HomeMy WebLinkAbout12920�
� .
_��� CITY OF DIAMOND BAR �]/
DEPARTMENT OF COMMLJNITY&DEVELOPMENT SERVICES -I
21660 E.Copley Drive Sirite 190
(909)860-3195 Fa�c(909)861-3117 ` PRESS
�'��', BUII.DIIVG PERMIT APPLICATION FIRMLY
QJOBSITE �g�S � �J��,�O���� /3/`,� DATE CATIOIJ� l L! —�9 NU BEF� �R �lC
¢ ADDRESS ,f7 �v� � /
� APN �AJS LOT �� TRACT OS/�- ISSUE TYPE OCC
DATE CONST. GROUP
p OWNER GAnc� "TTE{v/��LTO/�
ADDRESS ZONING SETBACKS
$ CfTY ZIP TEL. R�RT RW p�
4 APPLICANT TEL. SIDE/SIDE STREET RW ❑
� CONTRACTOR ���G� EL�GT72/G- �[� SIDE ❑
ADDRESS d4 L.
� CITY Fin,C/-,E-XTvv) ZIP C/� TEL.�� 5��O�// PROPOSED USE
� ARCH/ENG/ ' �/
DESIGNER A'f"D ,D�S/!�N
� ADDRESS !�l/2L fJ-�ysrp,c /;'Q�, NO.DWEL. NO. NO.
CITY /.A/E.fTM/rj7�l� ZIP� TEL �C/1���/i� UNITS STORIES BEDROOMS
v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION
� SFR/ADD/REM
p I HEREBY AFFlRM UNDER PENALTY OF PERNRY THAT I AM E%EMPT FROM THE CONTFACTORS LJ- G8l89B/CBfPOh
111 CQlSEIAWFORTHEFOILOWMOREAAH(SEC.7031.6BUSINESSANDPROFESSIONSCODEMIYCITVOR (�
V COUNTVWHIdiqEOUIRESAPERMRTOCONSTRUCT,ALTERDAPROVE.DEMOLISH.ORREPNRANV9TRUG W P81I0/�BCI(
� 7URE,PRIOR TO RS ISSUANCE,ALSO REOUIRES iHE MPLICAPIT FOR SUCH PERMR TO FILE A SIONED w
� STA7EMENT 7HAT HE OR SHE IS LICENSED PURSUANT TO TME PRONSIONS OF 7HE CONTRACTOR9 U� �
CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DMSION 3 OF THE BUSINE55 AND PR6 POOVSPB
FESSqN3COD�ORTHATHEORSHEI3IXEMPTTHEREFROMANDTHEBA515FORhiEALLEOEDEXEMP- �
TpN.AHYV10lAT10NOFSECTION70.t1.6BYANVAPVLICAHTFORAPERMRSUBIECTS7NEMPLICANT70 Z R6-ROO}
F, A GYVIL VENALTY OF NOT MORE T51AN FNE HUNDRED DOlURS(f6o0).):
� ❑4�.40WNEROFTHEPROPERTV.ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSAT/0N, 0 COmm6fC18I . -�
WLL DO 7HE WORK AND 7HE S7RUCNRE IS NO7 INTENDED OR OFFERED FOR SN.E(SEC.7oW,BUSI� J
NE55IND PROFESSqNS CODE TIE CONTTUCTORS LICENSE UW OOES NOT APPLV TO AN OWNER OF
� PROPERTVNTIOBURDSORIMPROVESTHEREON,ANDWNODOESSUCNWOqKHIMSELFORHERSELFOR � �
� THROUGH HIS OR HER OWN EMVLOVEES,VROVIDm TNAT SUCH IMPROVEMENTS ARE NOT PITENDED OR m
� OFFEREDFORSALEIF�FIDWEVER7HEBUILDINOORIMPROVEMINTISSOLDN7THMONEVEAROFCOMPLE-
Z �'TIOH.THE OWNER-BUIIDER WILL HAVE 7HE BURDEN OF PROVfNO THAT HE OR SHE DID HOT BUILD OR _
� IMPROVE FOR THE PURPOSE OF SALE�
W ❑I,ASOWNEROFTHEPROPEHfV,AME%CIUS�VELVCONTMCTWOWITHLICENSmCONTRACTORS
� TO COHSTAUCT TFfE PROJECT(SEC.70M,BUSINESS AND PROFESSIONS CODE 7HE CON7MCTOR9 LI- V91UeflOfl (�J.qpEq
CENSE UW DOE9 NOT APPIV TO Ml OWNER OF A PROPERTV WFID BUILDS OR W PROVES 7HEREON,AND '
� WMOCOHTMCTSFORSUCMVR0.IECTSNTTHACONTRAC70R(S)UCENSEDWRSUANT707HECONTRAP pUqNPTy �DESCRIPTION FEE �
roas ucaasE uw.�.
