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HomeMy WebLinkAbout13492 --� � CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � w 21660 E.Copley Drive Suite 190 � (909)860-3195 Fax(909)861-3117 PRE$$ ��m'� BUII,DING PERMIT APPLICATION FIRMLY QJOBSITE �'/7������� ��� �� n APPLICATION PERMIT �'.� �n� P/C Q ADDRESS_I �� DATE NUMBER��L• a � APN LOT TRACT � DA EE�� �7 / CONST. GROUP p OWNER p ADDRESS G�fc �L 2 ZONING SETBACKS � ciTv c��a e L�i L�C ZIP���TEL9��3 REART RW ❑ APPUCANT /Y TEL. .✓ SIDE/SIDE STREET RW ❑ � CONTRACTOR O uJ..�5� ti\� �4.C�+ SIDE ❑ Q ADDRESS PROPOSED USE � CfTY ZIP TEL. �� ARCH/ENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS. UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION 0 � SFR/ADD/�ENq eI HEREBY AFFlRY UNDER PENALT/OF PERRIRY THAT I AM IXEMPT FROM THE CONTAACTORS LI- Qg�Ag�C9fpOR � CENSELAWFORTHEFOLLOWOiOREA50N(SEC.70.71.68USWESSMIDPROFESSIONSCODEANVGTVOR (n COUMYNMICF/REOUIRESAPERMffTOCONSTRUCT,ALTER�MPROVE.DEMOLISH,OFREPAIHANVSTRUC- W patio/Deck TURE,PRIOR TO ITS ISSUANCE,ALSO REW IRES THE M7LICANT FOR SUCH PERMIT TO FILE A SICUlED w � STATEMENT THAT HE OH 9HE 19 LICENSED PURSUANT TO THE PROVISIONS OF 7HE CONTMCTORS LI- � C C813E UW(CHAVTER Y(COMMENCWO WITH SECTION 7000)OF DMSION 7 OF THE BUSINESS AND PRO- POOUSPO �� FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREFROAIANDTMEBASISFORTHEALLEOEDEXEMP• � V TION.ANVVIOLA710NOFSECTION7031.68YANYAPPLIC�NTFORAPERMITSU&lECTSTHEAPPIICMITTO Z Re•Roof � A CIVIL PENAL7Y OF NOT AqRE TMAN FNE HUNORED DOlLARS(i6001.): . � ❑4�.+`�M�NEROF7HEPROPERTY,ORMYEMPLOVEE9WITHWAOESA57HEIRSOLECOMPENSATION, O Comrt16fC191 � � WILL DO THE WORK,AND 7HE STRUC7URE IS NOT INTEND6D OR OfFERED FOR SALE(SEC.70at,BU51- J N NE53 A!ID PROFESSIONS CODE:THE COHTRAC70RS LICENSE UW DOES NOT AVPLY 70 AN OWNER oF � PROPENTV WViO BU0.DS OR B�/PROVES 7HE1iEON,AND NMO DOES SUCl/WORK HIMSELF OR HERSELF OR 2 7H(WIXiHHISORHEROMRIEMPLOYEES,PROVIOEDTHATSUp/WPROVB�IENTSAHENOTIIJTENDE00R m � OFFEREDPDR9ALEIF,MON�EVERTMEBURDINOORIMPROVEMBJTISSOLDWITMNONEVEAROFC0IAVLE- � `TION.7HE OWNERAUIIDER NALL HAVE THE BUROEN OF PROVIN(i THAT HE OR SHE DID NOT BUILD OR IMPiqVEFORTHEPURPO3EOFc�Fl � ❑I,ti40VINEROF7HEPROPEHfV,AMIXCLU5IVELYCONTMCTINON77HUCENSEDCON7MCTORS TO CONSTRUGT THE PRQIECT(SEC.7041,BUSINESS M1D PROFESSIONS CODE:THE COMTMC70R9 LI- V81U0fI0f1 ADJ.AREA CEN9E UW DOES NOT APPLV TO Ml ONMER OF A PHOPEHTY MRIO BUILDS OR IMPROVES THERE-0N,AND Wlq COHTMCTS FOR SUCH PRQIECTS WI7H A COHTMCTOR(S)LICENSED PURSUMIT 70 THE CONTRAG rauur-�-/-Euw.�. 4UANTITY DESCRIPTION FEE . � O'fAM D(EMPT UNDEH SEC. B.6 P.C.FOR THIS REASON J 0 a 3 U tL ¢ DATE / O ER 1— O W � LICENSED CONTRACTORS DECLARATION W � � I HEREBY AFFlRN UNDER PEIULTY OF PERIURY 7HAT I AM LICENSED UNOER PROVISIONS OF CNAPTER � S Y(COYMEHGNO M7I71 SECTION 7000)OF OMSION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z llU AIY LICENSE IS IH FlA1 FORCE AND EFFECT. m ' 0 LICENSE ClASS LIC.NO. j . � z] DATE CONTRACTOR a 1 LL � WORKERS'COMPENSATION DECLARATION Q � 1 HEREBV AFflRAI UNDER PENALTY OF PERIURV ONE OF THE FOLLOWIN6 DECLARATIONS: Z � _IHAVEANDWILLAWNTAINACEqTIFlCATEOFCONSENTTOSELF-INSUREFORVqPo(ERS' T � Q COAIPENSA710N,AS PROVIDED BV SECTION 370o OF 1HE UBOR CODE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT i3 ISSUEO. W � � � _IHAVEANDWILLMAINTAWWORKERS'COMPENSATIONINSURANC6,ASREWIREDBVSECTION Q 370o OF THE LABOR CODE,FOR THE