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HomeMy WebLinkAbout17839 (17) �\ C1TY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPIv�T1T SERVICES '� 21825 E.Copley Drive (909)8603195 Fax(909)861-3117 PRESS ��%�A� BUILDING PERMITAPPLICAT[ON FIRMLY � JOBSITE APPLICATION PERMIT j�� P/C o o ADDRESS�� I I�D I�JC�EE K 1��i VE DATE � NUMBEFi� # �/�' 7� � APN LOT TRACT � DA EE� � C Z TMPE �CC CONST. GROUP 0 owNeR'�'E N N I F E R G H U 1J br � ADDRESS �-II FSOWC��C1� 17�. ZONING SETBACKS 2�,��j��C1 o CITY��N�/'�C� ZIP�� TEL�I•F3E>IZfi3�I R�RT � � aw o� « APPUCANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR �P� SIDE �.. p o CDDRESS_-� M- Z�P 7�TEL. PROPOSED USE��� /�c�D�7ITl� w ARCH/ENG/ z DESIGNER T� �/VL� � t10 w NO.DWEL. NO. NO. a ADDRESS�Lrf Li��4L �C1�� cn UNITS I STORIES Z 3 � CIN/��� ZIP�TEI.� �=� ��"" BEDROOMS cn , DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION o OWNER-BUILDER DECLARATION SFRIADD/REM 2, ��('`✓ /7 Q U� p I HEREBY AFFIRM UNDER FENILLTY OF PE0.IURY THAT 1 AM E%EMPT FROM THE CONTfUCTORS LI• � Garaga/Carport W CENSEUWFORiHEFOLLOWINOREIISON(SEC.70.71.SBUSWESSANOVROFESSIONSCOOE:ANYCITYOR U COUNTYMRIICHREOUIRESAPERMITTOCONSTiiUCT.ALTER�IPROYE,DEM0U5H2ORREPAINANY57RUC• W patiolDeck � TUHE.PRIOR TO ff5�SSUANCE.hLSO REOUIRES THE A7FlICANT FOR SUCH PERMIT TO FlLE A SIGNED w STATEIAEM TFUT HE OR SHE IS UCENSED PURSUANT TO TNE PpONSiONS OF THE CONTRACTORS U• � CENSE LAW�pUDTER G(COIAMENCWO WI7H SECTION 1000)OF DIVISION�OF THE BUSiNESS AND PRO- V" PooUSpa FESSIONSCODE)ORTIUTHEDRSHEISIXEAAPTIHEREFROMANOTNEBASISFORTNE+LLLEGEDE%EL1P- (� �� TION.ANYVIOUiqNOFSECTION70J1.5BYANYAPP�ICANTiORAPERMITSU&IECTSTHEMPLICANTTO Z Re•Root A CML F NALTY OF NOT MORE T}1AN FNE HUNOFED DOLUAS(f500)J: ~ ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWACESASiHE1R5OLECOMVENSATpN, z YVILL DO THE WORK,AND THE STRUCTURE�5 NOi INTENDEO OR OFiERED FOR SALE(SEC.7W�,BUSb � Commercial - � NESS ANO CROFESSIONS CODE:THE LONTMCTORS UCENSE LAW DOES NOT MPLY TO AN O`NNER OF ? PROPERTY M?IO BUlD50R IMPROVES TIEREON,AND NMO DOES SUCH WORK HIIASELF OR HERSELF OR � 7Hq0UGHHISORHEROWNEMVLOVEES,OROVIDEDTHAT5UC/1MGROVEMEN75�RENOTMTENDEDOR m 0 OFFEFEDfORSILE15110N�EVER7NEBURDINCORIMPROVE/AENTI550lDVnTHINONEYEAROFCOMPLE- Z TION.THE OWNER-BUILDER VnLL HAVE THE BUROEN OF PROVINO TNAT HE OR SHE O�D NOT BUILD OR = p1PROVE FORTHE FURPOSE OF SALE} O 4�^OWNER OF THE PROPERTY,AM E%CLUSNEIY CONTMCfINO WITH IICENSED CONTMCTORS ¢ 70 CONS7RUCf TNE iRO.IECT�SEC.7W�,BUSINE55 ANO PROFESSIONS CODE:iHE CONiMC70R5 LI• V81118t10f1 ��� ADJ.AREA W CENSEUWDOESNOTAPGIYTOANONNEHOFAVROPER7YNA10BUILp50RIMPRWESTHEREOftAND � YhfOCONTMCiSFORSUCHPR�JECTSNITHACONTMCTOWSIUCENSEDPURSUANTTOTHECON7MG QUANTITY DESCRIPTION FEE � TORS LICENSE LAW.