HomeMy WebLinkAbout17698 �� CITY OF DIAMOND BAR
DEPARTMENT OP COMMUNTI'Y&DEVELOPIv�NT SERVICES
f �,�y 21825 E.Copley Drive
(909)860•3195 Faz(909)861-3117 PRESS
����� BUILDINGPERMITAP'PLICATION FIRMLY
o� JOBSITE ��O'Z �A-�f� � � APPLICATION �����PERMIT �� P/C
ADDRESS ����� DATE NUMBER p
� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER D
� ADD SS TZ� ZONING SEfBACKS
gCITY ZIP TEL. �) � REAR RW p �
APPLICANT TEL. SIDE/SIDESTREET RW O
� CONTRACTOR � SIDE ❑
ADDRESS
� CITY ZIP TEL PROPOSED USE �
P+�� ARCHIENG/ —
DESIGNER
Lzii NO.DWEL. � NO. I NO. �
a ADDRESS
� CITY 21P TEL. UNITS STORIES � BEDflOOMS
cn
cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNER-BUILDEH DECLARATION SFR/ADD/REM
O
p I HEREBY AFFlP/.l UNDEq PENAITY OF PERRIHV THAT 1 AM E%EAIPT LHOM THE CONTMCTORS L4 Garape/Carport
W CENSEUWFOR7MEFOLlON7NONEA50N(SEC.7W7.68USINESSANDPROiE55iONSCOOE:ANYpTYOR (n
U �7yNMICHqEOU�RESADERMITTCICONSTRUCT,ALTEf11MPROVE,DEMOL15H2ORREPNRANYS7RUG W Patio/Deck
� TURE,VRIOR TO RS ISSUANCE,ALSO REOUIRES TFIE APVLICANT FON SUp1 PERMIT TO illE A SIGNEO �
STATEMENT 7NAT HE OR SHE LS LICENSEO WRSU�INT TO TME PROV4StONS OF TNE CDNTqACTORS 11•
� CENSE UW(CFUPTER Y(COMMENCMa WITH SECTION 7000)OF DMSqN J OF 7HE BU41NE39 ANO PRO- LL PooVSpa
� iESSIONSLOO�ORTHATHEOR5HEI5EXEMPT7)IEREFROYIWDTHEBASISFORTHEALLEGEDEMEYP. (ry
TION.ANYVIOLATIONOfSECTION7Wt.5BYANYACPLICANTFORAPEAMITSU&1EC73TNEAVPLICANTTO Z Re-Roaf
A CML VEN/LTY OF!qT MORE i/Wi FIVE HUNDRED O011AR51f50o1J:
� OI.I�SOWNEROFTHEPROPEFTKORMVEMMOYEESWITHWA6ESASTHEIRSOLECOMPENSATION, 0 (,`pmmBfCIAI ��
Z WILL DO TME WORK,AND THE STNUCTURE B NOT IHTENDEO OR OFFERED FOR SALE 15EC.70u.BU56 J
� MESSAN�PROFESSIpJ4 CODE:T11E COMRACTORS UCENSE UW OOES NOTAPPLY TO AN OWNER Of ?
PiIOPER7Y WIIO BUILDS OR IMPpOVES THEREON,AND WMO DOES SUpI WORK HIMS4i OR XERSELF OR
� THHOUGHHISORHERONNEMPLOVEES,PROVIDEDTNATSUCNtlAOROVFMENTSARENOTINTEN0E00R m
W OFFEREGFORSALEF,NOWEVER'MEBUlDIN60RIMPROVEMENT1550lDWITHINONEYEAROFCOM7lE•
Z TION,T/E OWNER-BUILDEN Wltl.HAVE THE BURDEN OF VROVINa THAi HE OR SHE D�D NOT BURA OR
� IMPfiO'VEFORTHEGURPOSEOFSALE�
W 04�SDWNEHOFTHEPROPEfl7Y.AMEXCLUSIVELYCOMMLTIN�WITHLICENSEDCOMqACTORS
� TO CONSTRUCT TME PROJECT(SEG 7W�,BUSINE55 ANO OROFESSWNS CODE:7HE CONTMCTORS LI- VelU3GOf1 ADJ.AREA
� CENSEUWOOESNOTAPPLYTOMIOYlNEHOFAPROVERTYNRqBUILDSORIMPROVESTMEREON.ANO
WFqCONTMCT5FOR5Up7PROJECTSMAiHACONTMCTOR(S)LICENSEOPURSUANTTO7HECONTMP OUANTITY DESCRIPTION FEE
� TORS UCENSE LAW.�
O
❑IAM E%EMPTUNDER SEC. .t P.C.FORTHIS REASON Q
� /_ 'f _ U .
