HomeMy WebLinkAbout16910 (76) . �_ " \
�\ CTTY OF DIAMOND BAR �'�'-: ''}
DEPARTMENT OF COMMUNfR'&DEVELOPMENT SERVICES �
�. 21 s2s E.copley Drive :. '
"� (909)860.3195Fa�c(909)861-3117 % PRESS
..;�� r BUILDING PERMIT APPLICATION � �•',,� ,:;_' �%� FIRMLY
� JOBSITE � � �p t APPLICATION / PERMIT G' r P/C
o ADDRESS�S�l S • ��i�t+^'Lt�'�(}�. �i=�lL. �I✓C{ DATE ��-[-���I NUMBER 1 � M�—�-��
c� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER��✓l V S ��lo"1"i ur►t-l �..
ADDRESS 15"0� S- U��^1� +t�-- y VC ZONING SETBACKS
Z CITY L�:rtv"l�l'�t{ l�iwlYLZIP a LZLz"�TEL. FRONT RW ❑
g APPLICANT TEL REAR ❑
SIDE/SIDESTREET flW ❑
� CONTRACTOR HC��I� C'-'�it. "r SIDE ❑
oADDRE�St�$. `� W1CYL�1-£'t��-o �1n. PROPOSEDUSE �� ��r � 3 � 14L�wL�`1�+�'1 �A.�:tiCl.e�.s
CITY`�l ►61 e�'t'fZ� ZIP TEL(l,j.(i al3$��S?Z . �-..�.�.�- � -K --
w ARCH/ENG/ ��` � ��"�[ 1,J�4-1.1 DEMn 1�t,1.
W DESIGNER NO.DWEL ��}O~����� NO.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�
OOWNER-BUILDER DEGLARATION SFRlA EM
I HEREBY AFFlRM UNDER PEH/�LiY OF PEiWRY THAT 1 AM EXEAIPT FROAA TNE COMMMORS L4 GaragalCarport
W CENSEUWFORTHEFOLLOWINOREASONISEC.70Jt.58U51NE55ANDPROFE55iON5CODE:ANYCT'OR (n
CJ COUNiYMMIGHRE�UIRES�PERMIiTOCOHSTRUCT,ALTEFI,IMPFlOYE,DEMOUSH,ORREPAIRANY$TRUC• w patio/Deck
�Z 7URE.PFIOR TD RS ISSUANCE.1LL50 REOUIRES 7HE APVIICANT FOR SUGM PERMIT TO FIIE A SIGNEO
� SiATEIAENT TlUT HE OR SHE IS LICENSED PURSUANT TO 7ME VROYISIONS OF T11E CONTMCTORS LI•
� CENSE UW(dUPTER Y fWMMENCW4 WITH SECTION 7000)OF DIVISION 7 0F THE BUSINESS ANO PH0• �'�" PooVSpa
iE5510NS CODE)OR THAT HE OR SHE IS E%EAIPT THEREFROM M10 THE BA515 FOR THE ALLEGED EXEMP•
� 710N.ANYVIOLATIONOFSECTION7UI1.68YANVAPPLICANTFORAPEIiMITSU6IECTSTHEMPLICANTTO Z Re-Roa1
� ACMLPEWLLTYOFNOTMOREiHANFNEHUNDRE000LUAS(f5oo).):
Q ❑I,ASOWNEROFTHEPROPERTY.OF7MVEMPLOVEESWI7HWACfSASiHEIRSOLECOMFENSATqN, 0 �mmercia� �
Z Wlll DO THE WORK AND THE STRUCTURE IS NOT INiEN�ED OR OFFERED FOR SALE(SEG 7oN,BU56 J
� NE55 AND PHOFESSIONS CODE:T11E CONTRACTOiiS ULENSE UW DOES NOT A77LY TO AN OWNEfl OF j
PROPEFTY NA10 BURDS OR�.IPROVES iMEREON.lWD VAq DOES 5 W/WORK NIMSEIF Ofl MERSELF Ofl
Q THROUCHHISORHERDWNEAIPLOYEES.PfiOV1�EDTXATSUCHiMVROVEAIENTSARENOTWTEN�EDOR m
QOFFEREOFORSALEF,IIOWEVERTNEBUILDPJGORRAPROVEMEMISSOIDWITNINONEYEAROFCOMPLE•
Z TION.THE OWHER�BIIILOER NALL HAVE THE BURDEN OF PROVINO THAT ME OR SME DiD NOT BUILD OR
� IAI7ROVEFORTHEOURP0.5EOFSALEy
O l AS OVINER OF iNE VROPERTV.AA1 EXCLUSNELV CONTRACTINO WITH LICENSED CONiMCTOHS
� TO CONSTRUCT THE PROJECT(SEG 70N,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS L6 V0IU01I011 B AQI.AREA
W CENSEUWOOESNOTMPLYTOANOWNEROFAPROPER7YWHOBULOSORIIAP{lOVE57HEREON,AND
� W110GOt7TMCT5FOR5UCHPR0.1ECT5'M7HACONTMCTOR(S)UCENSEOPURSUANiTOTHECOMMG QUANTITY DESCRIPTION FEE
Y TORSUCENSEUW.).
