HomeMy WebLinkAbout16799 (35) f� CTTY OF DIAMOND BAR
! DEPARTMENT OF CONIIv1UNITY&DEVELOPMENT SERVICES
21825 E.Copley Drive .
"" (909)860.3195 Fax(909)861-3117 PRE$$
`%*'�' BUILDINGPERMITAPPLICATION FIRMLY
o ADDRESS / + / ✓' ��D `'�J� O DATE CATION? ' / O NUMBER__� #!C
l�
� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER ;
" ADD ESS � l-O ZONING SEiBACKS
Z CITY IP ( TE FRONT RW ❑
g APPLICANT TE . _ "T REAR ❑
SIDE/SIDE STREET RW ❑
� CONTRACTOR IN SIDE ❑
QC� SS Z�P - TE _ PROPOSED USE � S(�E�N Z
o ARCHlENG/
� DESIGNER NO.DWEL. N0. NO.
ADDRESS UNITS 7 STORIES �
� CITY ZIP TEL BEDROOMS
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNEFl-BUILDER DECLARAT�ON SFWADD/REM
O
p I HEREBV AFFIRM UNDER PEWLL7Y OF PE0.IURY THAT I M1 EXEMP7 FROM iHE LONTMCTOHS ll• GHf89e/CB�pOA
W CENSEUWFORTMEFdlOWINOREASON(SEC.7071.SBUSINESSINOPROFESSIONSCODE:ANYCITYOF (n
U COUNTYNMIpiqEWIRESl1PERMITTOCONSTRUCLALTERMPROVE.DEMOLISH.ORREPAIRANYSTRUG W PetlO/DBGk
W TURE,PF1OR TO ITS iSSUANCE,ALSO REOUIRES THE MPLICANT fOfl SUp1 PERMIT TO FILE A S�GNEO w
STATE�dENT THAT HE OR SHE IS UCENSEO PURSUANT TO TME VqOVISIONS OF THE CONTRACtORS ll�
gCENSELAW(CMAPTERY(COIAMENCW6WITHSECTIONTOOO�OFpIVISION]OFiHEBUSINESSANOVRP � PooVSpa
FESSpNSCOO�ORTHATMEOR5HEI5EXEMPTTHEREFROMANOhIEBA515FORTHE/�LLEGEDEXEIAP� (� /�..�
gTqN.ANVV10tAT10NOF5ECT1ON7077.58YANYAPPLICANTFOHAPERMITSU&IECTSTMEAVPLICANTTO Z RB•R00� y�,/
A CMLPENALTV OF NOT AIORE 7MAN FIVE MUNDRED OOLURS(SSoO).k
Z ❑�ASOWNEHOFTHEPROVER7Y,ORMVEMPLOYEESVnTHWAGESASTHEIR50LEGOMPEN5R71CN. O CORIrtIBfGldl � -
VALL DO THE WORK.AND THE STRUCiURE IS NOT IN7ENDED ON OFFEHEO FOH SALE(SEC.70��,BU51• J
� NESS AND VROFESSIONS WDE:THE CONiMCTORS LICENSE UW DOES NOT APPLY i0 AN OYMER OF j
PH07EHTV WF10 BU0.D5 OR MPi10VES T1IEREON.Ml�WHO DOES SUCH WORK HIMSELF OR MERSELf OR
2 THNOUGHHISORHERONRIEMPLOYEES,PROYIOEDTHATSUdiMPROVEMEMSARENOTINTENDEDOR m
w OFFfREpFpqS.LLE.IG,�tlW�IIERTM�e��N60R1610ROVEMENTIS50lDWRHINDNEYEAROFCOMttE�
Z T10N,7HE O'wNEREUIIDER vnLL MAVE THE BURDEN OF PROVwG TNAT HE OR SNE DID NOT BUILD OR
M1Pf1DVE FOR THE PURPOSE OF SALEy
W OI.ASOVlNEROFTHEPROPERTY,MIEXCLUSNELVCONTMCTM�WfTF1UCENSEOCONTMCTORS ^
� TO CONSTRUGT TME PRQIECT(SEC.70�t,BUSINESS AND iROFE3510N3 COOE:TFIE CONTMCTORS LI• V8IU8IIOf1 � AQI.AREA
W CENSEUWDOESNOTAPPLYTOANOWNEROFAPflOPERTYWMO8ULLD50RIMPqOVE5T/EREON,ANO
� MTIOCOMMCTSiOR5Up1PROJECTSWITMACONTMCTOR(5)LICENSEDPURSUiV7TTOTHECONTRAG QUANTITY DESCRIPTION FEE
Y TORSUCENSEUWJ. .+
� ❑IAMEXEYDTUNDERSEC. B.tG.C.FORTHISREA50N U E O� V �-
�
LL. � �f
Z DATE OWNER U L V S
� LICENSED CON7RAC70RS DECLARnTION w � L
� IHEREBYAFFIRMUNDERPENAITYOFPERNRVTHATIAML�CENSEDUNDERVROVI510NSOFCHMTEN U.
