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HomeMy WebLinkAbout17698 (33) CITY OF DIAMOND BAR �� ! DEPARTMENT OF COMMUNTIY 8c DEVELAPMENT SERVICES -,�/ 21925 E.Copley Drive `� '�`� (909)860-3195 Fax(909)861-3117 f PRESS ':'� BUILDING PERMIT APPLICA710N FIRMLY o� JOBSITE �����`—/�J APPLICATIOt� � ZO.�U`L- PERMIT //1��'` r/ P/C ADDRESS , DATE G NUMBER M � APN LOT RACT ISSUE TYPE OCC DATE � - ��CONST. GROUP p OWNER �� a ADDRES$ ZONING SETBACKS � CI ZIP TEL. � - FRONT RW ❑ g APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR .� SIDE O � ADDRES p PROPOSED USE CITY ZIP� EL �� 3 w ARCH1ENG/ DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROO� � CITY ZIP TEL. � u� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION Q OWNER-BU�LDER OECLARATION SFR/ADD/REM O p 1 HEREBY AFFIRM UNDER VENALTY OF PERAlHY MAT�AM E%EMPT FROM iHE CONTMCTORS U� GefBge/C8lpOR W CENSEUWFORTHEFOILOWINOREASON(SEC.7071.56USINESS/J:DPROFESSIONSLODE:MlYGTYOR (n U CpUNTYWHIp1RE0UIRESAPERMITTOfANSTRUCT,AITERIMPNOVE.DEMOI.ISH,ORREPAIRANYSTRUG W pdtip/petk � 7UHE.PRIOH TO tTS ISSIlANCE.ALSO REIX11RE5 THE APPLICAN7 i0R SUCH PEHMIT TO FILE A SIGNED w STATEMENT THAT HE OR 511E IS LICENSED W1FSlUlJT TO TNE GROVISiONS OF THE CANTNACiORS U• � CENSE UW(CHMiER a(COUMENpN�WITH SECTION 7000)OF OIVISiON 7 OF THE BUSINE55 AND PHO� � POOVSpB FESSIONSCWE)ORTFU7HEORSHEISEXEIAPTTNEREFRqAANDTHEBASISFORTMEALLECEDE%EMP� C7 � 7qN.ANYYIOLATqNOFSECTIONTQ11.68YANYAPPLIGWTFOFAPERMITSU&IECTSTMEAPPLiCANTTO Z Re-Roof A CML PENALiY OF NOT MORE iHAN itVE HUNORED DOLURS(f SoO�.): � ❑I,ASOWNEROFTHEPROPERTY,ORMVEMVLOYEESWITMWAGESASTMEIRSOLECOM�ENS�710N, � (�'pmT0ftl81 � Z WILLDO THE WORK,AND 7HE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.701�,BUSI• J N NESS AND VROFESSIONS COOE:THE CONTRACTORS UCENSE UW DOES NOT APP�Y TO AN OWNER OF � PROPER7Y VM11O BUILOS OR 0.1PROVES TNEREON.ANO WHD DOES SUCH WORK HIMSEIF OR HERSEIF OR [[ TMHOUCHNISORHEROWNEMPLOVEES,VPAVIDEDTHATSl1WIMPROVEAIENTSARENOTWTEN�EDOR m w OFFEREDFORS/LEIF,HOwEVE1l,THEBU0.DINOORUAPaOVEAlEMI5501.OWITHINONEYEAROFCOIJPLE � TqN,TNE OWNER�BUIIDER VYILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BURD OR � IMPROVEFORTHEPURP0.5EOFSALE). � W Ol�OYMEROFTHEGROPERTY,AMEXCLUSIVELYfAMRACTPlOWITHLICENSEDLONiRACTORS (L TO CANSTRUCT iNE PR0.IECT(SEG 7oN,BUSINE55 M!0 FROFESSIONS CODE:THE CONTMCTORS ll• VaIU2110f1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOIWOWNEROF�PROPEFTYWNOBUILDSORIMPROVES7HER[ON.AND � W1iOCONTfUCT5FOfl5UCMGROJECTSWITHACONTMCTOR�S)UCENSEDPURSUANTTOTHECONTRAG QUANTI DESCRIPTION FEE � TORSIICENSEUWj. � OIAMEXEMPTUNOERSEC. B.iP.GFORiHISREASON U '� ¢ � DATE OWNER V �¢ LICENSED CONTRACTORS DECLARATION W ¢ IHEREBYAFFIRMUNDEFPENALTYOFVERJURVTNATIM1lICEN5E0UNDERPROYI510N50FCNAVTER � p., i�COAIMENCINO WfTFISECTiON 7000)OF DMSiON 90F TME BU51NE55IND 7HOFESSpNS CODE,164D Z YY LICENSE IS W fULL FORCEANO EFFECT. m � LICENSE CLASS� LIC.N0.