HomeMy WebLinkAbout12-1036 _,��_ CITY OF DIAMOND BAR
� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �-
I 21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-70 PRESS
� ''"'. BUILDING PERNQT APPLICATION FIRMLY
o DDRESS �-I I �3 T ITl�I-VY�.1-�O DATEICATION g �� �?= NUMBER��I 0��" ��C
p D TEE � �� � " ONST.-�� GROUP
°O APN LOT TRACT
p OWNER G� JL.
o ADDRESS U �- ZONING SETBACKS
z CITY A• � ZIP��r[ TEL. � o� ��O ,� FRONT RW ❑ •
� APPLICANT TEL. REAR p
¢ SIDE/SIDE STREET RW p
� CONTRACTOR SIDE p
ADDRESS
� CITY ZIP TEL PROPOSED USE � W S
Si t r
w ARCH/ENG/ n E,�-{-� �,,J t �/
�z DESIGNER NO.DWEL. bR� NO. �� NO.
a ADDRESS
� 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 AFiIRM UNDER PENPL7Y OF PERIURY THAT I AM E%EMPT fROM THE COMMCTORS L4 Garage/Carport
W CENSEUWFORTHEFOILOWINOREASON(SEC.7a71.5BUSINESSANDPROFES510N5CODE:ANYqTVOR (J� �
U COUHryWHICHREWIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPNRMlYSTRUG �
W NRE,PRIOR TO RS ISSUANCE.AlSO REOUIRES THE A7PLICANT FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck
� STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONiMCTORS U• � � � .
� CENSE UW(CHAPTER i(COMMENCIN�W17H SECTION 7000)OF DiVI510N 3 OF THE BUSINESS AND PR6 POOVSpO
, 0 FESSIONSCOO�ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLE6EDE%EMP- �(� .
V TION.ANYVpU710NOFSECTION7037.58YANYA7PLICNfTFORAPERMITSUBJECTSTHEAPPLICANTTO Z� Re-Roal
� ACMLPEW�LiYOF NOT MORE TMAN FIVE HUNDRED OOLURS(i50D).):
Z ❑I,ASOWNEROF.THEPROPERTV,ORMYEMPLOVEESWITHINAGESASTHEIRSOLECOMPENSATqN, � 0 COffIfflBfC18I -
NALL DO THE WORIS AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SECJa<,BU56 J
� NESS ANU PROFESSIONS OODE:THE CONTRACTORS LICENSE UW OOES NOi APPLY TO AN OWNER OF � �
�ROPEHTY W/i0 BUILDS OR IMPROVES THEREON,M1D WHO DOES SUCH WORN HIMSELF OR HERSELF OR
wTMROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THA7 SUCH IMPROVEMEMSARE NOT INTENDED OR m ,
� OFFEREDPDRSALEIF,HOWEVER7HEBUILDIN60RIMPROVEMENTISSOLDWfTHINONEYEAROFCOMPLE-
Z TION,THE�ONMER-BUIIDER WILL HAVE 7HE BURDEN OF 7ROVING 7HA7 HE OR SHE DID NOT BUItD OR
� IMPROVE FOR THE PURP0.SE OF SAIE). �
(yJ ❑LASONRlEROFTHEPROPERIY,AMEXCIUSNELYCOMMCTNOWfTHLICENSEDCOMRACTORS
Q TO CONSTRUCT THE PRQIECT(SEC.70t�.�BU5INESS AND PROFESSIONS CODE:TiE CONTMCTORS LI- V81U0f10f1� Ap,J,/{R� �
W CENSE LAW DOES NO7M7LY TOAN OWNER OFA PROPER7V WHO BUILDS ON IM7POVES THEREON,M!D - �
� WHOCONTfUCTSFORSUCHPRQIECfSWfTFiACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTMG QUANTITY DESCRIPTION FEE -
Y NRS LICENSE UW.).
0 ❑1 AM El(EMPT UNDER SEG 8.8 P.C.FOR hilS REASON Q
?� U
� DATE I /1 • OWNER LLY LL�I-� ^ F-
� W
F„ LICENSED CONTRACTORS DECLARATION W
� I HEREBY AFFIRAI UNDER PENALTY OF�PERJURY 7HAT I AM�LICENSED UNDER PROVISIONS OF CHAPTER �
� 9(COMMENCINQ�WITH SECTION 70W)OF DIVISION J OF THE BUSINESS AND PROFESSIONS CODE,AND Z
X" A(Y LICENSE IS IN FULL FORCE AND EFFECT. m
LLI
� UCENSE CU1SS LIC.NO. j - .
V DATE CONTRACTOR d .