� i(COMMENCttdO WI7H SECf10N 70001 OF OMSION J Of TME BUSMESS AND PROFESSiONS CODE,AND Z
�� YY t10EN5E IS N FIAL FORCEAND EFFECT. m
� LICENSE OC1qT O� LIO'f0�� C�~�� J
-__.___. ..0 pATE � 0 CONTMCTOR �-
W
� WORKERS'COMPENSATION DECLARATION 4
� U
� IHEREBVAFFlRAIUNDERVENAITVOFDE0.11/RYONEOFTHEFOLLOWWGDECLARAT10N5: Z
Q
� _IFI�VEANOWILLMAINTNNACENTIFICATEOFCONSENTTOSElFdNSUREFORWOHIfERS' $
COMPENSATqN,lISPROVIDEDBVSELTION77000FTMEtABOfiCOOE,FORTMEVEHFORMANCE W
Q OFTHE WORK FOR NM1IICH THIS VEPoAiT IS ISSUED. �
"�V �IHAVEANDWILLM�IMAINWORKERSCOMPENSATqNINSURANCE,ASPEWIREDBVSECTION / �p
Q J7000FTHELA60RLODE,FORTHEVERFORMNJCEOFTHEWORKFORWHIp/THISPERMITIS �6 �.
ISSUED.MYW�ORK�E�HS-'yCO�M.�PENSATpNINSU NCECANRIE 40701ICYNUMBERARE: CONSTRUCTION
j GIRFIER �"�`��•�� �A���n� PLAN REVIEW
� Pa�cYNuraBER' . �"O �ivsL ELECTRIC
0 �ssecroaNemr+oreEoona�oocnerEar.trswnor��oouu�sK�ro�oA�ss�. PLUMBING
Z ICERTIFYTHA7NTHEPERFORMANCEOFTMEN'ORKFORWHiLMTHISPERA1iT45�55UE0,1 MECHANICNL
C7 SHALLNOTEMCLOYANYiERSONINANY ANNERSOAST06ECOMESU&IFCTTOTHE .,
� WORKEN5COMPENSATIONUWSOFCQi ORNI ,MIDAGREETMATIFIS BECOME INSPECTIONFEE
S SII9JECTTOTHEWORKERS'COMPENSA7 PP VISIONS ECTION7700 TME
cooE,�sww.coRrnmn�ca+v�vwmi s ao�s� ISSUANCE 5 O'O
O .T� �
p DATE: ` '�v 1 APPLICAN. SMIP •��O
� ENERGY P/C
� WMNINO:FA0.URETOSECUHEWOIiKERS'LOMPENS�TIONCOVERAGEISUNUWFUL.ANDSHILLLBE
�y SU9IECTANEl1PLOYERTOCRIMINALPENALTIESANOCIVILFWESUPTOONEHUNOREDiM0U5M70 ENERGYPERMIT
DOLUi35(Sloo,o00),IN ADDRION TO TNE COST OF COMPENSATION.DAAIAGES 0.5 PROVIDED FOR IN
� SECTIONJ70lOFiHEIABORCOOE.INTEREST,�NDATTORNEV'SFEES. RETENTIONFEE: � v �
OCONSTRUCTION LENDINGAGENCY PRE-ALT FEE:
� IHERE9YAGFIRMUNOERPEN�LTYOFPERAIRYTHATTHEREISACONSTRUCTIONLEN0INOAGENCY
FOR TIIE OEF�ORMANCE OF TNE WORK FOR N711L11 TIIS PERM�T IS ISSUEO(SEC.]OD7.CN.G).
