HomeMy WebLinkAbout1155 DIAMOND BAR BL (17) �
^ _���_ CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
T, 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
'°"'�W BUILDING PERMIT APPLICATION FIRMLY I�
¢ DDRIESS� I��� �• �/�� 1���/ O�/l
>- � APPLICATION PERMIT �p�/����p/C
p DATE NUMBER�L{(/-//7# OT�
� APN LOT TRACT ISSUE �� 'o TYPE � � OCC
—�� DATE CONST. GROUP
p OWNER U� tiJv
" ADDRESS lS • ZONING SETBACKS
0
� CI �P TEL '- � REOART RW ❑
APPLICANT TE���E,�,�C7y�,- SIDE/SIDE STREET RW ❑
� CONTRACTOR �' Q,(f SIDE p
� ADDRESS PROPOSED USE C x�ST� �r � T ...
� CI ZIP T � - �
i o ARCWENG/ �
z DESIGNER
a ADDRESS NO.DWEL. p,
cn UNITS STORIES BEDROOMS
� CITY ZIP TEL.
� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNEF-BUILDER DECLARATION
p SFR/ADD/REM
p I HEREBV AFFIRM UNDER PENALTY OF PEMIRV THAT I AA1 E%EMPT FROM THE CONTRACTORS U- G8f8gB/C9fPOh
W CENSEIAWFORTHEFOLLOWINOREASON(SEC.703t.5BUSINESSANDPROFESSIONSCODE:ANVCITYOF (n
U �qJ�.JJyWF{�qEp�IRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORHEPAIRANVSTRUC� w
W TURE,PRqR TO ITS ISSUANCE,AL50 REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Pe1I0/DBCI(
� STATEMENT TFUT HE OR SHE IS LICENSED PURSUAN7 TO THE PROVISIONS OF THE CONiRACTOFS LI-
� CENSE UW(CHAPTER D(CAMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 M1D PFO� u' POOVSPB
FESSIONSCODE)ORTIATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEOEDEXEMP� C7
TKKJ.ANY VIOLATION OF SECTION 7031.6 BV ANY APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT T0 Z Re-Roof
� A CIVIL PENALTV OF NOT MORE THAN FIVE HUNORED DOLLARS(i50D)J:
� ❑I,ASONMEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAOESASTHEIRSOLECOMPENSATION, COrt1rtIBfC18I
WILL DO THE WORK�ND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7011,BUSI� �
N NESS AND PROFESSIONS CODE:THE CONTRACTORS UCENSE UW DOES NOT APPLV TO AN OWNER OF � O O
PROFEHTV WFIO BUILDS OR IMPROVES THEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR
' Q THROUGHHISORHEROWNEMVLOVEES,PROVIDEDTHATSUCFIIMPROVEMENTSARENOTINTENDEDOR m
Q OFFEREDFORSALEIF,FqWEVERTMEBUILDINGORIMPROVEMENTI550LDWITMNONEVEAROFCOMPLE
Z TqN,THE OWNER-BUILDER WILL HAVE 7HE 9URDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR
� IMPROVE FOR THE PURPOSE OF SALE).
W ❑I,AS ONMER OF THE PROPEi7n',AA/EXQUSIVELV COMRACTINO WfTH LICENSED CONTRACTORS
� TO CONSTRUCT THE PRp1ECT(SEC.7oN,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- VfilUB�iOn �� ADJ.AREA
W CENSEUWDOESNOTAPPLVTOANON7JEROFAPROPERTVWHOBUILDSORIMPROVESTHERE-0N,AND
� NRiOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION
TORS LICENSE LAW.). FEE �
� O I AM E%EMPT UNDER SEC. B,8 P.C.FOR THIS REASON Q '�
� U
LL DA7E OWNER H
l
�Q LICENSED CONTRACTORS DECLARATION w
CL I HEREBV AFFIqM UNDER PENALTV OF PERJURV THAT I AM UCENSED UNDER PROVISIONS OF C q Z I �
d �G(COMMENCIMO WITH SECTION 7000)OF DMSION�OF THE BUSINESS AND PROFESSKKJS CODE.AN
X YY LICENSE IS IN FULL FORCE AND EFFECT. m
�LLJ � a
� LICENSE CLASS � LIC.NO. �
V DATE � � CONTRACTOR
W
� WORKERS'COMPENSATION DECLARATION �
N I HEREBV AFFIRM UNDER PENALTV OF PERIUFY ONE OF THE FOLLOWING DECURATIONS: �
� Z ..
