HomeMy WebLinkAboutNo Permit Number (11) �
CITY OF DIAMOND BAB �O�� ��
--- -- DEPARTMENT OF COMMUrTITY&D$VEIAPMENT SERVICES
� . 21660 E.Copley Drive Suitc 190 '
(909)860-3193 Fax(909)861-3117 PRESS
��'^�'f BUII.DING PERMIT APPLICATION FIRMLY
� JOBSITE APPLtCATION /.�.-J,/ PERMtT � /C
ADDRESS �LL � CV lI0'
o DATE NUMBER �f
$ ISSUE Typ� pCC
� O�N�_ LOT RAC DATE CONST. GROUP
� ADD SS A/a ZONING SETBACKS
FRONT
CI ZI L. REAR � ❑
APPLtCANT �K SIDE/SIDE STREET qW ❑
CONTRACT R SIDE C
� Cm.� op,��„� y,r �. PROPOSED USE _ �
'4'LY�L�- 21.�5��*tit TEL
� ARCH/ENG/ �S7r�c�
DESIGNER NC7��
ADDRESS NO.DWEL. NO. NO.
� CITY ZIP TEL UNITS STORIES BEDROOMS
N bESCRIPTION SQ.FT. FACTOR P5F ADJ.AREANALUATION
� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
1 HEREBY AFFlRU UNDER PENALiY OF PERRlRY TNAT I AM E%EMPT FROM THE CONfRACTOFS LI-
CEMSEIAWFORIFIEFOLLOWINGREASDN�SEG7o97.6B1151NE53AN�PROFES5qN5CD0E:ANYCITYOR � N Gef��CefpOR
COIMrYYAiICMREGURESAiERYRTOCONSTRl1CT,ALTFRMIPROVE,DEMOLI3H2ORpEPA1RANV8iRUC- . W VetIoIDBCk �
fURE.PRIOR TO ITS 168UANCE,AL90 REW IRES TNE APRMANT FOq 6UCN PERMIT TO FILE A BIONED ' W
BTATFMENT 7HAT HE OR SHE 16 LICENSE�PURSUANT T07HE PROYISIOHS OF TH6 CIXliqACTOR9 4-
CENSE lAW(CHAPTER�(COMMErvCiNa WITH 9EC7qN 7000)OF Drv6qN i pF TME BUSINEsS AND PRD- � POOVSpB
FESSIONS OOD�OR TFNT ME OFi SHE IS E7�MP7 iNEREFROM AND THE BASIS FOR TME ALLE�EU E%EMP-
TpN.N1Y VIOLATION OF 6ECfION 7071b 9Y ANYAPPLICAN7 FOR A VERMIT SUBJECf3 7F1E APOLIGWi l0 Z p�p�
� Il QYIL PENALTY OF NDT MORE TMIW FNE MUNDRED DOLLARS II!�O)J: � �
❑I,ASOMMEqOFTHEPHOPERTV,ORMYEMPLOYEESWIiHWA0E5AS7HEIHSOLECOMGENSATqN, COmmBfCiel
WILL 00 TiE YVORK ANO TFIf 8TRIICNIIE IS NOT IMENDED Op OFFENED FOq 9µE�SEC.7D.1�,BUSI- �
� NESS ANU PROFESSIONS CADE:THE CONTRACTOAS LICENSE LAW DOES NO7 MP4Y TO AN OWNER OF �?
