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HomeMy WebLinkAbout12413 �� CITY OF DIAMOND BAR � � DEPARTMENT OF COMMUMTY&DEVELOPMENT SERVICES 216b0 E.Copley Drive Suite i90 (909)860-3193 Fax(909)861-311T PRESS ��*^�.�� $UII.DING PERMIT APPLICATION FlRMLY � JOBSRE APPUCATIO�i`O 'n PERMIT � P/C o ADpRESS � DATE ` r NUMBER �F � ISSUE TYPE OCC APN LOT� TRA T.SZ�Z� DATE CONST, GAOUP � QWNER '�, ' ADDRE ZONING SETBACKS CITY ZIP TEL. r1 �c��"� FRONT RW ❑ APPLICANT TEL.r1r /ji�" REAR ❑ SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE ❑ g ADDR -' '� PROPOSED USE CITY ZIP TELGI��YA"i 7 � ARCWENG/ DESIGNER NO.DWEI. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. y DESCRIPTION 5�.FT. FACTaR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/AODfREM O I MEPEBY AFFliW UNOER PElLLLTY OF VERJURY hlAi I AM EXEAIFT FROM THE OONTRACTORS U• GBteeB�CBryOft C@18EUWFORTHEPDLLOWINORE�SOM(SEC7a97.6BUSINESSANDPROFE5S10NSCODEANVtlTYOR (f� OOUpTY1NHIpiqEpIIRESAPQiMRTOCONSTRUCT,A�TER111GROYE,OEAIOLISFiORREPAIRANVBTRUC- W P8t�0/DBCi( 7URE,PRqli 70 RS 189U11NCE,K80 REOUIRES THE APVLICANT FOR BUCH iERMIT TO iRE A BIONED ST/(fEMENT 7}M7 ME OR SY1E IS IICEN5E0 PURSUMrt TO iT1E PROVISIONS OF THE(7ONTMC70R9 U• CENSE UW(Q'U�PTER Y(CQAMENCING WITH SECTION 7000)OF DIYISION i OF TNE BUSINE55 MID Pip- � POO�SP9 FESSIONS C00�OR 1HAT NE OR 8NE IS E%EMPT THEREiROM ANO TNE BASIS FOH 7ME AtLEOE�E%ENP- TION.ANYVIOLA710lIOF8ECfION'W71.6BYANVAPPLICAMrfOR/1PERMITSUBJECTSTMEAPPLICANTTO Z R�Root � ACIVtLVENALTYOFNOTMORETXANFNEIQINONEDDOLLAHSIKmF)- � ._ 04���EROFTNEPROPERMORl1VEMVLQYEE3WITHWAdES�ISTNEIR90LEOQMOfiNSATDN. C� C�OTTBfGIeI 1MLL DO 1TIE WOIi1C,MO THE BTRl1CTURE IS NOT IHTENDE�OR OFFERED FOR SALE(SEC.7aa,BU51- J � NE9,.AND PROFE5910N5 OOCE:7ME COHTRAC7ORS�ICENSE lAW DOES NOTAPPLY 10 MI OWNER OF C PiqYERTYNRIOBUIlD80R61PROVE87TiEREON.ANDNNODOES6uCHWOpKHIMSELFORHERSELFOR � TXROUGHf95RtMERO1M1pAPL01'EES,FHOVIDEDTIATSUCFIMPROVEMENTSMENQfIN7FNDEDOR m OFFEqED PDRE�ILE i,FqNIEYEf�TiE 6ULDIN(i OR tAPROYEMEFR 16 SOI.O MTMCI ONE YEAR OF COMPLE- TqN.h1E OWNER�BUILDER M7LL N11YE TFIE BUMEN OF PROVINO THAT NE OR 6HE 010 NOT BUIID OR ■IVRDVE FDR7NE PURP0.5E OF EALq. O I,AS ONINER OF 1HE PROPEiiiY,Ald E%CLUSIYELY CONTRACTNO NrtTN LICEALSE�CONlAACT0R5 M CON5T16KT TME PROJECT(SEC.7oal,BUSINESS ANO VPOFESSIONS CODE:THE OONTMCTORS LL VelUeti017 ADJ.AREA � C@qEtAWDOESNOTAPPLVTOANOWNEROFAPROPERTVYVNOBULD40RMGROVE9hIEREON,AFm MM1qCONTHACiBFORBUq1VNOJECTSN17NA00NTMCTOR�BjUCENSEDPUR6UFMTOTHECONTMA� QUANTiTY DESCRIPTION FEE � 70it4l10ENSEIAWy J O I AY EXEIAPT UNDEH SEC. B.i P.C.FOR TWS REASON Q Q �= DAiE OWNER � . � � �� U � LICENSED CONTRACTOHS DECLARATION � � I NEREBY IIFFIRM UIDEN PENALTI OF PERNIRY TH�T 111Mt UCENSEO UNDEH PROWSIONS OF CHMTER � i�CpAAIENCHO WRX SECTqN 7DOO�OF DMSIDl190F TNF 6USINESSMl�VfiOFE5510N5 GODE./NO Z � W LICENSE 16 N Fllll FORCE AND EPFECT. m 0 ICE SE CLASS O _LIC.NO..S Z^�C'l"f�Z1C� j � CONTMCTOFi�TI�. f�77�� d �— WOqKER3'COMPENSATION DECLARATION � � � � � IMEREBYAFFlRMUNDERPENALIYOFOERNIRYONEOFiHEiOLLOWINGDECLARATIONS: Z �7.