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HomeMy WebLinkAbout16160 � CITY OF DTAMOND BAR � DBPARTMENT QF COMMUNITY&D$VELOPMENT SEItVICES ,; > 216bo E.Copley Ihivc 5uice ig0 PRESS � {9Q9)86Q3195 Fax(909)861-3117 FIRMLY �����w BUILDING PERMIT APPLICATIDN ���`��� � �� � JOB5ITE ) „'Z/^� ��e�� ,\`� \ a�� APPUCATION �_1 .\ { pERMIT � ''� PIC ) � � ADDRESS���l�JL! V '� DATE l NUMBER � � N �� ' �V lo `1 D —� lSSU� TYPE OCC � RPhi oT TRaCT DATE CONS7. GRQUP p OWNER ADDRESS U Vl .1`� ZdNING SETBACKS � CITY �_�� ZIP E . FRONT flW p APPLICAN7 TEI. REAa p � - S1DE/SIDE STA�ET AW p CONTRACTO � �'U`�� SIO� Q Q ADDRESS , pROPOSED USE Q CITY ZIP TEI� (J w ARCH/ G/ ��� � � z DESIGNER � NO.G1WEL. NO. � ADDRESS UNIT$ NO. N C�.N Z� STORIES BEDqOOMS y D�SCRIpTiON SQ.FT: FACTOR PSF ADJ,AREAN LUATtON O qWNER-BUILAEp DECLARATIDN S�q/ADO/qEµ �• r� ! 1 NER�Y AFFWM UNUEH>EtULTY qF PEfUUqV Tf1At t NA EXEMPT FFpµTHE COMTftAC70R3 LI• � �rege�Carport 1 l. � � � � CQJSElAWiORT!{EWL�[NVINGREA.90H(SEG7031,68U5p�ESSANDPROF¢$SqNSCppCs-ANVCtTYOR COUHT7WHICHREWINESAPERMfTTOO�NS7HLICT.KTERWPROVE.DEMO�ISH.ORH�pA1RANySiRUF W Pa�ip(�6C1( TURE,Ppqp i0 ITS ISSUANCE,11LSb REOUiRE4 TiIE APPUCMI7 FOp SIKY/PERMIT YO RL£A SICNED w � STATEAIEM THAT N£OR SME IS IJCEN9 W PURSilAr1T TO THE PlWVISION9 OF TkE CAHiMC7ppS U• CENSE4AW(CNAPTENY(COA�A�ENCWfiN11TH5ECTY7N700o)L7FDMSIDN74F7HE&1SINESSANDPRO. � POOVSpa FE5310h5CO�E30RTFNTHE�iSNE�SE%EMP'/THEREFRq�lAt7DTl1EBASIbFOR7HEALLEOEDEXEMP. (!] TIf1N.ANYNIXATpNOF$F:CT�4N709158YANVA�PLICAHYFORAPERM�TSUBJECISTNEAVPLICANiTO z Re-Roof � ACMLPEWLL7YOFNOTM7ftETHANR(VEMUNDHEDDOLUR5lfEW�,j, � �I,ASOMMMEA�F7NF PHQVEH'fY,OAMYEA1Pl0�'FE9V(ITHWAGESASh1EIN50LFCOMPENSATION, � �mmarclal ri1LL�O iNE WOH7(,AND 7'NE STflUCTURE�S HOT INTFWDE�di OFFENED FOR 51LLE�SEC.YOM.BUS�. _1 NE55 AND ViqFE5510N.4 WO£:THE COHTMCTORS LICEN6E LAW OOES N4T APPLV TO AN OWNER OR � PROPEq7YMlp&JRDSpHIMPA0YE37HEREOq.ANDWHnppE55UCHWOp1(HIMSELFORHERSELFOR � � � 7N7i0UpN/p8 pp NEq ONM 6AIVLOYEES,PiqYlOEQ TIAT SUCM MIPqOVEMENTS ARE NOT INTEN�ED Oq � � w OFFERHDFORSALEIF,HOMk�'ERTMEBIHLDWGOA►APPOVEMBtT1s$OIDWITHINONEYFi1RQFCaMRE i� � TpN.THE ONMERBIIhAER�NRIIUVE TNE BURD4!OF GROVMG 7HA7 HE OR SHE DID NOT BUIID OR � � 4APHOVEFORiNEPURPO5EOF5,�LE} , �4 N'��0.0F ME VFqPEiYfY.W E%ClU:NELY CON7PACTWp VATµUCENSFO CON:RAC70R$ � YO CONSTHUCTTHE PHq1ECT(SEG,iON,BUSINEBS/WD PROFESSIONS OOOE•THE CONTMC7ofl5 L6 VgIU8U0f1 �AbJ.AREq W CFNSEUWDOESNOTAPI'LYTONJOWNEROFAPpOPERY'/NRIOBUNDSOqI�.IPROVESTHEftEON.AIq � WF�DWHfNAC75FOR5�II;HPRQIEG�5YY�1TIAWNTRACTOR�3)LICENSED%JRSWWTTOTHEfnNTRAC_ qUAN71TY DESCRIPYION ta�s uca+s�uw.