�. � 0 O IAM EXEIAPT UNDER SEC. B.8 P.Q FOR THIS REASON at � O L'� �G '� � " r s�-L��r� Z DATE � OWNER � ����,J — ' W !1 �¢ : UCENSED CONTRACTO DECIARA ON W 2 IHEREBYAFFIRAIUNOERPEWLLTYOfPERJURYTHATIMALICENSEDUNDfRPROV15lONSOFCMAPTEP V. p„ Y�COA/AIENCWOWITHSECTION1000)OFOMSION70FTNEBUSINESSANDPROFESSIONSOODE,AND Z X MY 110EN5E IS N FUIL FORCE AND EFFECT. � L1J � LtCENSE CUISS � UC.NO. � . � J _.__ V DATE CONTRACTOR d W � i WORKERS'COMPENSATION DECLARATION Q CG J L N /L' NI HEREBYAFFIRM UNOER PENAL7Y OF FEFWHY ONE OFh1E FOLLOYnNG DECIAMTqNS: Z � �IHAVEMlDMALLMAINTAINACERIIFICATEOFLUl15ENTTOSELFaNSUREFORWORKER$' _ COMPENSATON,ASFROVIOEDBYSECTION�7ooOFTHELABORCODE,FORTHEPERFORMANCE w OF 7ME WORK FOR WMlpl THIS iERMIT IS ISSUED. � � � W _I HAVE M1D 1MLL MAINTAIN WORKERS'COMPENSATION INSURANCE.AS RfOUIRED BYSECTION Q ]7ao OFTHE UBOR CODE,FOR THE DERGORMANCE OF h1E WORK FOR NAIICHTH15 PERAIR IS /� �� J ISSUED.MY WORKERS'COMPENSATqN INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION .�C��� � j CARRiER PIAN REVIEW � i� _ Z Pa�crNUMeen ELECTRIC _� ¢ � (fW55ECrcNNEmNoiBEoo6q.ErEDafnEVEwwrsroRaJEH.lD�EDDot1uL;(S�m)oqtFSs). PLUMBING Z ICERTIFYTHATNTHEPERFORMANCEDFTHEMNRKFORNTnd11MI5PEAMITI5155UE0.1 MECHANICAL ,� U' SHFLLNOTEMPlOYM1YPER50NINANYMANNERSOASTOBECOMESUBJEC7TOTNE � WORKER5CdA7ENSATIONUW50fG1LIFORNI0.�NDAGREETNATIFISHDUlDBECOME INSPECTIONFEE S SU&IECTTOTHEWORNERS'COMPENSATIONPRONSIONSOFSECipN�7000FTHEUBOR '�► cooE,�swui cor+n+wm�canr�r wm+THosE Pao�sw�s. ISSUANCE 1 � SMIP !. . p DATE: APPLICANT: � ENERGY P/C WARNINd;FAILURE TO SECURE WOiiKERS'COMPENSATqN COVEMGE IS UNUWFUL,AND SH/�Ll BE , , .� SUfl1ECTANEMPLOVERTOCRIAIItLLLPENALTtESANDCMIFWESUPTOONEHUNOREOTHOU5AN0 ENERGYPERMIT OOLURS(f t00.000�.IN!1DDITION TO THE COST OF COAIPENSA7qN,OAAIACES AS PROVIDED FOR IN � SECTKKJ97oeOFTHEUBORCODE,NTEREST,ANDATTORNEYSFEES. RETENTIONFEE: � d ' CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O ' � I HfREBVA�FIRAI UNOER DENALTY OF VERRIRV THAT THERE IS A fANSTRlICT10N LENDWG AGENCY a- FOR THE PERFORMANCE OF THE WORK FOR NMIpI TH�S VERIAIT IS I55UEO(SEC.]097,CN.CJ. � � LENDEKSNAIAE � LENDEHS�DONE55 /� (_�)'^ /} � 1 GfRTIFV THAT I NAVE READ THIS APVLICATqN ANO SiATE TNATiHEABOVE INFORAIATION IS CORNECT. TOTAL FEES (( �J�(y.