Z
W
� IENDERSN�ME
� LENDER'SADDRE55 n �
W ICERTIFYiHATIHAVEREADTHISADPLICATqNANDSTATETMAiTHE11BOVEINGORAIATqNISCARREC7. TOTAL FEES � � ` � �
� IACREETOCOMPLYVnTMALLCI7YANOCOUNTYORDINANCESINOSTATEUWSRELATWGTOBU0.DIN6
CONSTRUCTION,AND HEREBY A1R410R2E REPRESENTATIVES OF THIS COUNTY TO ENTER UPoN THE
ABOVE�MENTIONED DROPERTY FOR INSPECTqN W RPOSES.
Z ��� � COMMENTS �-
o �
�
NPEqM E N E(PqINT)
�=�b-fl�
� SIG OF VERMITTEE DATE
� RECPT.N0. � PAID BY �.'F�� VALIDATION
WHITE—DepaRment Copy,YELLOW—Finance Copy,PINK—Assessor Capy,GOLbENFtOD—File Copy,GREEN—Applicant's Copy
: . ....., _... ...- .. . .. ._.,........�. _....,..,.. , - . . , � .. ...�-,�t..,... .-.r . ... ,. ��. ._�.. , ..� . ... .. , . ,
,... . .. .».,,........,.�.�.,__ _.-e-.�.,;.,. .... -
�ii�� o� rai���rora� �an€�
ir���Ec�a�saf+ ��coRo
� c� e y ._� r ...� ._ .4.�k``, ';S C..,'.._.._._�._,.._ .....� � _.�'v....-._..�..�� � �.•..�'��� � �... .�._..s_,
f►�-`h:a�_'iCl�►1 ) 4C^ I► � : �' 1 t I�f7.. .�CC I►6 �y•��E� I►� �—+e ey.� '
---_.___--_______._—_.____ �. . ... _._..__._._. . ._.__ ..----------__ _ ..� -- -.___ .__.__ ._.___,______.-------------_.Y__.__
SET BACK i ' FLOOR JOIST� . j
FTGS/FORMS/STEEL I FHA REQMTS
ELECTRIC GROLIN❑ UNDER FLOOR DUCT
GROUND PLUMBING UPIDER FLOOR CU��IDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER � FIREPLACE BO�JD BEAti1 I '
WATER SERVICE MID HT. BOND SEAF�i � '
ROOF SHEATHING , �-�Q�}-�Q� _ 8 FT. BOND BEAM __
FRAMINGNENTILIATION I � �)��- FIfJAL BOND BEAM
ROOF COVER ~f�%��'����T"'"'��"-"""-- PRE-GRADING
ROUGH HEATING � 1 BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBItdG FINISH GRADING
SHOWER/TU6 TEST POOL ELECTRIC
EXT. LATH/S�DING POOL FENCING �
WALL INSULATION POOL FINAL �
CEILING IN�ULATION OFF SITE IMPS.
DRYWALL NAILIPJG DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK Lf1NDSCAPE/IRRIG.
SEEP PiT/L.L. � ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. .'�5•o � FlRE DEPT. FINAL
FINAL HEATING � HEALTH DEPT. FINAL
FINAL ELECTRIC . • DEV. F�ES PAID
FINAL PLUMBING � ENERGY
_ r,�'��r.:,h4 P`iCic� I ..
CUMtJIENTS _
,- �
SEPTIC TANK SIZE
SEEP PIT/U SIZE
._.__����.�
��r� _
� .