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HomeMy WebLinkAbout16242 i ' �- - - - , - -- � � t.' �� ^ _f�� CITY OF DIAMOND BAR � ' ' r� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ' - �_ ? _ w 21660 E.Copley Drive Suite 190 ' (909)86a3195 Faz(909)861-3117 � PRESS I �'��',� BUILDING PERMTT APPLICATION 1 � . FIRMLY o D RIESS �3 ' I V L� �'1' DATE CATION �..�:-OI NUMB R��!'� 1�#/C O�!O � APN LOT TRACT 5����] �SSUE TYPE OCC p OWNER PU LT�- �-/D/►'(�S DATE CONST. GROUP p ADDRESS ZONING SETBACKS - !�"' '� '�'` " Z CITY17ifYindw[D BR7e-ZIP TE . - / FRONT RW ❑ g APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW � O CONTRACTOR P!.!L /-1'D/Yt E C D/eP• SIDE ❑ ADDRESS � CITY „J�/eV�/�f ZIP (o/�iEL. ROPOSED USE o ARCH/ENG/ 9"�-t�ll�QD z DESIGNER NO.DWEL. NO. NO. � CDDFiESS L�Q ZIP TEL. ` UNITS STORIES BEDROOMS � � v� DESCRIPTION SQ.FT. ACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM Z O ^ � � p 1 HEREBV AFFIRM UNDER PEN/�LT/OF PERtt1RV THAT 1 AM EXEMPT FROM THE CONTRACTORS LI� � Garage/Carport �j�j d� O I •. W CENSEUWFORTHEFOLLOWINGRF�150N(SEC.7o31.58U51NES5ANOPHOFE5510N5CADE:ANVCITYOR U COUNT'(WHICHqEWIRESAVERMiTTOCONSTAUCT.ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- W Pa110/DOCk Z TURE.PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPLICAHT FOR SUCH PEHMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO hiE PROVISIpJS OF THE CANTRAC70R5 LI- W � CENSE UW(CHAPTER Y(COMMENCINO WITH SECfION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- u' PooVSpa . FESSIONS OODE)OR THAT HE OR SHE IS EXEMPT7HEREFROM AND THE BASIS FOR THE/�LLEOED EXEMP- TqN.ANYVpUT10NOF5ECTION7o31.6BVANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � A CIVII 7ENALiY OF NOT MORE TVW�FNE HUNDRED DOLURS(t5oo).): � ❑I,ASOYMEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COR1mBfCl81 � VALL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFEiiED FOR SALE(SEC.704�,BUSI- J � NESS AND PROFESSIONS CODE:7HE CONTRACTORS UCENSE UW DOES NOT APPLV TO AN OWNER OF � _ PROPERTV VhlO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WOFiK HIMSELF OR HERSELF OR � hIROUGH HIS OR HER OWN EMPLOYEES,PROVIDEO THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m . , Q ,OFFEAEDFORSALEIF,HOWEVERTNEBUILDINGORIMPHOVEMEN71SSOlDWITHINONEVEAROFCOMPLE- " Z �TION,7HE OWNERAUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BU�ID OR � IMPROVE FOR THE PURPOSE OF SALEj. W �I,tiSOWNEROFTHEPROPEHTY,AMEXQU5IVELYCONTMCTINOWRHLICENSEDCONTRACTORS - (t TO CONSTRUCT THE PR0.IECT(SEC.7oa1,BUSINESS AND PROFESSIONS COUE:7HE CONTRAC70R5 ll- V81U0llOfl ADJ.AREA W CENSE UW OOES NOT APPLY TO AN OWNER OFA PROPERTY NMO BUILDS OR IMPROVES THEREON,AND � WNOCOMMCTSFORSUCHPR0.IECTSWITHACONTMC70R(5)LICENSEDPURSUAHfTOTHECONTRAG pUANTITY DESCRIPTION � FEE Y mas ucEnse uw.�. /\ � O I AM EXEMPT UNDER SEC. B.8 P.0.FOR THIS REASON Q ' �V 3 � Q � -O -'�- DATE OVMER U � �/ti�/ Z w 7/✓/GV � LICENSED CONTRACTORS DECLARATION w d �f' �f�`' �S�! [C I HEREBY AFFIRAI UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d 0(COMMEHCV!(i WITH SECTION 7000)OF DIVISION 7 OF TME BUSINESS AND PROFESSIONS CADE,AND Z ' X W UCENSE IS IN FULL FORC[AND EFFECT. �� ` L1J ` �/ m iL 0 LICENSE CLASS � LIC.N0. . 7 ,�r� /.�� j (�, (, VDATE 4'�/`J�d ' CONTRACTOR /"Lf LTF H'D/h� G d v W � � � WORKERS'COMPENSATION DECLAAATION � S'� ` � I NEHE AFFIRM UNDER PENALTY OF PERIUFY ONE OF THE FOLLOWING DECUMTIONS: Z /� ^ a.' � I HAVE AND WILL MAINTAIN A CEfiTIFICA7E OF CONSEM TO SELF-INSURE FOR WORKERS' 2 O n�� I COAIPENSATION,ASPROVIDEDBYSECTION37000FTHEUBORCODE,FORTHEPERFORMANCE U �� Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � , p-Il f"�,. � p V(/ W ' 1 HAVE AND WILL MAIHfAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION 1 Q 770o OF THE LABON CODE,FOR 7HE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ` ��`'y' �l � �, I `a,3.I 0 ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION 1 P 1 � CARRIER�A'G/F/L' Empt��i TALS . LD . PLAN REVIEW � POLICVNUMBER � 7d�L S�.