HomeMy WebLinkAboutNo Permit Number (13) �� CITY OF DIAMOND BAx n
I �,Q'Q IC� �`J
DEPARTMENT OF COMMiJNITY Bc DEVELOPMENT SERVICES
� 21660 E.Copley Drive Suite 190 /
(909)860-3195 Fax(909)861-3117 PRESS
.��.` svn.nnvc rE�rr arpr.icaTtox FIRMLY
oJOBSfTE APPLICATION PERMIT �i �RlG
ADDRESS��_�QjY' .�_J�L�� DATE ����NtlMBER � '� t " #�
� ISSUE T/pE pC� ,
APN t0T C DATE CONST. GROUP
p OWNER • _
� ADDR S ZONING S O�CKS RW ❑
� CITY Z�P�TE�, REAR
� APPLiCANT T� SIDFJSIDE STREET RW ❑
CONTRACTO ' SIDE ❑
� CIT1f S ZI TEL - PROPOSED USE �
� ARCFUENG/ �
OESIGNER NO.DWEL. NO. NO.
ADDRESS UNITS STORIES BEDROOMS
� CI7Y ZIP TEL.
�n DESCRIPTION SQ.Fi. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUtLDER DECI.ARATION SFRlAD�/REM
O
1 HEN�V AFFUW UNOEii VENILLTY OF PEiWRY 7HAT I AA1 EXEMP7 Ff10AA TNE CONfRACTpRS LI• G8f8{JB.�C9fp01I
CENSELAWFORTMEFOLLOWINOREASON(SEG709f.68U5M1E55ANDPROFESSIONSCODEANYCITYOR (n
OOUNTYN71�lIREOIJIRESAPEHMRTOCONSTRUCT,Ai.TER,IMPROVE,DEMOLI9{ORREWVRANYSTRUC• `W PBtiq/D6Ck
iURE,PiYOii 70 R9 I65l1ANCE,ALBO REGUIRF9 THE MPLICAMT FOR BUCN PERAIIT TO FIIE A 81GNED
bT�TENENT TT1A7 ME Oq SME IS LICENSED PURSW WT TO711E PROVISIONS OF TME GONiMCTOR9 U•
CENSE UW(CH1IPTEN Y(COMMENCING WI7N BECTION 70W)OF DIVISION 7 OF TXE BUSINE55�ND PR6 � POOYSpB
FESSIONSCODE)WITM�THEORBNEISE%EMPTiHEREFROMANDTXEBA515FORTHEAIIEOEDE%EMP• � (�
TION.ANYVpLATIOHOFSECT10N7W1.6BYANYAPPLICANfFORAPERMITSl1B1EC7STMEAV%.ICANTTO Z RaRaot .
A tlVIL PENAI.TY OF NDT YDpE TUN FNE NUNDRED�OLI.ARS(t,ao�):
04�..^��EROFTHEPROPERTY,DRMYfMPLOYEESNn7HWADE5AS7HEIFlSOLECOMPENSATpN, CORIRIBfCl81
� MN.L DO THE ri0i1K ANO THE 6TRUClUFiE IS NO'T IMENDED OR OFFERED FOR S1LLE�9EC,704�,BU31- �
NE53 AN�Pi10iESSION6 CO�E:hIE OONfMCTORB LICENSE LAW COES NOT MPLY 10 AN OWNER OF
� ►ROPEHfYWFpBUILDSORIMPROVESTT1EREpV.ANDWMODOESSUp1VNRKMnASELFORMER9ELFOR =
. � TNROUOMHISORMEROWNEMPIOYEEB.PROVI0WTH/1T9UCMMPqOVEMEHTSAHENOTMTEN�EDOH m
OFFEAW FORSALE.IF,F10WEVER7HE BULlMN�OR IMFROVEMENT IS SqD WIh11N ONE YEAR OF CqAP�E
T101i,iNE OMMER�IALDER NALL MAYE TNE BUROEN OF PROVINO THAT ME OR SHE DI�NOT BUILU OR
NAPiIOVE FORTFIE Pl1RPOSE OF SALE� � '
� O4��M�NEROFTNEPROPEHTV,AMEXCLUSIY0.VCONTMCTqJOVYf7MlICENSEDOONfRACTOqS
TO CON6TRUCTTNE PRO.IECT(SEC.Mu.BU911�SS AND PROFESSIdJS CODE:IHE CANTRACTORS U- VfllUet1011 ADJ.AREA
