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Home My WebLink About11368 E?;PI�ED ---��—� CITY OF DIAMOND BAR . � COMMUNITY DEVELOPMENT DEPARTMENT JUL 31 ZOD� 21660 E.Copley Drive Suite I90 PRESS (909)860-3195 Fax(909)861-3117 ' "°'`� BUILDING PERMITAPPLICATION FIRMLY � JOBSITE ga � ��`� /� APPUCATION� 5 PERMIT P/C o ADDRESS �J �S wab��"EG-� �{-�U� DATE �/ � NUMBER � N � ISSUE TYPE OCC APN ' LOT TRACT DATE CONST. GROUP p OWNER �/� LL ADD.ESS � � �'' ' ZONING SEfBACKS Z CIN � ZIP ��'S TEL. IeI "O�fl� FRONT RW ❑ o APPLICANT TEL S DE/SIDE STREET RW ❑ � CONTRACTOR SIDE p o ADDRESS '— , o CITY��_�6./1�1C�71P�2S�DTEL. 11- [� PROPOSEDUSE � wo ARCH/ENG/ . � z DESIGNER NO.DWEL. �nP/S /f / '9�/j��dK M}1 � „j"L� •kL�g � a ADDRESS UNITS STORIES BED�OOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF A0.1.AREANALUATION � - OWNER•BCILDERDECLARATION SFR/ADDiREM O � p I HEREBYAFFlRM UNDEP PENALTY OF PERNRV THAT I AM EXEI�PT FROM iHE COMMCTORS lb G829N/C81p011 - � � � ' W CENSEUWFORTHEFOLLOWIN4RF.0.50N(SEGta71.68U5WE55ANDPROFESSIONSCODE:ANYCINOR (n � U WUNTYWHICHREOUIRES�PEFMITTOOONSTRUCT,ALTER�PROVE,OEMOUSH,ORREPNPANYSTIiUC• W p8tiolDeck � Z TURE,PRIOR 7D I75ISSUANCE.AL50 REWIPES TXE APPLiCANT FOR SUCM PERMiT TO FILE A SIGNEO � W STATEMENT THA7 ME OR SHE IS LICENSED VURSUANi TO 7HE PROVISiONS OF THE CONTMCTORS U• W � CENSE UW(CHAPTER Y(COMAIENCWG WITH SECTION 70001 OF OIVISION�OF THE BUSINESS AND PFO� � PooUSpa � FESSIONS COOE)00.THAT HE Oi15HE IS E%EMPTTHEREFROMANO THE BASIS FORTHE ALLEGED EXEAIP• VTION.ANVVIOUTIONOFSECTION7o71.5BVANVAGPUCMITFORAFERMIT5U8JECT5THEADPUCANTTO Z Re-Roof .� . � ACML VENALTV OF NOTMORE TNN FIVE HUNDt7fD DOLLARS(t5o0).): ZDI.ASOWNEROFTHEPROPERTY,ORMYEMPLOYEESNATHWACESASTHEIRSOIECOMPENSATION, � �mmerciat ' � IMLL DO iNE WORK AND THE STRUC7URE IS NOT INTENDED OR OFFENED FOR SALE(SEC,701�,BU51• J NE55 ANO VROFESSIONS CO�E:TNE CON7MCiORSIICENSE Uw DOES NOT APGL1 TO IW OWNER OF � � PROPERTYNRIOBUIlD50RIMPROVESTHEREON,ANDMAIODOESSUCHWORKHIMSEIFORHERSELFOR = ' [C THROUCH HIS OR HER OWN EMPLOYEES.PROVIOEDTHAT SUCH IMPROVEMENTS ARE N0T INTENOED OR m . � OFFEREOFORSALEIF,HOWEVE0.TMEBUILDINGORIAIPROVEMEMISSOLDWfTMNONEVEAHOFCOMPIE• Z TION,THE OWNER�BVILDER WILL HAVE THE BURDEN OF VROVINO TMAT HE OR SHE DID NOT BUILD OR = IMPROVEfORTHEPUFP0.5EOF5ALE�. �y,� 04��u�NEROFTHEPROFERTY.A/AEXCLUSNELYCONTMCTINGWITFiLICEN5E000NTMCTORS Q TO CONSTRUCT T7E PROJECT(SEG 7W�.BUSINE55 ANO PROfE55lON5 CODE:7FIE CONTMCTORS Lb