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HomeMy WebLinkAboutNo Permit Number (11) CITY OF DIAMOND BAR � ��►U � r DEPARTMENT OF COMMiJNITY&DEVELOPMENT SERVICES � , 21660 E.Copley Drive Suite 190 . (909)860-3195 Fax(909)861-3117 � PAE$$ �'^N'� BUQ.DING P'ERMIT APPLICATION FIRMLY y JOBSITE - APPLICATION t D� I�..- PERMIT � b P/C o ADDRESS � u- —' DATE � � NUMBER N $ ISSUE 7yPE �C APN LOT T CT DATE CONST. GROUP g OWNER � ADD SS ' � ZONING SETBACKS CI ZI �, FRONT qyy p � APPLICANT REAR p SIDE/SIDE STREET RW p � CONTRACT R SIDE p ADD S � CITY ZI�TEL. .- PROPOSED USE � ARCH/ENG/ Qz-r,„ � DESIGNER ������L� ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNtTS STORIES BEDFi00MS � y DESCRIPTiON SQ.FT. FACTOR PSF ADJ.AREANALUATION ¢ OWNER-BUILDERDECLARATION SFWAOD/REM � O e I MERFBY AFFlRAI UNDER PENALIY OF CE0.1UqV T1UT I AM E%EMM FRdA THE CONTAIICTORS LF �g�8g8/CBI�On � CENSEIAWFORT/1EFOLLOWINOPEASONfSEC.7IXl1.68USWESS,W�PqOFE5510NSCODE;ANVCITYOR � (n COIN�RYNM1IICNRC•OUIRESAPERMRIOCONSTRUGT,�LTER�PROVE.DEMOl1&I,ORREVAIRMIY9THUC- W PddO/D6Ck TURE,PRIOA TO RB IBSUANCE,K80 RECUIRES THE AVPLICAM FOR SUCH PERAARTO RlE A&WED W � STATEMENT THAT HE OR 9HE 19 110ENSED IKIRSUANT TO 7HE PiqVI5pN8 Oi 7FIE OON�MCTOp6 LI� GENSE UW(CMAPTER�(COMMEMpNO WIT116EC110N 7aoa)OF OIVISION J OF TI1E 9USINE95/WD PRO- � POOVSpe FESSpNSCOD�ORTFNTMEOR8HE15EXEMPTiHEREFqOMANOTME8A315FORTHEALLE0E0EXEMP• (� TION.ANYVIOURIONOFSECTION70.11.6BYANYAPPLICMITFORAPEFUqTBUBJECTSTHE�PPLICANTTO Z qgqpp� � A CMl►ENIILTY OF NOT MOpE TMAN FIVE NUNOREO DOLLARS(55aq.)� � o ❑4ASOYYNEROFTIIEPqOPERiV,ORMYEYPLOVEESWITHWA0E5AST1EIR90lECOMPENSA710N, COrtIrtIB�Cl81 � - Z YYILL 00 TNE NIOqK,MID hIE STRUCTURE t3 NOT INTENOED OR OFFEHED FOR SALE(SEC.7oaa,BUbI� � � NESS AND PROFESSION6 OO�E:THE CONT WlC70R3 LICENSE L�W DOES N07 MPLY TO AN OWNER OF � VROGENTY YVFW BIIIIDS OR INiROVEBTMEREON,AND NM1IO OOES 611CH YN7NN MMSELF OR IIERSELF OR � TIYIOUGH FIIS OR MER OYJN FLIPLOYE[S,PFqYIDm THAT SUCM MAPROVEMEMS ME NOTMENDED OR m OFFERmFOF&LLE IF/pVYEYER TME BULDINOOq IMPROVEM�EN719 SOLD WRWN ONEVEMOF WMPIE� TION,iNE OWNE14Bl{ILDEH WILL NAVE lilE BURDEN OF iROVIN6 iHAT ME OR SHE DID NOT BURD OH MPFiOVE FOR THE rURPOAE OF SALE). �y,� �L A6 ONMEp OF iHE VRDPEIiT1:4A O(CLUSIVFLY