HomeMy WebLinkAbout10368 � _____ _..--
CITY OF DIAMOND BAR "'�,
COMMUNTfY DEVELOPMENT DBPARTMENT
�;,..� 21G6o E.Copley Drive 5aite 190 � PRESS
(909)86(�3t95 Fax(909)861-3117
'�'"""� BUILDING PERM[TAPPLICATION FIRMLY
o AJOBSITES �„�Ip•.l F��'hn►�A t 1` �.., APPUCATION �� NUMB R 6 � /�0 R �
{ DATE
c� ISSUE TYPE OCC
APN lOT� TAACT DATE CONS't GROUP
p OWNER
o ADDRESS �' ZONING SETBACKS
Z CITY ZIP TEL. ' � Q Z. FRONt RW ❑
g APPLICANT TEL����] REAR ❑
� SIDE/SIDE STRE�T ' RW ❑
CONTRACTOR La� H c_ SIDE ❑
Q AQDRES � �1Vi O�rr� (,.,, 10+�+
� CITY ZIP TEL " • ^) PROPOSEO USE
o ARCFUENGf
z�. DESIGNER�6w+P. NO.DWEL. NO. NO.
� ADDRESS UNITS STORIES BEDROOMS
CffY ZiP TEL
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�
Q OWNER-BI:ILDER OECLARATION �qpp/REM
O
p i H�er��ro�uraen vEwu'rv�verwnv nur i�ut Exeiuoi�wu if�e canq�cions u- Oare9e/Ce�ort
tiJ CENSEUWFONTMEFOLLOVYINGREA.SON(SEC.7091.5BUSMlESSA1bPROFES310N3CODEANYqTYOR (f�
U COUNiYWHK�IREdAltESAGERMff7000N5TM/GT,II7ERMPROVE.DEMOIISH,ONREPAIRANY3TAUG
� 71JAE PHqR TO ITS�6UANCE.MSO HEW IRES TME APPIICMfT WR SUCH PEPAIIT 70 FllE A SICNEO W PeGo/0ecic ,
� ST�TEIAENT 1MAY HE OR 3HE IS UCENSED PUPSLIIM TO THE Pf1DVIS1oNS OF iME CaNTNJ1CTORs LI- .
� CENSE UW(GUIPTER Y(GOYYEN[Li�1M7H SEGTION]aaU)OF OIVISpN�OF THE BUSINE551�18I PRQ LL �WUSPe
FES51QN3 COOE)OH TFNTftE01t SNE IS IXEMPT TMEflEFROMAMD TNE BAS73 FOR THEALLFOFD E%EMP•
� raN.�errvat�nowovsecnon�oai.eevnnv,�ar��rtr��Peiwrts�ecrsn�e�avuc�wrro Z Fle-Root
11C�vR.OEt+AL7YOFtaDT►1DRETH/u�FlVEtalnmaEDOo�URSf`�1.):
0 04�����PqOPERTV,011MYEMPLOVEE5IMTNWAGES/SIHEIR50LECOMPEN4AT10N, Q - ' � - ,
Z WILL DO T/ffi YVOFiK N/D iHE STAUCfI�E iS NOi 11lfEAR7ED OR OFFERED FOR SM.E lSEC.7611.&lSl- J Commercial .
NE55 NA Wi�FE5310N3 CWE�THE CDNTRACTORS 110EN5E LAW DOES NOT MPLY TO IW OWNER OF t .
N VROPEFiYri1qBUX.D30RIMPPOVES7HEREON.MJUW/10DOES3UGINbHKHIMSELFORXERSELFOR � . � '
Q THiOUGHW30RNEflOMR1EMPLOYEE9.PROVIDED7HAT9Uq11MPROVEMEMSARENOTNTEI�DOH m _
QOFFEREDiORSALEIF,FIOWEVEitiHE&M.OMN30itM1tPHOVE1rEMISSOtDW�T7M�lONEVEAHOFOOMPLE
z TION.T!�OWNEH�BUILDER WHL HAVE TNE&1FlOEN OF PROVMO THAT HE OR 9iE UW NOT BUKD di
� 9dPROVEFOR7HEPURG0560F3N.Ej.