�D�/I � �R ELECTRIC � �d' Ex P- S D` � 0 (fHSSEcfpNNF�NOTeE�LEfIDOF7HEPEw.TisFOaar+EHU1�DREDDOUaRs(Stoo)OalEss} PLUMBING � Z I CEHTIFV THAT IN 7HE PERFORMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUED,I MECHANICAL , O �` (,'} SHALL NOT EMPLOY ANY PEHSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE W Uj WORKERS'CAMPENSA710N LAWS OF CALIFORNIA,AND AGREE THAT IF 1 SHOULD BECOME INSPECTION FEE ! ^ SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LA80H ISSUANCE "' �, s CODE.I SHALL FORT1iWITH COMPLV WITH THOSE 7ROVISIONS. � SMIP p DATE: f�Q� APPLICANT: �u LT4 H-om E S , s. J WMNINO:FAILURE TO SECUfiE WORKERS'COMPENSA710N COVERAGE IS UNUWFUI,AN�SHALL BE ENERGY P/C � LL SUBJECTANEMPLOVERTOCRIMINALPENALTIESANOCIVILFINESUP700NEMUNDREDTHOUSAND ENERGYPERMIT • DOLLARS(f10o.o00),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION37oBOFiHELABOPCODE,INTEREST,ANDA7TORNEV'SFEES. � RETENTIONFEE: a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THA7 THERE IS A CONSTHUCTION LENDING AGENCY � � FOR THE PERFOfiMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7oe7,CIV C.). . W )/� L 1 ___– � LENDER'S NAME /�D/�L� 'LPL�L.T� rl!/N'/LS ��� F= LENDER'SAODRESS � I CER11fY THAT I HAVE READ 7HIS APPLICATION PND STATE 7HA7 THE ABOVE INFORMA7qN IS CARRECT. TOTAL FE ES •� , � � w I AGREE 70 COMPLV WITH ALL CITY AND CAUN7V ORDINANCES AND STA7E UWS REUTING TO BUILDING � CONSTRUCTION,AND HEREBY AUT/10RI2E REPRESENTATIVES OF THIS CWNTV TO ENTER UPON THE ' ZABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � � �� �1�� J' � PERMI EE NAME(P INn � �/� ' , I Q � 51 RE OF P ITTEE DATE ,� � �1 = RECPT.N0. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—ApplicanYs Copy � ,, ,,,�°��� CITY OF CB��f��1�9� ���i � � � � : ` � � � 19iqS�'�C�'E�DN ��CC�9�� � � . . .. ,� . �. .,� . � p � � ��o�a�.. � ,��,,,F._ � � � �� ��.. �:.�. . ., ��� <�_.� �:,5 � �n. . � �. Q�� ` �� � � , � a � � . <�' , ., „ �� � o-�,� , , �� e � ��.> �._ � s . r ' . . ,.' _ �.= 5ET BACK � � • j� � � � ' � � FLOOR JOIST � FTUS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DU�T — — _ __._..: ..._ GROUND PLUMBING �J`� UNDER FLOOR CUt�!DUIT , i . " ___ SLAB GRADE FIREPLACE�OUNDAl"ION . • � � _____ TEMP POWER FIREPLACE SONQ BEAM • � � _ WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING i�•- ��-�- 8 FC BOND BEAM� � ' FRAMINGNENTIUATION q '� FINAL BONQ BEQM __ � ROOF COVF_R ' PRE-GRADING � ROUGH HEATING BENCHING - ROUGH ELECTRIC ROUGW GRADING � • ROUGN PLUNIBING FINISH GRADING SHOWERTT'UB TEST � ' Q' POOL ELECTRIC _ EXT. V�1THlSIDING POOL FENCING WALL INSULATION POOL FINAL GEII.iNG I�JSlJLATl�N OFF SITE IMPS. ��__._.__.�_-•----__ DRYWAL.L NAILlNG " DEDICATIONS ' SEWER � - -c / FINAL ENG. I SEPTIC TANK LAN�SCAAEIIRRIG. � SEEP PIT/LL. . ON SITE lMPS. ---� ------- -- G�S AIR TES7 ;?^ ( FINAL ZONING F!N,�,L CC�NST. l ' FIRE DEPT. FINAL � FINA[�H�A,TING • HEALTH DEPT. FINAL + - FiNA�ELECTRIC � DEV. FEES FAID l_E=1?��iF�.�PLUFfi81NG ' I � ENERGY. --- — - _._�._. — �-- -----�-- , ►-- o �'.� ��` �:� - � ' ---- COUi(V1EfVTS - - -- �! . _____- -- ---- ; SEPTIC TqNK SIZE � SEEP P�i/U �IZE ___ — _-- — . ----- s `�'� -- --- - �r ,�'+ �b 2 X .1�, fj�t,5,t'� � '� . . . . — vy5��s��:,t��HY��`r S£4'^'�Y�` . —__— . +� R�-, �r ��qy����y'��y( ' e "H� 4ti C `�,�t,�y�''� . :.���� h��,i'�:�'fu�5,� y�y�+.; y� 1 k A'�'r �;Y '� � �� _'—�_'_ � c � , � a6 , , � � a ° • � �y.S'.'':��.{� �.�.'!. yc 1!.__�O • _ .__'.__.."_.__...__ ' ' • ' ".___ .��. r'� .