CONTRACTINO WITH LICENSE�CONTRIICTORS � 70 OONSTM1Cf T/IE PRO.IECT(EEC.7UN.BUSINE55 MD PROFESSIONS CO�E:7HE CONTN0.C1qH5 I,I� V8IY8I1011 ADJ.ARFA CENSE LAW OOES NOTAPPLY TOIW OVMER OF A PROPEflTV WFiOBUILDSOR IMPROVE9IHEREON,ilNO WHOOONTNACf9FDR8UC7iPHOJECTBWITHA00tliMCfOR(5)LICEN9EDPURSUANT1p7MECONTRAG pUANTITY DESCRIPTION FEE � 70iiSLICENSELAWJ. . O I AM FXEMPf UNDER SEC. B.\P.C.FOR THS qEA50N � � u `� LL' DATE OWNER ¢ � U . LICENSED CONTRACTORS DECLARATION W � 1 XEH�Y�FFIRM UNDER VENALTY OF PEIUURP TFU1T IAM LICENSED UNUEH PROVISIONS OF CHAPTER � � �(OOMMENCING WITN 9E ION 7000)OF DMSION e OF THE BUSINE35 ANO PROFESSIONS CAOE,AN� Z �� W UCENSE Ib N FUIL E At�EFFECL m Q UCENSE SS LIC.NO. j ,�—1 J WTE CONTRACI� .' a = WORKERS'COMPENSATION DECLARATION Q � INERFBVAFFlRAIUNDERPENAL7VOFPE0.IURYONEOFTNEfOLLOWINODECUMTIONS: Z � _IWNEMDWILLMAIqTIUNACEftfIFICFTEOFCON5ENT705ELF-INSUREFORYYOHKERS' � OOMPEN6ATpN,�SPROVIDEDBY6ECTION77ooOFTHELA90RCO�E,Fl�RiHEPERFORMANCE W Q OF hIE WORK FOR VMICN TNIS OEHMrt IS ISSUEO. �I Q �.I HAVE AND WILL MAIMNN YYOflKER3'COMPENSATION AJ5UMNCE.IIS REWIRED BY$ECTION 870o OF TNE LA90R CODE,FOR THE PERPDRAUW CE OF THE WOHK WR WHICH 7HI5 PERMIT IS J ISSUED.WY WORKER5'OOMPENSATION INSU CARRIE�R AND POLICY NUMBER ME: I CONSTRUCTION j CAi1RIER 1, PLAN EW � t / � POLICYNUMBER ,a � � LECTFIIC Q (nissEt'mnr�rpreEao�tFrmoF'n+eaEwars�torie�ooawtsR�m�ai�ss} PLUMBING a.� _.. . . LL � I CERTIfY THAT IN THE PERFONMANCE OF 1ME WORN FOR WNICN THIS PERAIIT IS ISSUED,I MECHANICAL SHALL NOT EMPLDY ANY iER50N W MIV I.WINER 60 AS TO BECOME 9U&IECT TO THE (q WORKERS'COMVENSATION UWS Of CAL1iORN1A,MlUAGHEETHAT IF I SHOUIO BECOME INS�FEE S SUBJECfTOTHEWORNERS'OOMPENSATqNPROVI5KKJ50FSECT10N97a00F7T1EUBOR �^wS ��� COOE,I6HALLFORTHN7THCOMFLVVATITHOSEPROVISIDNS. SUAN d� �_ � DATE:��� APPLICANT:��P�Q���-E.:= SMIP —� WAfWINO;FALURE TO SEIXJRE NtlRNERS'COMPENSAiION COVEqAOE IS IINUWRIL,AND SMALL BE ENERGV PJC __ ('!I�A7M�7�ONn a�� � 6U61ECTANEMPIOVEHTOCRIMIN�LPENhLT1E3ANDqVILflNESUPTOONEHUNDREDiMOU^uAND ENERGYPERMtT �+ �11�((J���7�[7 JDOlLAR3(ft0D,0a0}M/ADqTON TO TFIE COST OF COMPENS�TpN,DAMAOES AS PROVIOED FOR IN OBECTI�N 970!OFTHE 111BOR CODE,NJ7EREST,AND ATTORNENS FEES. qETENTION FEE: CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I