HomeMy WebLinkAbout1050 GRAND AV (11) 0"�r"� '� �'�//2 f/"�
____��_ CITY OF DIAMOND BAR ��"f'�/��� �D�f� ��I�D e�� �VJ7L
DEPARTMENT OF COMMUNITY&DEVELOP ENT SERVI ES
�, 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
� �'°�" BUILDING PERMIT APPLICATION FIRMLY
�� JOBSITE L �E ^ APPLICATION PERMIT p/C ,i_
ADDRESS I BSD %� G��D A'VE ( ' Z�_ DATE �7���D NUMBER 1Q�_�#
� APN L T TRACT DA EE s 25 CONST. ��
p OWNER � GROUP
�` ADDRESS D ZONING SEfBACKS
0
z CITY G' � ��, Z"I,P�� TEL.Q�'3STli d FRONT RW O
� APPLICANT-�"ry�ZJM-L�I�.s�D TEL.�(�#"G�,�t''S1Q� REAR �
SIDE/SIDE STREET RW ❑
� CONTRACTOR Ff(/E_..�'A O�TA11f� SIDE p
O ADDRESS ����P(j6J.j�ljQSA /Q9F
o CITY IS�N]74�LLD ZIP y�� TEL.GJ'�-f��-S'�(� PROPOSED USE�/��G1L'SIYJR/I�l�E T� /fELil//�n
o ARCWENG/
�z DESIGNER NO.DWEL. NO.
� ADDRESS NO.
� CITY ZIP TEL. UNITS STORIES BEDROOMS
cn
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
p I HEREBY AFFIRM UNDEF PENALTY OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� QgfBgB/CBfPOIi
W CENSE LAW FOR THE FOLLOWINO REASON(SEC.7031.6 BUSINESSAND PROFESSIONS CODE:M7V CITV OR (n
U COUNryW{��HREWIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUG W
w TURE.PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w Patlo/Deck
� STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PqOVISIONS OF TNE CONTRACTORS LI�
CENSE lAW(CHMTER 0(COMMENCINO WITH SECTION 7000)OF�IVISION 3 OF THE BUSINESS AND PR0. u- Pool/Spe
� FESSIONSCODE)ORT}IATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (}
V TION.ANV VIOLATION OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z pe-Roof
A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLLARS(f500).):
� ❑I,ASOWNEROFTHEPROPERTV,ORMVEM7LOYEESWITHWAGESASTHEIRSOIECOMPENSATION, � COrt1rt1BfCI81
Z WILL DO THE WORK,AND 7HE STRUC7URE IS NOT INTENDED OH OFFERED FOR SALE(SEC.7W�,BU51� J �
� NE55 AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPIV TO AN OWNER OF �
PROPER7Y WNO BUILOS OR IMPROVES THEREON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF Ofl
Q THfiQUC7Fi HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCN IMPROVEMENTS ARE NOT INTENDED OR m
Q OFFEREDFORSALEIF,FIOWEVEi�7HE8UIlAWGORIMPROVEMINTISSOLDWITHINONEVEAAOFCOMPLE-
Z TIDN,hiE OWNER�BUILDER WILL HAVE THE BUHDEN OF PROVIN6 THAT HE OR SHE DID NOT BUILD OR
� UAPNOVE FORTHE PURPOSE OF SAL�.
