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HomeMy WebLinkAbout12041 (14) ���� ���, j J L,� � CITY OF DIAMOND BAB � � " �f�� J 1 � -- -- DEPARTMENT OF COMMiJNITY&DEVELOPMENT SERVICES � . zi66oE.co�yna��s�c�z90 PRESS (909)86Q3195 Fax(909)8G1-3117 .����^��� BUQ.DING PERMIT APPLICATION FIRMLY � DDRESS lSbd ��br (.IJUf 1 OATEICATIO i '"� NUINBER� N/C � ISSUE TYPE OCC APN LO TRACT DATE CONST. GROUP °�j OWNER H G r "1 L ADDRESS (ni/" ZONING SETBACKS CITY S A ZIP 2- LG TEL - d FRONT RW ❑ APPLICANT � TE �R � 51DE/SIQE STREET fiW ❑ CONTRACTOR � ,L. SIDE ❑ g CIDDRE S , ZIP q��,oL .�L � PROPOSEDUSE ��Sg...r� ✓ir,j�L f��-f= 8 ARCFVENG/ •� � DESICiNER NO.OWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS y� CI7Y ZIP TEL. DESCRIPTiOh SQ.FT. FACTOR PSF ADJ.AREANALUATtON p� OWNER-BUILDER DECLARATION BFRIAD�/REM O p 1 NEREBY AFFlRM UN�ER PENALN OF VER.MiY TIiAT I AM EXEMPT FFOM THE CONiRACTORS LI- Q8fA081Cfl(pOR a CENSEIAWPOqT}1EfOLLOWINOREASd1�5EG.708t.68U51NES8ANDGROFES3pNSCODE:ANYGITYOR (n ZOOIRRYNt9CHREIXARESAVENMRiOWNSTFIULT,ALTER,MPROVEDEMOL1Sli3ORREGRIRANY$iRllC- W PAtlO/DeCk W 7URE,VRqft TO IT8 I6SUANCE,ALSO RE9UIRES TNE APP4�CANf FOfi BUCH PERMIT TO FILE�BIONED W � 8TATOAENT 7HAT XE OR BME IS LICEPISED PURSUMIT TO THE FROVISIONS OF THE CdlFRACTORS LI- COJSE UW(CNIIDTER/(COYYENCM70 WITH BECTION 7am)OF�INSION 1 OF THE BUSINE95 MA PR6 � POOVSpB fESSqNS COD�OR TMA7 NE OR BHE IS EXEMPT 7HEREFHOM MD T11E BA313 WR THEALLEOED pCEMP- TqN.ANYVIOLATIONOF6ECT10N7W7.6BYANYMPLICANTFOR�PERMITSUBJECTSTNEMPIICANTIb Z Re-Rao1 � AqNL►EN�LiI'OF NOT MORE�NAN FNE HUNDRm OOLURS p5o0).): ' OL�aMNEAOFTNEPROPERtt,OANYEMPLOYEESWITHNMCiEBASTHEIRSOLECOMPENSA7qN, 0 COfl1111BfClbl 1YLLL 00 TME WOAK,ANU TF1E 9TAUCTURE IS NOT INTEN�ED OR OFFEREO FOR SALE(SEC,7M�,BUSI- J NESu IWD PiiDFE651ON5 CODE:TIIE CONi1iAGTO1t5 LICETISE LAW OOES NOTMPLY 70 MI OWNER OF = � MOPEflTYNM1IOBULDSORYPROVES7FIEREON.ANDWMODOESBUCfIWOqKHINSELFORHERSELFOR C[ THAOU6HFOSORYENONMEWPLOYEES.PA01fI�EDTIATSUCHIMPROVEMENTBMENOTINTEN0E00R m � OFFEREOPOH9AI.EIF,MONfEVERTMEBULDINGOR111PROrEMEM68qDWRNINONEYEAROFCOMPLE- ' • TpN,THE OMMERiU1LDEH M�LL H/�YE 7lIE BURDEN OF P{lOVINO THA7 FE OR BNE DIO NOT BUIID OR MPHOVE WH THE VURPOSE OF SALE} � � O 4�aNMER OF TlIE PROPEFi7tl,AM E%CLUSIYELY Of�MMCTINO NrtTFI LICENSED COMMCTOFl9 TO OLWSTi0.1CT TME VHWECT(5EG 7D4t.BUSINESS MID PROFE93ION5 OOOE THE CONTFlACTGRS U� V81U9110f1 ADJ.AREA CENSE UW ODEe NOTAiPL1 TOIJi OWNEH OF APHOPERTY WFID BURDS ON tAPROVEB 7FIEHEON,AND � WFq00MRACT&FORSUCHPROJECTSWfTHACONfMCfUH(S)LICBdBEDPURSUANTTOTMECONTRAC- QU/INTITY DESCRIPTION FEE � 100.SUCO19EIAWJ. OIAME%EMP�UNDERBEC. B.IP.C.FORTF115qEA50N � U � DA7E OWNER � U � UCENSED CONTRACTORS DECLARATION � � i NEREBYIIFFIAIA UNDER PENAL7V OF DERJUi1Y 7YIAT I AIA LICENSE�UNDER PROVISIONS OF CHAP7ER � , .' s 0(ODIAYENCWO NA7f1 SEMION 7a0o�OF DMSION 7 OF ME BUSINESS AND PROFESSIONS CODE,AND Z X h1Y UCENSE IB N FVLL FOHCE AN�D1 EFFECL m � UCENSE G.ASS /� LIC.NO. L��y��Y�//��/ y j � DA7E CONTRIICTOR��.y�l d _ � `� WORKERS'COMPENSATION DECLARATION � � � IXEREBYAFFNAUNDERYENKIYOFPEFWRYONEOFTXEfOLLOWINODECLNiAT1ONS V H Q � _I NAVE AND WILL MAIN7AIAI ACERTIFICATE OF CONSEN7 TO SELF•INSURE FOR YVORKERS' S