VROPERTY Mllp BU0.DS OA MIPROVEB THEREON,ANDYAfO DOE6 3UCH WORK HIMSELFOiI MER50.F pq
� ilY1WOFIHI50RHEROWNBdPLOVEE3,PROVWE�THAT4UCFIIMPROVEMENT3MENO7NTENDEOGH � m
GFFENED PDRBALE IF,iIOYYEVER 7HE BUIDINOOR INPROVEMENf IS SOID WffHIN qJE 1'EAR OF�t7MPlE-
iION,iME OYIMER�UIIDER WILL INVE 7ME BURDEN OF PROVIN4 TNAT NE OR SNE O�NDT BUIID Oq
MPipVE POR SME PURP0.4E OF 8ALE} �
0�AS OWNER OF TFiF PROPERTY,AN El(CLUSIVELY CONTMCTINO VYRN LICENSED CONTUCTORS
� TO CONSTRUCT iHE PpO,1EC?(�C.7DM.BUSINESS AND PROFES4IONS OODE:THF OONTRACTafiS U� Ve1U9110n ADJ.AREA
CENSE lAW OOE9 NO7APPLY TO hN OYVNER OF A PROOERTY WHD BUH.DS OR MPPOVE9 THEREON,AND
YMF�OCOMRACT8FOR9l1CHVRO.IECfSWI7HACONTMCfOR�S�LICENSEDPUqSUANTTOTNECOHfRA0. pUAN7TfY DESCRIPTION
� ra�s ucvus uw.�. FEE `
O I AM IXEMM UNDER SEC. B.i P.C.FOR TNIS pE/WON q �,
U
� st
"—' o�rE oN+�eR
� LICENSEO CONTRACTORS DECLARATION W
� IHEFiEBYAFFIRIAUNDENPENAITYOFPEIUURYTWITINALICENSEDUNDERiROVISION$OFCHIIPTER �
� ��GpNAENGNGYlRMSEC710N'lo0o)OFDMSIONJOFThIEBU6INES5N10PROFE55�UV5GODE.AND z
�� MY LICENSE 16 N FULI f AND EFFECT. m
0� IICENSE 5S � LIC.NO. ',,,.I
t' MTE CONTRACTOR _ � a
Si
� WORKERS'COMPENSATION DECLARATION �
� IHEREBYAFflRMUNDERPENALTYOFPERIURYONEOfTHEFOLLOWINO�ECLARATIONS: Z
� _IHAVEMI�NIILLMAMTNNACERTIFICATEOFCONSENTTOSELFdNSUREFONNlORKERS' �
OOMPENSA710N,AS PHOVIDW BV SEGTON s/oo OF TlIE LABOR CODE,FOR lHE PENFORMIWCE `U
Q OF T1E WORK FOR WHldl TMS VERMR IS ISSUED. �
Q �I iUIVE/ND WILL AMT'TAIN WORKER5 COMPENSATION INSURANCE,AS REQUIRED BV SECTION
87o00FTHElABORCOOE,FORTHEPERPoRMANCEOFTHEWORKFOHIYHICMTHISPERM1T15
ISSUm.MYNpRKE �PE,.N�SATqN IN5U IER AND VOLICY NUMBER�RE: CONSTFiUC71ON
jCMRIER��/�,�/� �Y� P IEW n / /
� POLICYNUMBER �„yL�� ELECTRIC �
�
p' (nese[crn�r�EIDr+�TBE�wr�ErmaFnfa�aMr�srar�onEM+�or+mDotl�uuRiariora�ss�. PLUMBING
w
� I CEFITIFV TNA71N THE PERFORMANCE Of THE WOHK FOH WHICH iHIS PERMR IS ISSUED,1 MECHANICAL _s j�
6NILL NOi EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE
(q WORNER9'COMPENSATIDNLAMISOFCILLIFORNU�ANOAGHEETHATIFISHOIROBECOME INS FEE
S 611filECTTCI THE YVORKERS'f.YJMPENSJRpN PROVISIONS OF SECTION 71o0OF THE UBOR �
CODE,1 SHALL PoRT lY1 COMPLV NNTI7HOSE PROVISIONS. �SSUAN �
0 �
B DATE:_ 1 y_ APPLICANT:�� _ __ SMIP
� WMNINO:F�IWRE TD SECURE WORNERS'C061PENSATpN COVERAOE IS UNUWFUI,ANO SNALL BE ENERGY P/C /�r�.�
�y BUBJECTANEMPLOYERTOCRIMPIALPENALTIESANDCMLFNJESUPTOONEHUNUREDTHOUSAND ENERGYPERMILIi i OFDI
DOLLARS(3100.000),IN AOOITION TO 7HE GOST OF COMPENS�TqN,OAMAOES AS PROVIDED FOR IN
J BECTpN970lOFTHELABORCODE.INTEREST.ANDATTORNEYSFEES. RETENTIONFE�U�DING
O CONSTRUCTION LENDING AGENCY PRE•ALT FEE:
g IHEREBYAFFIqMUNDERPENAL7YOFPERIURYT1i5TTHEREISACONSTNUCTIONLENDINOAOENCY
FORTiE FERFORMANCE OF hfE WORK FOR WHICH THIS PERMIT IS ISSUE�(SEC.�oB7,qV.C.).
