HomeMy WebLinkAbout1155 DIAMOND BAR BL (9) ^---�,�� CTI'Y OF DIAMOND BAR - ��PI
DEPARTMENT OF COMMUNTIY 8t DEVELOPMENT SERVICES ���
� 3 Zis2s E.co�ey�e ` • PRESS
� (909)860-3195 Fax(909)861-3117 . . ' ' -
"'"'. BUILDING PERMIT APPLICATION . � � FIRMLY
} JOBSITE �, � DATE CATION I �� �� � NUMBER q/C v ��
o ADDRESS
� APN LOT TRACT DATE � �� ONST. GROUP II
p OWNER
�` ADDRESS G C� �I? ZONING SETBACKS
0
Z CITY LL IP 4 7,r�1rEL7�`+�� y 3�" 3 REART RW ❑
g APPLICANT �2�T,t Cr /i..w TEL.9o9-39�-$ / SIDE/SIDE STREET RW ❑
� CONTRACTOR G� � C 5� .' SIDE
ADDRESS ❑
o CITY C�4 i/�O rI G/'fl�TP -�/Z g4`�EL. - / S PROPOSED USE
o ARCH/ENG/ ( 7�1y/
z� DESIGNER NO.DWEL. NO. NO.
a ADDRESS
� CITY ZIP TEL. UNITS STORIES BEDROOMS
�
cn DESCRIPTION S�.Ff. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLAHATION SFR/ADD/REM
O
I HEREBV AFFIRM UNDER PENAL7V OF PERRIRY 7HAT I MI EXEMPT FROM 7HE CONT{UCTORS LI� G9f8�C8ryOR
W CENSELAWf-0RTHEFOLLOWINf3REASON(SEC.7071.6BUSWESSAN07ROFESSIONSCODE:ANVCITVOR (n
C1 COUNTVNT11p1RC-0UIRESAPEAMITTOCONS7RUC7,ALTER,IMPROVE,DEMOl1SH,ORREPNRANYS7AUG W PetlO/DBCk
� NRE,PRqR TO RS ISSUANCE,/�LSO REWIRES THE MPLIGWT FOR SUCH PERMIT TO FILE A SIONEO W ��
� STATEMENT iF1AT HE OR SHE IS LICENSED WRSUANT TO THE PROVISIONS OF THE CONTRACTOq3 ly �
� CENSE UW(CHAP7ER Y(COMMENqNO WI7H SEC710N 7000)OF DIVISION 3 OF THE BUSINESS AND PHO- PooUSpa
FESSqNS CODE)OR 7TUT HE OR SHE IS El(EMPT TiEREFROM AND THE BA515 FOR T1IEALLEOED EXEAIP- (� '
TION.ANVVqLAT10NOFSECTION70J1.6BVANYAPPLICAHTFORAPERMITSU&IECT57HEMPLICMlTTO Z Re-Root
� ACML PENALTY OF NOT MORE 7M/VJ FNE HUNDRED DOLI.ARS(f500).):
� OI,ASOWNEROFTHEPROPER7Y,ORMVEMPLOYEESWITH:WAOESASTHEIRSOLECOMPENSA7qN, � COmmBfClel . -�
WILL DO THE WORI(AND THE STRUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC,70l1,BU51- J
� NE95 AND PROFESSIONS CADE:7HE CANTRACTORS LICENSE Uw OOES NO7 MP�V TO AN OWNER OF �
PROPEiT'WFIO BUILDS OR IMPqOVES THEREON,AND NMO DOES SUCH WORI(HIMSELF OR HERSELF OR
Q THROUGH HIS OR HER OWN EMPLOYEES,PqOVIDED THAT SUpI IMPROVEMENTS ME NOT INTENDED OR m ,
� OFFERmFORSALEIF,MOWEVERTNEBUILDIN�ORIMPFOVEMBfTI550LDWITHINONEVEAROFCONPLE-
Z TqN,THE OWNER-BUILDER WILL HAVE THE BURDEN OF�ROVPIO THAT HE Oq SNE Dm HOT BUIID OR
� IMPROVE FOR THE PURPOSE OF SAI.E�. �
w ❑I,AS OVMER OF THE PROPEHTV,AM EXp.USNELV CONTMCTMO WfTH LICENSEO CONTMCTORS
[[ TO CANSTRUCT THE PROJECT(SEC.70/1,BUSINE53 AND PROFESSIONS CODE:THE COHTMCTORS U- V8IU8lI0f1 A0.1.AREA
W CENSE UW DOES NOTMPLV TO AN ONMER OF A PHOPERTV WHO BU6D5 OR IMPROVE9 THEREON,AND
� WFqWNTRAC7Sf-0RSUp1PHWEC73MA7HACOMRACTOR�S��ICENSEDPURSUANT70THECONiRAC� Qunrmry DESCRIPTION
Y TORS LJCENSE UW.). ' FEE �
¢ ❑1 AM EXEMP7 UNDER SEC. B.8 P.C.f-0R THIS REASON �
� V
� ¢
DATE OMMER F-
Z U
� UCENSED CONTRACTORS DECLARATION w
�
1 HEREBYAFFIRM UNDER PENALTY'OF PERAJRY hiA71 AM LICENSED UNDER PROVISIONS OF CHAP7ER �
� Y(COMMENCIHO WITH SECTION 7000)OF DMSION�OF THE&1SINESS AND PROFESSIONS CODE,AND Z '
��� W LICENSE IS IN FULL FORCE AND EFFECT.