.. � 1 AA1 E%EMPT UNDER SEC. P.0 REASON Q S L/�ES
// /
LL OATE � ONMER � " /� �•r� �OT�rs �
� W 5 ,� s�iaTw-J Co �
LICENSED CONTRACTORS D TION W �OO A /'YJ GG
� I HEREBY AFFlRM UNDER PENKTY OF PEitIUHY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER
d Y(COMMENCWO WITH SECTqN 7000)OF DMSION 3 OF hiE BUSINE55 M1D PROFESSIONS CODE,AND / ZOOA P�9r1�L 2
X MY LICENSE tS W FULL FORCE AND EFFECT.
oC—r a �f�IP/O?� D .8 �/ d/.-cui'r-,r ,
LICENSE CLASS �^p LIC.NO. /� �/
� V DATE �^���7/ CONTRACTOR_/Jr�CD GL��
W
� WORKERS'COMPENSATION DECLARATION � n� � -+
Cn ifl
� I HEREBY AFFIRM UNDER PENALTY Of VERIURV ONE OF hIE FIX.IOWINO DECI.ARAT ✓
� _INAVEANDMALLMAMTAINACERfIFlGTEOFCONSENTTOSELFaNSUREFORWORKERS'
COMPENSA7qN,AS PROVIDm BV SECTION 370o OF 7HE LABOR COOE.FOR THE PERFORMANCE
OF 7HE WORI(FOR NM111CH THIS PERMI7IS ISSUED.
� .
� _I HAVE AND WILL MAVfTAIN WORKEIiS'COMPENSA710N INSURANCE,AS REOUIRED BY SECTION' . �
Q 3700 0F THE U�BOR CODE,FOR THE PERFORMMICE OF THE WORN f-0R WHICH THIS PERMR IS
� ISSUED.MY WORKERS'COMPEN9ATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION '(
� CARRIER PLAN REVIEW
ZaoucVr�uMBER ECTRIC _ . 1
Q
� (n�sEcr10N1E�No7eEoa�REi�OFnfaEPo`RSFaqoNEHtInFiEDpo�v�Rs(itoo) PLUMBING
W
Z I CERTIFV THAT W hiE PERFOfiMANCE OF TNE OR WHlpi THIS PEFiMIT IS UED.I MECHANICAL �
U' SHALL NOT EMPLOY ANY PERSON P!ANY MAN S AS TO BE E SU ECT THE
(/J WORKERS'COMPENSATIONIAWSOFCALI 10. DAO TI HOUL BECOM INSPECTIONFEE
S SV&IECTTOTHEWORKERS'COMPENSAT P IS OFS 7ooOF7HE R �
CODE,I SHALL FORTMVITM COMPLV WI P ISSUANCE
O ��'APPLICANT SMIP �ITY-8�'����Y�DTfi
p DATE:
W
� WARNINO:FNLURETOSEWREWORKER S ION OEISUrMwFlIL,MIDSHALLBE ENERGYP/CDTT7T m�r
LJ lJl�. 1 1
�y SU&IECTMIEMPLOVERTOCRPIPIALPENALTIES D SUPTOONEHUNDREDTI10U9AND ENERGYPERMIT
DOLW19(iloo,o00J.IN�DDITION TO iHE COST O TION,DAMA�ES AS PROVI�ED FOR IN
J SEC710N 3708 OF 7HE UBOR CO�E.INTEREST,AND ATTORNEVS FEES. �
� RETENTION FEE:
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFlRM UNDER PENALTY OF PEFLIURY THAT 7HERE IS A CONS7RUC710N LENDIN(i AOENCV �,
Z FOR THE PERFORMANCE OF THE WORK WR MRiICH THIS PERMR IS ISSUED(SEC.�oW,CIV.C.�. ,
W
� IENDERS NAME . �
F- LENDERSADDRESS
� TOTAL FEES (/f �
� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE 7T/AT THE�BOVE INFORMATqN IS CORRECT.