Z
W
� LENDEH'S NAME , -
C LENDEfTS ADDRE53
� ICERTIFYTHATIHAVEREADTiISMPLICAl10NAND5TATETHATT1EA80VENFORMATIONISGORqECL TOTAL FEES
� I AOREE TO COMPLY WITH ALl CI7Y/�NO COUNTY ORDINANCES MJO ST�TE LMMS REU7ING TO BUIlDN6
� CONSTRUCTION,MDMEHEBYAt1t1qRIZEREPRESENTATIVESOFTHISCOUNTYTOEN7ERUPONiHE
11BOVE•MEMIONE�VROPEHTYFOFINSPECTIONPURPOSES. COMMENTS � tO1
�
7
m v ,w� �
Q
'n . frf 1 �L . ' /
(q 8qW1NREOF E DAiE
� RECPT.NO. PAID BY � YALIDATION� '
WHITE—Depertment Copy,YEILOW—Flnance Copy,PtNY.—Asaesaor Copy,GOIDENROD–�File Copy,GREEN—ApplicenCs Copy
,.. . ... ., ,. ,
. .. . . , ..: ::. ,, . ,. -,.,.. ,, .,.. ;..: .. . , , ,. , ,
, , ...
,. _ - . .,. .., . ,-:...,.. ,
' �`�� •- � r� CITY OF DtAMOND BAR
I(�1SPECTi01`�! RECtJf�D
F e � • � - - • � , . � .
8ET BACK . , . ,. FLOOR JOIST --, ; '. , ,� - , ,
.�
�TGS/FORMSlSTEEL FHA REQM;iS_ ,
ELECTRIC GROUND UNDER FLdOR.Q.UCT `-' " �� ..• - .
UNDER�LOQR CUMDUIT � '
GRt7UND PLUM8ING • ��. � " -" ' r
SCAB GRADE FIREP'LACE•�OUNDATfON � :..-'-= " . , -...`.`,;. :�. �
TEMP POWER � FIREPLACE BOND BEAfN '
WA7ER SERVICE - .. MID HT. BOND•BEAM• '•'- - - � � _'•, .1_,, �
ROOF SHEATHlNG� ' '�- . _.�� _ 8 FT. BQND QEAM. * - - - _ -• - -. � - - �
FRAMINGNEN7ILIATION FINAL BOND�BEAM ,
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING �
ROUGH ELECTRIC , l � � ROUGH GRADING
ROUGH PLUMBING FINISH GRADING j
SHOWERlTUB TEST POOL ELECTRIC
EXT: LATH/SIDING � ` PQOI FENGING :
WALL INSULATlON ; POOL FINAL
CEILWG lNSULATIOht } OFF SITE IMPS.
DRYWALL NAILING I ' DEdICATII�NS '
$EW�� FINAL ENG.
SEPTIC TANK � �ANDSCAPE/IRRIG. � —
SEEP PIT/�.L. � I I ON SITE IMPS.
�AS A!R�EST j. ,.,, . , ., FINAL ZONING
FfNAC G{�NST. -- '.' . � • -- -�- ,- ; � �iRE�EPT. FINAL i —'
fiNAL HEATING �`'-�( � , •'•� HEALTH DEPT. FINAL
FflVAL ELECTRlC � ��,_ ' � ; DEV. FEES PAID 'r
FINAL PLUMSING ! ' ENERGY '
� ; � , --
i � � .i .
Ci�1�YiiVfG1Y 1 J �
, �
, . _ - , � ---- . - r.- - .
, , pr1f,
OCGf !!<
. Y,��,� -.
,'; ! a'T'�7�?.f. T, �1 . . .. - - - . � . .
BEPTIC TANK SIZE'-'�'.��i':,' ';�i,r, ;)�'Tr�.;i(Jt:
SEEP P1TiU SI�E � •
�;
_._ � . — _ . _- . . . ---
r . � ._-�� ,-