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HomeMy WebLinkAbout12-758 . CITX OF DIAMOND BAR / I ----���— DEPARTMENT OF COMMUIVITY&DEVELOPMENT SERVICES � � :,��,;� . 21810 Copley Drive,Diamond Bar,CA 91765 PRESS � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 � ���+��W BU�.DING PERMIT APPLICATION FIRMLY � JOBSITE y J��, / APPLICATION PERMIT 'Z��cG,{ P/C � � I o ADDRESS 1� '7�1%�j ��' I �T�i S� DATE_� � 1 � NUMBER � �� a �al--t S� ISSUE �„� TYPE OCC � APN LOT TRACT r�� DATE ��� � � �NST.� GROUP p OWNER� V�ff1Qf.�1 ���� `�'��G ZpNING SETBACKS o ADDRESS ' FRONT RW ❑ ' gCITY f�j TEL. _ � REAR O APPLICAtrT � T� SIDE/SIDE STREET RW O � CONTRACTOR � —Z SIDE a o ADDRCSS ^ ' � � PROPOSED USE 1ICM� C�7y ZIP�TEL -�� � )r w ARCWENG/,/ 1 z DESICaNEfi/� �� NO.DWEL NO. NO. a ADDRESS� UNITS STORIES BEDROOMS � C�7y . ZIR TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � � OWNEA-BUILDER DECLARATION SFR/ADD/REM O 1 HEREBY AFFlRM UNDER PENKT'aF FEA.RIRY TUT 1 AM EXFJAVT FF01A THE CONTRACTOR3 LL C,arage/Carport. W CENSEUWFONTHEFOLIOWIN(7REASON(SEC.7037.68USWESSANDPROFESSIONSCODEANYC�TYOR (n . G) CpUNTyMMiCHREOUIRESAPERFffT7000NSTRUCT.ALTER�PROVE.DEMOLISl1.ORRE7AIR/�NVSTiiUG w Patiol0eck . . �� NRE,PRIDR TO RS 65UANCE.A�SO AEW�RE9 THE APPUCANT FOR SUC1i PEiU11T TO FlLE A SIONED 57ATEYEHf THAT HE OR SME IS L10EtJ5ED PURSUMIT TO 7HE PROVISIONS OF.7HE CONTMCTOR9 lF � pQOUSpe � CtN9E UW(CMAPTEA D(COMMENCWO N�ITN SECTION�0001�DMSION 7 OF 7HE BUSME53 AND PR6 Q FESSiON5CO0�ORTHATHEORSHEISE%EAIPThIEREFROMANDTHEeA515FORTHEALlEOEDE%EMP• V TION.ANYVIOU�TqNOFSECT10N7031.6BVANYAYPLMNfTFORAPERMITSUBJEGTSTHEAPVLICANiTO Z RaRoof � �A CML PENALTr OF NOT A40RE SW�N FNE HUNDRED DOLLMS(f5oo�.): Q ❑I,ASON7IEROF7HEPROPER7Y,ORMYEMPLOYEESWfT/1YJACiE5A5THEIR50LECOMPENSA710N, � CORIlfI0fCl2� Z Wft.L DO THE WORK,AND THE BTRUCTURE IS NOT INTFNDED OR OFFERED FOR SALE(SEC.7�,BU56 J . � NESS AND PROFESSIONS COOE:THE CONTFUCTORS LICENSE UlW DOES NOT A7PLY TO AN OWNER OF � . PpOPEH7YN71�BU�LD80N�MVROVESTHERfON,ANDWHODOE55UCHWORKHI/ASELFORHE�ELKOR m , � THNOUONWSORHEROWNEMCLOYEES.PROV�EDTHATSUCHWPROVEMEMSARENOTMTENDEDOR W pFFEqmWq9ALEIF,/qWEVERTHEBUILDWOORIMPROVEMENTISSOLDWfTH�NONEYEAROFCOMFLE- 0 TION,THE OWNER�BUILDER WILL HAVE TME BURDEN OF PROVIN6 THAT H6 OR SHE DID NOT BUILD OR � ' ' Z