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HomeMy WebLinkAbout17881 . . m. _ _......-.-"-' �-_ .�.�_._. ._ _ . . . � � . CTTY OF DIAMOND BAR � �'�' � DEPARTMENT OF COIvIIvIUN1TY&DEVELOPMENT SERVICES � � 21825 E.Copley Drive Y (909)8603195 Fax(9a9)861-3117 PRES ��'%��� BUILDING PERMIT APPLICATION FIRMLY ¢ ADDRESS I d �� VV�''' sp�1�C ►/r' APPUCATION �' /�—�� PERMIT /' / P/C o {� DATE�/ NUMBER / �� # � APN �OT TRACT ISSUE TYPE OCC DATE CONST. GROUP p OWNE�' 1 �� ' � o ADDRESS It ZONING SETBACKS z CITY C , IP TEL L _ �- FRONT RW ❑ g APPLICANT TEL(����1 �� REAR � � * 7mff�� SIDFJSIDESTREET RW ❑ � CONTRACTOR - SIDE p � ADDRESS PROPOSEDUSE �� � � J Y-f �t'.. K� � CI7Y ZIP �TEL. � �W ARCH/ENG/ .��,N C"►1 ��P 1 ; �� DESIGNER � � NO.DWEL NO. � ,NO. �� � a ADDRESS � CfTY � Z�p ,�� UNITS STORIES BEDROOMS � <n �ESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/AOD/REM O p 1 HEREBV AFFIR►1 UNDER VENALiY OF GERIURY THAT 1 MI E1(EMPT FROM THE CONTMCTORS LI• Gaf090/CdfpOfS � W CENSEUWFORTHEFOILOWiNGREASOH(SEC.7071.6BUSMESSANDPROFESSIONSCODE:ANYCINOR (n C.� COUNTYWMICHREOUIRESAVERMRTOCONSTRUCT,ALTERIMPROVE.DEMOLISM.ORREPNRANYSTRUG• w w NRE FHIOR TO RS ISSUANCE.ALSO REWIRES THE APPLICANT FOR SUCM PERMIT TO i1LE A SIGNED W PatiolDeck STATEMENT THAT HE OR SHE IS LICENSEO PURSUAN7 TO THE PROVISIONS OF THE CONTMCTORS U- � CENSE UW(d1APTERi(WMMENpNO YA7H SECTION 7000)OF DIYISqN]OF TME BUSINE35 ANO PRO- � PooVSpa � FESSqNSCODEIORTHATHEDR5HEI5E7(EMPTTHEREFPOMANOTHEBASISFORTHEALLEGEOEXEMP• C7 TION.ANYYIOLATIONOFSECilON70�7.SBY�NYACDLICANTFORAVERA11T5U&IECTSTHEADP�ICANTTO Z Re-Root � ACML FENALTY OF NOT MORE hLW FIVE HUNORED�OLURS�i5o061: � ❑I,ASOWNEROFTHEPROPERTY.ORMYEMPLOYEESWITNWACES/�STMEtR50LECOMPENSATqN, 0 CommefCi01 - Z WILL DD THE WORK.MN TXE SiRUCTURE IS NOT INTENOE�OR OFFERE�FOR SAIE(SEG 70N.BU51� J � NESS/JJD PROFESSIONS CODE TME CONTMCTORS UCENSE UW DOES NOT APPLV TO AN OWNER Of ? VROFERTY Wlp BU0.D5 OR IMPROVES THEREON,AND WMO DOES SUCH M/ORK NIuSELF OR HERSELF OR � 7MROUGHHISORHEqOWNEMP�0YEE5,Vf10V10EDTHATSUCHMPROVEMENTS�RENOTINTEN�E00R LO � OFFEREOfORSALEIF,NOWEVE0.7NEBUlD1NOOR1IAPROVEMEHTI550LD4ATMNONEYEAqOFCOAlGLE- / Z 710N,THE OV�TIERSUILDER WILL MAVE THE BUROEN OF PROVINO T1AT ME OR SNE OID NOT BUIID OR � NIPROVE FOR iME PURPOSE OF SALE} O 