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HomeMy WebLinkAbout17930 (19) �` CITY OF DIAMOND BAR �� DEPARTI�IENT OF COIvIIv1UNITY&DEVELOPMENT SERVICES � ��y 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 � Pf�Es$ �`� BUILDINGPERMITAPPLICATION F RMLY o� JOBSITE �LL?JSI r APPLICATION �'1 � PERMIT � P/C ADDRESS � ���t- G '� • DATE �� NUMBER 0 � APN LOT TRACT �SSUE Rt� TYPE OCC a OWNER L L�hT,/h�G/n� DA7E V �CONST. GROUP o ADDRESS �'" ZONING SEiBACKS z CITY �• •ZIP_L/ EL. FRONT Ryy ❑ g APPLICANT TEL. REAR p � SIDE/SIDE STREET RW D � CONTRACTOR � - SIDE ❑ � ADDRESS — t<�/T r _ � • o CITY ali./�L/� ZIP n S=TEL. / PROPOSED USE o ARCH/ENG/ � DESIGNER NO.DWEL NO. NO. = C'DnDrRESS ZIP TEL. UNITS STORIES BEDROOMS � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLAHATION SFWADD/REM O 1 MEREBY AFFIRM UNDER VENALTY OF PEMIRY 7HA7 I AM EXEMPT iROM iHE CONLHACTORS L�• Gaf8Q0IC8ry0R W CENSELAWFOqiHEFOLLOWINOREA50N(SEC.70.71.SBUSINESSANDPROFESSIONSWOE:�NYCITYOR (n U COUNTYWHICNREOUHESAPERMITTOCONSiRUCT,ALTEflIM7ROVE.DEMOUSH,ORREPAIqANYSTRVG W pati0/DeCk � TURE.PRIOH TO RS ISSUANCE.P150 RE�UIRES THE APPUCANT FOR SUCH PEPMIT TO FILE A SIGNED W STATEAIEM THAT HE OR SNE IS LICENSE�PURSUANT TO 7HE PROVISIONS OF TME CONTMCTORS LI• � CENSE UW(UTAPTER Y(CAMAIENCINO VJITM SECTIDN 7000)OF OIVISION f OF TNE BUSINESS AND VR0. � POOUSpB . '� FESSIONSCOOE�ORTHATNEORSHEISE%EA/PTTNEREFROIAANOTMEBASISFORTXEALLECEDEXEMP- (� V TON.AN'/VKKATIONOFSECTKKJ7W1.6BYAN1'APPLICANTFORAPERMITSUBJECTSTHEA�PUCANTTO Z Re-Roo1 ACMLPENALTY OF NOT MORE iHAN FIVE HUNORED DOLURS(f5oo).�: � OI.ASOWNEROFTHEPROPERTY,ORAIYEMPLOYEESwIiMWAGE5A5iHEIRSOLECOMPENS�TqN, � COf11T0fCI31 � Z WILL DO iME WORKµ�THE STRUCTURE S NOT INTENDED OR OFFERED FOR SPLE(SEG TON.BU51• J N NESS AND PROFESSiONS CODE:THE CONTMCTORS LICENSE LAW DOES NOT MPLY TO AN OWNER OF = PROPERTY NTIO BUILDS OR IMPROVES TMEFEON,AND WT10 DOES SUCN WORN HIMSELF Ofl MERSELF OR [L T1Fi0UGHHI50RHEROWNEMPLOYEES,GHOVIDEDTHAT5UCH4APROVEMENTSARENOTMENOE00R m OOFFEREDFORSILEtF,F10WEVE0.TMEBULDINGORiIICROVEMENTI55qDWTTH�NONEVEAROFCAMPIE� Z 710N,7HE OWNER�BUtLOER WILL HAVE iHE BUROEN OF FROVIN(i TMA7 HE OR SME DIO NO7 BUILD OR = pAPqOVEFOHTHEPURPoSEOFSALE� �y,� 04�OV1NEROFTHEGROPEHTY.AME%LlUSIVELYLOMRACTINOVYITHLICENSEDCONTMCTORS � 70 CONSTRUCT TME PRQIECT(SEC.701a,BUSINE55 AND PROiE5510N5 COOE:7ME CONTRACTORS U� V8IU8IIOf1 AQI.AREA 111 CENSEUWOOESNOTAPP�YTONiOYMEROF�PROPERTYWHOBUILD50RIMPRpVESTHEREON,AN� 1-� WMOCONTMCTSfORSULHPHOJECT5WI7MACONiPAC70R(5)LICENSEDPURSUANTTOTHECON7fLlG auavnrv DESCRIPTION FEE � TORSIICENSEUW.j. � � � ❑IAM E%EIAPT UNDER SEC. B.l P.C.FOR TNIS PEASON � U ti. � OATE OWNER U Z W � UCENSED CONTRACTORS DECLARATION W 1 HEFE9Y AFFIRM UNDEH PENALTY OF VERNHV THAT 1 M1 LICENSED UNDEF VROVISIONS OF CHAPTEH � Y(COMMENCW6WITMSECfqN7000) MSION70FTHEBUSINESSANDPROFESSIONSCODE.AND Z U � � O �� MY LICENSE IS tlJ FULL F C��E ECT. �^� � � m � UCENSE CLASS LIC.NO. � b j V DATE � CONTRACTOFl �'I_ a W � WORKERS'COMPENSATION DECLARATION a � IHEREBYAFFIRAIUNDENPENALTYOFpE0.NRVONEOFTHEfOLLOWINGDECIAMTIONS: Z � IHAVEANDWILLMAINTAINACERTIFlCATEOFCONSEMTOSELFdNSUREFO1iWORKERS' _ Q WeNd/,A3VROV10EDBV5ECT10N71000FTNElABORCODE,fORTHEVERFORAI.WCE W Q THEWOFKFORWMICHTHISPER/AITISISSUED. � � �IHAVEANDWILLbWMAINWORKERS'COMPENSATIONINSUFiANCE,ASREWIREDBY5ECT10N Q97000FTMELABORCOOE.FORTMEPERFORMANCEOPTMEWORKFORWMICHhI15PERM1715 J ISSUED.MYNqRKERS'GOMPENSA�T[��{,INS�ANCEGRqIEFANDFOLICYNUMBERME: CONSTFUCTION j CARRIER � • � PLAN REVIEW � V0.ICYNUMBER (L(A C_` 7 C� ELECTRIC � (RtlSSECf10HNEmNOTBEC01.GiEfmOFTEPEMtT6FOliONE o ts+ )ar���s} PLUMBING �_ ( Z ICEHTIFYTHATINTHEPERFORMANCEOFTHEWORKiOHWMICH HISPENMI 1 I UED,I MECHANICAL (7 SMALlNOTEMPLOY PERSONNANYMANNERSOAS OBE 1ESU HE (n WORKERS'COMPENS iONUW50FGLLIFORNI� G � OlA ECOME INSPECTIONFEE S SUBJECTT EWO ERS'COMDENSATIONPR F r/ELA80R CODE,1 co NITMCOAIPLVN7MT/105 ovi ' ISSUANCE �J �, O ) p DaiE: `4Mrc�cnNT: SMIP � WMNIN�:FAIURETO ECUREWORNERS'LOMPENSATIONCOVERA EISUNUWFULANOSHALLBE ENERGYP/C � SUBJECTANEIAPLOY TOCRI/AINALPENALTIESANOCMLFMESUPTOqJEHUNDFEDT110U5AND ENERGYPERMIT DOLLARS(f10o,000�,IN�DDITION iOTME fAST OF COMPENSATqN,DAIAACES AS PROViDED FOR IN ¢ SECT10NJ10lOF7HEUBOfiCODE,MTER[ST,ANDATTORN[Y'SiEES. RETENT�ONFEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEREOYA�FIRMUNDERVENALTYOFPEILNRVTNATTNEREISACON5TRl1CT10NLENDINGAGENCY FOR THE OERFORMANCE OF TNE WORK FOR NA1t[]I TNIS FENMIT IS ISSIIED(SEC.]oal,CIV.GJ. Z W � LENDER'S NAME C lENOER'SI�DORESS ¢ I CERTIFY TNAT I HAVE READ TH15�7VLICATION ANO STATE TUT THE ABOVE WFORMATqN I5 CORRECL TOTAL FE ES �/� W IAGREETOCOMttVWITMALLCITYANOCOtINTYOR�INRNCESANOSTATEUWSRELATIN6TOBUILDING �/ � � � CONSTRUCTION,MIDNEREBYAUTIIORRER[VR �NTATN SO THISCOUNNTOENTERUPONTNE ZA80VE�MENTbNED0110PF,y1�'FpRINSPECT v -s. COMMENTS � L o V � � 4 PERMITTEENAME(PW � N CT (n SIGNATURE OF VERMITTE DAT � RECPT.�O. _PAID BY VALIDATION WMITE—Department Copy.YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO ile Copy,GRE N— �licant's Copy -,..,�..,.��..+r�r ��,+,' . '�i`•,..'.a+.i,.��.4.a,�nr,i . ,��tc 4 . 'r, �.n . •.t.--r?n' . ., ..-�r, . _.. ,. t „ . , .-. _. , ' _... .-_. ._ . � ....,�. .- .-�...... .... � •.� ry� ., .. . ' ".. . .. -.. , i ,. . . . . . . . ... .. '��.' . � � � ciT�� o�= oi�tir�;or�a Br�r �t��t�c�:�or� ���o�� �..�..__._.� __._�_._._._ _,... _�__.____.,_�__,____.� _ ,_____r_ .___�_.. _ . ���E--�,.'a�;r;;�:ic�►'� c� ��i"= 1►`�`al.a_�E ����i I►�k-7Ca—.�i�'tc�y►+a er�4.1"� I►�F-�.���c-�,t!��.� , .._..___.____ _.._..... -----._._.___ _.__.._.------_�__.________ ----.--.. ._____.._._____, ..__._:._ _______ SE7 BACY� --�---._rY�+ - ; FLOOR JOIST � � FTGSIFORMSlSTEEL I FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT � }� � GROUND PLUMBING -C - UNDER FLOOR CUP�IDUIT I j SLAB GRADE FIREPLf10E FOUNDATION � TEMP POWER _ i ___�_ FIREPLACE BOND 6EAM I WATER SERVICE I I � �41D HT. �OND BEAM ROOF SHEATHING a FT. BONDBEAM FRAMINGNENTILIATION I FINAL BON�BEAh4 ROOF COVER I PAE-GR.ADING ROUGH HEATING BENCHI��lG ROUGH ELECTRIC ROUGFi GRADING ROUGH PLUMBING I FINISH GRADING SHOWER�iUB TEST � � POOL ELECTRIC EXT. L.ATH/SIDING � POOL FENCING WALL INSULATIOfJ � ---�rPOOL FINAL CEILING INBULATION I OFF SITE IMPS. DRYWALL NAILING i DEDICATIO;JS SEWER � FINAL ENG. SEPTIC TANK � LANDSCAPE/IRRIG. � SEEP PIT/L.L. _1_ � OfJ SITE IMPS. � GAS AIR TEST FINAL ZONiNG FINAL CONST. � � �IRE DEFT. FItJA'_ FINAL HEATING �_ � HFALTH DEPT_ FINAL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUMBING � � ENERGY � �i"��il.r'�''�'��7'��;'�: _-_._�._-__ I ,..,......_._.._._...___� .. ......�___�_,_...�.i COMMENTS __ _ __ �r �z �o't�� .�=-- ,��� o z �%.-.�� r./,r i-�.�,p��,�r�c. v�� / SEPTIC TANK SIZE SEEP PIT/U SIZE I��� �� ���� �-� _ ; i i � ; � i � -----_�._., ._'___..._. __.___.____.