HomeMy WebLinkAbout10865 �
i
- CITY OF DIAMOND BAR �' ,
COMMUNITY DEVELOPMENT DEPARTMEN"�= �
:,,,w . 21660 E.Copley Drive Suite 190 PRESv
(909)860-3195 Fax(909)861-3117
"'n'"� BUILDING PERMIT APPLICATION FIRMLY
� JOBSITE �7 Q APPUCATION PERMIT P/C �
o ADDRESS �'� DATE NUMBER �� #
� ISSUE i -' TYPE OCC '
APN LO[���--� TRACT DATE CONST. GROUP
p OWNER _ ��7h iY�T�I �
"- ADDRESS ZONING SETBACKS
oCITY I�^ T�.�,b_ ZIP L.���1� REAR Rw ❑
o APPLICANT TEL. SIDE/SIDE STREET RW Cl
� CONTRACTO SIDE � ❑ "
� ADDREy� �'Tr � PROPOSED USE —
o CIN v 'Z/ ZIP f �L. �6'�s 3�/
w ARCHlENG/
WDESIGNER NO.DWEL. NO. NO.
a ADDRESS UNJTS STORIES BEDROOMS
� CITY ZIP TEL.
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�
� OWNER-BI:ILDEfl DECLARATION _ SFR/ADD/REM �
O
� I HEREBY AFFIRM UNDEfl PENALTV OF PER.IURV THAT 1 AM EXEMPT FROM THE CANiRACTORS U� � Garage/Carport
W CFNSELAWFORTHEfOLLOWMGREA50N(SEG.7031.5BUSINESSANDPROFESSIONSCADE�.ANYCITYOR
U COUNTYWHICHREDUIRESRPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORFEPAIRANVSTRUC- �jJ pg[iWDP.Ck
WTUqE,PFION TO IT3 ISSUANCE AL50 RE�UIRES 7ME APPLICANT FOR SUCH PERMIT TO FILE A SIGNEO W
� STATEMENT'fHAT HE OR SHE IS LICENSED PURSUANT TO THE PROVI510NS OF TNE CONTRACTORS LI- ,
� CENSE UW(CHAPTER 0(COMMENCING WITN SECTION 70W)OF DIVISION 3 OF THE BUSINE55 ANO PRO- u' PooUSpa �
� FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� (� .
V TION.ANVVtOUTIONOFSECTION7031.58VANVAPPLICANTFORAPERMIT5U9JECT5THEAPPL�GANTTO Z Re-Roof -
F A dVIL VENALTY OF NOT MOHE THAN FNE HUNDRED DOLLARS(fsao�.):
p ❑I,ASONMEROF�iIEPROPERTV.ORMVEMPLOVEESWITHWAGESA57HEIRSO�ECOMPENSATION, � COff1ff10fC131
Z WILL DO THE YVORK,M!O TME STRUCTURE tS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BU51- J
NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF
� PFlOPEflTYWHOBUI�OSORIMPROVESTHEREON,ANDWHODOE55lICHWORKMIMSELFORHERSEIFOR � �
� THROUGHHISOFHEROWNEMPLOYEES,PPOVIDE�THATSUCHIMPROVEMENTSARENOTINTEN�EDOR m
W OFFEREDWRSPLEIF,HOWEVERiHEBUILDINGOFIMPFOVEMENT1550LDWRHINONEYEAROFCOMPLE- }
� TION,THE OWNER-BUILOER N9LL HAVE 7HE 9UR�EN OF PROV7NG 7HAT HE OR SHE DID NOT BUItD OH -
� IMPROVE FOR THE PUflPOSE OF SALE). � '
❑1,AS OWNEROFTHE PROPERTY,AM EXCLUSNELY CONTMCTING WITH UCENSED CONTRACTOFS
� TO CONSTHUCT THE PRQIECT�SEC.7044.BUSMESS AND PROFESSIONS CAOE:THE CONTRACTORS U- VdIUBtlOf1 ADJ.AREA �- �
W CENSEUWOOESNOTAPPLYTOANOWN[F10FAPFOPERTVWHOBU�DSORIMPROVESTNEREON,AN�
FWHOCONTPACTSFORSUCHPPOJECTSWITHACANTRACTOR�S)LICENSEOPURSUAN�TOTMECONTRAG QUANTITV DESCRIPTION •' FEE ��
� TORS LICENSE UW.�. • _
J
� ❑I AM EXEMP7 UNDER SEc. 8.8 P.C.FOR THIS REASON U
� ¢ .e+
LL OATE OWNER U - ' �
� LICENSED CONTRACTORS DECLARATiON _ �j �
Q IHEREBYAFFIPMUNOFAPEN�LTYOfPERJURYTHATIAMLICENSEDUNDERPROVi510N50FCMAPTER �
d 9(COMMENqNO WfTH SECTION 7000)OFDMSION 3 DF THE Bl1SINESS AND PROFESSIONS CODE,AND Z
W A7Y LICENSE IS IN FULL fORCE AN�EFFECT. m
� �
� LICENSE CLASS C" LIC.NO. � J
V DATE �CONTRACTOR _ e� a
W
� WORKERS'COMPENSATION DECLARATION J
� a
� IHEREBYAFFIRMUNDERPENAITVOFPERJURVONEOFTHEWLIOWIN60EClARAT�ONS �
N Z
Q
� IHAVEANDWILLMAINTAINACEflTIFiCATEOFWNS[MTOSELF-INSUREFORWORKEflS' 2
COMPENSATION,ASPHOVIDED6YSECilON37ooOFTHEi.AeORCODE,FORTHEPEPf-0RMANCE U
� OF THE WORK FOF WHICH7HI5 PEPMIT IS ISSUED. �
�
W 1 HAVE AND WILL AIAIMAM WORNERS'CAIdPENSATION INSIIRANCE,AS REWIRE�BV SECTION
Q 37000FTHEL CODE,FOR7HEPEflWRMANCEOFTHEWORKFORWHICMTHISPERMITIS �1,0/�
ISSUEO.MY WC � TION IY${JB�PC�NRRIER POLICV NVMBEfl AflE: CONSTRUCTION l��
J
� cr,RaEq - PLAN REVIEW
Z PouCV NUMBER ELECTRIC
¢ �nmsEcr�N�noreE�r[-0oFn�vewxtsroaor���oaLws(sioa�aitFssl. PLUMBING
�
w
Z I CERTIFV THAT M TNE PERFORMANCE Of THE WORK FOH WHICH THIS PERMIT 45ISSlJED.I MECHANICAL
('3 SHALL NOT EMPLOY PNY PERSON IN ANY MANNER 50 AS TO BECAME SUBJECT TO THE
� WORKERS'COMPENSATION UWS OF CALIFORNIA,MI�AGREE THAT IG I SHOULO BECOME WSPECTION FEE -
SU9IECT TO THE WOFii(ERS'CAMPENSATION PROVISIONS DF SECTION 37000f TME UBOR '. � p� /S' p/)
~ GODE,I SHALL FORTHWIiH CAMPLY WITH TNOSE PHOVISIONS. ISSUANCE � � �
0 SMIP +-~.~� � ��
p �ATE: APPLICANT.
