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HomeMy WebLinkAbout11143 - 1370 S VALLEY VISTA DR (2) _ ..- -- _. -- ---�-.... ...._ ....._..._._ _.__._,_,,. � .. . - CITY OF DIAMOND BAR � � ' COMMUNII'Y DEVELOPMENT DEPARTMENT �/� , .,,,,W . 21660 E.Copley Drive Suite 190 PRESS (909)660�3195 Fax(909)861-3117 'H�" BUILDING PERMIT APPLICATION FIRMLY � JOBSITE (' � APPLICATION � PERMIT � Pl � o ADDRESS ��D ✓ • ����� V � �r I DATE � NUMBER �� #� � ISSUE TYPE OCC APN OT Tfl CT DATE CONST. GROUP p OWNER , ��_ d� �►Abdl ZONING SETBACKS o ADDRESS �� W CITY ZIP TEL. FRONT RW ❑ � APPLICANT TEL. REAR ❑ SIDFJSIDE ST ET RW�_ U � CONTRACT 1�f . SiDE C ADDRE S O b � CITY F l ZIP TE � YLl PROPOSED USE o ARCH/ENG/ � , z� �ESIGNER - NO.DWEL. NO. NO. a ADDRES UNITS STORIES BEDROOMS � CITY ZIP�p TE o � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANAIUATION � OWNER-BI:IL�ER DECLARATION SFq1ADD/REM O � I HEREBY AFFIqM UNDER PENALTY OF PER.NRY THAT I AA1 E%EA1PT FROM THE CONfMCTOR5 U- G8IBg0/C21�7011 W CENSELAWFOHTMEFOLLOWINGREASON(SEC.7o37.58USINESSANOPROFE5910NSCADE:ANYCITYOq (n C,� COUNTYWHICHREOUIRESAPERMITTOCON61AUC7,ALTEH.IMVROVE.DEMOLISH.ONREPAIRANVS7RUC- W pati0/DBCk WTURE.PRIDR TO ITS ISSl1ANCE,ALSO REQUIRES THE 11PPUCANT FOR SUGH PERMIT TO FILE A SIGNED W � BTATEMENT THAY HE OR SHE IS LICENSED PURbUANT TO THE PROVISIONS OF iHE CONTMCTORS LI� � CENSE UW(CMAPTER B(COMMENCING WITH SECTION 7Wo)OF DIVISpN J OF TNE BU51NE55 ANO Pfl0- � P�OUSPe ^ FESS�ONSCO�E)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBAS�SFORTHEA��EOEDEXEMP- � TION.ANVVIOLATIONOFSECTION7n31.59V11NYNPPLICRNTWflAPEHMITSUBJECTSTME�PPLICANTTO Z RB-fa001 � A CIVIL PENILLTY OP NOT h10RE THAN FIYE HUNDNEO OOLLARS(t5o0)J: � C11,ASOWNEROFTHEPROPERTY.OFMVEMPLOVEESWITHWAGESA5T1/EIRSOLECOMPENSA710N. C� COTRIBfC18I Z YYILL W THE WOHK,AND THE STFiUCTURE 19 NOT iNTEN�EO OR OFFEREP fOR SALE(SEC,�01�,BUSi- J NESSAND PqOFESSIONS CO�E:THE CANTRACTORS I,ICENSE LAW�OES NOT AFPLY TO AN OWNEF OF � Pft07ERTYYVh108UILD50RIMPROYEST}7EflEON,ANDNMO00E5SUCHWORKHIMSELFORHERSF.IFOR � Q THROUGHHISORHEROWNEMPLOVEES,PROVIDE07HATSUCMUAPROVEMENTSARENOTINTENOE�OR m � OFFEREDFORSALEIF.MOWEYEH,YIIEBUIl01NGOHIMPROVEMENi1380LDWITHINONEYEAROFCOMPLE � TION,THE OWNER-BUILDER WILL HAVE TNE BUFlDEN OF PROVING TH�T ME OR SHE DID NOT Bl11LD OR � IMPROVE FOq THE PURPO5E OF SALEI. C]I,AS OWNER OF THE PHOPEHTI;AM E%C WSIVELV CONTRACTING WITH LICENSED CONTpACTORS � TO CONSTRUCT THE PROJECT(SEG 704a,BUSINE55 AND FROFESSIONS GODE:THE C�NiPACTORS LI- W CENSELAWpOESNOTMPIYIYIANOWNEROFAPROPER7VWNOBUILDSORIMPFOUESTHEREON,AND alUB[IO� ADJ.AREA � WHOCONTRACTSFOR5UQ7PpOJECTSWITHACONTRACTOR�S)UGENSEDPURSUANTTOTNECONTRAG �QUANTITY DESC IPTION FEE TOR3LICENSELAW.). Q 0 L I AM EXEMPT UNOER SEC. B.!P.C.FOR THIS HEA90N U � � LL OA7E ' � ONMEfl U ' ' � LICENSED CONTRACTORS DECLARATION —� � w IHERE9Y�FFIRMUNDERPEN�LTYOFPEFJURYTHATIMALICENSEDUNDERPHOVI90NSOFCHAPTER � d 9(C061MENCING WITH SECTION 7aoo)OF ONISION 7 OF THE BUSINESS AND 7ROFESSIDNS CODE,ANO Z 'X YY UCENSE IS W FULL FOFlCE AN�FFEC7. m _,�� � LIGENSE CU55 —I LIC.NO. � c���— � V DATE � � CONTRACTOR CS.