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HomeMy WebLinkAbout1724 MORNING CANYON RD % ' �,P�2�� ��_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES C�/ G�� 21660 E.Copley Drive Suite 190 / =��' PRESS (909)860-3195 Fax(909)861-3117 ���A�. BUILDING PERMIT APPLICATION FIRMLY o DDRESS �727 ��RN(N!� C�4 NY�� KU�-T7 DATEICATION "I�` U�NUMB R� � #/�O �� ` $ ISSUE ' �.r� TYPE • OCC APN LOT TRACT DATE I ���O� CONST. GROUP p OWNER � O N��"I (�� Zp o ADDRESS 17 dR.N t N(� �N Yo 17 ZONING SETBACKS � CITY • �N� ZIP �/7�s TEL.g�1 SG�I"I 3 FRONT RW ❑ APPLICANT . 1�l L- REAR ❑ � SIDE/SIDE STREET RW ❑ c� CONTRACTOR SIDE ❑ I o ADDRESS PROPOSED USE Y'`�'�v CITY ZIP TEL. ��� F_� o ARCWENG/ iz DESIGNER NO.DWEL. NO. NO. n. ADDHESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn OESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O I MEREBY AFFlRM UNDER PENALiY OF PERIURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- GBffl(JB/C8�011 W CEHSEUWFORTHEFOILOWINOREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITYOR (n U COUHfVMMIp1RE0UIRESAPERMRTOCONSTRUCT,AL7ER,IMPROVE,DEMOUSH,ORREPAIRANY57RUG W PeflO/DBCk Z NRE,PRIOR TO ITS ISSUANCE,ALSO REWIfiES hIE APPLICAM FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS 4CENSED PURSUANT TO 7HE PROVISIONS OF 7HE CANTRACTORS LI- w � CENSE LAW(CHAPTER Y(COMMENCINQ VII7H SEC710N 7000)OF DIVISION 3 OF THE BUSINE55 AND PR6 � POOUSpB FESSIONS OODE)OR THAT HE OR SHE IS EXEMPT 7HEREFROM AND 7HE BA515 FOR THE ALLEGED EXEMP• V TION.AHY VIOLATION OF SECTION 7037.5 BYANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT T0 Z Re-Roof � A CML PENALiV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500).): � ❑I,/�SOWNEROFTHEPROVERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOIECOMPENSAT10N, � COfnmBfClel - MALL DO THE WORIL AND THE STRUCTUHE IS NOT INTENDED OR OFFERED FOR SALE(SEC.701t,BUSI- J � NESS AND PROFESSIONS CODE:7HE CON7MC70RS LICENSE lAW OOES NOT APPLV TO AN OWNER OF � , PqOPEfRY WMO BUILDS OR IMPROVES THEREON,M1D NMO DOES SUCFi WORK HIMSELF OR HERSELF OR Q hfiqUGH HIS OR HER OWN EM7LOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � COFFERmFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWI7NINONEYE�ROFCOMPLE- Z �-TION,THE ONMERAUILDER WILL HAVE THE BURDEN OF PROVINO hIAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF S�LEJ. �, W ❑I,AS OWNEROF THE PROPERTY,AM El(CLUSIVELY COMRACTING W1TH LICENSED COMRACTORS [[ TO CONSTRUCT THE PRQIECT(SEC.7041,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� VelUe110l1 �- C.F� ADJ.A � CENSEUWDOESNOTAPPLYTOANOMMEROFAPROPERTYWHOBUILDSORIMPROVE57HEREON,AND WHOCONTMCTSFORSUp1PRQ1ECTSWI7HACONTfUCTOR(S)LICENSEDPURSUANT70THECONTMG QUANTITY DESCRIPTION FEE � TORS LICENSE UW.). Q ❑I AA1 IXEAIFT UNDER SEC. B.d P.C.FO THIS REASON U � Q DATE �a� OWNER � W � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFfIfUI UNOER PENALTY OF PERIURV 7HAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � - � Y(COMAIENCINO WITM SECTION 700D)OF OIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z �� AIY UCENSE IS IN FULL FORCE AND EFFECT. m � UCENSE CLASS LIC.NO. � � j � V DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION -� Q � I HEREBY AFFIRM UNDER PENALTV OF PERIURY ONE OF THE FOILOWINO DECURATIONS: U � Z � _I HAVE AND WILL MAINTAIN A CEHTIFICATE OF CANSENT TO SELF-INSURE