HomeMy WebLinkAbout17959 (19) C1TY OF DIAMOND BAR �
"�� DEPARTN�NT OF COMMUNTfY&DEVELOPMENT SERViCES
2I825 E.Copley Drive
(909)860-3195 Fax(909)861-3117 PR ESS
'%:�' BUILDING PERMITAPPLICATION FIRMLY
� JOBSITE APPLICATIO 1 ERMIT ` P/C
� ADDRES pATE NUMBERL�_ p
� ISSUE PE C
APN LOT RACT DATE CONST. GROUP
p OWNER �
"' ADDRESS ZONING SETBACKS
z CITY ZI TEL FRONT RW O
S APPLICANT TEL. p�'A �
� SIDE/SIDE STREET RW O
� CONTRACT SIDE p
Q ADDRES PROPOSED USE
� CIN - ZI TEL. � � � e
Pu ARC NG/ `
� DESIGNER N .D N0. NO.
o., ADDRESS UNITS STORIES ' BEDROOMS
� CITY ZIP TEL
� DESCRIPTION SO.FT. FACTOR PSF ADJ_AREANALUATION
� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
p 1 MEHEBY AFFlRM IAJDER DENALiY Oi PERJURY 1riAi I AM E%EMCT FPAM THE CONTMGTORS LL Garepe/Carport
W CENSELAWFORTHEFOILOWWOREASON(SEC.70.71.6BUSINESSANDVROFESSIONSCODE:ANYCYTYOR (f�
U COl1NiyWHICHREOUIRE3AGERAAITTOCON57RUCLAl7ERMPROVE.OEMOLISI.ORHEPAIqANYSiRUC• W P81(OIDBCk
� NRE.PIUOR M ITS ISSUANCE,ALSO REOUIRES THE AGPLICANT FOR SUp1 PERMITTO FLLE A SIGNED W
STATEMEM THAT HE OR SNE IS UCENSED PUqSUANT TO THE VROVISIONS OF THE COMR/.CTORS Lb
� GENSE U1W(CH�VTEN Y(COMMENCRJ(3 MniH SECTIOf!70001 OF GIVISqN 3 OF THE BUSiNE55 AND PRO- LL' PooVSPe
FESSKK�S CODE)DR THAT HE OR SHE IS EXfMPT TMEREFNOM AND THE BASIS FOR TME/�LLEGED E7fEMP•
VT1ON.nMIV1oLAilONOF5ECf10N7a71.68Y11NYI1PPLICl1MFORAPERMITSU&IECTSTMEMPLM•ANTTO Z qe•R��
A GViI VENALTY OF NOT MORE TW W FIVE MINDRED DOLLARS psoo)J:
� 04���EROFTHEPROPERTV,ORMYEA/PLOVEESWITHWACESAS7HE�RSOLECOMVEN5A710N, 0 CORIrt10tC�01 -
YYILL DOTHE WOFiK.AND THE STRUCiURE IS NOT INTENDED ON OFFENED FOR SALE(gEC.7oI1,BUSI• J
� NESSAND FROFESSIONS COOE:TNE CONTAACTONS IICENSE LAW OOES NOT ADttY TO AN pWHER OF ? ,
FiqPERTY Yhq BU0.DS OR IMVROVE57HEPEON.M/D WIIO DOES SUCH WOAN HIMSELF OR NERSELF OR
CL THqOUCHW50RHERqvNEMPIOVEES,PPOV10EDri1ATSUCMWPROVEMEN75ARENOTRlTENOE�OR m
pOFFEREDFORS�IE.IF,IIDWEYER7MEBUILDINUIXiIMPROVEMENTI5501DWITMNONEYEMOFCOMPIE
Z TiON.THE OWNEH�BUILDER VNLL HAVE THE BURDEN OF PROVINO iHAT HE OFl SHE D�D NOi BUIID OR
� MVROVEFOqiMEPUNPOSEOFSALE�
O 4�OWNER OF1HE GROPER7Y,AM EXCUIS�VEIY CONTMCTNO YnTM UCENSED COHTRAC70RS
� 70 CONSTRUCT 1HE PROJECT(SfC.70u,BUSiNESS ANO PROFESSIONS CODE:TNE CON7RACTORS L6 V0W9Ii0 ADJ.AREA
W CENSEUWDOESNOT�PPLYTOANOWNEROFAPROPERTYNTIOBVILDSOR�MPROVESTNEHEON,AND
� NRqCANTMCT5iOR5UCHPHOJECTSWIh1ACOHTRACTOR(S)L�CENSEDCURSUAMTOTHECONTM4 pUANTITY DESCRiPTION FEE
� TD0.SUCENSEUwI.