�� � j � on�d Z'��.'1���CONTMCTOFI��! n• w � WORKERS'COMPENSATION DECLARATION a � IHEREBYAFFIRIA UNCER PENALTY OFpEfLRlRV ONE OF iNE FOLLOWINO DECIAFAT10N5: U C� ¢ G �IMAVEANDWILLMAIMAMACERTIFlGTEOFLONSEMTOSELFaNSUREFORWOqKER3' _ � COMPENS�TION,ASPROVIDEDBYSECTKKJ77000FT11ELABORCODE,FOR7HEPERFOR6IANCE w OF iHE WORK FOR WHlpl THIS VERMIT IS ISSUEO. � � w _IHAVEANUWILL�.UIMAINWOPoCERS'COMPENSATIONINSURANCE.ASRFOUIREOBVSECTION Oi7000F THE UBOR CODE,iOR THE OERFORMANCE OFTHE WORK FOR WIGp17H15 PERMIT IS J0��b J ISSUE�.MYYMJRKEFtS'COMPE S�TIONINSURANCECA 'RM1DVOlILYNUMBERARE CONSTRUCTION j CARRiER � PLAN REVIEW � POLICVNUMBEH � ELECTRIC 0 (iHlSSECTqNN�NOT8EO�I.TLE7E00FhEPEib.RSfORONEF4R�DREDOCUA0.;�Sf0�diLE55) PLUMBING Z I CENTIFY iHaT P!THE PERFORMANCE OF TME WOFK FON WHICHTMiS PERMIT IS ISSUED.I MECHANICAL (,�} SHALLNOTEMPLOVANYPERSONINANYMANNERSOASTOBECAMESUBJECTTOTHE y WORKER5COMPENSATIONUWSOFCAIIFORNiA.ANDIIGREETHATIFISHWLDBECOME INSPECTIONFEE S SUfl1ECTTOTHEWORNER5COMPENSATIONPROVISIONSOFSECT10N77000FTHEUBOR COOE,1 SHAil FORTIWITH COIA%.V WITM TMOSE VROVISIONS. ISSUANCE Q� � SMIP �IO p DATE: APPLICAM: � ENERGY P!C WARNINO:F�ILURE TO SEIXIHE 1MORNERS'CAMPENSATION COVERAGE IS UNUWFUL,AND SNALL BE �y SUQIECTANEMPIOYERTOCRIIAINALCENALT1ESMlOLMLFWESUPTOONENUNDREDiMOUSAND ENER6YPERMIT DOILARS(f 100.00D).IN AODITION i01HE COST OF fAA1PENSATION.DAMAGES AS VROVIOEO FOR IN � SECTqN7TOeOFTNEUBORCODE,NTEREST,MlOATTORNEY'SFEES. R�ENTIONFEE: � � Q pw.. CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYIIFFIRMUNOER7ENAlTYOFGE0.1URYiHATTHEREISACONSTRUCTIONIENDIN6AGENCY Z FOR THE VEFFORu1wCE OF iHE WORN FOH WF7Iqi THIS GERMITIS ISSUEO(SEC.9Da7.CIV.C.). W � LENDER'SNAME 1=— IENDEH'SADORE55 Q (� w ICERTIfYTHATIHAVERFlDTHISAPDLICA7qNANDSTATETHAiTNE/�BOVEINFORMATIONISCOHRECT. TOTAL FEES 3�.��+ d IAGREETOCOAIPLVWITNALLCfiYANOCIXlNTYOMINANCESAN�STATEUWSREUTINGTOBUILDING � CONSTRUCTION,ANONEREBVAUTFIORIZERE�RESENTITNESOF7HISCOUNTYTOENTEHUPONTME Z ABOVE-MENTIONEDGROP T'/ ORINSPECTiONFUHCOSES. COMMENTS 0 /\, � v m GERMi7TEENAAIE(P ¢ Dy- � - � (fj S�ONATUREOFVERMIT�EE OATE �r� � RECPT.�O.�� AID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—ApD��nt's Copy � �� : -.. .r... , .. .�,,: .:.,y- y �.. ��� ....,...�.�. . .,. ..., ... . -r.F- �,1;j... . .. ... ••.e--+-�•- � .c ..,. �. --. . . ,. . . ..� . � ,... r�-��� O� l�l�M�R�f3 B/�P l��!5i EC:!Ol�1 F�CC��t'� iI�4-�F.�4J�p'���.r�. . ^...-. �! Y1.,� .........���v��r�_F�cr l����S��-_........n....��.1���/!'��1d-��G�1�',.P��I� ��- . E'��`4.�`n T .��+��w�'�C~���rl. . � , � ..._..._. .....�......_. .._... . ... ......._..._�._._....._.... :.. ...r�...v..�...._. _ .._..___._... ....._...'.""'._._.....�_.�_.._..._._....._._.._ __" _ .". SET BACK ---- ---- ___.__ -- .-- , I � � FLOOR JOIST � . I FTGS/FORP�iSlSTEEL I � FHA REQMTS � ELECTRIC GROUND � ' � U��JDER FLOOR �UCT GROUND PLUMBING I I I UPlDER FLOOR CUf�IDUIT' � _ SLAB GRADE I FIREPLACE FOUNDATION i TEMP POWER I T�I� FIREPLACE BOND BEAM _� WATER SEAVICE I MID HT. BOND BEA�A • ROOF SH�A7'HING �Z,'�Z -��.f�— , . � 8 FT. 60NU 6EAh.1 . FRAMINGNENTIUATION I j /� _I_FINAL BOND BEA0.4 �ROOF COVER 13/lOG�JL � PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC R�UGH GRADING ROUGH PLUMEING � FINISN GRADING --� SHOU'✓ER/TUB TEST � POOL ELECTRIC EXT. LATH/SIDWG � POOL FENCING 1NALL IfdSULATION POOL FINAL CEILING IN�ULATION OFF SITE IPJIPS. DRYWALL NAILING DEDICATIOfJS SEWER FINAL ENG. � I SEPTIC TANK � . LANDSCAPc/IRRIG. � SEEP PIT/LL. �N SITE IP�QPS. GAS AIR TEST FIPJAL ZONIPdG FINAL CONST. FIRE DEPT. FINA'_ FINAL HEATiNG HEALTH DEPT. FINAL FI��IAL ELEC7RIC DEV. FEES PAID FINAL PLUMBING � ENERGY -- — ,�.;�`=r."',;�=�:��:r. _. . — - �.,.___ ��_.__, -_--------- COM«IENTS SEPTIC TANK SIZE . SEEP PIT/U SIZE ,I���__..______.� ,��y� � � 1