VERFORMMICE OF THE wORN FOR WHICH 7HIS PERMI7IS � ISSUED.MY WORKERS'COMPENSA710N INSURANCE CAARIER AND VOLICV NUMBER ARE CONSTRUCTION � awPoea PLAN REVIEW �Z aoucr�u►�eER ELECTRIC , D Q — 0 (n�sEcror+r�t+o7eeoor,a�7�ov7reaEar,�rswaor�Mir�nt�ooau3s�sim�oq�ss} PLUMBING w Z I CERTIFV iHAT BI THE PERFORAIANCE OF THE WORK f-0R N711CN iH15 PERA/IT t5 ISSUED,I MECHANICAL ��rxitrSY(1 Q � SFiM1 NOT EMPLOY/JIY PERSON IN ANY MANNER SO AS TO BECOME SUBIECT TO THE '�'�`(� �,Jl`1i�+ +�+�� ' N WORKERS'COMPENSA710N LAM/5 OF CALIf-0RNIA,AND�OREE hIAT IF I SHOULD BECOME INSPECTION FEE ����� .-. t I� T "1 � SUBJECT 70 THE WORKEFS'COMPENS�TION PROVISIONS OF SECTqH a7oo OF itiE UBOR �T�� Q i�1� .••++�v s COOE,ISHALLFORTHWIhICOA1PLVWITHTHOSEPROVISIONS. ISSUANCE �.�SI � -��� �g y�� � �� �SMIP u nni^.1 '= T �VbV �ATE � MRIC/WT: � � ��VY W ENEflGY P/C � WARNINO:FAILURE TO SEWHE WORKERS'COMPENSATION CAVERAOE IS UNLAWFUL,AND SHALL BE , � SUBJECTMIEMPLOYER70CAIMINALPENAL7IESANDCIVILFINESUP7oONEHUNOREDhiOUSAND ENERGYPERMIT DOLLARS(5700,000j.pl ADDITION TO TIE COST OF CAMPENSATpN,DAMAOES AS PROVIDED FOR IN ,�5'��'5.7}1 ¢ SECTqN370EOFTHELABORCOOE,INTERE5T,MIDATTORNEY'SFEES. RETENTION FEE: H lil fl\�I(C]L OCONSTFUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFlRM UNDER PEN/�LTY OF PERIURY THAT THERE IS A CONSTRUCTION LENDWG AOENCV Z FOR THE PERFORMANCE OF THE WORK F-0R WHICH THIS PERMIT IS ISSUED(SEC.30v7,CIV.C.�. - W � LENDERS NAME � � LENDER'SADDRESS � ICERTIFYTHATIHAVEREADTHISAPPLICATKJNANDSTATETHATh1EABOVEINFORMATIONISCORRECT, TOTAL FEES w I A�HEE TO COMPLY WITH ILLL CITY AND COUN7V ORDWANCES M1D STATE LAWS REl.A7WO TO WILDINO � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTA7IVES OF THIS COUNTY 70 ENTER UPON THE - ZABOVE-MENiIONED PHOPERTY FOR INSPECTION PURPOSES. COMMENTS " � ' Nl D � � P I E NA1AE � Q � � I AT � RECPT.NO. PAID BY VALIDATION � WHITE--0epartrnent Copy,YELLOW--Finence CoPY.PINK—Assessor Copy,pOLDENROD--File Copy,GREEN—Applicant's Copy �9TY OF D9e�61��6l91D 1�R,6� � � Ii6���'���B�I�I �E�OR�B - _ , , - �`���3 [ o � `� �,��,. ' ; g ' �. .��.b; �]�` 0�1 :, ;_; 'y t�L�� '.� -,� ° o �� SET BACK . FLOOR JOIST � : S � � FTGS/FORMS/STEEL ' � ' FHA REQMTS ' ' � ' ' ' ELECTRIC GROUND , , UNDER FLOOR DU'G�f . : , GHOUND PLUMBING UNDER FLOOR CQ�4f�UIT�,. ', � ' ' ;:�' . ' SLAB GRA�E 7 � F�;iEPLA�G�E�.O�N ATION,--• ; � ' � TEMP POWER ' �� ' � ' FIREPLACE BONQ•BEAM • WATER SERVICE MID HT. BOND B�Afi/1= •," ' '- - _, ROOF SHEATHING 8 FT. BOND BEAM FRAMtNG/�/ENTILIATtON FINAL BOND BEAM ROOF COVFR PRE-GRADING ROUGt-!FiEATING BENCHIJVG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FI;JISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. IATH/SIDING P�OL FENCING WALL{�!�'ULATION POOL FINAL CEILING'INSULA710N OFF SITE IMPS. DRYWALL NAILING DEDfCATiONS SEWER . FtNAL ENG. ' SEFTIC TAf�K tANDSCAPE/IRRlG. � SEEP PiT1�.L. ON SITE lMPS. GAS�4��i TEST FlNAL ZQNING FINAf. CON�T. • -` . • • • � FIRE OEPT. FINAL ' „ FIN,�L NE�ITINC., HEP�LTH DEPT.',FIi�AL _ ` _ `j �INAL ELECTRiC � DEV. FEES PAID � � ~� -� � ' ` �I�I,�L PLUMBING ENERGY _ � p p r�.:=.�`.. ��� _ ' : � - j ��lL+tfVl�ttl I� . � . �_-- • --- - � - --- -- ---�- - I � ��! �`�' �' „ — -_--�._._ � �� -` --- _ ____ ti - . . - � . SEPTIC TANK SIZE � - . SEEP PITIU SiZE ��� ��° �; •�.,��, o , . �, `-i '� a:c; , '�il'J � . T I.S: • -�. s�x. < � � � . 1 r � g � �y _. ..l� , .�, �. _ c�� -: � �-� , _. � `.` � - - . __ ' . - - .