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HomeMy WebLinkAbout12-2056 (11) �� _ CITY OF DIAMOND BAR � DEPARTMENT OF CONIMUNITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �+'�"'�.W BUILDING PERNIIT APPLICATION FIRMLY � JOBSITE ,/ ^ �,I' ' o ADDRESS/� /��� �lY �,`wN DATE CATION��/� ��f� NUMB R�� #,C l � `r APN LOT TRACT DATE � Ii ONST. �,. OCC ' p OWNER��,�(/�/LS' �SfELL�d(/ST ���OUP o ADDRESS ZONING SETBACKS FRONT R�/y p z CITY ZIP TEL. � � APPLICANT TEL. REAR p Z SIDE/SIDE STREET RW p ¢ CONTRACTOR GE SIDE p' � ADDRESS • . o CITY�Ldc!FJV!��R ZIP TEL 7/S!?�Q�� PROPOSED USE _ � �-t>�►'L� S wo ARC ENG/ �� iz DESIGNER NO.DWEL. NO. NO. a ADDRESS cn UNITS STORIES BEDROOMS � CITY ZIP TEL. � , DESCF3IPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADO/REM O p I HEREBY AFFlRM UNDER 7ENALTY OF PERIURV THAT 1 AM E7(EMPT FROM iHE CONTRACTORS LI- G3fa9B/C3fpOff W CENSEUWFOR7HEFOLLOWINGREASON(SEC.7m1.SBt151HE5SANDPROFESSIONSCODEANYCITYOR (n C-� CIXJHTYNMICHREOUIRESAPERMITTOCONSTRUCT.ALTER�PROVE.DEAIOLISH,ORREPAIpANVSTRUC w TURE.7RIOR TO RS ISSUANCE AL50 REOUIRES THE APPLICANf FOR SUCH PERMIT TO FILE A SIGNEO w Palio/Deck � STATEMEM THAT HE OR SHE IS 110EN5ED PURSUAN�TO THE PRONSIONS OF THE CAN�MCTORS LI- � CENSE UW(CFUPTEH e(COMMENCING WI7H SECTWN 7000)Of DIVISION a OF TiE Bl15INE55 MJU Pq0- � Paol/Spa 0 FESSIOHSCOOE�ORTHATHEORSHEISEXEA/PTTHEREFROMANDTHE9ASISFORTHEALLEGEDE%EMV- C7 U TpN.MlYVIOUTIONOFSECTION7IXi1.5BYANYMPLICANTFORAPERMIT5UBIECTSTiEA�PLICANTTO Z q�Rool A CML PEfU1TY OF NOT MOpE TFUN FNE HUNOqED DOLLMS(S50o).): � ❑I.ASOWNEROFTHEVROPERTY,ORMYEMPLOYEESWRHWAGESASTHEIRSOIECOMPENSATION, O COrt11TIBft78I � Z 1NLL�O THE WORKµ0 hiE STRUCTURE U^NOT INTENDED OR OFFERED FOH SALE(SEC.7ou,BU51- J � NESS AND VROFESSIONS COOE THE CONTRACTORS�ICENSE UW DOES NOT MPLY TO AN OWNER OF � - PROVEHTY WFIO BUILDSOR IMVROVES THEREON,AND WHO DOES SUCN WORK HIAISELF OH HEPSEIFOR wTHROUG/I HIS OR HER OWN EMGIOVEES,PROVIDED TUT SUCJIIMPROVEMENTS ARE NO7 NJTENOED OR m � OFFEAmFORSALEIF,HOWEVER71/EBUILDWGOHIM7ROVEAIENTI550LDW1T11iNONEYEAROFCAMPLE- z TION,THE OWNER-BUILDER WILL HAVE T1E BUHOEN OF VROVING 7HAT HE OR SHE DID NO7 BUILD OR � IMPROVE FOR THE 7URP0.5E OF SALE} W OI,ASONMEROFTHEPROPEA7Y,AMEXCLUSNELYCOMMCTWGWfR1lICENSEDCOHTMCTORS [[ TO CONSTRUCT THE PR0.IECT(SEC.70a�,BUSINE55 AND PROFESSIONS CODE:T1E CAMMCTOqS Ll- VelUdtlOn 0' ADJ.AREA ' W CENSE UW DOES NOTM7LY TOAN OWNER OFA PROPER7Y WHO BUILDS OR IMPqOVES THEREON,/�ND � W1/OCAHTRACTSFOFlSUCHPRQIECTSWIh1ACONTRACTOFi(5)LICENSE�PURSUANTTOTHECONTiUG ounNnrr DESCRIPIION FEE � T00.5 110ENSE LAW.). � ❑I AAA EXEMPT UNDER SEG 8.8 V.G FOR 7HIS REASON Q U � DATE _ OWNER ¢ � P Z U � LICENSED COrIfRACTORS DECLARATION W � I HEREBY AFFlA�I UNDER PENALTY Of PERtt1RY h7AT IAM LICENSED UN�ER PROVISIONS Of GHACTER � � Y(COMAIENCIHO WITH SECTION 7000)OF DMSION]OF iHE BUSINESS ANO PROFESSIONS OODE,/WO Z � �xx W IICENSE IS IN FULL FORCE AHD EFFECT. ry /) � CENSE CLASS LIC.NO. `� �� ` ��� � � v �n� 4���6 /y corrrrucroa � GJ�J t�c� a w � WOfaKEAS'COMPENSATION DECLARATION Q � � � 1 HEREBY AFFIRM UNDER PENALTY OF PERJUqY ONE OF THE FOLLOWWG DECLARATIOHS: Z � _I HAVE M1D WILL MNNTAIN A CERTIFICA7E OF CANSEM TO SELF-INSURE FOR WORKERS' _ COMPENSATION,il5 PROVIOED 8Y SECTION 3700 OF THE LABOR COD�FOR THE PERfORMANCE U Q OF TiE WORK FOR WHICli THIS 7EFMIT IS ISSUED. � � w _i HAVE AND YALL MAIMAIN WORKERS'COMPENSATION INSUMNCE,AS REOU�RED BV SECTION Q a700 OF THE LABOR CADE.FOR THE VERFORMINCE OF THE WOfU(FOq W WCH THIS PEPMI715 j� J , ISSUED.MY WORXEAS COMPENSK(ION MSUMNCE CAARIER AND POLICY NUMBERME CONSTRUCTION �� � ¢ CAHRIER��JLfi S � PLANREVIEW � � POLICY NUMBER ��e��- � Z� ELECTFiIC �c/�3 3 p fnn�sEcnoNr+�r+oreEaonaFrmoFn+Ev�rs�one�oatu�sgim�oq�ssl PIUMBING D- � � Z I CERTIFV THAT IN hIE PERFOMIANCE OF 7HE WO R wHIp17H15 PERMIT IS LSSUED,1 MECHANICAI (S SHN1 NOT EMPLOY ANY 7ERSON W PIJY MAN O AS TO BECAME SU&IECT TO THE � WORKERS'COMVENSAT70N UWS OF CALI AAND AGREE TiAT IF I SHOULU BECAME INSPECTION FEE = SUBJECi TO hiE VYORKERS'COMPEN I ROVISqNS OF SECJT O oo F THE UBOH (� � CAD I SFULL FOf7�HWIT1 COAIPL Of.Lc PROVI51 N5. ISSUANCE � � �(� �/ p pp . +/'I� �I�—APPLI �SMIP a. /� w ENERGY P/C J WARNIN6:FAIWRE TO SECURE WOfllCERS'CAMVENSATION CAVERAGE IS UNLAWFUL.AND SMALL BE � � SU&IECT AN EMPLOYER 70 CRIMINAL FENALTIES ANO CIVIL FINES UP TOONE HUNDRE�THWSANO ENERGY PERMIT ¢ DOIIAFiS(f1o0,000),IN ADDITION 70 THE COST OF COMPENSATION.DAMAGES AS PROVIDED tUR IN ,� SECTION 37oe OF THE LABOR COD�IN7ERE5T,AND ATTORNEYS FEES. � RETENTION FEE: OCONSTRUCTION�ENDING AGENCY PRE-D� � 1 HEREBY AFFlRM UNDER PENPLTY OF PERIUHY 7HAT THERE IS ACANSTRUCTION LENOING AGENCY � • fOR THE PERfOiiAIANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUEO(SEC.7osr,pV.G} Ti.7 Z W � LENOER'S NMIE F-� IENDER'S ADDRE55 ) � /�� w ICERTIFYTHATIHAVEiiEADiH15APPUCATIONANDSTATETHATTiE�BOVEWFORMAT10NI5CORAECT. TOTAL FEES -/ b��Y i � I AGREE TO COMPLY WIiH ALL CfTY ANO COUNTY OFOINANCES M10 STATE UWS REUTNG TO BULLDING � �� � CONSTRUCfION,AND HEREBY AIf�HORRE REPRESENTATNES OF THIS COUNTY TO EMER U�ON THE Z ABOVE•MEPRIONED PROPERTY FOR INSPECTION PURPOSES. � � COMMENTS � .�,�r,�-� � m FER E E(VR�Nn ` ` -��/ i � I � R E DA7E = RECPT.NO. PAID BY VALIDATION ~ WHITE--0e ent Copy,YELLOVY—Finance Copy.PINK—Auessor Co GOLDENROO--Fiie py. 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ROOF COVER i pFE-GRADING --------- .'----- --------- - � ROUGH HEAT!NG I-------------I--------— ;BENCI-rlf.G ------------- ----- ------- ROUGH�LECTRIC------� -__ -I--------------_� �ROUGH GfiADIh1G --- -- ---- ------- P,OUGH PLUf'v131�lG j �_ ;FINISH GRADING SHOb�/ER/TUaTEST � � IPGOLELECIftIC EXT.LATH�'SIDIfJG � i POOL FENCINv �rVALL INSULATIO�! � � � �POOL FIRIAL CEII_I�`JG IRISULATIOf`J I �— �CFF 517E Ih!tFS. DRY�NALL NAILING___ _ _ i ;DEDICATIOi�JS -- --�---------_ ------- --- `___----�----------- --------- --------------- SENIER �FINAL ENG. --------- --- -- -- �---------------------- -------- ------- -- �-------- SEPTICTANK � �LA,NDSCAPE/IRRIG. �-------------------- - ---- ---- - --- ------------------- ------ SEEP PITiL.L. ' I ON SITE IiV1P5. r,AS AIRT[ST !FINAL ZONING FIiVALCONST. � ��!RE DEPT.F!P•lAL FINAL HEATING � 'HEALTH DEPT.FINAL FINt\L ELECTRIC i ;DEV.FEES PAIO FINA,L PLUNIBING :EPJERGY FINA,L PLANItJG � i � --�--------� ------ --- - ' FINAL ENGINEERING � -• -- -- --- -- -�--- -- -----�-— �------ -------------��d����� �m=����3 COrViMENTS _..----- -- --------- ----- ScPTICTANKSIZE -----_. _-------- -.---------- --- SEEP PIT/U SIZE —�— — —�- --- ----- — �� ,;�. - ----- ------�- —---- ------------ ----------- � _ � � ' --- -- - — ------- ---- -- � '� 3 �____'__�_ "—____"_. �__� __'__�' __ �" ' .. .r � � ____'_'_'—___"—"_'__—'____ __�_ _�'__ __�._' �_"'__�.. � _ ' . ^��_ _ _ ' ___ _____ "_ '___' __ '" ____ "� _