPIALPEWLLTiESANDCMLFNESUPTOONEMINAREDT110U5AND ENERCaYPERMtT OOIlARS(i100,0001.N ADDITION TOIYIE C0.5T OF COMPENSl1TqN,O�GES Il5 VROVDED FOfl IN ¢ SECTI�N17oeOFTHEUBORCODENTFFEST,ANDATfORNEYSiEES. RETENTIONFEE: � oFUiArro�vn�a � a CONSTRUCTION LENDING AGENCY PRE•ALT FEE Ii.DING�`iTT�S�'-�%r�'�V O � INERE9YAFFlRMIlAERPENILLTYOFVEFWIt/iW�TTHEREISACONSiflUCT10NtFNDWOAGENCY Z FOR iHE OEflFOM�WCE OF iME WORK iON N'MKi/7H15 7EN/IT IS ISSUEO(SEG]ov7,CN.G). W � LENDER'9 WVAE � � LENDER9ADORE55 , w ICERnFY7MAYIHAVERE/DiHISAVDLIGT�ONMUSTATETNATTNEABONENFORIIATIONISCOHRER. TOTAL:FEES r � , d IAOREETOCOMPLYYrtMl1LLCT'ANDGOIMTVOMRlAHCESIWOSTA7EUM/SHEUTINOTOBNLD�NO ��� -O�/ , � CONSTRVCTION,ANOMEREBYMf1)10RQEREPRESENTATNESOFTHISCOUNiYTOENTEHUPONTHE .. �(�n ;` /,BOVE�MENTqNEDPiqPEF7YfORIN5PER10NM1�SES. COMMENTS �J�: v 9 ��� �� . �— . � m v�w� ¢ e tvwrrt� � � -� � 'i I ri.0 �t1 ' � oaru�lu oF v �" ��� pplD BY � VALIDATION � . . RECPT.N0. WH�TE—DeDertment Copy.YELLOW—finance Copy,PINK—Asseesa Copy,GOLDENROD—File G�py,GREEN—ApplicenCs Copy - � • ,.. . . . �- . . ., . . . .. . , . . . , .. . ..,y ..�. . .. „ ... 1 i . _. _ ; r ,, _ . � . ' � . ,; ` ._ � � `- k� CITY OF DIAMOND.BAR � �r. �- ;:�, _ . _ _ . ,.. .__.-- -__ .,... . . - � ... .� `. � . INSPECTION RECORD;,� -',' ' �.• , � . .� - .,\ . . :'� , :� -: -- �' , f.., ., ._ . : i .. . � � , � - � � � , . � . SET BACK`. _` ` �,• ' ' '' \ , FLOOR JOIST ', • • , _� � � ; - FiGS/FORMSlSTEEL ,-Z.. :'c0 FHA REQMTS - -- -- - • - - — ' - � ELECTRIC GROUND - - �" - - "UNDER FLOOR DUCT ,. ' : ',- � _ - GROUND PLUMBING UNDER FLOOR CO�IDUIT ' - • • SLAB GRADE-- " " � - - � • - � FIREPLACE FOUNbATION •-� '-��- -- - •- � - - 7EMP POWER - --- ` - - - ' ` ' `• FIREPLACE BOND BEAM .� _ . _. _._._.. _ � - - -..._... -- ---; . WATER SERVICE _ - - � ---- �� 'MID HT.BOND BEAM • ' " ' ' � ' ROOF SHEATHING - � - " - " 8 FT.BOND BEAM - • FRAMINGNENTILIATION � FINAL'BOND BEAM • � �- � ROOF COVER PRE-GRADING � � -_'' � � ROUGH HEATING - - - -� �- - BENCHING` '� �, � � ' ' •,• � - _ _. . ' � . ROUGH ELECTRIC -; - '= - - � ' ROUGH GRADING ,� : . : ` ROUGH PLUMBING�' " � - - - - ' - �� � FINISH GRADING , , • • SHOWER/TLIB TEST. � - �- � � - � POOL ELECTRIC ' � � . . EXT.LA7H/SIDING � � POOL FENCING . WALL INSUlAT10N � POOL FINAL CEILING INSULATION • , OFF SITE IMPS. � ' DRYWALL NAILING ' DEDICATIONS - ; .• SEWER ; � FINAL ENG. � SEPTIC TANK __. _: . _. . . . - '� LANDSCAPE/IRRIG. ' . SEEP PIT/L.L- . - --- - . - - � '^` ON SITE IMPS. � , , GAS AIR TEST � - � ---- - --- - ' - - = FINAL ZONING � • • -. FINAL CONST: - - FIRE DEPT. FINAL FINAL HEATING - - HEALTH DEPT.FINAI� � _ _.. .. - - FINAL ELECTRIC - " �- - ; ' ' DEV.FEES PAID � -� � FINAL PLUMBING ENERGY . , � e • - - _ . . _..__ ... COMMENTS � - � •� '. ; �, . . , � , , - _ . .. _ . . . ; . .. � , - ; , . . .. � . SEPTIG TANK SIZE � ' � ' . . - SEEP PIT/U SIZE ' � � , , . . -- � , , :. .. . . ,� . � � - . . � . _ .. .. . ' , . -- � _.. . - . . , ; .. . ' .- . .. � r .. . . ., r ,. . � --- , .. - ,