W I A(iREE TO COMPLV N7TH ALL CRV M1D COUNTV ORDINANCES AND STATE UWS RELATINO TO BUdDINO
� CONSTRUC710N,AND HEREBV AUTHORIZE REPRESENTATNES OF 7HI5 COUNTV TO ENTER UPON THE �
ZABOVE-MENT%NlED PROPERTV FOR INSPECTqN PURPOSES. COMMENTS
� �/�f�i7 �1��-/4C./Q-��
J
�
m PERMITTE E(PRI
¢ �/ ��
N ..
� g o�TE RECPT.NO. PAID BY VALIDATION
� WHITE—Deparlment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,pOLDENROD--File Copy,GREEN—ApplicaM'y Copy �
/
� - C
CITV OF DIAMOND BAR
Bt�SIPECTIC)f�(I i3ECOF�D����
o � � , . � > . � � ,
. � .
SET BACK • FIOOR JOIST , -,;", . .
FTGS/FORMS/STEEL FHA REQMTS -
ELEC7RIC GROUND UNDER FLOOR DUCl' � . ' '
GROUND PLUMBING UNDER FLOOR CO�IDUIT �
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER ' FIREPLACE BOND BEAM .
WATER SERVICE � MID HT. BOND BEAN1' ' � ' '
RUOF SHEATHING 8 FT. BOND.BEAM ;.t.
FRAMINGNENTILIATION F(NAL BOND BEAM•, '
ROOF COVER PRE-GRADING � � . ��.,' ' ;
ROUGH HEATING BENCNING�•'- '� • -. - � � :'..•:. :'•' �`' . S
ROUGH ELECTRIC ROUGH GRADING
.,
R�UGF-I PLUMBING ' FINISH GRADING
SHOWEFUTUB TEST POOI.ELECTRIC
EXT. LATH/SIDING PDOL FENCING
WALL INSULATION POOL FINAL
CEIUNG INSULATION OFF SITE IMPS. ---
DF�YWALL NAILING QEDICATIONS
SEWER FINAL ENG. • -
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L..L. ON SITE IMPS.
-�AS AIR TEST � FINAL ZONlNG
FINAL CQNST. -�.., ' '"` ' � FlRE DEPT. FINAL
FlNAC HEATlNG � , . ,,, �` `� � � HEALTH DEPT.FINAC , •
FlNAL ELECTRIC , ,. ,,, •,�,: �.' � DEV. FEES PAID -
Fif�lAL PLUMBING : � , ;�, , ;, _ ENERGY
a t i ,.,. • ,,.�,. ,
� �
m .� � . >
, , ,: . . . ., � ,
�
COMMENTS .
F� �1.�i ( - l,
,
.1 _�, � -
. . ,,; ,, �
_ , ,
. . .�. . _. ., .,. . . . ..
. . _ . . , .. .���_ . . ,
SEPTIC TANK SIZE �' ' '
SEEP PIT/U SIZE .
� ,
°' '�,y � ':'� .
v� t � ' �, y �
�
.,
�.
��� �� �
r
p • . � . � � � , , . , _ � ., Q
V � �. . . . . � '� � . ! . � . ,