❑4l150MMEROi TNE PHOPEHiV,AM O(f1U51Y��CONTMC7�NQ MIITH LIGENSED CONfMCTORS
Q TO CONSTRUC7lTiE PRO.IEGT(SEC.tON.BUSINE33 MID PHOFESS10N3 CODE:THE CONTRACTON9 U• VBNlatian AQI-AAEA
W CB19EUri00ESNO�MPLYTOANOWNEROFAPROPEHTY'M10BUADSORWPRDVE3THEREON.ANO ,,
i wr+ocormuctsFonsua�rra�crswm+�cartn�cronis�uc�+sEoaunswwrmn�ca�rtw�c OUANTITY DESCRIPTION FEE
f- TORSUC915EUWJ.
� ❑1 MI IXBIPT U�ER SEC. B.l P.C.fOR THIS REASON U
� � a
D1RE OVMER �� �
Z W
Q IICENSED CONTRACTORS DECIARAT1pN W
� 1 HEREBYAFFMW U�EIf PEN/�17Y OF PEtWHY i}UT I AM LICENSED INDEIi PPOVISqN3 OF GUPTER V. � �
� 0(COMMAENCMIf�WfiH SECTION 7000)OF DM510N]OFTHE�NESS AND PROFESSq415 COOE.MiD 2
AAY IJCENSE�IN FULL FORCE AND EFFECT.
lll m
� t,ICENSEq.ASS LIC.NO. j
V w� cor�tA�croa a .
w
� WORKERS'CWYIPENSATION DECIARATION �
= U
� 1 NEREBV AFFlRM UAER PENILLTY OF PEIWM ONE OF TIE fOLLOWINO DECL�MTION3:
� zQ
� _�INAVEMAYYIILMAMAMACEATIFIGTE�CONSEHTiOSELFiNSUREFORMiOltlCERB' 2
� COMVElISATION.+LSVFOVqEDBYSECTiONJlO00FTHEUBO/iCWE.PoR7YlEPERFO/MANCE W .
OF 7HE NKNIX WR WHICM TMIS PEPNR IS ISSUEO. � c
W
�1 HAVE�NO WRl M�MAR7 WaACEMS CO/APEN51UlON�N3UNANCE.A&REOUIREDlY SEC7%XI
QH700�THEiJIBONCODE.FOR7NEPERWRMANCEOFiHEWOR�CiORWliIQ1Tfl5VEiWiT13
� 65UED.MY NONKEPS'mMPEN5IR10N iNSURMiCE CARRIER AND POLICY MIMBER ME: CONSTRUCTION
�, cu+wen��� �� PUw aE�nEw �'
z Pa�cvra�en(� ��"� �p,\ � � ELECTRIC
4 �nas��roaree�ocn�r�r�swna�ra�a�oat,vn4s+mla+�f PLUMBING
0
W MECHANICAL
� Z 1 CEFITIFV/1UT NI TXE VERFOWANCE OF TiE MORK WN NMldf 7HI5 PEPMR IS ISSUE�,1
C•} SMN.L NOT EMPLOYANV PERSON M ANY MMS7ER SOAS TO BECpdE 8UBJECT TO THE
� µ�ORKEqS'CpMPEN3ATpNUWSOFGILIFOAMUNmAGAEETHATIfISHOULDBECOME iNSPECTIONFEE
� SUBJECT 701HE YYORKERS COMPENSATION PfqV1510N5 OF SFCTION 9700 CF THE IABOR
aooe,i Stut�FOAirnnrH�r�r wi7�\THOSE PiqV1510N4. ISSUANCE ��
p WTE:��,�_ APPLICAM: �/��VLI �LI��,t SMIP '�]_
� ENEf�',Y P/C
WAlININCt FALURfi M SELUPE MARNENS'COMPEN5+ITIOM COVEWIQE IS UMAWFlA.lWD SW�IL BE
LL SUDJECf AN EMPLOYEATO CANAp1I1 PENAL7'IE6 Mq CMl FNES UV 7ooNE M11�f�7�1IXJSURI ENEAOY PERMIT �
DOLUIR5IS700.Oa0�.M1.WO�TION TO 11E COST OF COMPBiSATION.0AMA6ES AS PROVIDED FOR IN I'
J[�[ 9ECTIqi970lOF7HELAbDNODDE.WTENEST,MDAiiO11NEY5iEE3. RETENTIONFEE: �-D��
d CpNSTRUC710N LENDING HCENCY PAE-ALT FEE:
� IHEREBVAFFlRMU�IDERPENPLTYDFVEKNIRYTNIUTMEPE1511CONSTRUCTIONLENO�H3AGENCY
FOR 7}g PERFOFUA/�NCE OF 7HE WOflK FOR WMICH TNIS PEfU.RT IS ISSUEO(�C.JOh.pV.C.).