V81U3Si0f1 � ADJ.AREA W �ENSEUWDOESNOTMPLYTOANOWNEROFAPftOPERTYNR708UM1DSORIMPROVESTIEREON,AND - � W/IOCONTRACTSFOHSUCH7R0.1ECTSWITHAGONTMCTOR(SJIILENSEDPURSUNNT70TMECONTRAG QUANTIN DESCR�PTION � � FEE . Y TORS UCENSE UW.).: ¢ OIAIAE%EAIPTUNDERSEC. B-tV.QFORTH15REA50N � � - � �� . . _ .. . . . . . � � DATE OWNER V � : LIGENSED CONTRACTORS DECLARATION W ' � 1 HEREBYAFFIRAI UN�ER VENAL�YOF PERIURV iHAT IAM LICENSED UNDER VRONSIONS OF LHAPTER V. � p., O�COIAIAENCINONATHSECTqN)000)OFONISION70FTNEBUSWESSAN�PROFESSIONSCODE,AhD Z X MYIICENSE IS N FUII FORCE M10 EFFECT. m W ^� �j ' Q UCENSE CLASS��J�J�LIC.NO.�/�SS � � � � V DATE�a��D""�j�J CONTRACTO �- W j � WORKERS'COMPENSATION DECUIRATION („'�"; a V, �v J U � I HEFEBY AFFIRM UN�ER PENALTY OF PERIURV ONE OFTHE FOLLOWINO DEGLAM7pN5: Z Q � �IHAVEANDWRIMAINTAINACER7IFICATEDFCONSEMTOSELFJNSUREFORWD1iNER5 = � � CqAPENSATION,ASPROVIDEDBVSCCTION77000FTHEUBORCODE,FORTHEPERFOHMANCE W OF THE WORK FON VMICH THIS PERMIT IS ISSUED. � � W �IHAVEANOWILLMAIN7AINWORKERS'LOMPENSATIONINSURANCE.�SNEWIHEDBYSECf10N O 97000F7HELABORCOOE,FORTHEPERFORMANCEOFTXEWORKFORWHIp/THI5GERIAITIS �/� �}/-/�� ISSUED.MY CAMPENSATIO INSUFANCECARfl1ERANDPOLIGYNUMBERr E: . CONSTRUCTION � � L•J II `� � J � ^j� /�i✓!/f � PLAN REVIEW j CARRIER�� 7 S 1,.(js- SFi�I�IC�' � va�cYNUMBER � ELECTRIC -� �xsEcrnNn�mrqreEca.�r�oct�vEa.rT�sxaanie�ooau�uis aqoa� PLUMBING Z ICEFTIFYTINTPITMEPERFORMANCEOFTHEWOfUCFORVlHiCMTHISVERMITI5�55UE0,1 MECHANICAL C7 SHALL NOi EMPIOYANY PERSON W ANY MANNEfl SOAS i0 BECOME SUBJEGT TO iHE _ ' � WOPoCERS'WIAPENSATIDNUWSOFCALIFORNIAANDAGREETMATIFISHOIADBECOME � INSPECTIONFEE- ^ '^ «�+.•� - SU&IECTTOTNEVlORKERS'CDIAPENSATIONPfiON510N50FSE ON770o UBOR , s cooE.isw�uconnMnrNcan�rvnn� PROVISIgN ISSUANCE " f� �71 � � 3 9sr p DATE: ^ID� APPLICANT: SMIP �`�O � ENERGY PIC J WARNINQ:FAM1URETOSECUREWORKERS'COAIPENSATIONCAVERAGEISUNLAWFULANDSM�LLLBE (� LL SUBJECTANEMPLOYfRTOCRIMW/�IPENALTIESANOCMLFINE5U7TOONEHUNOREDTM0U5AND ENERGYPERMIT ��,j� DOLLARS�f foa,0o0),IN ADOITON TO THE COST OF COAIPENSATION,DNAAGES AS PROVIDED FON IN J SECiIDN770eOF7HEUBORLODE,INTERE3T,ANDATTOFWEI'SfEES. - RETENTIONFEE: �� 2 d �� CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � ' � O � IMEREBVAFFlRM UNOERGENALTYOFPE0.IURYTHATTHEREISACONSTRUC710NLENDM�ACENCY �- FORTMEFERFORMANCEOFTHEWORKFORWHICHTHISPERMITISISSUED(SEG7097,CIV.C.). Z . . .. . .. . . .. . . . . . W � � LENOER'S NAME � LENDER'SADORESS � w