HomeMy WebLinkAbout18373 �� C1TY OF DIAMOND BAR ��+�
� � DEPARTME?`'T OF COMMUNTCY&bEVELOPMENT SERVICES // /
21825 E.Copley Drive l�
(909)860-3I95 Fax(909)8G1-3117 PRESS
��'���� � BUILDING PERMIT APPLICATION FIRMLY
a ADD ESS� I 11� I�AST L.�. 1tpG� ``� . APP��CATION PERMIT P/C
o DATE •�a NUMBEH1�I _�N
� APN LOT TRACT ISSUE TYPE OCC
DATE CONST. GROUP
p OWNE3— �1. —
o ADDRESS �' C 5 t ZONING SETBACKS
Z CITY Y"otr9 � ZIP R1'1 LS rE�So�s`t3 �6q� FRONT RW ❑
o APPLICANT �a �✓- E TEL. yoo�_� O�'7 REAR ❑
� SIDE/SIDESTREET FiW ❑
� CONTRACTOR_�LL STAQ WE�T�F.'CZ E�F}�T�SLS SIDE ❑
ADDRESS 17 S�G LPkts f�to+� i�•
o ciTv l.aks.�►asNo�e,� Z�p TELr60o'Ja,7 Oq� PROPOSED USE
w ARCH/ENG/ 3�
z OESIGNER �
w NO.OWEL. NO. NO.
a ADORESS
� CITY ZIP TEL. UNITS STORIES BEDROOMS
cn
cn DESCRIPTION SQ.FT. FACTOF PSF ADJ.AREANALUATION
� I OV'MER-BUILDER DECIARAT10N SFR/ADD/REM
O
I HEREBY AFFlRIA UN�ER VENALTV OF VEiWRY TXAT 1 MA E%EMPT FRO�A TME CON?MCTORS LI. G2f0fl9lC8fPOfI
W CENSEUWFORTHEfOLLOWINGREASON(SEC.7a71.58U51NE55ANDp40fE55WNSCOOE:ANvdTYOR (f)
U ppl7a7YV,T7ICHqEWIRESAPERMITTOCONSTRUCT,ALTE0.1MOROVE.DEMOLISn,OpREPAIRANYSTRUG W P2IIO/DOCk
. w TURE,VRqR TO ITS ISSUANCE,AL50 REOUIRES TME AVVUCJWT FOR SUp1 iERMIT TO FllE�SiGNED W
57ATEMENT T11AT HE OR SME IS LICENSED PURSUArR TO TNE VROlnSIONS OF TNE CONTfUCTORS tl•
� CENSE UW(QNPTER Y(L�DIAMENCING W�TM SEG�ION 70W)OF DIVISION 7 C�F THE BUSiNE55 AN�PRO- u" PooVSpa
iE5510N5C00E)ORTNATMEORSHEISE%EMPTiHEREfRqAANDTHEBAS15FORiHEQlEOEDE%EM?• C7
� TION.ANYVqlAT10NOFSECT10N7071.5BYANYAPPL�CANi FORIIPERMITSU9JEC15iH'eAPPLILANITO Z qe-Roal •
ACML CENALTY OF NOT MORE TMAN FNE HUNDRED DOlUFS(S5o0�): �
p OI���EROFTMEPROPERTY,ORMVEA1PlOVEESWITHWACE5A57HEiRSOLFC0IAPENSATAN, 0 Cammercial
Z WILL DO TtE WORN,AND THE STRUCTURE IS NOT INiENDCD OH OFFEREO FOR SALE(SEC.7011.BU51• J
� NESS ANO GROFESSIpN5l,U0E:THE GONTMLTORS UCENSE UW DOES NO'AVPLY TO AN OWNER OF �
PROFERTY Mn10 BU0.D5 OR IMOROVES THEREON,AND Nn10 OOES SUCN WORK MIMSEIF OR 11EHSELf OR
CL TMROUGHHISORMEROWNFMPLOVEES,PROVIOEDTHAT3UCHMPflOYEMENTSARENOTMTENDEOOR m
0 OFFEREDFORS�IEIF,IqWEVERiNEBUILDINGORMPROVEMENTISSOIDWITHINONEYEAqOFCOMVLE•
Z TION.THE OWNER-BUIIDEH WILL MAVE TME BURDEN OF VROVWG'HAT NE OR SME 0�0 NOT BUIID OR
= IMPROVE FORTHE PURPOSEOF SALE�
W 04ASOWNEROFTNEVRODERTY,AME%CLUSNELYCONTRACTNCWiTNUCENSEDCONTRAC70R5