W
� WORKERS'COMPENSATION DECLARATION Q
� 1 HEREBV AFFIRM UNDER PENAL7V OF PERJUHY ONE OF THE FOLLOWING DECURATIONS: Z � � � � �
� _IHAVEAND�WILlMA1NTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' _ -
COMPENSATION,tiS PROVIDED BV SECTION 370o OF THE UBOR CODE,FOR THE PERFORMANCE �U�
Q OF 7HE WORK FOR NM1IICH iH�S PERMIT IS ISSUED. � � � '
w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE;AS REOUIRED BV SECTION � J ��/
Q 37000FTHE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHIGi THIS PERMR IS �/ /. {)(_/ �L�
ISSUED.MV WORKEAS'COMPENSA7qN INSURANCE CARRIER ANU POLICY NUMBER ARE: �CONSTRUCTION- U I �� /
jCARRIEH PLANAEVIEW
� POLICV NUMBER
Z ELECTRIC
¢
p (rwssEcr�or+NFIDr+oTaEoo�rmoFn�a�w.r�swaa+E�xo��ooauasls�oo)oatFssl PLUMBING
Z I CERTIFV THAT IN hiE PERFORMANCE OF 7HE.WORI(POR WHICH THIS PEfU11T IS ISSUED,I �MECHANICAL
C,�} SNALL NOT EMPLOV ANY 7ERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE � �
� WORKERS'COMPENSATION LAWS OF CALIFORNIA AND AGREE THA7 IF I SHOULD BECAME �NSPECTION FEE
? SUBJECT TO THE WORKERS'COM7ENSATION PRONSIONS OF SECTION 37000F THE LABOR ��� � �'7 ,
CODE,I SHALL fOHTMYIiH COMPLY WITH TNOSE PROVISIONS. ISSUANCE .. /�
� SMIP �
p DATE: APMICANT: '
JENERGY P/C I
WARNINO:FAIWRE TO SECURE WORKERS'COMPENSATION COVEMGE IS UNLAWFUL,AND SHALL 8E
� SUBJECT AN EMPLOYER 70 CRIMINAL PENALTIES AND CIVIL fWES UP TO ONE HUNORED THOUSAND ENERGY PERM�T
DOLLARS(5100,OOD),IN ADDI710N TO THE C0.5T OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN
J SECTION 370e OF TiE UBOR CODE,INTEREST,AND ATfORNEYS FEES. � � �. � �
Q RETENTION FEE: A
OCONSTRUCTION LENDING AGENCY p ALT FEE: � _ j
� I HEREBY AFFIRM UNDER PENALTY OF PERIURY THA7 7HERE IS A CONSTRUCTION LENDINU A6ENCY �� I�� , Q � I
d� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUEU(SEC.3077,CIY.C.). �
Z
W .
LENDERS NMIE
�
F— LENDER'SADDRESS
w �ICERTIFYTHATIHAVEREADTHISAPPUCATIONANDSTA7ETiATTHEABOVEINFORMATIONISODRRECT. TOTAL FEES �7 �� �
� 1 AGREE TO COMPLY WITH ALL CITV AND CIXINTY ORDINANCES AND STATE UWS RELATING TO BUILDING V
� CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF 7HI5 COUNTY TO ENTER UPON THE �
Z ABOVE-MEMION U PROPERiY FOR INSPECTION PURP0.SES. �COMMENTS ��
� �'��� C/��-�✓�
_
m PERMITTEE NAME(VRINn �
Q
I �
� SIGNANRE OF PEHMITfEE DAT ,'
, = RECPT.NO. PAID BY VALIDATION
~ WHITE—De rtment Co YELLOW--Finence
pa py, Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Appl{canYs Copy
c�-�v oF �i�n�oN� Ba�
II�SPECTl0�6 RI�COF�D - .
; � t� � o - � �-�n��. ._ y�� �— t - ��
�:` � + r � �� � ': ?i`i s � �.���- • � P'-w � � _'�,� o � � t
. . ra
. . .. y '
� ..��. _. . !,� �,.... "x. �.-.yu.�.. �:fa e�"_a . ss.. .,`e' ..t�,' � :k:a _< .._ :-.. . _
-. ..� _ : ' . . _ . ._ _.. . . _ . .� , . .
SET BACK � ;FLOOR JOIST
_..._..____-._......------._...--------
------r--._.-._.._..------- -----.....----
;------------_..---- ------- ------_..._---_.----_—
FTGS/FORMS/STEEL i j FHA REQMTS--------_...---------._..___.._....------------------------
----------------- -------
ELECTRIC GROUND � UNDER FLOOR DUCT
GRQUND PLUMBING i ;UNDER FLOOR CONDUIT
SLAB GRADE j F�REPLACE FOUNDATION
TEMP POWER I FIREPLACE BOND BEAM
WATER SERVICE I MID HT.BOND BFAM
ROOF SHEATHING i 8 Fl".BOND BEAM
FRAMING/VENTILATION j FINAL BOND BEAM
--------------------------------------.—--------------------------- -- -------- -----------------------
ROOF COVER PRE-GRADING
------ -- ------ - ----------_... ------------------.__...------._._...------ ----..._...---------------....._._....---
ROUGH HEATING I BENCHING
ROUGH ELECTRIC f ROUGH GRADING
ROUGH PLUMBING i FINISH GRADING
SHQWER/TUBTEST I 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 AIRTEST / FINAL ZONING
FINAL CONST. •I�-)'Z �FIRE DEPT.FINAL
FINAL HEATING j HEALTH DEPT.FINAL
FINAL ELECTRIC �DEV.FEES PAID
FINAL PLUMBING ENERGY
FINAL PLANING
FINAL ENGINEERING • o 0 4i`
C4MMENTS _ --- _ __ —
SEPTICTANKSIZE
SEEP PIT/U SIZE
hat'��'. —________ _'_______ "____'_ __'_'__'____—' ___—.—_
��t
� �i� �t
� N .
_.; �5,
�a� � '�+ .�-==r�'�� -__----. _ _- -- -- __"-__ _
��.
i: {y"-. ��#1+'^.-�c � .f.
' .,., � 4�-.:
'�& ��-''� r,.�:r� ---- -��--�-----�-------- ��----�- ------"--------'--�-----�-- _.. _
����� �° � — -- � ---------------
x `�, � �`a' 'Y_
�3'� .r�. sf t.# .-��.
,,.., �i. �^':�'� .
� ,� �� _ --------'---'--------------------------- -
�*i T� t�Jy �';�.�' — __'
ni�}
y�.�,il_.. U�1: '