ICERTIFYTMATIHRVEHEADTHISAPPLICATIONANDSTATE7FUTTHEABOVENFORMATiONISCORREC2 TOTAL FEES . � � IAGREE TO COMPLV WITiI�ILCITY AND COUNTY ORDINANCES AND STATE UN�S RELATWO TO BUI�OING � CONSTRUCTION,ANDNEREBVAUTMDRIZEFEPRESEN7A7IVESOFTMISCOVNT`/TOENTERUPONTHE Z ABOVE�MENTI0NED7ROPEHTYFORINSPECTIONGURPOSES. _ . COMMENTS J � m pERMfTT PYE IPRiNT) � � � 0-9 � Rc PERMITiEE DATE ` � RECPL NO. PAID BY VALIDATI � � -• -� � WNITE—Department Gapy,YELLOW—Finance Gopy,PINK—Assessor Copy,GOLDENROO—File Copy,GREEN—ApplicanPs Copy . . r �. . �'. .� . '�... � . ..�.. „-1, :. . .�.... . .. . . � . .. 1 � �r. . . .. ` i. .� . , � . . .. . . �.� . , ' .. CITY OF DlAfllIOND BAR` . , ; ' � INSPECTION RECORD � , ',� - .. � . . � . �:. - _ l��' - • � � t • ' j - � � , � . � SET BACK � _ ' FLOOR JOIST ' FfGS/FORMS/STEEL - FHA REQMTS ; ", , . � - ,:,' — ' ' ELECTRIC GROUND - ' UNDER FLbOA,DUCT: -• ; ,, .' -, ,-; - ', -,�. : - GROUND PLUMBING �� : ' UNDER FLbOR CONDUIT �= �`' ''.: '-. ^ � � SLAB GRADE- � ' � ' ' FIREPLACE FOUNDATION TEMP POWER --_ _ _ ,�- --- _ FIREPLACE BOND BEAM�i �..� ' !, - ','' . ., . , - ; , ; , _ , . .-.. , . - . , : , ... , . .... .. , . •_.- - WATER SERVICE-'�i-� MID H�':;B�ND BEAM,�� - � ' � -; . _ . , _ '...,_„`. ROOE SHEqT}:{�NG��•• - , ;+ _. ,. �;� , '•' ; 8 Fl:BOND BEAM �� ' FRAMING/�ENTILyATION `""� '�' ` - """t� FINAL BOND BEAM � �•• ROOF COVER - . PRE-GRADING " ' _ _ ROUGH HEATING _ _ _ � BENCHING _. _ __. . ROUGN ELECTRIC -- ROUGH GRADING ROUGH PLUMBING- - - - FINISH GRADING ` SHOWEF�lTUB TEST - POOL ELECTRIC � EXT.LATH/SIDING ' ',••:\�= POOL'FENCING WALL INSULATION �, 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 FtNAL CONST: - - - - - FIRE DEPT.FINAL FINAL HEATING - - - - -- - - - HEALTH DEPT. FINAL -,- . . - - - � FINAL ELECTRIC - --- DEV. FEES PAID _ � FINAL PLUMBING ENERGY � � _. . •,�: �, ��: . . . .`. �J�T � �� . , _ - _ , , � , . , - - . _ _ _ - - - . _ - - - __. _ , , COMMENTS -- � � .. ; , � � - -__ _ - _ _ - -- . _- - --_ . , . ___ __ � � � , - . `�• . . _ . . . . . . . , _ __ _ - . (;,,. �\: •. ..;�� -,� .a\� ,' _ _ � • _ .., � �• .�- .,. _� , _ . . ;, ; , � _ . _ .._--3 � . I -r-_. (` - -_ . . __. . . � . . - . i � �t � J�` -.�.. .`1` J.^�\\ v . , . ` "l. .;`, �. .. . I _ !;(l�' �� ' a . . , — - _ , ,� . . . _ . � , SEPTICTANK SIZE : , , ._ _ _ - -_ _ _� i SEEP PIT/U SIZE - - . _ , . � i ; , - - . , . -, . _ _ _ �� _ _ , _ - - , 'ti � � . ,,�--I, . ` ,�``\ _ ,-. :,'t�"' �, -� ,� �� , , . � �'� \ -;'�\ - \'� _\'• � ', - .