• (j '�J� J� w IAGREEI000M7LYWITHALLGITVANDCOUNTVORDININCESANDSTATEUN'SREUIWOTOBUM1DINO .ly o-" � CONSTRUCTION,MlDHEREBYAUTHORREREPRCSEMATNESOFTHISCOUMY70ENTERUPONTHE �1 ZAB .MENTIONEDGROPERTYFORINSPECTqNPURPO5E5. COMMENTS \ � , � ` � m VERMITTEE NAME(PR� i� � � SiGNATURE VERMI E OATE ' � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy.GOLOENROD—File Copy,GFiEEN—ApplicanYs Copy , �;• , • . ... .., ..� :u�' ', , .. r�,. - -,a.. . ,.. . , . _ . -. . _.,. .�,.. � . , - .. -.. .. .. . ��i i� �i" ����I,��.'iu�1' y���i �16Sv t`�[.�� i �V�� S—i��11i'll./ ;1►�E�:�-`,ifl�.l�l ;��Y:'�_i____�,I�yF�;I::e,.C�e�,ti � } I►q�.�j;.a�.�c �'C�'1i'E �'Y�w��: (i��-'�-a�.�''��).�� __.....___—__=--____.--�---------- - - ----- - _ __ _ ..... __.__._.__.._,..._ .._.� - -- _ _� . _- --:--_.__.______ SET BACK � - -I- -- ---- --- � I ; FLOOR J�IST :� I _---_ _ _ FTGS/FORP�1S/STEEL� •` ' I FfiA RE�P�TS '� � � ����z�,�- � � ELECTRIC GROUND ; ; ! UNDER FLOOR bUCT . }I ! - GROUND PLUMBRJG � U��1DER FLOOR CUf�!DUIT . 1 � ' �� � — �,Q� �------�--- . - SLRB GRADE Y/_lC ._Zf_.Ri�- I _�I FIHEPLACE FOU`lDATION �.j` � `• TEMP POWER � f� __� I FIREPLACE EiOND BEAP�1 � WATER SERVICE ' � _�� � i �.�ID HT. E30ND BEAP�1 " . �f"�(— � • .- � ROOFSHEATHING 7t:��'�_ � --�- II F-i". BOP�D BEAP�1 / y,�;-�_r FRAMINGNENTILIATION .7�J���• � ' -- •»�-,FINAL 60ND BEA�4 _ I _ ROOF COVER I 1 ' PRc-GRADING ROUGH HEATING ._�� r�' "`� BENCHING ' - ' I ROUGH ELECTRIC '�'M: .-D�._`�..--�--^--�•��-- � ROUGH GRADING �—� ROUGH PLUMBING � � ' FI�JISH GRADING SHOWERIfUB TEST _ � � POOL ELECTRIC EXT.LATH/SIDING �� POOL FENCING WALL INSULATION .. -�Z � POOL FIP�AL ' CEILING IN�ULATION �_�-p � � OFF SITE IMPS. _ ' DRYWALL NAILING i�/� ��� � DEDICATIONS SEWER FI�JAL ENG. SEPTIC TANK LAfdDSCAPEIiRRIG. � SEEP PITILL. � ' � OfJ SITE IMPS. � GAS AIR TEST - FINAL ZONItJG FINAL CONST. � I �� ,� I � �!RE DEPT. FINA! 7 3e•ot_ _ FINAL HEATING � �_ � HEALTH QEPT. FIPJAL . • FINAL ELECTRIC � ' DEV. FEES PAID � FINAL PLUMBING �ENERGY � _ —��,.�w.__�.�� .!«'`,C.�� �Tv-- i 1 COP��IMENTS FD�. h%�t ox1�Y_C� 6oTa�—;.� r��� t�•.�c��? �� �ricr u�� tJ9T'�u,f'i� �� ��.�,�c: VC-�—�L.'1�,��—�)�t-t-'S l�C-,A�f�m�: �.lN C���=�� -- ' �Z•o3.—N_�QU{L'C_F�--A�'�—�`�—�'��—.�1�/k�fc�'rsA�---�—I��.���_�R�iS� SEPTIC TANh SIZE SEEP PITIU SIZE �__�_.._�.._��., i�'� ; ���w� �� , , .. , , _ .._ _ . . _'-?_. ._ _- ----- � ' �