4�5 OWNER OF iME VR07ERf1:AM E%CLUSNELY COMMCTINO N7TM LICENSED CANTMCTORS � 70 CONSTRUCT TNE PRQIECT(SEC.7Da�,BUSINE55 ANO PROFESSIONS CODE:THE CONTRACTORS U- V2IU21i0�1 L'I�'� ADJ.AREA Ll1 CENSEUWDOESNOTAPPLVTOANOYA�fROFAPROPERTYNRfOBU1LD40RIMPROyESMEREON,MlD � �_ NTqCONTRAC7SWR5UpiVHO.lECiSWITN�CONTMCiOfi15)IICENSEDPURSUANTTOTMECONTMP OUANTITY DESCRIPTION FEE Y TORS LICENSE UW). � ��IAME%EMPTUNDEHSEC. B.6P.CFORTHISREASON Q � / —� c' cc V"' DATE � �O� OWNER V Z , W �¢ UCENSEO CONTRACTORS DECLAAATION W 2 IHEREBYAiFIRMUNpERDENALTYOFPE0.1l1fIYiMAT1AMLICENSEDUNOERPRON510N50FtHA7TER � � Y(COMMENCINQ WITH SECTION 7000)OF OIN510N f OF TME BU5INESSAND PROFE5510N5 CODE,AND Z �� LIY LILENSE IS IN FULL iORCE AND EFFECi. m � LICENSE CUSS LIC.NO. J V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECIAFtATION Q � IHEREBYAfFIRMUNDERPENALTYOFPE0.NRYONEOFTHEFOLLOW�NG�ECIAMTqNS: Z � �IHAVEANOWILLMAINTAIN1ICERTIFlCATEOFCONSENTTOSELF-INSUREFORWORKERS' _ Q COMPENSATION,ASPROYIDEOBYSELTKKi7Io00FTMEUBOfiCODE.FORiMEPEfliORMANCE W OF TIE WORK FOR Vh1iCN THIS OERM�71S ISSUED. � � _I HAVE ANO WILL AAAINTAIN WORKERS'COMPENSATWN INSUMNCE.AS REOUIRED BY SECTqN Qi7o00F1HE{,ABORCODE.FORTHEPERFOPIAANCEOFTHEWORKFORNM111diTMISPERMITIS ��F�/� � ISSUED.IAYWORKERSCAMPENSl1TqNINSUMNCEGIRRIEflANOPOLICYNUMBER11flE: CONSTRUCTION _ (/ y CAHFIER PIAN REVIEW � POIICYNUMBER ELECTRIC � �ssecr��mwreeoa.+Rt�noFnevera�r�sroaa�ru�000�wis�t+aoloA�ssl PLUMBING Z I CERTIFV TNAT INTHE PERFORMANCE OF TME WOFK FOR YYH�p/THIS 7EAAUT IS ISSUED,1 MECHANICAL (J SHALLNOTFMPLOYAN'lGERSONWANYMANNERSO�STOBEWI��ESUBJECiTOTME � WORKERS'COMPENSATIONUWSOFCALIfORNIA,ANDACREETMATIFISNpUlpBECOAIE INSPECTIONFEE SU&JECTTOTHEWORI(ERS'C04PENSATIONOROVISIONSOFSECTION77000iTNEUBOR _7/_ �^ -�j CODE,I SFULI FOFiT1iWITH COMP�Y WIi1/TMOSE PROVISIONS, ISSUANCE . _[-,,� �� � �%`�"�-� v�� [� O ` � - —7� p DATE: aPPLICAN7: SMIP _ �� .� L' W ENERGYPlC 11 DD �nn� � WAqNIN6�GAdl1RETO5ECUREVJORKERS'COMPENSATpNCOVEMGEISl1NLAWFlA.11NDSHILLLBE �1-7T—� y LL SU[iJECTNIEMPLOYEFTOCRIMWALPENALTIESANDCMLFMESUPTOONEHUNDPEDT110US�WD ENERGYPERMIT � DOl1AR5(�t00,OD0),W ADOITION TO TME COST OF CAMPENSATqN,DhMAGES AS iROVIDED FOR IN ¢ SECTION]lOeOFTHELABORCODE.NTENEST,ANDATfORNEYSFEES RETENTIONFEE: � a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: �k� �- � 0 ---'------�-- � IHEREBYAFFIRMUNDERPENALTYOFFERJURVTMATTHEREISACONSTRUCTIONIENDWCAGENCY fOR TNE PERFOXMANCE OF THE WOFK FOR WNIGH THIS VERMIT IS ISSUED{SEL.709�,CIV.CJ. Z W � LENDERS NAA1E � LENDER'S/�DDRESS ¢ ICERTIFYMATIH�VEpEADTHISAPVLICATIONANOSTATETUiTHEABOVEWFOWA�TIONISCORRECL TOTAL FEES • w IACREETOCOIAPLYWITHALLCITVANUCOUNTYORDINANCESANDSTATEUWSREUTINQTOBWLDiNC � CONSTRUCTION,MIDMEREBYAUTHORREHEPRESEMATNESOFTM15C0UNT'70ENTERUPONTHE ZABOVE-ME NED R07ERTV fOH Iy5PEC7qN PUfiPO5E5. COMMENTS � �j�;� �, �, 7�un�- _ m PERMITTEENAM�(PW1in �� I � � y� � �If—�Z, (n SICNAN F VERMIREE D�TE � RECPT.NO. �'L'� PAID BY � VALIDATION WHITE—Departmant Copy.VELLOW—Finance Copy,PINK—AssessorCopy,GOLDENROD—File Copy.GREEN—Applieant's Copy � .. ; .. � . _ . ,' .,.-.�..> ��,�.,'.�� .�:,. ���:i�.•.�s. ;.,�,......:,rt'�'i'��:'1� �: ;'a. ...����� �.... , ..� � ..iKh,_ ..f.`�' . � , . � , .. . .. - cs�;� c►r= fl���r���a��� ���� �rw�7-�c�-�o�� ��cc�:�Q `"�I►'�'�:�=i� .CC��1►�tl '� rr��.^•� I►��M^�Ft,at���s� __..__.._..�►'}�y:��.�� �FCi�fi'C�Tc};,���I►��-'�(:-1.:zc,`i��=� "-� . . .. . __.. ______ . _ __... _.___�._._...._.______.._. ____.__...�_._. ..._ ._ .__.=---.__ _.._._ .._.__._.__..�..�___ SET E3ACK _..______.__-------- i � I FLOOR JOlST , � ------ _ ----�— FTGS/FORP�1S/STEEL I � � FHA REQMTS ELECTRIC GROUf�lD ; ' j UNDEFi FLOOR DUCT GRQUND PLUMBING � � UI�IDER FLOOR CUf��DUIT SLAB GRADE FIREPLr10E �OUtJDATiON l TEh4P POWER � FIREPLACE BO`JD 6EAM ; WATER SERVICE i MID HT. E�OND BEAM ROOF SHEATHfNG t�j�OL�_��"_ £3 FT. EOP�D BEAM FRAMINGNENTILIATION � FINAL BU��dD F3EAPJ1 ROOF COVER ���G _ PRE-GRADING I � ROUGH HEATING BENCHI�lG � . ROUGH ELECTRIC I ROUGH GRADING ROUGH PLUMBING � FI�dISH uRADING SHOWER/TUB TEST � POOL ELECTRIG EXT. LATH/SIDING j � POOL FENCING WALL INSULATION POOL FINAL CEILING IN�ULATION OFF SITE IMPS. QRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TF�NK � • LANDSCAPE/IRRIG. � SEEP PIT/L.L. ON SITE IP.4PS. GAS AIR TEST FINAL ZONIf4G FINAL CONST. ! , �!RE DEPT. FI�JAL ' FINAL HEATING � HEALTH DEPT. FINAL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUPJIF3ING ENERGY _-- - -� .Y��''"'_}�''_'�{`.� _ _ ____ COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE _ _�.___�_�__.�.i ��r� i � � � 'IMf�' —:i _.. i :y �I �� I