Loading...
HomeMy WebLinkAbout11-283 (5) _�` _ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 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 a DDRIESS� 17 ` O ������ �tll- �I r I �3 r APPLICATIO PERMIT p/C {�'fZ o � DATE �� I �� NUMBER # ��" a��� � ISSUE r NPE OCC APN LOT. �T.g,ACT DATE �'✓ CONST.�Q�GAOUP p OWNERX P,f'�(���C� �^�'[S G� � p ADDRESS � � ZONING SETBACKS Z CITY V ZI�� TEL. � FRONT RW ❑ o APPLICAN TE REAR p Z � SIDE/SIDE STREET RW p a CONTRACTO O SIDE p ADDRES 4 � CITY ' ZIP�(,� TEL. �► Q- 6t (� PROPOSED USE /I�{'��� � w ARCH/ENG/ z DESIGNER� w NO.DWEL. NO. NO. a ADDRESS cn UNITS STORIES BEDAOOMS � CITY ZIP TEL. � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBY AFFIRM UNDER PENALN OF PERIURV THA7 I AM E%EMPT FHOM 7HE CONTRACTORS ll- (�yfeg0/CefpOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.5BUSINESSANDPROFESSIONSCADE:ANYCITYOR (n U COUNTVWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE.DEMOUSH,ORREPAIRANVSTRUG � w TURE,PHIOR TO ITS ISSUANCE.ALSO REQUIFES THE APPIICANT FOR SUCH PERMI7 TO FILE A SIGNED w Patio/Deck � STATEMENT THA7 HE OR SHE IS LICENSED PURSUANT TO THE PPOVISIONS OF THE CON7RACTORS LI� � � CENSE LAW(CHAPTER Y(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSPB , O FESSIONS CADE)OR iHAT HE OR SHE IS ExEMPT THEREFROM AND THE BASIS FOR 7HEALLEGED E7(EMP- (� V TION.ANVVIOLATIONOFSECTION7031.SBYANVAPPLICANTFOHAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof � A CIVIL PENALTY OF NO7 MORE THAN FIVE HUNDRED DOLLARS(S50o).): Z ❑I,ASONRJEROFTHEPROPERTV,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECAMPENSATION, � COffIrtIBlClel WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70/1,BUSI- J � NESS AND PROFESSIONS CODE:THE CANTRAC70R5 LICENSE LAW DOES NO7 APPLV TO AN OWNER OF � — PqOPER7VWHOBUILDSORIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR Q THROUGH HIS OR HER OWN EMGLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEHEDFORSALE.IF,HOWEVERTMEBUILDINGORIMPROVEMEN7ISSOLDWI7MINONEVEAROFCOMPLE� Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,AS OWNER OF 7HE PROPERTV,AM EXCLUSIVELY CON7RACTING WI7H LICENSED CONTRACTORS � TO CONS7RUCT THE PR0.IECT(SEC.70��,BUSINESS AND PiiOFE5510N5 CODE:THE CONTRACTORS LI- V81U8�1Of1 ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN OVMER OF A PROPERTV WHO BUILDS OH IMPflOVES THEREON,AND � NRiOCONTRACTSFORSUCHPRQIECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑1 AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � Le�- -r' � BG{1'IL � U � � �ATE OWNER F- � W I � LICENSED CONTRACTORS DECLARAT�ON W � I HEREBY AFfIFM UNOER PENALTV OF PERJURv THAT I AM LICENSED UNDER PROVISIONS OF CHAGTER � . � B(COMMENCING WITH SECTION 7000)OF OIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z 0 AICENSE CLASSFU FORCE AfJD EF�CT. LIC.NO. ��+ vv .J � C V ATE � CONTRACTOR d W � WORKERS'COMPENSATION DECIARATION Q � I HEREBV AFFIRM UNDER PENALTY OF 7ERIURY ONE OF THE FOLIOWING DECURATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICA7E OF CONSEN7TO SELF�INSURE FOR WORNERS' _ ¢ CQMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOH CODE,FOR THE PERFORMANCE U Q OF RK FOR WHICH THIS PERMIT IS ISSUED. � � � w I HAVE AND WILL MAMTAIN WOiiKERS'COMPENSA710N INSURANCE,AS REDUIRED BY SECTION Q37000FTHELABORCODE.FORTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS ��D-�,p J ISSUED.MV ORKEoRS'CA ENSATION I UR`ANCE CARRIER A ICY NUMBER ARE: CONSTRUCTION U J j � CARRIER ` ` O• PLAN REVIEW ��'�• G��'} Z POLICYNUMBER ELECTRIC Q � (iHLSSECiX7NNE�NOTBE00MPLEfEDOFTHEPERMfrISFORONEVM1kDRED00LLARSR��)���} PLUMBING Z I CERTIFV THAT M THE PERFORMANCE OF THE WORK FOR WHICH T ERMIT IS ISSUED.I MECHANICAL LJ SHALL NOT EMPLOV ANY PERSON IN ANY MANNEF SO AS TO 0EC SUBJECT TO T E � WORKERS'COMPENSATION LAWS OF CALIFORNI ND AGREE IF 1 SHOULD B OME INSPECT�ON FEE = SU&IECTTOTHEWOFiKEHS'COM7ENSATIONP ISIONSOF TION37000F !� CODE,��SHA��THWITHCOMPIV WITHT 5 PROVI510 ISSUANCE l.J 0 p OAT APPLICANT: SMIP ���� J WARNING:FAILURE TO SECURE WORKERS'CO P TION CAV AG UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJECTANEMPLOYERTOCRIMINALPENALTIE CIVILFINE U OONEHUNDREDTHOUSAN� ENERGYPERMIT DOLLARS(5100,000�,IN ADDITION TO7HE COS7 COMPENSATI ,DAMAGES AS PROVIDED fOR IN J SECTION37080FTHELABORCODE,INTERE , �A770RNEV'SFEES. �. O� p� RETENTION FEE: OCONSTRU ION LENDING AGENCY pRE-ALT FEE: .� � I HEFEBY AFFIflM UNDEF PENALTV OF PERJURV THAT THEilE IS A CONSTRUCTION LENDING AGENCY �J,e_�n � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.�. k•Lyl'7'!�! z w � LENDER'S NAME F– IENDER'SADDRESS �/� w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES 1� �� �� � [ – • • � � I AGf1EE TO COMPLV WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS REUTING TO BUILDING � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESEN7A71VE5 OF THIS COUN7V 70 ENTER UVON THE Z ABOVE�MENTI �VROPERTY FOF INSPECTIO uRvosEs. COMMENTS � � � OA-Q►�l l l p m PERMITT AME(PRINT) . � x 'i ��� � � � � ✓ Vlp� � � SIG AT E E TTEE �A7E = RECPT.NO. PAID BY .3 VALIDATION ~ WHITE—Department Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy � �e�v o� �o�►���� ��� i�s��c�o�� ���o�� � ,� . t;; 0a�pl�(�4�Oa DLJ`�C. _��.. Da�3pG�G3 �a�pC(���Oa DGJ4C �a�(�I�G40a SET BACK FLOQFi JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOQR CONDUIT SLAB GRADE FIREPLACE FOUNDATIQN TEMP POWER FIREPLACE B�ND BEAM WATER SERVICE MID HT. BOND BEAM - � ROOF SHEATHING ' 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM � ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING � ROUGH PLUMBING FINISH C.�RADING SHOWERlrUB TEST 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. QN SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC p �� DEV. FEES PAID _ __ FINAL PLUMBING . ENERGY --------- --- - - -------......-------..------. _--- ---I-------------------- ��o � ` COMMEfVTS —_ _ _ ____ SEPTIC TANK SIZE . SEEP PIT/U SIZE a - — - � � - - � `