p O IM.�EXEYPT UNDEH SEC. B.t P.0 FOH TF115 REASON U
LL DATE OYMER �
Z W
� UCENSED CONTRACTORS DECLARATION W
� IMEREBY�FFIRMUNDERPENALttOFFERIURYTM7IAMLICEN5E0UNDERPf�NS10N5OFCHAPTEN Vr
p� Y(COMIAENqNON7THSECT10N7Do0)OFOIVISqN70FT11E8U5INE5S.WOVROFESSqNSC00E,AND Z
`L YY LICENSE IS N FULL FORCE AND EFFELT.
m
� IICENSECUSS LIG.NO.�,��, �
� OATE � � COMRACTOR� a
W
� WOf7KERS'COMPENSATION DECLARATION 4 .
� IHEREBVAFFlRMUNDERPEN.LLTYOfVER.AIRYONEOFTHEFOLLOVANGOECUAAT10N5: V
C� Q
� _INAVEANDNALLMAMiNNACERTFICAiEOFCONSENTMSEIf-IN9UREFONWOR1tER5' _
COM7ENSATION,ASPAOVIDEDBYSECTWN9�ooOFTHEL/�ONCODE,FORiHEPERFORMANCE W
OFTHE WORK iOR WHlpl THIS VERII�TIS ISSUED. �
O
_I HAVE AND YALL MNNTAIN WORKERS'COMVENSATION INSUMNCE,AS REOVIRED BV SECTqN �O
Q J7000F THE LABOR CODE,FOR T11E PERiOiWMlCE OF THE WORK iOR WHICHINIS PERIAIT 15
ISSUED.IdY RSCOMV SATIONINSURANCECARPoERIINDPOLICYNUMBERME: CONSTRUCTION �
� CARRIER ���'+ �� PUW REVIEW
Z VOLICYNUMBEH "Lr� ELECTRIC
4
� (iHISSECnoNA£mr+otBEOo�.stE7EDOFiIEPE�wYtsPoaONEF�►D�DOott�Fts(S+oqORlf551. PLUMBING .
Z I CENTIFY TXAT N iHE VERFORMANLE OF TME WVRK iOR WHICH TMIS PERMIT I5�55UE0,l MECHANICAL
(} $HNJ.NOT EMPLOY M!Y PERSON IN ANY MANNER 50 AS TO BECAME SUBJECT TO THE
� VfOpNENSCdAPENS�TqNUM'SOFCALIFOflN1AANDAOREETMATIFISNOUIDBECOME INSPECTIONFEE
S SUBJECTTOTHEVfOflNERS'COAiPENSATqNPROV1510N50FSECTI0N9t000FTHElABON �
CODE,I SIULL FORTINATH COMttV WIIH THOSE PR (� N5. ISSUANCE
0 , / SMIP .�
p DATE����,c APpLICANT. � -
� ENERGY P/C
WARNINO:FMURE TO SECURE WORKERS'Cd.�PENSATqN fAVEFACE IS UNLAWFUL M1D 3 WLLL BE
�y, SUBJECTMIEMPLOYERNCfliMINALPENALTIESAN�CMLFWE9UPTOpNEHUNOREDi/1W5AND ENERGYPERMIT
DOLURS(f 100,OooJ,W ADDITION TO TNE COST OF COMP�SATION.DAMACES AS VROVI[1EU FOR IN
� SECTION770lOFTHEU180RWOE.NTEREST,MIDATfORNEY'SFEES. RETENTIONFEE: �
a CONS7RUCTION LENDINGAGENCY pRE-ALT FEE:
� INEREBYAFflRMUNDERPENAITYOFPERIUHYTNATiHERE1SACONSTRUCiIONIENDWOACENCY
� FORTHEDERFORMANCEOFTNEWOHKFORWHIp/7MISVERYITI5155UEU(SEC.]OY7,CIV.G�. � .