CONPENSAiION,AS PROVIDE�BY BECTION i7oo OF iHE LA8017 COOE,FOR THE PERNHMANCE w OF T}IE N'OFiK FOR WMlpi iM5►ERMIT 15185UED. � � �,I MAVE MID WILL WUNTAIN WORI(ERS'COMPENSATpN INSUMNCE.A3 REOUIRED BY SECrION 4 7/00 OF 7HE IABOH CODE,FOR 7NE PERFORMN7dCE OF TH6 VYORK FOR WMiCH THIS PE WAIT IS Q ISSUEQMYWORKERS' PEN9AT W9URANCECARHIERANDPOLICYNUMBERARE CONSTFiUCTION j CMRIER �'�'� � e- PLAN REVIEW � POIICY NUMBER��`��, � 1���� ELECTAIC � �s[crnN�Ho�reeoor,a�paFnEr�r�sAoaorie�omuaasa�m�an�ss� PIUMBING � Z 1 CERTIFY TMT W THE PERFORMANCE OF T/7E YVORK FOR WHlpi TM9 PERMR IS SUED,1 MECHANICAL �'} SM�LL NOT EMPIAY ANY PERSON N ANY MIW NER SO AS TO BECOME SUBJE THE i•'- • y WOii10ER5'COMPENSAiqNUW50FCALIFOqNU,ANDAGREETMATIFI ECOME INSPECTIONFEE SM `- SUBJECT TO THE YNORKERS'COMPENSATION VROVtS10NS OF SECTqN .ME UBOR _ _�`� r moe,i sw�tL�n+coran�v 4ose oaowsaNs. ISSUANCE � � I� �+ p OATE��/L�—� APRICANT: SMIP 'r' � W/WNINO:FAILURG TO SECURE NfORKER3'COMPENSATION COVERACiE IS UNIAYYFUL,ANO 514LLL BE ENERGY P/C �y &16�ECf AN EMPLOVER TO CRIMINAL PENlLLTIES AND CNIL FINES UV TO ONE NUNDflEO TFiDU5AND ENERGY PERMIT r OOLLARS(f10o,0001.���TIONTOTXECO5TOFCOMVENSATION.�AMA6ESASPROViDE�FORW � BECTION 9700 OF T1E LABOR COOE.MEREST,ANO�TTORNEYS FEES. RETENTION FEE: CONSTRUCTION LENDING AGENCY PRE-ALT FEE: I MEi1EBYAFFIpM UNDER PENALTY OF PERIURY THA7 THERE IS A CONS7RUCTION LENOWO AOENCY FOH h1E PERPoRMIINCE OF iNE WORK PDR WNlpl TNIS VERMIT IS ISSUED(6EC.90Y7,CIV.C.�. � LENDER'S NAYE C LENDER'9 ADDRESS � ICERTIFYINATINAVEREADTHISAPPl1CAT10NANUSTAiETHATTHEIBOVEMFORMATIONISCORRECT. TOTAL FEES � ,� � IA(iREETOCOMPLVWITFIALLCRYANOCOIMTYOHDPUNCESINDBTATELAWSRELATINOTOBUlDINO ✓ //�� OON9TRUCTION,AND HEREBY AU7FqR4E REVRESENTATIVES OF TNIS COUNTV TO ENTER UPON 7HE � MOVE•MENTqNED►(iOPERTY PoR INSPECiION PURP0.4E9. COMMENTS krt�- � � Q PE A, �.s--� r � � . r y &ONA RE O PERMR7EE DATE � /T � RECPT.NO.__ PND BY ��VAUDATION'. [-/ WHITE--Depertmsnt Copy,VELIOW-�Inence Copy,PINK—Assessa Copy,OOLDENROD—File Copy,GREEN—ApplicanCs Capy . . , , .. . .� ... ���. . .....i.. : ..�Fi^"• . . . CITY OF DIAMOND BAR liolSPECTfON RECCiF�D ' • � � e - • � r � . � . SET BACK . ,s ' FLOOR JOIST '; �� , FTGS/FORMS/STEEL FHA REGIMTS EtECTRiC GROUN� UNDER F�OOR DUCT ' � GROUND PLUMBING UNDER FLOOR C�M1IDUIT• . ' SLAB GRA[]E FIREf��ACE FOUNDATION � ' ' ,. .. :.-- TEMP POWER FIREPLACE 80ND BEAM ' � WATEFi SERVICE MID HT. BOND BEAM � � - '� � -• . RO�F SHEATHING 8 F1'. B�ND BEAM � � FRAMING/V�NTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGN HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERITUB TEST ' POOL ELECTRlC EXT.tATH/SIDING � POOL FENCING WALL INSULATION POOL FINAL __ CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATiDNS SEWER y FINAL ENG. SEPTIC TANK LANDSCAPE/lRRIG. SEEP PIT/L..L � ON SITE IMPS. GAS A!R TEST � FiNAL 20NING FINAL CONST.' FIRE DEPL FINAL I FINAL HEAT�NC� , ; � ( HEALTH DEPT. FINAL � FINAL ELECTRIC � i DEV. FEES PRID FINAL PLUMSING y - j � ENERGY i � � _-f..__ � � i � � �� � � -- — connn��r�-rs � � . : . . : . .. -, - ; . . � �: , . � :y � _ . � . - . . . � . . <,.� ..., . -. . _. - SEPTIG TANK SIZE SEEF PIT/U SIZE — � � . � - '� '. � � . ; .. , � . , , , � �--