w ❑I,ASONMEROFTHEPROPEHTV,AMEJ(CLUSNEIYCONTMCTWOWITHLICENSEDCONiMCTORS
[= TO CONSTHUCT THE PR0.JECT(SEC.70N,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI- V8IU8UOf1 ADJ.AREA
W CENSEIAWDOESNOTAPPLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND
� NM1fOCONTMCTSFORSUCHPR0.1ECT5WITHACONTRACTOR(S)IICENSEDPURSUANTTOTHECONiRAG QUANTITY DESCRIPTION
Y TORSLICENSELAWJ. FEE
� ❑I AM EXEMPT UNDER SEC. B.8 P.C,FOR THIS REASON Q VV( L�^� �,�
� U
� DA7E OWNER F-
Z U
FQ LICENSED CONTRACTORS DECLARATION w
¢ I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � y
� G(COMMENCING WITH SECTION 7000)OF DIVISION 3 OP THE BUSINESS AND PROFESSIONS CODE,AND Z 7Ll q-�. So
uv LICENSE IS W FULL FORCE AND EFFEC7. m W
LLI
� UCENSE CLA� � LIC.NO. ��� . �
V DATE �J' � I D CONTRACTOR D a
w
� WORKERS'COMPENSATION DECLARATION Q 4 �
� 1 HEREBY AFFIRM UNDER 7ENALTV OF PERIURV ONE OF THE FOLLOWING OECLARATIONS: �
� Z
� _I HAVE AND WIIL MAINTAIN A GERTIFICATE OF CANSENT TO SELF�INSURE FOR WORICERS' _
� COMPENSATION,AS PqOVIDED BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U
OF 7HE WORK FOq WHICH THIS PEiiM1T IS ISSUED. W
� �
� _I HAVE AND WILL MAINTAIN WOR)(ERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION
Q 370u OF THE LABOR CODE,FOR THE PEFFORMANCE OF THE WORK FOR WHIG1 THIS PERMIT IS
ISSLIED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBERME: CONSTRUCTION
� CARRIER PLAN REVIEW �
� POLICY NUMBER
� R�� tio .so
� (iHSSEC�qNNE�ND7BE00MPLEfFDOFhEPEPo.T�tSFORONEHUI�DF7EDDOLIARS(f100)ORlES51 � 1 � �V
W
Z I CERTIFV THAT IN THE PERFORMANCE OF TNE WORN FOR WHICH THIS PERMIT IS ISSUEO,I M CHA I 2 C�n
C} SHALL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECAME SU&IECT TO THE
(n VIORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOPEE THAT IF I SHOULD BECOME INSPECTION FEE
S SU&IECT TO THE WORNEPS'COM7ENSATION PROVISIONS OF SECTION 37oa OF THE I.ABOR �� Q Q
CADE,I ALLF THWITHCOMPLVWITHTH SEPROVISbNS. ISSUANC
p DATE:—'�[/� APPLICANT����7�^ SMIP
W T
J WARNINO:FAILURE TO SECURE WORNEF75'CAMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C �
� SU&IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSMlD ENERGY PERMIT �
DOLLARS(5700,000).IN�ODITION TO THE C0.5T OF COMPENSATqN,DAMAGES AS PHOVIDED f-0R IN
J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES.
w TION FEE: � , Q Q
O CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDINO AGENCV
� FOR THE PERFORMANCE OF THE WORK FOR WHIp1 THIS PERAl1T IS ISSUE�(SEC.30G7,CIV.C.�.
Z
W
� LENDER'S NMIE
I— IENDER'SADDRESS
�
� I CERTIFV THAT I HAVE READ THIS APPIICATION AND STATE T1iAT THE ABOVE INFORAIATION IS fARRECT. TOTAL FE ES � � �
W I AOREE TO CAMPLV WITH ALL CRY AND COUNTV ORDINANCES ANO STATE UWS REUTINO TO BU0.DIN0
� CONSTRUCTION,AND HEREBV AUTHOf11ZE REPRESENTATNES OF THIS CWNTV TO ENTEF UPON THE
� ABOVE�MENTIONED PROPER7Y FOF INSPECTqN PURPOSES.
Z COMMENTS �
� CdG�a� ��riB�2
_
m PERMI E N E(PRltfn ` �
� L �O
N KiNA P IT7EE DATE
� RECPT.NO. PAID BY - VALIDATION P�P I._
WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanCs Copy
. •�, CI�V O� DI�,�ViC)R�D �AR . �
I�S�I�CTIOf� RfECORD
�"OG�J�pLC�4�OG�I -���` ����,j��{���,�i� .:�r [I�I�C�' ,D���.:� ° ' i��� m
SET BACK FLOOR JOIST '
FTGS/FORMS/STEEL FHA REOMTS
ELECTRIC GROUND UNDER FLOQR DUCT
GROUND PLUMBING UNDER,FLOOR CONDUIT '
SLAB GRADE FIREP�ACE FOUNDATION •
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM
ROOF SHEATHING ' 8 F-f'. BOND BEAM
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADI.NG
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POQL FENCING
WALL INSULATION POOL FINAL
CEI�ING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK . LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
�� � "''-� ,`:'
COIVIMENTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
a '
�.
�. � .�
� �. _ :����:
r�". ��
��� ��� ���f'�.�"��t�} . • .