�. FEE � ❑1��EMPT UNOIiR S�C 8,6 P.C.FOR TryIS RKl�50N Q � � -- — U � - Q DA76 OwNER_ F- O _ _ � � _) F IJCEN5ED CON7RACTORS DECLARATION W �� � I HEilEBY RfFl1W UNDEp pENA�,TY OF PElVURY THA7IFG�,tCENSED�NpER PROYISK�f79 0F�11AFTEA `' NS p� i(fX�AMENCIipWfSHSE�TIONT000)OFOMSION3OFTFIEBUSINE35ANDPROFESSIpNSCbDE,AND z � L��� +X W LICENSE i5 9J FULL HpRCE FND EFFECT. m � u�E�E�u55�. a ��.No. S 17 5 9 3 � WDATE 9!3,I�� _CONTRACTOR pi�I�P Hnmas a � � 1yORKERS'COMPENSATION DECIARATION -� n f �' G t � tNE vnFF7RMtlNOERVENALIYOFPCRNtriONEOF7MEFOlLOYnNGDECUMTbH3: z L/ � � � IXAHEANpWI1.�rMINYhM1ACEkfIFICATEt7FGON5ENTTb$ElFlNSUHEFORyVOflNEq,S' _ "'( � /'�� Q ODMhENSA7pN,A5 PpOvroED BY SECTYJN awo OF THE UgOFi COpE,FOR TF1E PERFONAu�4E U � Q �OFiHEWOANF(1PN�MCHTf1157ERY1TI5155UED. � � W ' �� }� �MAVEANOV'�LLANINTMNWDRICERS'ODMP£N50.TIONtNSUyWpE,A5NE0UliiEOBYSEGIWN / � Q 31000FTNEUBORCOOE.FONTMEPERFDPMANCEOFiHfiWOiiKFOqWHIGNT{HSOEFMARIS � ��e� 1 � ISSUED.MYriQF�KEH$'CO:IPEN$�TION WSU'31�NCEGRRIEftNNPOI.iGYNUM9ERAFiE' CONSTF{UCT�ON I���i �� � �_ �,�j � �aERi P�cific Emnlevee IIIS. C�_ PLANFEYIEW � ���EF. WL�2C 4 0'1 87A �LEGTRIC • � II}6SECIlONNE�NOT8E00MRETEDCFhEPEfMf6FONONEMl�f1EDWUAFi51S7�diLESS} PLUMBING { � l ^ � ,Z, ICEqTIF1'TNATINTMEPERWpM�NCEOFTHEWC]RKFOHWNICH��$PERMIi1515SUE0.� MECHAIVICAL � { � • ! (7 ShV�IL NUT EMPtOY AnV PEXSGi P1 M11'MANNEp SO AS Tp BEGGAE SUBJECT T07HE (%� WORKEP5G04PFNSAippHUW50GCILIFORN��,AAI�AGREETNATIFI51bULDBECOME INSPECTIONFEE � SUBJECTTOTNEI'NRKEfl3'�MPENSATIptiPRpytSpNSqp$ECTpN37o00FTMElABOA �� ,J` � '.pDE,ISHALLF"OA7M'MTHCOMPCY'NRM7HOSEPflON510N5. ISSUANCE � 5/1/07 Aulte Homes SMIP DAT�: APPI�CANT: ���a � r � _1 1 1_ 1 � WMNINO•FNLI:RETO:iECl/HEWORKERS'GOI.�PENSATIONCOVEMGEISUMAWFULANOSHALLBE ENERGYPIC � SU&1ECiANEMPLOY�Fl10CRIMWALPENALTIESANDGNILFME54PTOQNEHUNOqEDTHOU$ANO ENERGYPERMIT ��f• 2 �„ DOILAfiS(5100,000),INAOD4TIONTOTHEWSTOFCOMPF,MSATqN,DAMAGE5l15PROYl0E0FORIN —- � SEC1pN�70aOFh1E�ABORGQDE,INTEREST.MAATTORNEY'SFpES. RETENTIONFEE: OCON57pUCTION LENDING AGENCY pRE-Al7 FEE; � IHEPE6YIFGIqµUNO{.RPENI�LTYOFPERIURYTHATTMEREISACONSTRUCn�NIENDINGAGENCV � FOR�'FIF 7ERFORMANf:E OF THE WORK FOfl WH¢,H 7H1Y PERMIT�$195UE0(SEC 10p'!,GIV,C). `,' � LEN4EH'SNµ1E SLone [P]dite Home Or�} F'- LENOERSADDRE55_ W ICEqTIFY�I/ATIMAV&READTNISAP7�ICATIONANOSThTElHATTHE�IBOVEINfO�+MATqN160DMiECT. TOTAL FE�S F�� 2 Q �t�D� 4 I AGREE TO COMVLY W�TH ALL CT'ANO COUN7'1 OfiD�N W�ES M�0 SiAT�V(WS qEU77NG TO 6�LLD�NG �•-,,�• � �STRVCTION,ANDHE0.E6YAUTFIOqIZENE7R�SENTqTIVESOFTHISC4UNTYTO�MERUPONTHE �90VE-MENTqNED7flOPERTYF RINSPEGTqMVUfliCISES. 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Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 ON •,---,...4,,..