�/ m
� UCENSEC ��S�_ LIC.NO. �'�/I ���^ �
w DATE CONTRACTOR_� � 5/_�GI I�_t a
V_�—.
� WORKERS'COMPENSATION DECLARATION �
N 1 HEREBYAFFIRM UNDER PENAL7V OF PERIURY ONE OF hiE FOLLOW WO DECUMTIONS: V
� Z
� � _IHAVEMAWILLMAPITAMACERTIFlCATEOFCONSENTTOSELHNSUREFORWOHKERS' �
Q COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U
Q OF THE WORN FOR WHICH THI9 PERMIT 19 ISSUEO. �
QW _1 HAVE AND WILL NAINTAPI WORKERS'COAIPENSATqN INSURANCE,AS REOUIRED BV SECTION ///���
37000F TNE LABOR CODE.FOR TNE PERFORMMICE OF THE WORK FOR WHIp1 THIS PERMR IS � �R
ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION V
� c�wRiER � PLAN REVIEW �
0 POLICV NUMBER
Z ELECTRIC
¢
p (rwssEcnor�r�rioreEaonRETIDOFnfa�rswaa�Mrnr�oounAs(f�oolaa�ss� PLUMBING
w
Z I CERTIFV THA7 Pl THE PERFORAIANCE OF THE WORN FOR WHICH 7HI5 PERMIT IS ISSUED.1 MECHANICAL
C} SFU11 NOT EMPLOV ANY PERSON IN ANY MMINER SO AS TO BECOME SU&IECi TO THE
(/) WORKERS COMPENSATION UWS OF CALIFOfiNlti AND AOREE TMAT IF I SHOULD BECOME INSPECTION FEE
S SU&IECT TO THE WORKERS'COMPENSATKIN PROVISIONS OF SECTION 37o00F THE LABOR .
CODE,ISHALLFORTHVATMCOMPLVWI7HT�5 EPROVISIONS. ISSU/WCE T
p DATE:_��APPLICANT. _4[���,��/�•� �SMIP S �,J
� � ENERGY P/C
WARNINO:FA URE O SEWRE WORKER9'COMPENSATKKJ COVERAOE IS UNLAWFUL,AIJD SHALL BE
LL SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCNILFINESU7TOONEHUNDREDTHOU91WD ENERGYPERMIT
DOLURS(i7oo.o00�.IN ADDI710N TO TME COST OF COMPENSATION,DAMAOES AS PROVIDED FOR W
J SECTqN 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'3 FEES. � .
Q RETENTION FEE: �
OCONSTRUCTION LENDING AGENCY � PRE-ALT FEE:
� I HEREBV AFFIRAI UNDER PENALTV OF PERIURV THAT THERE IS ACONSTRUCTION LENDINO AOENCV
� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERAIIT IS ISSUED(SEC.30D7,CIV.CJ.
Z �U
W
� LENDER'S NAME ' ,�
H LENDER'S ADDRE55
� TOTAL FEES N � QA/✓q�—�--
� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE WFORMATqN IS CORHECT.
Zw I AQREE TO COMPLV N7TH N.L CfTV AND COUNTY ORDINANCES AND STATE UWS RELATIHO TO WqAINO '^ ,1 �
CONSTRUCTION,AND HEREBV AUT}K)RIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE ��y�
ABOVE�MEMqNED VROPERTV FOR INSPEC PU E5.
0 ' ,� COMMENTS
J f. 7 ��-
_
m PERMITTEE NAME(PRI
¢ O�
�
� SIONANREOFPERMfTTEE . D T
� RECPT.NO. � PAID BY VALIDATION
WHITE—Depehment Copy,YELLOW�Inence Capy,PINK—Assessor Copy,GOLDENR D—Flle Copy,6REEN—ApplicanYa Copy
���f �V� �D�e��ViO(�9�9 ��(R
Of��I�fE(GVD�� V�E��V��
uJU�JIr'ISV�U U�11�1 d `� ' uKJ�UG-'I5 � � UJ�J�LSL`9 U U�JU'Ji D • ' G ��
1 t� OG����
SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CU�IDUIT
SLAB GRADE FIREPLACE FOUNDATION
7EMP POWER FIREPLACE BOND BEAM
WATER SERVICE • MiD HT. BOND BEAM
ROOF SHEAi"HING 8 FT. BOND BEAM
FRAMINGNENTILlA71UN FINAL BQND BEAM
ROOF COVER PRE-GRAdING �
ROUGH HEATING BENCHING
, ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUPdIBING FINISH GRADING
SH�WEFt/TUB TEST P�OL ELECTRIC
EXT.LATH/SIDING POOL FENCING -
WALL INSULATION POOL F�NAL
CEILING INSULATION OFF SITE IMPS.
ORYWALL NAiLING DEDICATIONS
SEWER FINAL ENG.
SEPTlC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.�. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINA�CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC QEV. FEES PAID
FINAL PLUMBING ENERGY
C�O� a � o
COMMEfVTS
SEPTIC TANK SIZE
SEEP PiT/U SIZE
�
�i . '�
