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HomeMy WebLinkAbout12-672 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 Hotline(909)839-7027 PRESS ."°"', BUILDING PERMIT APPLICATION F�RMLY o� JOBSITE ' ( APPLICATIO PERMIT Z-.��7 �p/C ADDRES DATE � I NUMBE� �� # I � ISSUE TyPE j p�C APN LOT TRACT DATE � ` CONST. I V�'}'L� GROUP p OWNER I o A ESS ZONING SETBACKS Z CI ZIP TE FRONT RW p • � APPLICA T TE REAR p Z SIDE/SIDE STREEf RW ❑ � CON RACTOR SIDE ❑ AD SS � CI ZIP T - PROPOSED USE n o ARCWENG/ �, �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � v� DESCRIPTION 5Q.hT. FACTOR PSF ADJ.AbiEANALUATtON p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFIRM UNDER�PENALTY OF PERNRY THAT t AM EXEMPT fROAI THE CONTMCTORS LI- GefeJO/CBfPOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCOOE:ANYCITYOR � (n � U (bUNTYWHIpiREOUIRESAPERMITTOCON5THUCT,ALTEH,IMPROVE,DEMOUSH,ORREVAIRANYSTRUG � � � w TURE,PRIOR TO RS�ISSUANCE,AL50 REOUIRES THE APPLICANf FOR SUCH PERMIT TO FILE A SIONED �W PatidDeck � STATEMEM THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONSOF THE COMRACTORS LI- � .� . � � CENSE UW(CHAPTER D(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF iHE BUSINESS AND PRO- POOUSp9 Q FESSIONSCOO�OflTHATHEORSHEISE](EMPTTHEREFROMANDTHEBASISFORTHEALLE6EOEXEMP• (� � V TqN.ANYVIOLATIONOFSECT10N7o31.58YANYAPPLICANTFORAPERMITSU&IECTSiHEAPPLICANTTO Z. Re-Rool ACML CENALTY OG NOT MORE THAN FNE HUNDpED DOLURS(5500).�: � Q ❑I,ASONMEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COfI1l118fC181 - Z N7LL DO THE WORK�ND THE STRUCTURE IS NOT IHTENDED OR OFFERED FOR 3ALE(SEC.-7oI4,BUSI- J � � NESS AND FROFESSIONS CODE:THE CANTRACTORS LICENSE UW DOES NOT APPLV 70 AN OWNER OF ? -� - PROPEiRY WFiO BUILDS Ofi IMPROVES THEREON,PND VA10 OOES SUCH WOHK HIMSELF OR HERSELF OR Q THROUGHHISORNEROWNEMVLOVEES,VROVIDEDTHATSUpiIMPROVEMENTSARENO7INTENDEDOR . m � � . Q OFFEREDFORSKEIF,HOWEVERIMEBUILDINGORIMPROVEAIENTISSOIDWfTHINONEYEAROFCOMPLE• Z TION,THE OWNER-BUILDER N1LL HAVE THE BURDEN OF GROVING 7HAT HE OR SHE DID NO7 BUIID OR � IMPROVE FOR THE PURPOSE Oi SALE). � � w ❑I,ASONMEROF7HEPROPERTV,AME%CLUSNELYCANTRACTINOWrtHIICENSEDCONTRACTORS � TO CONSTRUCT THE PRQIECT(SEC.70N,BUSINESS AND PROFESSIONS CODE:7HE COMMCTOflS LI- VaIUHIIDfl ADJ.AREA � W CENSELAWOOESNOTMPLYTOANONMEHOFAPROPERTYWHOBUILDSOHIMPROVESTHEREON,AND � W/iOCONTRACTSiORSUCHPR0.IEGTSWITHACONTRACTOR(5)UCENSEDPURSUANTTOTHECONTMG pU� I DESCRIPTION FEE . � TORS LICENSE UW.). � � ❑1 AM EXEMVT UNDER SE0. .�B.8 P.C.GOR THIS qEASON Q �V � � ?� U � DATE ONMER � � W �,= LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRM UNDER PENALTY OFPERIURY THAT IAMlICENSED UNDER PROVISbNS Of CHAPTER �_ � �'. � 9(COMMENCIMO WITH SECTION 7000)Of DIVISION 30F THE BUSINESS ANO PROFESSIONS CODE,AN� Z, Ii XL� MY LJCENSE IS IN FORCE AND EF EC7. m LLI � UCENSE CLA LIC.NO. �� � � . � V DATE � � . CONTRACTOq I d . W � WORKERS'COMPENSATION DECLARATION ¢ � 1 HEREBV AFFIRM UNDER PENAL7Y OF VERIURY ONE OF THE FOLLOWING DECIARATIONS: Z � . � O _IHAVEANDWILLMAINTAINACERTIFICA7EOFCONSEMTOSELF-INSUREFOHWOW(ERS' _ Q COM7ENSATION,AS PROVIDED BV SECTION 3700 OF 7HE LABOR CODE,FOR THE PERWRMANCE W� Q F/OF THE WOHK FOR Vh11CH 7HIS PERMIT IS ISSUED. � - w —�y}-1 HAVE AND WILL MAIMAIN WORNERS`COMPENSATION INSURANCE;AS REOUIRED BV SECfION � � Q 1 3700 OF THE LABOR COOE,FOR PERFORM CEOF THE WORK FOR WHlpi THIS PERMIT IS, ISSUED.MY RKERS'COMPE 5 INSUR GE C RgjER�AND POLICY NUMBER ARE: CONSTRUCTION� ll j CARRIER V PLAN REVIEW . .. . . 0 POLICV NUMBER Z ELECTRIC Q � (IILLSSECIqNN�NDTBE00APLETmOF r-0aor�Mx�oam oo)oq�ss� �PIUMBING - Z �CERTIFV THAT IN THE PERF CE OF THE WORK FOR WHICH THIS PERMIT IS IS eo,i �MECHANICAL C7 SHALL NOT EMPLOY ANY P ON IN ANY MAtJNER SO AS 70 BECAMEBUBJECT TO E � N WORNER'CAMPENSAT UWS Of CALIFORN11 AND AGREE THAT IF I SHOU� ECAME INSPECTION FEE ? SU&IE TO THE �R RS'COMPENSATION PROVISIONS OP SECTION 3 F THE IABOR � � �.! . / E SNAtL F hl COA/PLY WITH THOSE PROVISIONS. ISSUANCE � � � SMIP p DA A ANL - J WARNINO:FAILURE TO SECURE MIORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,ANDBFiALL BE ENERGY�P/C . � SU&IEC7ANEMPLOVERTOCFIMINALPENALTfESAN�CIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(S10o.o00),IN ADDI710N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 37oe OF 7HE LABOR CODE,INTEREST,AND ATfORNEY'S FEES. � RETENTION FEE: OCONSTRUCTION I.ENDING AGENCY PRE-ALT FEE: � 1 HEREBY AFFIFlM UNDER FENAI.7Y OF PERIURV THA7 THERE IS ACONSTRUCTION LENDINO AGENCY �' FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30W,CIK C.). Z W ��, LENDER'S NAME F— LENDER'SADDRESS � TOTAL FEES �� 7� W flTIFV 7HAT I HAVE READ THIS APPLICATION AND STATE THAThiEABOVE INFORMATION IS CORAECT. � 1 AG E TO COMPLY N7h1 ALL CT'AND CAUNTY ORDINAN ES AND STATE UWS REUTING TO BUILDING � CAN RUCTION,AND HEREBY RIZE REPRESEN T ES OF THIS COUNTY TO EMER UPON THE Z ABO -M MIONED PROPER OR I SPECTION PUR s. COMMENTS " _ • �-� m ERMITTEE N (PRi/ln ' � � �2 �/j ONAAfR OF PERMIfTEE ATE �/ _ _ • RECPT.NO. PAIDBY v VALIDATIO ~ W E—De ement Co YELLOW—Finance Co PINK—Assessor Co GOIDENHOD--File pa pY, py, py, Copy.GREEN—Applicant's CopY CITY OF DI�lMOND BAR INSPECTOON REC(3RD . , N, _ . _ u. . : _ . � ,��� �� _� r „ � � �. � , � 8 � -. r. e ��� �: o Q� =� � o � e , � �r _ � �� � � a 4� 3 ' 'p �y.. ' ` d' " .� y. -� „ , �� u. � . . . r�..�4 2s •' : :..ko : . ,.r ..v a SET BACK ;FLOOR JOIST FTGS/FORMS/STEEL j FHA REQMTS ____ ________ _ ELECTRIC GROUND I UNDER FLOOR DUCT GROUND PLUMBING :;UNDER FLOOR CONQUIT SLAB GRADE I FIREPLACE FOUNDATION TEMP POWER ;FIREPLACE BOND BEAM WATER SERVICE I MID HT.BOND BEAM ROOF SHEATHING �8 FT.BOND BEAM FRAMING/VENTILATION j FINAL BOND BEAM_ ____ _...---------------------- ---------- -. _..----------------- , -------- _._-- --------� _.._.__.-_._._.._ ROOF COVER �PRE-GRADING ----------...---------------__..----------------------...----._._....___...._..---..-...----....._.....- ;.---.........._.......__..............._._._.__...........--------- ...._._...__....._...._.._._.........---__..._...._._.._...._._.___....._......_...---- _._._.-- ROUGH HEATING j BENCHING ROUGH ELECTRIC j ROUGH GRADING ROUGH PLUMBING �FINISH GRADING SHOWER/TUBTEST �POOL ELECTRIC EXT.LATH/SIDING !POOL FENCING WALL INSULATION ;POOL FINAL CEILING INSULATION �OFF SITE IMPS. ORYWALL NAILING DEDICATIONS SEWER �FINAL ENG. - - ------ --- - ---- - - - --------___- 5EPTICTANK LANDSCAPE/IRRIG. _.......__.-.....--------...---- ---------_ _- ...._._..-------------- �--------__ -----.._.__- .._.._. _._.... ___ _.._ _._._____..._ SEEP PIT/LL. �ON SITE IMPS. GAS AIR TEST � !FINAL ZONING FINAL CQNST. j FIRE DEPT.FINAL FINAL HEATING ;HEALTH DEPT.FINAL FINAL ELECTRIC �DEV.FEES PAID FINAL PLUMBING ;ENERGY � FINAL PLANING � -- ----------------- --- ----___-__------------- FINAL ENGINEERING _ ___ • � � � ___ ___ ___ _ COMMENTS ----- -- ---------------------- � ------------- ,� ----------- -- ---------- , -,--------- ___. 1 � / C��..�_ �. ��' �.. � � �- �__ ��, ���.' �. , , ------------------- -----------------_ -�----- - �----�.--- ---__ _---- - ---- � �� ��..�---- . y - ---- --- - ------ � �-- -- SEPTICTANKSIZE SEEP PIT/U SIZE ----. __..._...---- ------------ ----------..._..._...-._..__ � "��� ���� - - - - -- --- � - �, _ .. --------- .....---- -----------_-- - ---_ - ...--- ----------------- � �p: - - � �_4 _