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HomeMy WebLinkAbout15673 �t EXPIRED _� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES a ai�o E.coPiey na�e s�c�i90 APR 2 5 2003 � (909)86a3195 Fau(909)861-3117 PRE$$. I �'�'� BUII.DIN PERMIT APPLICATION � i : __ FIRMLY, N' JOBSITE � ' APPUCATION ,,,fl) PERMIT /C//�j3 P/C o ADDRESS DATE ��v NUMBER J�v / � $ ISSUE jO I_ TYPE OCC APN T C DATE � �P - CONST. GROUP p OWNER �` ADDRE � c ZONING SETBACKS � CITY �I , ZIP TEL. R�RT RW ❑� APPLICANT TEL. SIDE/SIQE STREET RW ❑ � CONTRACTOR � .�, SIDE ❑ � CIIY E % ZIP �� TEL{ PROPOSED USE o ARCH/ENG/ � DESIGNER NO.DWEL. NO. N . ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � v� • DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANAIUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFlRY WIDER PENPL7V OF VE0.AIRV TUT I MI E7(EMPT FAOM TME CONTMCTORS LF Garage/Cerport ^ W CEHSE UW FORTHE FOLLOWIN(3 REASON(SEC.7031.6 BUSpJE53AND PROFESSIDNS CODE ANV qTYOR (n C..7 OplN7TVWHICHREpIARESAPEPoARTOCONSTRUCT.PLTER,IMPROVE.DEMOLJSH.ORREPAIRANI'STAUC• w �Z TURE,PRIOR TO RS ISBUANCE,AL50 RE�UIRES THE MVLICANT FOR SUCH PERMIT TO FILE A SIONED w P81I0/D9CI( STA7EAIEHf THAT HE OR SHE 19 LICENSEb PURSUANT 70 THE PROVISIONS OF THE CON7RACTORS U� � CENSE UW(CHAP7ER Y(COMMENCMO WITH SECTION 70D0)OF DIVISION J OF THE BUSINE55 AND PRP � POOVSPO FESSIONS COO�OR THATHE OR SHE 19 E%EMPT THEREFROM AND THE BASIS FOR THE ALLC-0ED E%EMP- � TION.ANYVIOLATIDNOFSECTIOH7W1.6BYANYMVLICANTFORAVERMITSU&IECTSTHEMPLICANTTO Z Re-Roof � A CIVIL PENALiY OF NOT MORE T1AN FNE HUNDRED DOLURS(t600)J: � ❑4��N�NEROFTHEPpOPERTV,ORMVEMPLOYEESWITHWA6E5A5THEIRSOLECOMPENSATION, � (�,pmffle�Cl91 � WILL DO 7HE WORIC AND THE STRUCTURE IS HOT INTENDED OR OfFERED FOR SALE(SEC.701�,BU51� J � NESS AND PROFE5910N9 COOE THE CONTMCTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPERfY WFq 8URD3 OR IMPROVES THERC-0N,AND WHO DOES SUCH NqRK HIMSELF OR HERSELF OR 2 7NqOlXiH HIS OR HER OWN EYPLOYEES,VROv1DED hIAT SUG/IMPROVEA/EMS ARE NO7 PfTENDED OR m � OfFHiIDPDRSALEIF,/10WEVER7MEBlALDPIOORUAPROVEM@lTISSOLDN7THINONEVEAROFCOMPLE- � �'TION,iHE OYYNER-BUtL,DER MALL HAVE TME BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR WPROVE FOq THE PURP0.SE OF SALE�. W ❑I,ti40WNEROFTHEPROPERfV,AMIXClU51VELYCONTRACfWOWRHLICENSEDCONTRACTOR9 � 70 CONSTRUCT THE PqpIECT(SEC.70u,BUSINESS AND VROFESSIONS CODE THE CONTFACTORS U- VelUOflOn ADJ.AREA CEHSE UW DOE9 NOT MPLY 70 AN OWNER OF A PROPERTY WFIO BURDS OR W PROVE9 THEREON.AND � W/pCON7RACf8FORSUCHPR0.1ECT3 ITiACOHTMC70 )LICENSEDPURSUANT70THECONTRAG Q�J DESCRIPTION FEE � � 70R3 LICEHSE UW.). /J�q— ❑1 AM IXEMPT UTAER BEC. /—�%/'1 ���� r 0.i P.C.FOR THIS REASON � 3 � � ¢ DATE OWNER V � LICENSED CONTRACTORS DECLAAATION W r- � 1 HEFiEBV AFFIRAI UNDER PENKTV OF PEfLIUfiY THAT I AM LICENSED UNDER PROVI910NS OF CHAPTER � � Y(COAMENGNO WIh15ECT10N 7000)OF DMSION 3 OF THE BUSINESS AND PROFESSIONS D Z MY LICENSE IS Pl FUII RCE AND EFFECT. m 0 � � LICENSE CUSS L�C.NO. � . VDATE � CONTRACTOR / � W � , � WORKERS'COMPENSATIO DECLARA �2 I1 � _ N 1 HEREBV AFFlRM UNDER PENALTY OF PERJURY ONE OF E FOLIOWINO DEClARA710N / � N � _I HAVE AND LNLL MAIMAIH A CEHfIFIGTE OF CON TO SELF-INSURE FOR WO E ' _ � Q COMPENSATION,AS VROVIDED BY SECTION 370o OF R COOE.FO E w Q OF THE WORK FOR NTIK;FI THIS PERMIT IS ISSUED. � � � Q _IHAVEANDWILLMAPfTAPIWORKERS'COMPENSATIONINSURANCE,ASREWIREDB EC7qN .