¢ OIIUIE%EMPTUNDERSEC. B.6V.C.FORTHISREASON � �
� U
� �
OATE OWNER V
�.Q UCENSED CONTRACTORS DECLARATION W
¢ IMEFEBYAFFIRMUNOENPENALTYOFPERNRY7HATIIIMLICENSEDUNOERVROVISIONSOFCHMTER Vr
d i(COMMENCWOWITHSECTION7000)OFOMSION�OF7ME9USINESSANDPROFESS�ONSCODE,AND Z
� MYLICENSEISINFULLFORCEANDEFFECT.
m
� LICENSpE CUSS � LIC.NO. ���� ����,��.� �
~ DATE �1 � L' �L CONTRACTOR� �g�Lv•=C�S d
U — — -
W
� WORKERS'COMPENSATION DECLARATION a
� U
� IHEREBVAFFiM1UNDEROENALTYOFVERIURVONEOF151EFOLLOWINODECUMTqNS:
N Q
� �If1�VEANDWILIMAMTMNACERTFICATEOFCONSENTTOSELFdNSUREFORWD/L(ER5 =
COMPENSA7qN,A5PROVIDE�BY5EC710N�70oOFTMELABORCODE,FORTNEiERFORMANCE W
Of T1E WORK FOR NM1IICH THIS VERMIT IS iS5UE0. �
�
W _IHAYEANDWILLMNMAINWORKERS'CAMPENSATIONINSURANCE,ASREWIREDBYSECTION ///
� 77ooOFiHEUBORC00E.FORTMEPER�ORMANCEOFTHEWORKFORWHIpi7N15PERMITIS
ISSVED.MYWORKERS'COMPENSATIONINSURANCECARRIERANUPOLICYNUMBERARE: CONSTRUCTION L / ���
� GRRIER PLAN REVIEW �„y
Z voucrr�uueEn ELECTRIC
¢
� (f/OSSECfptJNEmNOTBE�.WLETIDOFh£PEFIMTSPoRONEFMDRED00.1A{iSK10�ORLRS) PLUMBING
Z ICERTIFYiHATINTNEiERFORMANCEOFTHEWORKFOHNM1iiCMTHISPERMRI5155UED,1 MECHANICAL
(3 SHALL NOT EMPLOY ANV PERSIXJ W MJY MANNER SOAS TO BECOME SU&IECT TO 1HE
N WORKERS'COMPENSAT10NlAW50FCALIFOflNI/�AND�GREETHATIFISMOULDBECOME INSPECTIONFEE — "--•
S SU&IECTTO7HEWORKERS'COMVENSATiONGROV15iON50F5ECTION17o00F7HEUBOR r�^\� ,j )
cooE,i sw�u FoarHvnrH cour�r vn ase vaov}}�� r+s. ISSUANCE - '
� DATE:�p'' v�_ APRICANT: ,�+ ` � SMIP ����\.�
0 �
� WARNING:F�0.URETOSECUREVJORKERS'COMPENSATIONCOVERAGEISUNUWFULANDSHALLBE ENERGYPIC �
LL SVBJECTANEMPLOYERTOCRIMWALPEtU171ESANOCMLFWESUPTOONEMUNOREDTHOUSAND ENERGYPERMIT
DOLUFIS(5100.000).IN MDITON TO hIE C0.5T OF COMPENSATION,OAMACES AS PROVIDED FOR IN
� SECTqND70eOFTHELABOftCOOE,IN7EHE5T,/iNDATfORNEV'SFEES. RETENTIONFEE: � '
aW.. CONSTRUCTION LENDING AGENCY pRE•ALT FEE: —`Y--r–�
� INEREBVAFFIiiMUNOERPENAITYOF7E0.1URYTHATTHEREISACONSTRUCTIONtENDINGAGENCY
n- FORTHEFERFORMIWCEOFiHEWORKFORWNICHTMISPERMITI51S5UE0(SEC709l,CIV.C.).