�
� LEMDEA'S p11AAE
!- LEPOEiT'SMDRESS
� �(�RTIF/7HATIYUVENEAU7MSAVPlICA710M1UJD5TATETM11T7HEABOVENFORY1UlONISCORNECT. TOTAL FEES �
d I MAEE TO LOYRY WITM Alt CRY ANU Cd1NTY ORONJWCES MA STAiE tAN+S REUITWG TO&1BD�PK4
I„ CpNSTqUC71oN,MDHExE8YA1fIFfOWZEREPRESENTATNE90FTHI5CQl#JTYTOENTEqUPONTHE
`.+�. �BOVEddENTION W GROiEMY FOH MSPEC�ION PURPOSES. CQMMENTS
� JQ�,. La� �
m ENiWE1PR�N� `' .. Q
y J���`'
� SIONA E I - DQE
� i�CPT.NO. D BY VALIDATION
WHITE-0epartment Copy,YELLOW--Finsnce Cqry.PiNK—Aaseasor Coy.GOLDE AOD—Fib Copy,OREEN—�+ppik�fs Copy
..\.
..r... . . ..._ _., ._. .5^.._:,�u, j....'ti....-:Y::'.v�'..i..f•'4 ��..Ye • ...c .�a. y:�ti. " '�Sr`
CITI' �F �IAMOND B�kR
II�SP�CI"��t�l ��CU�
�4 ..�� '�'.1�� � �t1�)�:9��tU� Y� r w � �
SET BACl� �LOOR JOfST
FTGS/FORMS/STEEL :� 7 �J FHA REQMTS a
ELECTRIC GROUND UM1YDER FLOOA DUCT : `1
GROUND PLUMBING UN'DER FLOU'R CC7�1�7UiT � '' ' • --
SlHI3 GRADE � � FIREPLACE�O'UNDATION ' ' ' � �
TEFRP PO",ISlEFi FiFtEPLACE Bdh4D BEA�hl1- ' . .
_ . -- ,_., . - - - •
VJtii�f�R SERVNCE� " ' � = -.•_' -' -- MID Hl'.BOt*VD -AM �
ROOF SHEATHING 8 FT. E30ND BEAM
FRAtviWGNENl"ILIATION ��-5�7 FINAL BOND BEAh9 �
ROOF COWER PRE-GRADWG
ROUGH I-�'EATING E3ENCHING
ROUGH ELECTRIC -}=Q7 RpUGH GRADWG
ROUGH PLUMBING FINISH Gf�dD�P�G
SHOWERlfUB TE57 F'dOL ELECT�i�IG
EXT.LATN/SIDING / PC70L FERI'Ci`P1G
VJALL INSULATION PQQL Flt"dAL
CEILING INSULATION OFF SITE lftA'PS.
DRYV�lALL NAIUNG DEDICATI'OA�fS
����q FINAL ENG.