U. �
DATE OWNER b U .
a �
4� UCENSED CONTRACTORS DECLARATION W
[� I HEREBVAFFIAM IA�DER VENA�TV OF CERlURv TUT IAM LICEN5E0 UNDER PROVISqNS O�CHAPTER �
p� Y�COMMENCWOWITHSECTION70oo)OFDIVISqN]OFTMEBUSINESSANDPROFESSIONSCOOE.AVD Z
`L AIY IICENSE i5 Nl FlJLL iORCE AND EFFECT. m
� UCENSE CUSS UC.NO. j
V DATE COMMCTOR � - d
W
� WORKERS'COMPENSATION�ECU1pATION —i
¢
� IHEREBYAFFIRMUNDEIiPENALTYOFiERRlRYONEOFTMEFOLLO'MN6DEGlARAT10N5: Z
� _IIMVEANOWILLMAIN7AMACERiIFICATEOFCONSENTTOSELF-INSUREfOflWORKERS' 2
CdAPEN5ATION.A9PROVIDECBVSECTION]'�ooOiTHEU80iiCO0E,FOHiHEPERFO{WANCE 'U
OF TME WORK FOH WHICH THIS GERMIT IS ISSUED. �
C
_I HAVE AND WILL MAIN7AIN WORNERS'COMPENSATiON INSUIUNCE.AS REOUiqED BY SECTION
Q 9100 OF THE LABOF COOE,FOfi TME PEfliORMANCE OF THE WORK FOR WNIp17M15 FERMR IS ��-�
� ISSVED.MYNqRKERSCOMPfNSATiONINSUiLWCECARqIEN�NDPOLICYMIAIBFRAAE: CONSTRUCTION
�, CARRIER PLAN REVIEW
ZZ0 POLICYNUAIBER ELECTRIC
� (fIISSECIIONNE�NDTBEWl.YLEIEDOFTVEPEAMtSPoR[MEH+�DREDOOLLAiLsR�0010ALF55l PLUMBING
Z ICEHTIFYTMATWTHEPERFORMANCEOFTNEWOPXFORWMiCHTHISVERMITlqI55UE0.� MECHANICAL
(•} SMAILNOTEMPLOYANVFER50NN/WYMMlNERSOA9TOBECOMESU&IECTTOTHE
y WORNERS'fAMPEN5AT10NUW50FCALIFORNIA,ANDAGREETHATIFISNOUIDBEGDIAE INSPECT�ONFEE
5�1WECT TO THE WORKERS CAMVENSATION PFi�S10N50F SECTION]�0o OF THE UBOA
-rj CODE,1 SHAIl FORTMWITH COMPLYN7TM iHOSE PRONSIDNS. ISSUANCE �
� SMIP
p DATE: APPLICANT.
J WARNIN6:FALURETOSECUREVNftKERS'C0IAPENSATIONCOVERAGEISUNUWFV4ANOSHALLBE ENERGYP/C (.�
�y SU&IECTANEMROYEflTOCWMINALPENALTIESAN�GVILFINESUVTOONENUNOREDTNOUS�WD ENERGYPERMIT I .\)�
DOLL�RS�f Iao,Ooo),IN ADOITION TO THE COSi OF 001�1PENS�TION,D�GES AS DROYIOEO FOR IN
aSECTpN 77oe OF THE LABOH OOOE.OVTEREST,MIDATTORNEY'3 FEES. RETENTION FEE:
pW. CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� INEREBVA�FINAIUNOERPENALTVOFPE0.1URViMATTNEREISACONSTHUCTIONIFNOWOAGENCY '
FOR THE FERFORMANCE OF TYIE WORN FOR WMldl THIS VERMIT IS ISSUED(SE0.]OY7,CIV.C.�.
