HomeMy WebLinkAbout12-449 ��F�_ CITY OF DIAMOND BAR : /
� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES v
• ��' 21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection flotline(909)839-7027 � PRESS
;�'°^'. BUILDING PERbQT APPLICATION , FI�MLY
� JOBSITE X • ,1 J q� p� " APPLICATIO PERMIT p/C
o ADDRESS• ����Y �IA S�r''� �-^N' IJ`�trwx� pr� DATE �I b I �2 NUMBER /� � p� �a-�
`r APN LOT� TRACT D TEE / /���� ONST. l.6�C./�� GROUP
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� ADDRESS� ZONING SETBACKS
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a ADDRESS NO.DWEL. NO. NO.
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I��� v� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
�,,•Y O OWNER-BUILDER DECLARATION SFR/ADD/REM
I HEREBY AFFlRM UN�ER PENALTY OF PERIURY THA7 I AM EXEM7T FROM TiE CONTRACTORS LF Garage/Carport
W CENSEUWFORTHEFOILOWINGREA.,W�(SEC.7031.5BUSINESSANDPROFESSIONSCOOE:ANYCITYOR (n
C� COUHTI'WHICHREOUIRESAPERMITTOCONSTRUCT,AL7ER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUG -
w TURE,PRIOR N RS ISSUANCE,ALSO REOUIRES THE APPUCANf FOR SUCH PERMIT TO FILE A SI�NED w Pati DBCk 2t�V
� STATEMENT THAT HE OR SHE IS L�CENSED PURSUANT TO THE PROVISIONS OF THE COMMCTOHS U- �
� CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7Doo)OF DIVISION 3 OF THE BUSINESS AND PRO- POO�Sp9
_ � FESSIONS COOE)OR THATHE OR SHE IS E%EMPTTHEREFFiOM AND THE BASIS FOR THEALLEGED EXEMP• (� .
V TION.ANVVIOUTIONOFSECTION7031.6BYANVAPVLICANTFORAPERMIiSUBJECTSTHEAPPUCANTTO Z Re-Roof
ACML PENALN OF NOT MORE THAN FNE HUNDRED DOLURS(i50D).):
� ❑I,ASOWNEROFTHEVROVERTV,ORMYEMPLOVEESWITHINAGES/�STHEIRSOLECOM7ENSATION, 0 COrtirtIBfC101 -
Z WILL DO THE WORK M1D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70�(BU51- _J �
� NESS ANO�ROFESSIONS CODE:TNE CONTRACTORS UCENSE LAW DOES NOT APVLY 70 AN OVMER OF � �
PROPERTV NT10 BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR i
Q iHROUGH HIS OR HER ONM EMPLOVEES,PROVIDED THA7 SUpi IMPROVEMENTS ARE NO7INTENDED OR m �
� OFFEAmPoRSALEIF,FiOWEVER,iHE8U1LDINOORIMPROVEMENTISSOLOWfTMINONEYEAROFCOMPLE
Z TION,7HE�OWNER�BUIIDER WILL HAVE h1E BURDEN OF PROVING 7HA7 HE OR SHE DID NOT BUIID OR .
� 'IMPROVE FOR THE PURP0.5E OF SALE).
❑1,AS OWNER OF THE PROPERTV,AA1 EXClU51VELY CANTMCTINO WfTH IICENSED CONTRACTORS
Q TO CONS7RUCT THE PR0.IECT(SEG.70//,�BUSINESS AND PROGESSIONS CODE:THE COHTMCTORS LI- VaI11afI011 S��J ADJ.AREA � �
W CENSE UW DOES NO7MVLV TO AN ONMER OFA PROPER7Y WHO BUILDS OR IMPROVES iHEREON,AND -
� WHOCONTRACTSFOASUC}IPR0.1ECfSWITiACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTAAG pUANTITY DESCRIPTION FEE �
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❑I AM E%EA17T UNDER SEC. B.6 P.C.FOR THIS REASON Q
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DATE � OWNER H
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� LICENSED CONTRACTORS DECLARATION w i
� I HEREBYAFFIRM UNDER PENALTV OF 7ERIURY 7HAT I AM LICENSED UNDER PROVISIONS Of CFWPTER � � � � � 'i
p, 9(COMMENCINO WI7H SECTION 7000)Of DIVISION 90f THE BUSINESS AND PROFESSIONS ODDE,AND Z,
� MY LICENSE IS IN fULL FORCE AND EFFECT. m - � - � �
� UCENSE CLAS � LIC.NO. �g��.r � � , I
V DATE Q/�=/� .�� L CONTRACTOR a . .. . I
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� WORKERS'COMPENSATION DECLARATION Q
� I HEREBYAFFIRM UNDER PENALTV Of PERJURV ONE OF THE FOLLAWING DECLARATIONS: . Z �
� _I HAVE�AND WILL MAMTNN A CERTIFICATE OF CONSEM 70 SELF-INSURE FOR WOR!(ERS' _