XEREBYAFFIRM UNDER iENi1LTY OF PERJURY TIMT TMEHE IS ACONSTRUGTION LENOWG�OENCY FOF 7FIE PERFMIANlCE OF TME WORN PDR WHICM THIS iEHM1T IS ISSI�D(SEC.70Y7,CIY.CJ. � � LENDEFY9 NAME � LENDER'SADDqE35 W� TOTAL FEES ICERTIFYTHA7IH�VEREADTl113MPLIC�TIONANOSTIITET17ATiHEl1BOVENFOfOd�TqNISCORRECT. ' "� d IAUqEETOCOMPLVWfTHALLGRYANOCOUNTYORDIHANCESANDSTATEUIWSREIATWOTOBU1lDIN6 � � CONSTRUCTqN,AND HENEBYAUTMORIZE HEFpESEMATIYES OF h115 COUHfY TO ENTEH UPON THE . ABOVE•MEHfpNEO VROPERTM FOH INSPECTION PUHPOSES. COMMENTS � � m P EE INp � �' �-�tl� � f/ �' &ONATURE EMAITTEE D1UE r � RECPT.NO. PAID BY 1 VALIDATION WHITE—DepartmeM Copy,YELLOW—finance Copy,PINK—Asseasa Copy,GOLDENROD—Flle Copy,GREEN—Applicant's Copy -. . , .., ....,,. , ,.... , . . . . . , . .. . , . . ; . ,. . , , �• � :� ; �,.�', ' CITY aF DI/�.MOND BAR . . INSPECTIC3N RECOFiD� � • s e � • � - • e r � - � - 5ET BACK ' - � ' FLOOR J�IST...�, � • ~. ' ' y �'� , ', - . FTGS/FCIF�MS/STEEL � FHA REQMTS.�, -. ELECTRIC GROUND UNDER F.LQQR;DUCT:�,...:: - ,•, �.,-"� GROUND PLUMBING UNDER,FL.UQR.C�M��11T_ �,; , , _ ,:�;__�•_ _, : :. ` �. - ; _ ':�`. ;, � � SLAB GRADE FIREPLA6E'�FO(1NDATION---—� �' . . - _ TEMP POWER FIREPLACE BOND BEAlV! WATER SERVICE MID HT.BOP1b��BEAM• '•'• - � � � - `� • - , ;, . .. ROOF SHEATHtN�. . � . -- S F1'.BZ]ND 8EA � - -- , . _ .- ---.� � . . . ^ �--....� . , FRAMINGNENTILIATION FINAL BOND•BEAM ROOF CUVER � i PAE-GRADING ROUGH HEATING BENCHING ' ROUGH ELECTRlC I � ROUGH GRADING ' ROUGH PLUMBING { FINISN GRADING SHOWEA/TUB TEST PO�L ELECTRlC EXT.LATH/51D1NG POOL FENCING WALL INSUtATIUN POOL FINAI. CEILING INSULATION OFF SITE IMPS. DRYWALL NAI�lNG � DEDICATIONS SEWER_ ; FINAL ENG. SEPTlC 7ANK � LANDSCAPE/IRRIG. SEEP PITlL.�. i i , ON SITE iMPS. GAS AIR�'TEST .� . . � FINAL ZONING ; `FINtAL�ONST. - ----- � •- - • • - � , � '; FIRE DEPT. FfNAL`--I� i FIN�k��HEATING � - ` ' � � - ' '� HEALTH DEPT. FINAL � FifYAL ECECTRIC �' f,' ' � ' : i DEV. FEES PAIQ ' ; FINAL PLUMBING ; i ENERGY I _.. ` + m—__.._.�'. . � � � � COMMENTS , -. . —. � - — �i. .. c . . . .. • , 3�A^ �:t1,��")N:�l: ; .. �s :: _ , , . _ , , , .tL�,� ��.r r- . . . � !),. SEP71C TRNK SI��'� � � � SEEP PIT/U SIZE � - - � ', • _. —. . ---... , . ,, . . . . J i .. �