SEPTIC T�h1K ��� • � . LANDSCAf°ElfF3R1'G.
SEEP PITlL.L. ON SITE(MPS.
GA��IR,TEST° � - "' FMhAL'LO'W11�PG
"FI�f�At G09rtS7. • FiRE D�PT. FINAL
F{(dAl HEATING - " �� HEALTH DEPT. FINAL
. __. _—._.
FiNAL ELEC7RIC � DEV. FEES PA{D
FIN,�L PLUNiBWG I E�IERGY
��
• i
CO�u`l�viENTS
�4D� � Q i��1�
�,,,, , _
SEP71C T�ihiK 51ZE �_�_
SEEP PIT/U S1ZE — —
�
Ed -
�= 4 G �/g � aa��ds-� --,��,s•�.���- ��� �,��� � -
WALNUT VALLEY UNIFIED SCHOOL DISTRICT
880 SOUTH LEMON AVEIYUE WALNUT CA 41789
CERTIFICATE OF COMPLIANCE
With Fee Provisions of
Govemment Code Section 65996
t
DEVEI:OPER/OWNE �m0� v}��_ �
ADDRESS �� _. Si ture f App cant
CITY/ZIP-�,��� � ��� - e person signing represents that he/sbe is authorized
TELEPHONE �q � ����_ _ to ign on behatf of the owner/developer and that the
information provided is true and accurate to the best of
his/her knowledge.
NEW LOT ADDRESS USE OF BUILDING TOTAL SQ.FT.
_____ _ Residential/Commercial/Indushial
Ciry
HOME IMPROVEMENT OR REMODELING PROJECf
ADDRES$�� C�1 W►�l Q s — D CRTPTIOZUIIY�-t ti��Vi�t�-t/V�- g( TOTAL���
—�
Diamond Bar _Walnut (Bedroom, amily Rm_,Kitchen,etc.) �xz�
. Signature of Superintendent of Buildings � �/ � l��?� Date �--�—�
TO BE COMPLETED BY SCHOOL BISTRICT
FEE SCHEDULE: The development fees levied by the Walnut Valley Unified TOTAL FE DUE
School District under provision of Grnernment Code §65995 $T _
are: (EFF. 6/10/9� Residential Development �1.84/sq.ft, Receipt# _
CommercialJIndustrial a0.30/sq,fG Date
Fees are assessed on TOTAL square footage "living space" of ALL new or remodeling cons ction projects OVER 500 sq. feet
(eliminating garage or uncovered pado).
t __ This is to certify that all fees due to the Walnut Valiey Unifed Schoo]Disuict under provision of Government Code Section
65995 have been received and a building petmit may be issued.
_�'I1iis is to certify that the above described development has been determined to be EXEMPT ftom the development fees of
Government Code Secuon 65995 and a building permit may be�ssued.
Fxemption Justification: PRO.iEC'� IS 500 OR LESS SQUARE FEE'� �_
OTHER
�4��._ � �
Vernon Medeiros
J
Assistant Superintendent
Fiscal and Facilities Management
1/87 Rev. 2/88; 6/88; 8/89; 1/90; 8/90; 10/90; 8/92; 6/93; 1iJ93; 8J94;6/96;1/97
PLEASE SEE NOTICE OF 90-DAY PERIOD FOR PROTEST OF FEES ON REVERSE SIDE
NOTICE OF 90-DAY PERIOD FOR PROTEST OF FEES
Section 66020 af the Government Code enacted as Assembly Bill 3091,set forth as Chapter 549,
Statutes of the State of California, 1996 effective January 1, 1997, requires that this school
district provide a written notice to the project applicant at the time of payment of school fees,
mitigation payments or other exactions. This notice is to advise you that any protest in regard
to such amounts or the validity thereof in accordance with Section 66020 of the Government
Code and other applicable law, commences with such payment or perforrnance of any other
requirement as described in Section 66020 of the Government Code. Additionally, this notice
advises that the protest thereof mast occur within 90 calendar days thereafter. •