� '�� Q �)v � _IlMYEANDNIILLMAIN7NN�CEiiTIFlGATEOFCONSENTTOSELFaNSUREFORWORKER3' � �p � �(�� COYPENSATpN,ASPFiOVIUEDBY8EC710N97000FTNELABOACOOE,fORTNEVERWRMANCE W OF iNEN�OpK FOR WHICH T1U5 PENMIT IS ISSUEU. � � �� d 1 MAVE AND N7LL MAIMAM WORKEAS'CWdPENSA7pN INSUAANCE,AS REGUIRED BV SECTION Q 970D OF TIiE LIIBOR COOE.FON 111E PERFORMANCE OF TME WORK FOR YMICH TNIS PERMIT IS � ISSUEQ NY WORKER'COMPENSATION NISUFWICE HIE AND POLICY UMBERARE: CONSTRUCTION � GNRIER PLAN REVIEW � PaicvnuMOER � ELECTRIC 0 �rOssEctpar�rpTeeopurtermoFnEpEw.�r�swna��000iW�aptm�ori�ss? PLUMBING Z 1 CEHTIFY 7HlR W TIE PEfIFOHMANCE OF THE N'ORK FOA WMlqi TMIS PERMIT IS IS6UED,I MECHANICAL M (� SHALL NOT EMPIOY ANV VERSON N ANY NANNER 50/5 T0 �ME SUBJECT TO THE y WORKERS'COMPENSATqNIA TSlRIFL� IA,ANDA 0.TIi18WDULDBEODME IN5PECTIONFEE L- SUBJECTTOiHEVNORKERS' PE SATqNv 4B CT� y F E - XCOOE�9y�LL FOflTMWITH MPLY 1 GR � ISSUANCE �' v �/yY� ��-'[' pATE:__�C 7__ APRIC SMIP � WMNINO:FAILURGTOSEWREWORKE ' COVERAOEISUNLAWFUL,ANOBNALLBE ENERGYP/C �y BUBJECTANEMPLOVERTOCRIMWALOE �LFINESUPTOONEHUNDNEDTFiOUSAN� ENERGYPERMIT r OOLLARS(iloo,00O�,WADDITIONTOTHE O PENSATqN,UAMAOESASPFlWIDEDFORW � SE4TIIX�187oe OFTHE U1BOR WDE,IIVTEREST,IND 11TTONNEY3 FEES. {'{ETENTION FEE: CONSTRUCTION LENDING AGENCY PHE-ALT FEE: � IHEREBYAFFIfiMUNDERPENAL7YOFPEHIWNTMAT7NERE13ACONSTRUCTIONLENOINOAOENCY FOfl TNE YERFORMANGE OF 7NE WORK FOR WHlpi TNIS PERMIT IS ISSUED(SEC.�OW.CIV.C.�. � r�. I LENDER'b NAME � LENOER'S AOURESS 1 CERTIFY T7AT 1 MMIE REAO TIIS�1PPLIWTqN ANO STATE hNT TqE ABOYE INFORMATION IS CORRECT. TOTAL FE ES � f S—,�j. ��6 � I AOREE TO COMPLY WITFI A�l CIfY AND OOUNT/OFONMICES AND STATE tAWS NEUTMIfi TO W LMNO CONSTRUCTION,AND HERE6V AUfHOf11ZE REVRESENTATNES OF THI5 COUNTY TO EMER UPON 7HE S�. ABOVEIAEMIONEU PfqPERTV FOR INSPECf10N PURPO6E3. COMMENTS � PERMfTT I1ME(PRI /�%] � /'� V� / � / /w'11 1 r ' 1 � � lIC111RlIFiE ' . .r� RECPT.NO. PAID BY VAl.IDATIQN F ITE-0epertrnent YELLOYV—FlnancaC PINK—AasessorCo GOLDENROD—File Copy, opy, py, Copy,6REEN—ApplicanCaCopy _ _. , ... ,. . _ � .. ' . . . . ..... , . . ' . .. .. . �.�., „-r',. � • � ' . . . . �� � � �- i .. . .� , , � CITY OF DI/�MOND BAR . � �INSPECTION RECORD . : � , , . � . . ! , , . � . ' SET BACK ' � FL�OR JOIST , Fi'GS/FORMS/STEEL FHA REQMTS, - ELECTRIC GROUND UNDER FLOOR DUCT - - � GROUND PLUMBING UNDER FLUOR CU�IDUIT . _. ` � SWB GRADE FIREPLACE F UI�DATION ='- - • - - TEMP POWER FIREPLACE BOND�BEAM -- -- �-� --- �-- WATEA SERVICE MID HT. BOND BEAM � � �- -- � ROOF SHEATHING '$FL$OND$EAM FRAMING/VENTILIATION FINAL BONO BEAM ROOF COVER PRE-GRADING ROUGH HEATING G/,� �-�• BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GflADING SHOWERCfUB TEST POOL ELECTRlC EXT. tATH/SIDING PQOL FENCING WALL INSULATfON POaL FINAL ' CEILING IhlSULATION OFF SITE IMPS. � DRYWALL iVAILING DEDICATIOIVS SEWER FINAL ENG. ' SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. - OP1 SITE IMPS. GAS AIR TEST FINAL ZONIIVG FfNAL CONST. ! FIRE DEPT. FINAL � FINAL HEATING 2 � i HEALTH DEPT. FINAL FINAL E�ECTRIC "''� � ; DEV. FEES PAID FINAL PLUMBIfVG � ; ENERGY � O _ COMM€I�ll�'S � ._. _ _.. _ , ' � .. , � . . ... . ,,. ._...... 1 . �:�.:.. ' SEPTIC TRNK S1ZE SEEP PITIU SIZE � � — � , . . _•- _: �` . - .--.�. ..