w ENERGV P/C
J WMNINO:FAILURE TO SECURE WORNERS'COMPENSATION CAVERAGE IS 11NIAWFl1L,AND SHALI BE y�+ ''J
�y SU&lEC7ANEMPLOVERTOCRIMINALPENALTIESANDCIVIIFINESUPTOONEHUNOflEOTHOUSAND ENERGYPERMIT g�,S.T�j �^,_,�J
DOLLARS(570D,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN
� SECTION3�aeDGTHELABORCODE.INTEREST.ANDATNRNEY'SFEES. RETENTIONFEE:
� CONSTHUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDEfl PENALTY OF PEM1IUflY THATTHERE IS A CONSTRUCTION LENOING AGENCY
n- FOR 7HE PERWRMANCE OG THE WORN FOR WH�CH THIS PERMIT IS ISSUED�SEC,3097.CIV.C.�.
Z
W ___
S LENDER'SNAME
�
C LENOEfiS�DRESS , �Q
W ICERTIFITHATIHAVEHEADiHISAPPUCATIONANDSTATETHATTHEABOVEMFORIAAT10NI5CORRECT. TOTAL FEES
� IA�REETOCOMPLYWIT'riALLCITYANDCOUNTYOR0INANGESAN�STATELAWSFELATINGTO8UILDING
� CANSTRUCTION,ANDHEREBYAUhiORIZEfiCPRESENTATNESOFTHISCOUNTYTOENTERl1PONTHE
Z ABOVE�MENTIONEDPROPERTV FOP INSPECTION PURPO ±� COMMENTS
0 1
�
EE NAME iPH11Jn
� '
���,i Uj SIGNATUfiEOFPERMITTEE . DATE
� = RECPL N0. PAID BY YALlDATION
~ WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessar Copy,GOLDENROD—File Copy.GREEN—ApplicanPs Copy
�:\ �� .. . . ... ....... ....,. .'. .. ,. i� . . . . . , . ,
\
CITY OF DtAMt7i�D BAR
i1VSPECTIt3N t�ECOFtD
p � � � • � � � � � N . IY
.... �.... _
SET BACK � ' FLOOR JO{ST `
FfGSIFaRMS/STEEL � I FHA REQMTS - �
ELECTRIC GRdUND UNDER F�OUR.DUCT �. -
GROUND PW(�BING UNQER FLOdR C0�4DU1'�
S�AB GRADE FIREPLACE FOUNDAIION
TEMP POWER FIREPIAC�BOND BEAIv�-� _ :._ _ ' _ .
WATER SERVIGE� • - - - -- MIO HT BONQ BEAM
- --� - _
RE3C3F SHEA7HING 0 $ ' 8 F�:BOND BEAM -
FRAMlNGNENTILIATION FINAL BQND BEAM
R04F CUVER C� r r/T PRE-GRADING
ROUGH HEATING ' BENCHING "�
ROUGH ELECTRIC R()UGH GRADING
RC}UGH P�13M81NG FINISH GRADlNG
BHOWERlfUB TEBT POOL ELECTRIC
EXT.LATN/51DIfV� � �• POpL F�NCING
WALL lf�SULATIQN POOL FINAL
CEILiNG fNSULATIbN OFF SITE IMPS.
DRYWALL NAILIIVG DEDiCAT10NS
SEWER , , , FINAL ENG.
SEPTIC TAM1iK ' , LANDSCAFE/IRRIG.
SEEP P!T/L.L. ON SITE IMPS.
� GA5 AIR TEST FINAL ZpNING
FINAL CONST. l FIRE dEPT. FINAL
FINA�NEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV:F�ES PAID .
F1NAL PLUfiv181NG EN�RGY _ `
_ � -
C4MMENTS
�,
•'�
�
. . � ,
,�__ F
- ,, -�� �; t �
•,
SEPTIC TANK SIZE .
SEEP PITlU SIZE
' ,M - , . •
. ,