COMPENSATION,AS PROVIDED BY SECTION 3700 Of THE LABOR ODOE,FOR THE PERPoRMANCE W�
Q OF TiE WORK FOR WHICH THIS PERMIT IS ISSUED. � . � I
� _IHAVEANDWILLM/UMAINWORKERS�COMPENSATIONINSURANCE,ASREWIREDBYSECTION
Q -37000F THE UBOR CODE,FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS VERMIT IS y
� ISSUFA.MY WORKEAS'COMPENSATION INSURANCE CMRIER AND POLICY NUMBER ARE: CONSTRUCTION� .. 1�J\ . �
j CARRIER PLAN REVIEW 1�� • ��I
� POLICV�NUMBER �
Z ELECTRIC �
¢
� (fF1156E(,'f10tJNFIDNOTBEW�P1.ETmOFTNEPERAfftSFOROt�EMA�DRED00UMS(5100)ORL6S} PLUMBING � �
Z I CERTIFY THAT IN THE FERFORMANCE OFTHE V/ORN FOfl WHICH THIS PERMIT IS ISSUE0.1 MECHANICAL�
C'} SMALL NOT EM7LOY ANY 7ERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE
� WORKERS'CAMPENSATION IAWS OF CALIFORNIA,AN�AGREE 7HA71F I SHOULD BECAME INSPECTION FEE �
? SUBJECTTOTHEYIONKERS'�COMPENSATIONPROVISIONSOFSECTION37o00FTHEUBOR - --- - �//
CADE,1 SHAIl FORTHWI7H COMP�Y WITI THOSE PROVISIONS. ISSUANCE �y�
� SMIP .J V
p DATE: APPLICANf:
J WARNINO:FA0.URE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNUWFUL,AND SHAL�BE ENERGY P/C
� SUBJECTAN EMPLOVER TO CHIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDHED THOUSAND ENERGY PERMIT
DOLLARS(i7oo,00D),IN ADDITION 70 THE COST OF CAMPENSATION,DAMAGES/�S PROVIDED FOR IN
¢ SECTION 370!OF THE LABOR CODE,INTEREST,ANDATTORNEYS FEES. ' RETENTION FEE:
oCONSTRUCTION LENDING AGENCY PR�Ej-A�LT/FE'E:
� I HEREBY AFFIRIA UNDERPENALTV OF PERIURY THAT THERE IS A CANSTRUCTION IENDIN6 AGENCY /�/T,�F I'�
FOR THE PERFORMANCE OF THE WORK FOR N?i1Ci7 THIS PERMIT IS ISSUEU(SEC.3097,CIV.CJ. �
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��. LENDERS NAME .
F- IENDER'SADDRESS
� �I CERTIFY 7HAT PHAVE READ THIS MVLICATION AND STA7E THAT THE ABOVE INPORlAATION IS CORHECL TO ITAL F E ES i`\' � ` �Q�
w 1 AGREE TO COMPLY N7TH AlL CITV AND COUNTY ORDINANCES AND STATE UWS REUTING TO BUILDING
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.� CANSTRUCTION,AND HEREBY AUTFIORIZE REPRESENTATNES OF 7HIS COUNTY TO ENTEF UPON THE �
Z ABOVE-MENTIONED PROPER F I SPE TION PURP0.SES. COMMENTS �
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m PERMfTTEE NAME(PRI " �
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Uj SIONANRE OF PERMITTE DA7E
= RECPT..NO. PAID BY VALIDATION
~ WHITE—Department Copy,YELLOW�'u�ence Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Appl(canCs Copy
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SET BACK • • FLOOR JOIST
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FTGS/FOkMS/STEEL � � " fHA REQMTS
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ELECTRIC GROUND UND[R FLOOR DUCT
GROUND PWMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUM1lDATION
TEMP PQVVER €FIREPLACE BOND BEAM
WATER SERVICE MID HT.BOND QEAM
ROOF SHEA�HING '8 FT.BOND BEAM
FRAMING/VENTILATION FINAL BOND BEAM
---- ---- -- ---- —- ------------ -- —----------
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ,ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUBTEST POOL ELECTRIC
EXT.LATH;SIDING �POOL FENCING
WALL INSULATION :POOL FINAL
CEILING INSULATION 'OFF SITE IMPS.
DRYWALL NAILING i DEDICATIONS
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SEWER i FINAL ENG.
SEPTICTANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. 'ON SITE IMPS
GAS AIRTEST FINAL ZONING
FINAL CONST. FIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT.FINAL
FINAL ELECTRIC DEV.FEES PAID
FINAL PLUN181NG 'ENERGY
FINAL PLANING "
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