�
� IENDERSNAME
� LENDER'SADDHE55
w ICERTILYT/ATIHAVEREADTHISAPPLICATIONANDSTATETHATTNEABOVENFORUATIONISCORRECT. TOTAL FEES ����U �� �
� IAGREETOCOMPLYWITHILLCfTYANOCOUNTYORDINANCE5ANO5TATEUWSREUTNOTOBNIDIN6
� CONSTRULTION,ANONEflEOVAUTHORI2EREPRESENT�TNE50FMISCOUNTYTOEN7ERUPONTHE �
Z MENTIONEDPPOPEFT/FONINSPECTIONPURPOSES. COMMENTS
� ���l ��1 A � r
f� PE*"►'V��l �-�, 11, �, O �
^
� SIG ATUREOFPERMITiEE D�TE
� RECPT.NO. PAID BY VALIDATION
WHITE—Department Copy.YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENRO�File Capy,GREEN—Applicant's Copy
�. t5�c•5
..... ._. _.. .. ,-..... . ._... .. __.,
. . _v... � . . _
. ..,., _.
� .� . , . . . . ... .. ... „ .. i � . . � .. .. . . ..�..�.�.X;•�'t:�:'.*..,,a'.SSrti '" ..,!r-�rYt'+'.�.7�..R . .. ... �, r . . . ,. . . - . • .. . �. .. ..... � i'. • �
�iTe' OF DI�fJ�Qf�"D B�R
1P�fSP�C�101'V��ECOf�D
. i
�I►�F-���!��.`��1����� I��)�'EC:= I►yF-'�F�,=teritel�i ;l�r��i:��c,��c.�t��►�k ,ex;;�C�,� � �c;o
I"_, �.� 4-�? .� �..�A�
,� - _. ----- -
._____.________... --.--.-------.- ..-.----.._..,__.�_....._.. ,__._... .__..V____--------._._.._._�---__..�._._..�_.__
SET BACK � _ �;• FLOOR JOIS,T„�.
FTGS/FORP�151STEEL r , ( : . FHA REQM1ATS
ELECTRIC GROUND �� UNDER FLOOR DUCT �
GROUND PLUMBING UNDER FLOO�R•G�Ut�IDUIT
SLAB GRADE FIREPIACE FOUNDATION '
TEMP POWER • FIREPLACE BOND BEAM
WATER SERVICE � MID HL BOND BEAh�1
ROOF SHEATHING /� � • � 8 F7. BO.'VD BF1�tii �
FRAMINGNENTILIATION 8/Z� �/ FINAL BOND BEAti1
ROOF COVER t � PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ,-•� , ROUGH GRADING
ROUGH PLUMBING �� �� FINISH GRADING
SHOWER/TUB TEST /� POOL ELECTRIC
EXT. LATH/SIDING /Q � POOL FENCING
VJALL INSULATIOPJ � �� POOL FINAL
�
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER � FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PITlL.L. ' ON SITE IhAPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. ����Q FIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC � DEV. FEES PAID
FINAL PLUMBING ENERGY
cJcj�,sr.c;lc elc;'r:
- . ..�:Z.��.. . �
COMMENTS
,
ti
SEPTIC TANK SIZE '
SEEP PIT/U SIZE
I�aP �� .
i
,���� ,�''�,, .
, , � �";
•;, � I
1
� . � \ '
� "
_. . �
----- ._ -._---- -_. ..