� _IFIAVEANDWILLMAINTAINACERTIFICATEOFCANSENTTOSELF�INSUREFOFWORNERS' (_
� COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE IABOR CODE,FOR THE PERFORMANCE �C,
OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED. 2
� '
w �1 HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BV SECTION
Q 370o OFTHE LABOR CODE,FOR THE.PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �
ISSUED.MV WORKERSa'S�P ATION INSU CE C/A�RRIE AND POLICY NUMBER E: '* CONSTRUCTION
� CARRIER ��T�7T��N Y� I�N S(J �/I PLAN REVIEW
Z0 POUCVNUMBER '. �q � ELECTRIC
Q
p f�������7BE�A�LEfIDOFT1$PEp�TI$FpHp.�EFiI.�REDDOLUf�IS�roIaRLESS} PLUMBING �
w
Z I CERTIFV THAT IN THE PERFORMANCE OF THE M/ORl(FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL 2
G} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE '
(/� WORNERS'CAMPENSATION LAWS OF CALIFORNIq AND AQqEE THAT IF I SHOULD BECOME INSPECTION FEE
= SU&IECTTOTHEWORKERS'COMPENS�IONPROVISIONSOFSECTIO OOOFTHEIABOR
COOE,I SHALL FORTHWITN COMPLV W}�THOSE PROVISIONS. �,/fl ISSUANCE
p DA�� APPLICAN7��l\�� A�I l/T ,�, SMIP � -
WARNINO:FAILUflE TO SECURE WOqKERS'COMPENSATION CAVEfiAGE IS UNIAWFUL,AND SHALL BE ENERGY P/C 3 b. �
� SU&IECTANEMPLOVERTOCqIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSMlD ENERGYPERMIT ��'
DOLLARS({700,000J,IN ADDITION TO THE COST OF CAMPENSATKKJ,DAMAGES AS PROVIDED FOR IN
J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. 4'
w AETENTION FEE: _ ' L�I ��
O CONSTRUCTION LENDING AGENCY pq _ �� �
ALT
��� 2 .
� I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AOENCV �_yi
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oD7,CIV.CJ.
Z • _
W
� LENDER'S NAME . '
F— LENDER'SADDRE55
�
w ICERTIFVTHATIHAVEREAD7HISAPPLICATIONANDSTATETHATTHEABOVEWFOqMATqNISCORAECT. TOTAL FEES 33��� -^'
� I AGREE TO COMPLV WfTH ALL GTV AND COUNTY ORDINANCES AND STATE LAWS RELATINO TO BUILDINO
� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER U70N THE ` 3 .��
Z A E-MENTIONED PROPERTV FOF INSPECTION PUR705E5. (��
� '`S� K COMMENTS �
P NAME(P
, -2L =1.� 0
IO RE OF V ITTE OATE . '
/ RECPT.NO. �4C.,e� PAID BY CL VAUDATION
~ WHITE—De Rment
pa Copy,YELLOW�inance Copy,PINK—Assessa Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy
4\�
CIT'V O� Di6SiliiOND �A+Fi
I�ISP�C�90i� {��CORD
� . . �. _
-,,.�.: o
;� ���p�c�400a oa� = a����c��o� ��� ��p��o� � ��� ������ � x
0
SET BACK FLOOR JOIST' �
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND • UNDER FLOOR DUCT �
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID H'T. BOND BEAM �
ROOF SHEATHING 8 FT. BOND BEAM �
FRAMING/VENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST � � FINALjZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
.�OOC�-'w�
COMMEIVTS
SEPTIC TANK SIZE J
SEEP PIT/U SIZE
GJ
.,� C�
�� .
�,' � ; � '