CENSE LAW DOES/qT APPlYTO AN qNNER OF A PROPER'IY WFp BUM1DB OR IMPFioVES THEREON,AND
YYIiOOONfMC7s FOR 8Ud1 PAWECT9 W17HACONiRAC1�DR(9)LICENSED PUR9VANT TOTHE CONTRA4
� �uc�x+sEuw�. �, . QUANTITY DESCFIPTION FEE
O 1 AM IXEMPT UNDER 6EC. B.6 P.C.fOR THIS REIISIXJ �
U
L_L � M K
DATE ONMER �
� LICENSED CONTRACTORS DECU4RATION W
� I MEREBY AFFqM Ip�ER PENKT'OF PEFUUFiY 7XAT 1 AM LICENSED I1N�EH iROVISpNS OF CHAFiER �
� Y(COYYENCWOWITNSECTqN70ao)OFDIYISqN90FTNE8U51NESSANDVROFE551DN5CA0E,AND Z
MY IICENSE IS MI ML FgNf#IN�EFFECT. m
l � �
0 LICENSE 35 �-�r LIC.ND. ' _ �
� DATE � ' ' CONTRACTO
WONKERS'COMPENSATION DECLARATION �
� I MEREBY AFFIRM UNDER PENAL7Y OF PE0.M1IRY ONE OF TXE FOLLOWINq DECUMTIONS: Z
� _IHAVEANDWILLY+IINTAINACERTIflGTEOFCONSENTTOSELFaNSUREWRNqqKERS' _
COMPENSATION,AS PRONDm BY SECTION 9700 OF THE LABDR CODE,PoR THE PERFORMIWCE U
Q OF hiE W�RK F00.WHItlI TWS PERMR 181631JE0. �
1 HAVE/ND WILL MAIMNN WORKERS CpAPENSATION INSUNANCE,AS REOl11RED BY 6ECTION
�C 87000FTF1E LA90R GOOE,FOR T11E PERPOPoNANCE OF7HE WORK FOR WMICN iH13 PERMIT IS
ISSUED.MYNOR H{OMPENSATION IN9URA Bl�qRRH1ER AND PIX1CY NIIMBER ME: CONSTRUCTIDN
jCARRIER�,_ P EW
� POLICY NUMBER � 'LECTRIC
0 m+ssFcnaNr�nareEao�rfuoF,�,e�warswr+«+errxor�ooauu�sm,ao�«j�ssy �NG
� I CERTIFY THAT W TME PERFORMANCE Of iHE WORK FOR WHICJi THIS PERMI719 ISSUED,l MECHANICAL
BWLLI NOi EMPIAY ANY VERSdJ IN ANV MANNER 50 AS TO BECOME 5UBJEC7 TO THE
(q WORKERS'COMPENSATIONLAWSOFGdIFORNIqANDAGREETHATIFISHWLOBECOME IN NFEE �'
6UBJECT TO 7HE YYOIMEH5 COMPENSI1TqN PRONSIONS OF SECTION 77oD OF hIE ViBOR Y�.:.:. . /�^
-~j CODE,16HN1 R7MMTMCOMPLYY\�JAVR�Q SEiROVI510N5. SSUANCE � J
pDATE:!/ -�9 APPLICANT:� l�l¢� �j"`� SMIP
� WARfJINO:FNLURE TO 6ECIlRE WORKERS'CpAPENSATION COVEHAOE I6 UNLANfFVI,AND SHALL BE ENERGY P/C n r T � C. 1Q�Q
[= SUBJECTANEMPLOVERMCRMINALPENALTIESAN�CIVILFHJE9UPTOONEMUNDREDTFIOUSIWO ENERGYPERMIT
�OlWiS(i100.000�.NI ADDITION i0 THE COSTOF COMPENS�TION,DAMAQES AS PROVIDED FOR IN
¢ 9ECTqN�70!OF THE LABOR OODE,INTEREST.AND ATTORNEYS FEES. �
RETENTION FEE: (��fl�F��},����B�
� CONSTHUCTION LENDING AGENCY B o������_���
PRE�ALT FEE: i TiT f`
I HEREBYIIFFIRM UNDER PENKTY OF PERRIRY ti1R7 T1ERE IS�CONS7RUCTION LENDING AOENCY
FORTME PERPoRMANCE OFTME WORI(FOF MR71CY17XI5 PERMIT IS ISSUED(SEG 30W,pV.G�.
Z
W
� LENDER'SlMME ' �
� LEM�ER'SAOORESS
� ICER7IFYTNATIHAVENEADTNISAPPLICATION/WDSTATETUTiMEA60VEINFORMATpNISCORHECT. TOTAL FEES .
� I A[iflEE TO COMPLt WRH N.L CRV MlO 00UNTY ORUMANCES ANO STATE UVYS REU?INO TO BUILDIf�Ki
K
CONSTRUCTqN,ANDHEREBYAIlf1qRIZEREPRESENTATIVESDFTW5C0UNTYTOEMERUPON7HE _��� �"hL
S�. I�BOVEAAENTIONE�VROPEH7YFOR NiSP,FC�110N PURPOSES. COMMENTS � � / �'l
� � t
�
m PERMITTEE VF ..
� * ��
VJ 610 TUREOFPE DATE . �-
� . RECPT.NO. PAID BY ' VILLIDATION
WHITE—Departrnent Copy,YELLOW—Flnance Capy,PINK—Asseasa Copy,(3pLDENR�Ie C.opy,GREEN—ApplicanPe Copy
� ' CITY OF DIAMOND BAR � . .
t1VSPECTION F�ECOf�D.
• � � l � � d � � � �
SET BACK _'- . , FLOOR JOIST-: , �, •,, ;, •
FfGSIFORMS/STEEL FHA R�QMT$ _,
ELECTRIC GR�UND UNDER'FLOdR'IIUCT" ''.- � - ' -
GROUND PLUMBING UNDER�LQO.j-�C�J�I[lUIT�• � �, � _ � '
SLAS GRADE FIRE�'LA�E F011=N[�ATION`;'•- 'f. . .. -. ._
TEMP POWER FIREPLACE BOND�EAM =--
WATER SERVECE - MID HT.80N�BEkM-�° '- .- • -- "
RO�F SHEATHING--` i'' . `- • -- - • 8 FT. BONID BEAWI'.� y. -- ' i•• , - -- _ �
FRAMINGNENTILIATION FINAC BOND BEAM
ROOF COVER PRE-GRADING
ROUGN HEATING BENCHING
ROUGN ELECTRIC � - ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHt7WERITUB TEST POOL ELECTRIC '
EXT.LATH/SIDING � POOI.FENCING
WALL INSULATION POOL FINAL
CElLING INSULATlON (JFF SITE IMPS.
DRYWALL NAILING � I DEDICATIONS
SEWER � FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/�.1. QN SITE 1MP5. �
GAS,AIR 7EST � �. � FINAL ZONING �
FtNAtCE?NST: __�..., • ..�. _ . . ... - • �;' � FIRE DEPT. FINAL �-
'FINAL'NERTING ' �` �'' '' '� '� ";� ; HEALTH DEPT. FINAL
F1NAL ELECTRIC �� ' � , ���` ' DEV. FEES PAIQ � _-----
FINAL PLUMBING l , ; ENERGY
� � � --
i . ir � _ _
GC?MMENTS
. . „ ..... .
_ .
.. ,
. ..
. - __ .� : , .� . . -------
, _ -----
.
--.- . .. ..
,
.. ... „ . ,
3�Et � �.T::I i' - , __. ,. . _._ .. ._. . . -
SEPTIC TANK SIZ��,Lx,�r��,-�;�r-, ,{��.-:
SEEP PITN.SIZE�.�•r:r:i-�-� �i�,'•.•, :'1r'`;r3,'ttJS.'
�, ' � N
� a . ' � i
I�
'���,� 'lii �� ��j
i
' __ , , ' __ � ; __l._....t . -._.
-��': 4•�.. . . -
1
' _ ` . .... _ •'.� _