�� a W � WORKERS'COMPENSATION DECLARATION Q N IHEREBY�FFlFMUN�ERPENALT'OFDERIIIRVDNEOFTNEWLLOWING�ECLARATIONS: U � Z Q � _IHAVEANDWILLMAIMAINACEFiTIFICATEOFCONSENTTOSELF-INSUREFORWORNERS' S � COM7ENSATION.ASPROVI�EDBVSECTION37000fTMELABORC�E.FOHTMEPERPDRMANCE•z . W , OF THE WORK FOR WNICH THIS PERMIT IS ISSUED. ' � � � . • � W �IHAVEANOWILLMAIMAINWORNEFS'COMPENSATIONINSUMNCE.A9REW�AEDBYSECTION Q 37o00FTFiELABORC00E,FORTiEiERFORMANCEOFTHEWORNFORWHICHh115PERMITIS ISSUED.MVWOHKERS'COMPENSATIONINSURANCECARRIERANDVOLICVWl1MBERARE: CONSTRUCTION' . J � j CAflfl1ER PLAN REVIEW ' - Z POLICYNUMBER ELECTRIC Q 0 (MlSSECiIONNE�NDTBECOMPLEfFDOF7NEPEfNNfBFOR�NEHUPaFfD00l1M5R��)��4 PLUMBING Z I CERTIFY THAT M THE PERFORMANCE OFTME WONK FOfl'M11CH iH15 PERM�T IS ISSUED,1 MECHANICAL (J SHALLNOT EAIPLOYANV PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TOTHE � WOPoCERS'COLIPENSATION�AWSOFCALIFOqN10.AN0ACREETMATIFI5HOl1LOBECOME INSPECTIONFEE � SUBJECTTOTHE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LA80R � p� � COOE.I 5HALL FORTMNITH COMPLY WITH T�SE PROVISIO - J ISSUANCE � SMIP . S� p DATE: l" �- �� APPLICANT: W ENERGY P/C � WIIRNING:FAILURE TO SECUflE N^DRKERS'COMPENSATION CAYERAGE IS UNUWFLA..AN�SHALL 8E LL Sll&IECTANEMPLOVEHTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHl1NDHEDTlKK1SAND ENERGYPERMIT DOLLARS(f100.00��,IN ADDITION TOTHE COSTOF COMPENSATION,DAMAGES AS PROVIDEO FOR IN � 9ECTION97000Fh1ELABORCODE,INiEREST,AN�ATTORNEY'SFEES. RETENTIONFEE: _ � � CONSTRUCTION LENDINC�AGENCY PRE-ALT FEE: O � IHEREBYAFFIRMUNDEPPEN�LT/OFPENJURYTHATTHEREISACONSTRUCTIONLENOINGAGENCY FOH TNE PEHFORMANCE OF 7HE WORK FOR WHICH THIS PEHMIT IS ISSUED(SEC.7091,qV.C.�. Z � LENDER'S NAME � 1— LENDER'S AOORE55 r � I CERTIFYTHAi i FUYE REAO THIS APPUCATpN AND STATE TMAT TME ABOVE INFORMATION IS CORRECT. TOTAL FE ES !� •��. � I AGREE TO COMPLY WITN AlL CITY AND COUNTY ORDINANCESAND STATE LAWS qELATING 70 BUILOING CONSTRUCTION,�ND NEREBYAUTHORIZE REPRESENTATlVES OF iH15 COUNTY TO ENTEH 11PON THE � ABOVE-MENTpNEDPpOPER7YFORINSVECTIONPURPO5E5. COMMENTS � J � m PERMITTEE NAME(PRINn � � 1-�-� � SM3Nl1TUREOFPEHMITTEE OATE � RECPT.NO. PAID BY VALIDATION � WHITE--Department Copy,YELLOW---Finence Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN—Appli t's Cqry � � CITY t7F DIAMOt�D BA(� . , � INSPECTIC3t� RECC?RD E . � • c - s � j � • e - SET BACK FLOOR JOIST FTGSIFQRMSlSTEEL _ _T FHA REQMTS __� ~ , , ti ELECTRIC GROUND 11NDER FLOOR QUC7 � � � � � .•.,,� GROUND PLUMBING UNDER FLQOR CU�IDUIT 1 SLAB GRAQE � FIFiEPLACE FOUNDATION. � TEMP POWER � � FIREPLACE BOND BEAM`�i � ` '" WATER SERVICE MID HT.�BOND:BEAM•. '� ' ••'�, ." � ., RODF SHEATHING ; 8 FT.BOND BEAM FRAMINGNENTILIATION FINAL BONQ BEAM~ � - ROOFCOVER PRE-GRADi�7G � � ' ' - •-`_�, ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADtNG RQUGH PLUMBING FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT.LATH/SIDING � ' PC}OL FENCING WALL INSULATION POOL FINAL CEILING INSULATION i OFF SITE IMPS. DRYWALL NAILING i DEDICATIONS i SEWER � FINAL ENG, SEPTIC TANK . • LANDSCAPE/IRRIG. SEEP PIT/L.L. ' ON SITE IMPS. GAS AIFi TEST FINAL ZONING FINAL GOIVST. / p � FIRE DEPT. FINAL f •� . _ FINAL HEATING � � HEALTH DEPT. FINAL FINAL ELECTRIC ' � DEV. FEES PAID FINAL PLUMBING � ' ENERGY ' ` — . __ � � I M � r _ � 7 COMMENTS ����5 �L'�x D 4-� ��,o�*-�'�D 6 y ��� ,�- .. . r=-��•�G- �f 3�l g�r , r� . , � , . � SEPTIC TANK 51ZE � ,�.e��; SEEP PIT/U SIZE � _ 1 � ,, N�� , t _ . �. , _ � . ,' - �