� TO CANSTRUC'T 1Mf PHOJECT�SEC.701�,BUSINESS AND PROFESSIONS CODE:TME COHfRACTORS U- V31U3tiOf1 � ADJ.AREA �
W CENSEUWDOESNOTAPPLYTOANOVrtJEROFAPROOERTYYMOdUn.D50RIMPR'�VESTNEHEON,AND
� WHOCONTMCTSfOHSUCHPROJECTSWiTHACONTMCTOR(S�L�CEhSEDPUFSUMITTOTHEGONTMG QUANTITY DESCRIPTION FEE
Y TORS LICENSE UW). �
� O I AM EXEMPT UNDER SEC. B.1 i.C.iOq THIS NEASON U
�
LL �
DATE OWNER U
Z W
QLICENSED CONTRACTORS DECLARATION w
Q IMEREBYAFFIRMUNDERiE1U1TYOFPEfWRYIMATUMIICENSEDUNDERVROViSIONSOiCHAVTER � A £ t
� Y�COMMENCWQ WItM SECipN 70001 OF DNISIDN]OF THE BUSINESS AND DFOFESS�ONS CO�E.AND Z �1 l..
X 11Y IICENSE IS IN FUII FORCE AN�EFFECL � m
LL
� UCENSE CU155 � G �IC.NO. b J
V DATE� � CONTRACTOR � « 1 a
o� WORKERS'COMPENSATION DECLARATION�/�,CQ .�
¢
� IHERE8VIIFFIR4UNOERFENAITYOfFERIURVONEOFTNEFOLLON"NCDECLAMTIONS: Z
� �INAVEANDWILLMNNTAINACERTIiICATEOGCpJSENTTOSElFANSUHEFORM�OHKGRS' _
COMPENSA7qN.ASVROV10EDBVSECTI0N77000FTHELA80RC00E.FOHTHEPERFORIAANCE `U
OF TME WORN fOR WMId1 THIS VENAIT iS ISSUED. �
� I
W ,�1 HAVE AND WiLL MAiNTAIN WOFlNERS'COMPENSATION INSURANCE.AS REOUIRED BY SECTION
Q �70a OF THE LABOH CADE,FOR THE PERFORAIANCE OF THE WORK FOR W111CM THIS PERMIT IS
LSSUED.WV.'OqKERS'COMPENSATiONINSURANCEGRHIERANDiOLICYNUMBEHARE: CONSTRUCTION
� �,RaEA_ S7-ArE Fv�✓o PLAN REVIEI"J
Z voucrauueEA ' I� ELECTRIC
¢
� (I)i$$ECIICNNEmN0T8EWAYLEfmOFhEPERMTbWRONEHI�ORED�ULIRSR�0�10RLE55� PLUMBING
Z 1tERTiFVTHATMTNEPERFORMANCEOFTNEWORI(FORWHiCHTMS7ENIJITiSISSUED,I MECHANICAL
(} SHALL NOT EIAPLOV ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO7HE
� WORKERS'COMPENSATIONLAWSOFG41fORNIA,11N0AGREETIUTIFISHOULDBECOME INS?ECTIONFEE
S SUBJECTTO THE M/ORKERS'COAIPENSATION PROVI ONS OF SECTqN 7�ao Oi iHE OR
cooE.�sw�voArHvmH ca+v�r wm�tnose ovisia+ � ISSUANCE .
� SMIP
p DATE: APPUCANT:
J WARNING:FA4URETOSECUREWORKERS'COMVENSATqNtOVER EISUNUWFUL.AN�SHAILBE ENERGYP/C
� SU&IECfANEMPLOYEflTOCRIMNUIPENALTIESAN�GIVRFINE5UP700NEHUNDREDT/10U5AN0 ENERGYPERMIT
DOIURS(f 100.000�.W�DOITION TO THE COST OF COMVENSA7qN,O/JA�GES IS VROVIDED FOR IN
¢ SECTION�70lOFTT1EUBOROODE.WTEREST,ANDATTOPNEYSFEES. qETENTIONFEE:
a I CONSTRUCTION LENDING AGENCY PRE•ALT FEE: '
O '
� INEREBVAFFt{iMUNDERPENALTVOFPEFJURYTHATTMENEI5AWN5TRUCTIONLENDINGAGENCY
a- FOR 1HE GERFORMANCE OF THE WOAK fOR WHICN THIS PEFMtT IS ISSUED(SEC.7oG7,CIV.C.�.