Z
W
� LENDEICS NAA1E
C IENDEN'S�DORESS
w IGEflTIFYTHATIHAVEREMTHISAiPIICAt10NAND57ATEiMATT1EABOVENFONA1�T10NISCORRECt TOTAL FEES (34• f�
� IAGREETOCOMPLYN7TMhLLCRYANDCOUNTYOR�INANCESMIDSTATEUNSREUTIN(7TOBUILp�NO
� CONSTRUCTION,ANDFIEREBVAUTF70R2EREPRESEN7ATrvE50FTHISCCUNTYTOENTEqUPONTHE
Z ABOYE�MENTqN PpOPER7Y FOR iNSPECTiON VUA705E5. COMMENTS
m P�
a PERMI E N ryFLN
N �
vj SN3NATUPEOFP M EE ���1
� RECPT.N0. .PAID BY VAIIDATION
WHITE—Oepanment Copy,YELLOW—Finanee Copy,PINK—Assessor Copy.GOL NRO ile Copy.GREEN—Applicanl's opy
�e . �.n . . .. .. .. .- , .... .-, t .. < .r . . . ..„ ,.iR�:;i,:,T,;3n:Y..�1.:. vi��.: . .�.'wy!}:'t+:i1�oY,`�-�». e .. ..�� , :.d;�,t�itr....,F..h'n. . .:-x[�^,�`.. .,._ .. ,
CITY �F DI�'a�JfOND BAR
iPJSPEC�"IOf� RECORD
- '11����i�t�i`,_� ',�'��Yr� �1�`�y������`�.�� : t�►��.�.��`���...._��.�.�.__�- �°�'1��� -.. 11���;��.�� �
- ___ _ ,_,. .. ....� . . _ _. _ �....� _ . , ,
SET BACK , ` - FLOOR JOIST '_ j �;
FTGSIFORMSISTEEL ' I FHA REQMTS
ELECTRIC GROUNQ ; ' UNDER FLOOR DUCT �
GROUND PLUMBING I UNDER FLOOR�CU�IDUIT . :'I ; '
SLAB GRADE I � FIREPLACE FOUNDATION ' I �
TEMP POWER I, I ; FIREPLACE BOND BEAM
WATER SERVICE I i MID HT.E30ND BEAM �
ROOF SHEATHING � �/Z�jJ� -� . �� . 8 Ef. 6�ND BEAM` ' ,
TI I � ON � ` � FINAL BOND BEAM
FRAMING/VEN L ATI
ROOF COVER ' Q � PRE-GRADING �
ROUGH HEATING � BENCHING
ROUGH ELECTRIC � i I ROUGH GRADING
ROUGH PLUMBING I FINISH GRADING
SNOWERffUB 7EST i , POOL ELECTRIC
EXT.LATHlSIDING i POOL FENCING '
WALL INSULATI�N - POOL FINAL
CEILING INSULATION � OFF SITE IMPS. ;
DRYWALL•NAILING i j OEDICATIONS I
SEWER ._ � � FINAL ENG.
. SEP71C TANK � � LANDSCAPE/IRRIG. �� .
SEEP PIT/L.L. � � � '•� ' OW SITE IMPS.
GAS AIR TEST � � FINAL ZONING
FINAL CONST. ���Z � ! �IRE DEPT. FINA!
FINAL HEATING � i j , HEALTH DEPT. FINAL
FINAL ELECTRIC � ' ' DEV. FEES PAID
FINAL PLUMBING ; ENERGY
i
, , .
, � i ;,r -, a ;.,� �,.,�: - -
. . . .- - -- � -�-'---- , ���n. _r-:. ,� . .,. , J
COMMENTS
' SEPTIC 7ANK SIZE
SEEP PIT/U SIZE
f�}� . . . .
' � � �
'�� . . . `�,
_. . ; ; _ ,
, ,�� '� � �� , , .
,