� ]7000F 7HE IABOR CODE,FOR THE PERFORMANCE OF THE WOR1C FOR NRi1CH 7HI5 PERMIT IS � ISSUm.NY WORKERS'COMPENSATION INSURANCE CARRIER AND 70l.ICV NUMBER ARE CONSTRUCTION � c�r�aiER � PLAN REVIEW � aat.icr riuMeER � ELECTRIC _ 0 (n�ssEcnor�r�wiBEc��v�E7�oFne�rswqor��arn�Dpplq��s+op)op�.ry, PLUMBING Z [J �CERTIFV THA7 IN THE PERFORMANCE OF TME WORK FOR WHICH h115 PERMIT IS ISSUED,I MECHANICAL � C7 {7\SHALL NOT EMPLOY ANY PERSON PI ANY MANNER 50 AS 70 BECOME SU&IECT TO7HE (/) Y I�bRKERS'COMPENSATION UWS OF GLIFORN10.�ND AOREE THAT IF I SMOULD BECOME INSPECTION FEE , S SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE UBOR caoE. 5 ro n�ca.ra�rwn Ea hsi ' ISSUANCE O ^/� p DATE: APPLICANT: ! � �SMIP �r����DO� � WARNINO:FAILURE TO SECURE VIOHKERS'COMPENSA COVERAOE IS UNLAWFUI.M1D SH�LL 0E ENERGY P/C T �y SU&IECT/WEMPLOVERTOCRIMMALPENALTIESANDCMLFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT'1 1 DOLURS(iloo,000),W/�DDITION 707HE COST OF COMPENSA710N,�AMA�ES AS PROVIDED FOH IN TT � SECTION 370E OF THE LABOR COOE.INTERE57,AND ATTORNEVS FEES. ' RETENTION FE��+�D • OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HERFBV AFFlRM UNDER PENALTY OF PERNRV THAT THEHE IS A CONSTRUCTION LENDING AOENCV �- - - Z FOR THE PERFORMANCE OF THE WORK FOR wHICH hIIS PERMIT IS ISSUED(SEC.3oW,CIV.CJ. , ., W � LENDER'S NMIE � ' . � � LENDER'SADORE55 � TOTAL FEES � 1 CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE TNAT TNE ABOVE INFORMATqN IS CORRECT. w I AOHEE TO COMPLV N7TH ALL CT'M1D COUNTV ORDINANCES M!D STATE UWS R TINO TO BU0.DING d � CONSTFiUCT HEREBV AUTHORIZE RE7RESEM S OF THIS COUNTV TO ER UPON E ' , ' � � , Z ABOVE-ME ED ROPER, PEC710N W ES CO NTS ' � �� � � � � � _ (� vE IE� � i . .. Q � N SqNANR DATE RECPT.NO. PAID BY ' � VALIDATION � � WHITE�epartment Copy,YELLOW--Finence Copy,PINK—Asaeasor Copy,GOLDENROD--File Copy,GREEN—Applicanfs Copy �' �����;�� ciTv oF ���►�on�� ��� � a�s��c-�ao� ���o�� t:��5 :.t'� ;��?t, . k� _ _ � m � <- �l;D , .�' , , � e f ;:',�.. , '�'-��"� t1U�-I�.Lr'��� C3 0`���,`' ,,.�` p :���„�. SET BACK � fp Z �� � � FLOOR JOIS�T .� � FTGS/FORMS/STEEL ' ' ' FHA REQMTS • ELECTRIC GROUND /e UNDER FLDOR DUCT GROUND PLUMBING UNDER FLOOR CU�IDUIT SLAB GRADE FIRERLACE FOUNDATION TEMP POWER FIREP�ACE BOND BEAM WATER SERVICE MID HT. BOND�BEAM ' ' ROOF SF�EATHIMG 8 FT. BONQ BEAM • ' FRAMiNGN,ENTILiATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATlNG BENCHING ROUGH ELECTRIC ROUGH GRAD1NG ROUGH PLU1vIBING � FINISH GRADING SHOWERITUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WA�L INSULATION POOL FINAL CEI�ING INSULATION OFF SITE IMPS. DRYWALL NAILING . DEDICATIONS SEWER FINAL ENG. SEPTIC TANK . LANDSCAPE/lRRIG. SEEP PITJL�.. � ON SITE IMPS. V' �~ GAS A!R TEST _Z � � FINAL ZONING i `� FIIVAL CONST: FIRE DEPT. FiNAL • � FIN.AL HEATiNG HEA�TH DEPT. FINAL - FiNAL ELECTRIC DEV. FEES PAID � ^ FIt�dAL PLUMBING ENERGY � ,� -- m � tl ,�-,��: � ,�; • s , COMMENTS ..-Z� —o� �g 7� �o�✓ _��,✓� ti i— C �.e 'i-?.a-�Z ����.1���6� oc� �� ' ----- ^Z( -cx� �!Q 1b� ----.,—.--. SEPTIC TANK SiZE , ` � -, ' SEEP PIT/tJ.SIZE -- Y ,��y�y�y�'.� �'��i� d1�'15�.���PY . {� � � t +� �... _ Ity��`a�a »�.�31_'-�4"�gv�'� �gs�a .,y�..�. h�j�'a� � .���� ��t� . ������� �t�'�� . 1 , . fi LA� h `C �'T����� v��'a����.. ., /! 'O ` ���`'?°� � �'�"��r�:.�� - , , � , � • � .�A��Y�� �� .��� ' . . . . 'FP. :�;,�,�p tna �' i ��'°:: . � �' ��- 1'� � . '