W
� LENDER'S NAME I�
� I
LENDERSADDNESS
� ICERTIFYTHATINAVEREADTMISAPPIICATIONANDSTATETHATTHEABOYEINFORM�TprvISWRRECi TOTAL FEES �
W IAGREEtOCOA/VLVWITHALLCRVANDCOUNTYORDINANCESANOSTATEUY/SRELATWGTOBUtLOING �
� CONSTRUCTION.AKDHEREBYAUTMOR2EREPRESENTATIVESOFTHISCOUNTYTOFNTERUPONTNE
ZABOVE�4ENTqNEDDROPERTYFORINSVECTIONVURPO5E5. COMMENTS
� � 1 f'/
� �-�/P�y'��f/ �!f�
m PERMITfEENMAE � �
Q �
N
� Sic r VE . EE i� �
� RECPT.NO. . _PAID BY VALIDATION
! WHITE—Department Gopy,YEU.OW—Fnance Copy,PINK—Assessor Copy,GOLOENROD—FileCopy,GREEN—AppliwnYsCopy
CiT�P ��= DI�'�,ftrJt�ti� �3r4R
• ltt�r��TECaP� �?�GO�D
.�.,,.�.__.._..._., ,..�..
� t� �,
a(�E.�;.�����`a,���t,,,,F ;,e�;,��;.. �,1�►�`�.��e�,,�e�i'¢`��.,.�.....'!,►}'�r1�F::.�1'.���^�� � ;�.�. �._-�ar•�'.��`..��3. �`�;� !
SET BACK _�..._�. .:� -...__. .._.i._... .._�._.._ _� ;�iWFLCOR JOIST 4�---�- �� _ . ._ ..... _ _.._....... ..
—=—�—
FTGS/FORMSISTEEL �___ _ � FHA REQ"�-1TS
ELECTRIC GROUND ( � UND�R FLOOR DUCT � I
GR�UND PLUh1BING i � Uh1�7E:R FLOOR CUP�!DU1T. � �
_ T _'_
SLAB GRADE i �~ i !_FIHFPLF,CE'FOUNDATIO�d I I
TEP�1p POWER i ___, I FIREPLAC�BOPdD BEAM �
WATER SERVICE t PAID HL E30N� E3E�t�.� " �
�–.__ --- –
ROOF SHEATHIfdG � � � ~ E3 FT. 60 JD;BEq"�t
----- ----�----
FRAMING,NENTILIATIOP�I � FIPJAL E30ND BEAh,'
ROOF COVER I i PRE-G�iADING !
ROUGH HEATWG � � BENCHIPJG I
ROUGH ELECTRIC � ROUGH GR.ADIN; _ __�
ROUGH PLUMBING I ; FINISH GRAOING
SHOWER�'TUB 7EST ( i { POO�ELECTRIC
. . � ' ._"" . ___�_—_." '__._.__._._�•_�—�_T _:-::�:�'_ ___ �— _
EXT. LATH/SIDING i POOL FENCI��dG
WALL INSULATION ^ �—� ; PaOi FIfdAL
CEILING INSULATION �� (�FF SITE IR4PS.
DRYWALL NAILING DEDICATIONS
SEWER FIPJAL ENG. �
SEF-�IC TANK � LAPJDSCAPE/IRRIG. j
SEEP PIT/LL CN SITE Ih-1PS.
GAS AIR TEST � �, FI�JAL ZO�dIh1G
FINAL COPJST. � ; � FIRE DEPT. FIPdAL
�----
FINAL HEATING ! � HEALTFI DEr7. FIfJAL
FiNAL ELECTRIC I i � DEV. FEES PAID
� � -- , . --i�' ENERGY ---
FIttiA,L PLUh1BING � ; �,�r- i., .�-- - -- — --
G/.Il�.L _�i�'�(/C'ti ��f' c i �� G � .
t �,Ff"��'fl�C..� .._...�....
�.�'a,..1.-,.a.r i..
CU�ti�IMENTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE — '-- --
__._.____._'w�,._.__....._._.i -- - .
_ � � - --- -
, } i 'I
,r�r� :'''�, --- -- -
�� I
��
._��..����.-��� -� - � .