FOR NKIRKERS' 2 COMPENSATION,AS PROVIDED BY SECTON J7000F THE LABOR CODE,FOP THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMI7IS ISSUED. � � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION 1 Q 9700 OF THE UBOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS � a ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION jc�aaiEa PLAN REVIEW � i � POLICY NUMBER ELECTRIC 0 (IYU6SECf10NN�NOT8E00AilEfIDOFi}�PEPoATISFi�RONEFUrOREDDOLLMSR��)�LESS? PLUMBING Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL LJ SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SOAS TO BECAME SU&IECT TO THE � WORKERS'COMPENSATION UWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE S SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 9700 OF THE LABOR CODE.I SHALL FORTHNATH COMPI.V WITI THOSE PROVISIONS. ISSUANCE � SMIP p DATE: � APPLICANC � , w ENERGY P/C � � , J WARNINO:FAILURE TO SECURE WORKERS'CAMPENSATION CAVERAGE IS UNUWFUL,AND SHALL BE � � SU&IECTMI EMPLOYER TO CRIMINAL PENALT�ES AND CIVIL FINES UP TO ONE NUNDRED THOUSAND '�I,�'♦ ENERGY PERMIT /h } DOLLARS(5100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAG�9 AS PROVIDED FOR IN -� W,s� - � SECTION 3708 OF THE LABOR CODE,IN7ERE5T,AND ATTORNEV'S FEES. F{ETENTION FEE: d CONSTRUCTION LENDING AGENCY PRE-AlT FEE: � I HEREBYAFFIqM UNDEH PENALTY OF PERJUHV THAT THERE IS ACONSTRUCTION LENDING AGENCY ' - FOF THE PERFORMANCE OF 7HE WORK FOR WHICN 7HI5 PEfiM1T IS ISSUED(SEC.7oW,CIV.Q�. �p Z W � LENDER'SNAME H LENDEIYSAD�RESS 1 � I CEflTIFY THAT I HAVE READ THIS APPLICATION M!D STATE 7HATTIE ABOVE INFORMA7qN IS CORRECT. TOTAL FE ES w 1 AGREE TO COMPLV N7TH ALL CfTY AND COUHTV OR�INMICES AND STATE UWS RELATINO 70 BURDING / (� � CONSTRUCTION,MIDHEREBVAUTHORIZEREPRESENTATIVESOF7HISCOUNTVTOENTERUPON7HE /^_ y� A .,� w�f11 �I- � f /1 ,�`_ `���� � ABOVE-MENTIOHED VROPERTV FOR INSPEC710N PURP0.SES. ` 1 1 1 / ll V V `�1 �d/�yv-��� Z COMMENTS �,i�r� E-- � O /�, �'- % , . ? c�c9�l:r^t� .p , i - i� =;;-��- � m PE I N (P � • � �_ � -'�e� `�(� � _ . c�.�_ f��--�C7 y IONATURE OF PERA1fTTEE DATE ' � RECPT.NO. PAID BY VALIDATION � WHITE—Depertment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy . . _ ..,. . � .�. .... . .,.y,���:. . . . � . - ... . � . . . . � ... , . .... . . . l�.�.ti.. , , .. . ... . . 1;„ .� . ' •y• • C�T'1( OF DI/�NIOND BAFi , - 9�SPEC1'AON I�EC��iD �.:t di�r�i'r��`�'`y' Y.+. ,��.'�...`, 5 � � � 0 `�`� e . o � � � o � � U �u uU{�� �� °. . . _ � . . . � , . � , � SET BACK ' ' � � FLOOR JOIST ; � • FTGS/FORMS/STEEL -�� FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CU�IDUIT � • � SLAB GRADE � FIREPLACE FOUNDATION TEMP POWER � FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING - S FT. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING � . SHOWER/TUB TEST POdL ELECTRIC � EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION � OFF SITE IMPS. DRYWALL NAI�WG DEDICATIONS SEWER FINAL:ENG. SEPTIC TANK . . . LANDSCAPE/IRRIG. SEEP PIT/L.L. � ' ON SITE IMPS. GAS AIR TEST FINAL ZC3NING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT.;FINAL _ _ ,_ �,�, . , FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY . z ..� .��F� ri'��'�$ ��n;c+� COMiViENTS SEPTIC TANK SIZE SEEP PIT/U SIZE .. � �6 re � .�.Y _ . , � —a:i����../,� '�,�-. 2y� . '�' ,LV� �� k L J' _ • ` ;7.�' i � ! f- ,. � ��.� . . . � � . . / �