--.0 BUILDING PERMIT APPLICA ESS — JOBSITE (030 CCes-1 0 k-e-„)0(2-, ADDR APPI OT I .4..., OWNER 2 ADDRESS QUI IIILMMiII—_ CITY 1.-af 1., it\-$4-' ZIP* E 11WRI,Frt.S. ' APPLICANT TEL. i CONTRACTO- A VIiNID, ADDRESS ' 11211111111PIaIlAi CITY ZIP . • ARCH/ Gii--1--- lea—k DESIGNE .. FI 110_, ,. . ' ADDRESS lawa-iiiirevaiettmmi ir CITY ZI•441&1:4) -s dr OWNER-BUILDER DECLARATION I HERESY AFFIRM UNDER PENALTY OF PEFUURY THAT I AM EXEMPT FROM THE CONTRACTORS LI. CENSE LAW FORME FOLLOWING REASON (SEC. 733%.5 SUNNESS AND PROFESSIONS coos;ANY CRY oR CoUNTY WHICH REQUIRES A PERIM-TO CONsTRUCT.ALTER,IMPROVE. DEMOLISH.OR REPAIR ANY STRUC- TURE. PRIOR TO ITS ISSUANCE.ALSO REQUIRES THE APPUCANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI. CENSE LAW(CHAPTER 0 (Ccsmercato WITH SECTION Taco)OF DIVISION 3 OF THE BUSINESS AND PRO. CESSIONS CODE)OR THAT HE OP SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP. TION.ANY VIOLAT/ON OF SECTON NM 5 By ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO ACNE PENALTY OF NOT'MDRE THAN WE HUNDRED DOLLARS($,550).): 0 I,As owNER oF D.* PROPERTY,OR my EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044. BUSI, NESS AND PROFESSIONS MA:THE CONTRACTORS UcENsE LAW DOES NOT APPLY TO AN OWNER OF PROpEN/Y WHO BUILDS OR IMPROVES THEREON.AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUISH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF. HOWEVER,THE BUILDING OR WPROvEMENT Is SOLD WITHIN ONE WAR OF MAPLE. MN.THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD DPI IMPROVE FOR THE PURPOSE Of SALE). 0 I.AS MASSER OF THE PROPERTY.AM EXCLUSIVELY CONTRACTING WITH UcENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC.TON, BUSINESS AND PROFESSIONS CODE THE CONTRACTORS u. CENSE LAW DOES NOT APpLY TO AN OWNER OF A PI40PERTy WHO BUILDS OR IMPROVES THEREON.AND WHO CONTRACTS FOR SUcH PROJECTS WITH A CoNTRACTOR(si LICENSED PURSUANT TO THE CONTRAC_ TORS UCENSE LAW.). 0 I AM EXEMPT UNDER SEC B.6 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 0 (COMMENCING WITH SEsTION TOSS)OF DIWSION s OF THE BUSINESS AND PROFESSIONS CODE.AND MY LICENSE IS W FULL FORCE AND EFFECT. LICENSE CLASS A LIC N0. 517593 DATE 9/3/Q1 CONTRACTOR PUIte_HaineS_, WORKERS'COMPENSATION DECLARATION IHERY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: i HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' ' COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE .Of THE WORK CDR WHICH THIS PERMIT IS ISSUED. i HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTlON Ma OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS*COMPENSATOR INsU3ANCE CARRIER AND POLICY NUMBER ARE. GARNER Pacifir, Employee Ins. Co poLicy NumBEF wi_Rr: 4301 1117A • (INESECIONNEEDNDTBECOWPLETEDOCRE PERAT E FOR ONE HUNCREOCOLIARS(SIOD)ORLEs,7). I CERTIFY THAT INNS PERFORMANCE Of THE WORK FOR WHICH THIS PERMIT IS ISSUED. I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER$0 AS TO BECOME SUBJECT TONE WORKERS COMPENSATOR LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME . SUBJECT TO THE WORKERS COMPENSATOR PROVISIONS OF SECTlON 3130 OF THE LABOR CODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: 5/1/O1 APPLICANT: Pu Ite Homes WARNiNG• FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNuIWFuL AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVE FINES Up TO ONE HUNDRED THoUSAND DOLLARS(3100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN , SECTION 3703 OF THE LABOR CODE INTEREST.AND ATTORNEY'S FEES. CONSTRUCTlON LENDING AGENCY i HEREBY AFFIRM URDU%PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC 3057,CIV C). LENDERS NAME None 1 Pulte Home Corp) LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY F R INSPECTION PURPOSES. / PERmITTE NAlA R ) ..... Aff // ! . - ) SIG,,,,.." OF PERM: .• DATE APPLICATION DATE •- L.. •3 PERMIT 61 tit-)P/C rNi_ou NUMBER �-. * \--•1 ISSUE DATE TYPE OCC CONST. GROUP FRONT SEfBACKS ZONING REAR SIDE RW 0 ./ 0 SIDE/SIDE STREET RW 0 0 N0. BROPOSED ,UNITS USE DWEL. N0. N0. STORIES BEDROOMS u) SQ. FT FACTOR PSF tu mermansimorimomplo u- DESCRIPTION Iiffillf411111MAIM 0 mil ADJ.AREAN .WATION z 1 i sqlmoomai Gerage/Carport Patio/Deck Po(/Spa Re-Roof 6 Commercial -1 ---IMIIIIMIIIIIMMIIMIMMINS 5 isrom CO ADIAREA lI . k valuation . le,1/4 QUANTITY DESCRIPTION FEE ...i Milt 0 ec- il . • 4, � (..., a 1111110 1111111011Mt 111111111V 111111107MAIN IIMMIIIIIII. 110 ...Q.(' -.J ...., Lu 0 z Fa m D NV Jaw Ellar' striarat Mt r- mmilirett ..ctimimur - c 0 2 < w m v.,i' t ',3 IirClllllllllllllll.11llll 11161111=mm VAIIMER 1 1 1,va-- CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION PEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION PEE: PRE-ALT FEE: a . nronellilliiimmis.4.410M 11Nammumnimin � '�) '•-)0 -311z:1s)._-• -71-711 i_ a el c. , 'I TOTAL t . t COMMENTS FE IS I inn] RECPT. NO PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy, PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy CIRADINCI t A lY OF DIAMOND BAR INSPECIION RECORD A 0o EI'Jr,T F1C.ND EAM PrINID _ _6'FT 34-)NEJ BEAM irinND BEAM citE.I,JCHiNG {POOL ELECTRIC ;--,.,- L'.1-:,1 .-.^.:.)ii-A.'..- i i POC'..:i_r'ENCNO 4:4 t-1- !.. r...:fr....:-..-_ . --i.: . :-- . L.-- .. - ... ...• ECAlif iNS I r I P tE r- - 41 A-17;j•.?1-7,Ar'."-- "u�,/,ATF.p ! z lOSV-1.2(IA f . . — – —�— -)-1-7•-(A - 1-?.14-: • , - r. • r ,H �-. . .' •• - 0.9�� ���1��� . • :4. :4;- 1'7 A:-4:4"U Sto.c(4-