IMPROYE FOR 7HE PURPOSE OF S/�LE} . . _ ❑I,AS OWNER OF 7HE PROPEHfV,'AM EXCIUSNELY CONTRACTINa WfTH LICENSED CONTRACTORS ' - '� • [[[W��� 70 CON57RUG7 THE PRQIEC7(SEC.7oN,�BUSINESS AND PROFESSION3 CODE:TNE�CONTMC70R3 ll- V01U9t ADJ.AREA� � � CENSE UW DOES NOT APPLY TO AN OWNER OF A PROPERTV WFIO BULDS OA IMPROVE9 THERE-0N,AND , � ' �� WFqCOMAAGT5iOR3UGHPROJEC7SN7THACONTRACiOR�SyLICENSEDPUfiSUANf70THECONTiiAG pUANTITY DESCRIPTION EE � � 70q5 LiCE E UW.). . . /. J/� .t /]/] �EXEMPT W�DFA SEC. � �B.6 7.0.FOR 7H15 REASON Q /�I ✓ V'� � �� U d`s ' D � DATE � �^ OWNER�� ~ � � � � UCENSED CONTRACTORS DECLARATION �W . �+ _Z � [�Y D ' � 1 HEREBY AFFIRM UMDER PENALT'OF PERNRV 7HAT I AM�LICENSE�UNDER PRONSION4 OF GfAPTER � � r��n)� � d a(COMMENGN[1 WITH SEC��DN 7oro)OF DMSION J OF THE 9USMESS ANO PROFE5510N5 WDE,MID . • ��� . X A/Y IICENSE IS M FULL FORCE AND EFFEC7. �^� :y LlJ o Lv 5 ��pN��fl�.__(-tJl.f_,;'8,�, � UCENSE CLASS LIC.NO.. �r S V OATE I�� I�`/� CONTRACTOR —(� '��" ' . lLl � �A � WORKERS'COMPENSATION DECLARATION U G j� � 1 HEA��AFFIfU1 UNDER PENAL7Y Of PERNHV ONE OF THE FOLLOW WG DECIARAT10N4: �_ �� _I HAVE�AND W�LL M/UNTAIN A CERTIFICATE OF CONSEM TO SELF-INSURE FOR MIOR1(ER5 t� Q GOMPENSATION,AS PROVtDED BY SECTON 370D�F T1E LABOR CODE,FOR THE PERFORMANCE W� OF 711E WORIC FOR WHICM T719 PERMIT tS ISSUED. � � _t HAVE AND WILL MAIMAW WOPKERS'COMPENSA710N INSURANCE,AS REOUIRED BY SECTION Q 370o OF�7HE LABOR CODE,FOR 7HE PERFORMANCE�OF THE WORK FOR WFIIp1 THIS VERAlI71S, c a ISSUED.MY WORKERS'COAIPFJlSATION INSURANCE C/JiRIER�AND POIICY NUM9ER ARE �CONSTRUCTION�� � J� �`'� '�� j c�aAiEa PLlW.REVIEW ���t"q �9 Zvoi.�cr NtiraeEa - ._ .. . . . . . _. . . ELEGTRIC . . . C�'1�-�� . �� ¢ � �nresEctqNr�IDw7ee�rIDaFnga�r.rrswaarF�xn�ooa.�wsMaofoA�ssl PLUMBING W MECHANICAL �5�p,Sg Z 1 CERTIF'/THAT IN7HE PERFOW.IANCE OF'fFiE.WORX fOA WHICHTHI3 PERAi�T IS�SSUED,1 (} SHALL NOT EAIPLOV ANY PERSON Pl ANY MANNER SO AS TO BECOME SUBJECT TO THE � WORNERS'COMPENSA770NUWSOFCAIIFORNIA.ANDAGREE71iAT�FISHOVLDBECOME INSPECTIONFEE� . — SUBJECTTOTHEWORKERS'�COMPEN9ATqNPRpVIS10MSOFSECT10N37000FTHEUBOR �SSUANCE \� ` '�\ CODE.I SIIALL FORTMVITH COGPLY VA7H TNOSE PROVI� p DA7E ,naPL�CANf: .SMIP � ' �� W � ENERGY P/C ��' �� J WApMNCi:�FA TOSEWREWORKEF75COMPENSATIONCAVEiUGEiSUNLAWGUL.ANOSHALLBE � � �] J SUBJEC7 AN EMPLOYER 70 CR1bINAL PENALilES AND CML FWES UP TOONE HUNDRED THWSAND S� • �1� � ENEROY.PERMIT DOlUR3(f100.000),W�DUfTpN TO THE COST OF COMP£NSA710N.DAMA6E5 AS PHOVIDED FOR IN � � �r J SECTION 370!OF 7HE LABOR CODE,INTEREST,AND ATTbRNEY'S FEES. ' R�EN7�ON FEE: �`' b `� . � � CONSTRUCTION�LENDING AGENCY �PRE-ALT FEE: � n.. ��/� CC 1 NEREHY AFFlRM UNDER�PENAL7Y OF PERIURV TNAT THERE IS ACONSTRUGTION�ENDINO AOENCY ��7��� �`-�� Za-� �FOR 7ME PERGORMANCE OF THE WOR1(FOR WV11CN 7HIS PER1AfT IS ISSUEU(SEC:3007,CIV.C.). . W . . . . . . . � � � ��, LENDERBNAME . . . . .. . 1=- LENDERSADDRE55 � � - � �a TOTAt FEES `�'`}� � �� ���� ` 9� w I CEfi71FV THAT I�HAVE READ TH13 APPLICATION AND STATE TNA7THE ABOVE WFOqMAT10N IS CORREC7. , � I A6REE TO CAMPLY WITH ALL CT'AND COUN71'ORDINMICES AND STATE UWS RELATWO TO BUILDIN(i , COMSTRUCfION,ANp HEAEBV AIfTHOR1ZE REPRESEN7Ai1VES OF 7HI5 COUNtt TO ENf6R UPON hiE ABOVE-MEMtONEO PROPER7Y FOR INSPECiION WRP0.5E5. � Z --J�� COMMENTS� 1.•�7av�� ��ci�'�C W/ca �. ����� � m VER{�IRTEE NAA1E lPw�'�Tl � �`7�/) ``,/J . . . � �/ T / v Ic � 3�i .l ' ��t Uj SIONATURE OF PERM�iTEE � DA7 RECPT.NO. PAID BY ALIDATION � WHITE—Deparbnent Copy.YELLOW--Finence CoPY.PINK=Assessor Copy.GOLDENROD--File Copy,6REEN—ApplkanYa Copy - CITY OF DI/�MOND: BAR ., INSPECTIOI� RECORD .:y �j � � ,�. � 0 F'�-�jb"�� � � g� m 4r�T k� �� � � � ��.� � .0 ;.,r q �.t ...�_ ,- �.. .... ,. ... . -�': . �,::.. ... ,.: SEi"BACK FLOOR JOtST FTGSlFORMS/STEEL FHA REQMTS ELECTRlC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SlAB GRADE FIREPLACE FOU(JOATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ROOF SHEATHI(JG 8 FT.BOND BEAM FRAMING/VENTILATION y FINAL BOND BEAM ROOF COVER ' PRE-GRADING ROUGH HEATING ` BENCHItdG ROUGH ELECTRIC '3( �3 ~ � ROt1GH GRADING ROUGH PLUMBING FINISH GRADING SNOWERltUBTEST POOL ELECTRIC EXT.LATH/SIDING " POOL FENCIPIG WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. QRYWALL NAIIIIdG DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AfR TEST ' � • FINAL ZQNING FINAI CONST. Q-2; f FIRE DEPT.HNAL FlNAL HEATING ' ' NEALTN DEPT.FIfdAL FlNAL ELECTRIC —Z' ) DEV.FEES PA1D F1NAL PLUMBING -�,;— ; ,, ENERGY FINAL PLANING � FINAL ENGIIdEERING .�'� . • m e COMMENTS 3 a, � � l SEP7ICTANK SIZE SEEP PIT/U SIZE ,S :+