�
� LENOERS NMIE �
F-- LENOERSADDRESS
� ICERTIFYTHATIIUVEREPDTHISMVLICATIDNANOSTATEiHATTHEA80VE1NFORMATpNISCpqRECT. T�TAL FEES //�J�\
W IAQREETOCOMPLYN7THr1�CfTYANDCWNTYORDINANCESANOSTATEUWSREUTNOTOBUqDINO � �/�.J
� CONSTRUCTION,ANDHEREBYAUTHOHIZEREPRESEMATIVESOFTMISCOUNTYTOENTERUPONTNE
Z ABOVE�MEMIDNED PROOERTV FOR INSVECTION PUR705E5.
COMMENTS
�
J
�
m PEIU11TfEE �� I"�` �
N G � f
N 61GNATUFEOFPERMITTEE OATE
� RECPT.N0. PPJD BY ' VALIDATION
WHITE—Department Capy,YELLOW—Finenee Copy,PINK—Assassor Copy,GOLDENROO--File Copy,GFEEN—Applicant's Copy
�. ,.._:, �;�;,.,-,.�,:. .�.... _ . . .
. � 'T'!. .:�C��+:J"'r-,.::1.°.�.."'>n�...,yJ ni...�nv�.:.�..-...�...._ .-e--••---�.n. . -.. v ...v.. . � ,. .. . .
. . i AjOlv'�4JtC�^�;+p••.J+..,-r�rrv`Ml��crv,.,--n-....��. ,��i_•�.,.,,.:..-.. ... ."y.�•a,,,. -.,,,-
CITY OF DIAMOND BAR ,
It�Sf�cC a lf.�N RECO�� ~ ��
.'iI� ��p,C�►�.�. .,.'..LL�����i��_.Y.:,�.1►����i�c:��ar� �.�����e�Io���� .. o�;,���. �� � o`=�
-�--� .--. _ ......��_ - � �`�•��
SET BACK ' ' ' � t � FLOOR JOIST• �-' � � . -
FTGS/FORMSISTEEL FHA REaMTS
ELECTRIC GROUND • UNDER FLDOR DUCT �
GROUND PLUMBING UNDER.F.LOOR CUf�IDUiT I
SLAB GRADE I FIREPLACE FOUNDATIOPd
TEMP POWER I � FIREPLACE BOPJD BEAM
WATER SERVICE � I MID HT. BOND BEAM I I
RQOF SHEATHING ` �Z��� I 8 FT.BOND BEAM I �
FRAMINGNENTILIATION( �' FINAL BOND BEAM
ROOF COVER . I��p��I PRE-GRADING �
ROUGH HEATING BENCHING (
FiOUGH ELECTRIC I ROUGH GRADING I
ROUGH PLUMBING � FINISH GRADING
SHOWERRUB TEST � ' POOL ELECTRIC
EXT.LATH/SIDING ( 'i , POOL FENCING ;
WALL INSULATION � POOL FINAL
CEILING INSULATION i OFF SITE IMPS.
DRYWALL NAILING j � DEDICATIONS
SEWER ; FINAL ENG.
SEPTIC7ANK J I LANDSCAPEIIFIRIG.
SEEP P!T/LL. ' OPJ SITE IMPS.
GAS AIR TEST � ' I FINAL ZONING �
FINAL CONST. � � ' F!RE DEPT.FINAL �
FINAL HEATING � I ; HEALTH DEPT. FINAL . � �
FINAL ELECTRIC � � DEV. FEES PAID
FINAL PLUMBING i I ENERGY �
' � �
_ . . . _ __ .. � _ .. � . ._._v-._ � .'A�'C�k6'Yt � . .. . �
- - .l, ..� e c:e•: �.. _
COMMENTS
SEPTIC TANK SIZE
SEEP PI7/U SIZE
���:i
_ ;
_ . ._ _ _ �
�;
1 �
;����� . _ „��
'."ai
-- i
_ _ ��
_ : .:, �__ _
3 . 4� _ iJ � i , � � - .
�� ��� , , �'i