Loading...
HomeMy WebLinkAbout16315 - ^� \ � CITY OF DIAMOND BAR u� + DEPARTMENT OF COMMi�ITY dt DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 � (909)86a3195 Faz(909)861-3117 '" PRESS � �'^�"�� BUQ.DING PERMIT APPLICATION � FIRMLY � JOBSITE Q %� /� �¢/� APPLICATION �j � PERMIT �� �/C o ADDRESS�Iv S T��y J' - ��� DATE v �� NUMBER � ISSUE � TYPE OCC APN LOT TRACT DATE � CONST. GROUP °C OWNER S ADDR S ZONING SETBACKS Z CITY ZI Z TE _ _ FRONT RW ❑ g APPLI ANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOR � !� SIDE ❑ � ADDRESS � CITY�f�//=� ZIP� TEL. PROPOSED USE o ARCH/ENG/ � DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � � CITY ZIP TEL. � v� DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION I Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBY AFFlRM UNDER PENALTV OF PERIURV THAT I MI E%EMPT FROM THE CONTfUC70R5�I- Gef99B/C9fpOR LLI CENSEIAWPORTHEFOILOWNOREASON(SEC.7031.6BUSp1ESSANDPROFE5510NSCO0EANYCT'OR, (n U pqJNryWHK�/{IEpV{pE$APEHMRTOCOIISTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIRANYSTRUG W P8I10/DBCK � T1HE.PRqR TO RS ISSUANCE,ALSO REWIRES THE MPLICANT FOR SUCM PERMR TO FILE A SIGNED w � 9TAiEMENT THAT HE OR SHE IS LICENSEO PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� LL � CENSE UW(CHAPTER Y(COMMENCIN(i WITH SECTIODI 7000)OF DMSqN 3 OF TME BUSINESS AND PRO- PooUSpa FESSqNS CODE)OR 71M7 HE OR SHE IS E%EMPi 7HEREFROM AND 7HE BASIS FOR 7HE ALLEOED EXEMP� TqN.ANYV101A710NOFSECT10N70.11.6BYANYMPLICM7TFORAPEHMITSU&lECTSiHEAPPLICANTTO Z p�q�} � A CML PEN�LTV OF NOT MORE TYUN FNE HUNDRED DOILARS(t600).�: , • O ❑Lh40NMEROFTHEPROPERTV,ORMYEMPLOVEESVnhIWAOESASTHEIRSOLECOMPENSA710N, O Cpry�mBfC181 , � . � WILL DO THE WOiiK AHD THE STRUCTURE IS NOT INTENDm OR OFFEAED FOR S�LE(SEC.7041,BU51� J N NE59 AND PROFE9510N3 CODE THE CONTMC70R5 LICENSE UW DOES NOT MPLV 70 AN OWNER OF � PROPEHiY WHO BU4D5 OR IMPROVES THEREON,AND V/lq DOES SUCN WORK HIA/SELF OR HERSELF OR LL iHROUGH HI9 OR HER ONM EAIPLOYEE9,PROVIDED T1iAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEAmFOR3ALEIF,HOWEVEiLTiE8U0.DIN00RIMPROVEAIENTI550LDWfTHINONEYEAAOFCOMPLE- 0 �'TION,THE OWNERSUILDER M7LL MAVE THE BURDEN OF PROVINO iHAT HE OH SHE DID NOT BUIID OR Z IMPROVE FOH 7HE PURPOSE OF 9ALE). . _ ❑1,AS OWNER OF THE PROPERTV,AM IXCLUSNELV CONTMCTPIO NRT}i 110ENSED CONi{UCTORS W � � TO CONSTRUCT THE PRQIECT(9EC.70M,BUSINESS AND PHOFESSIONS CODE:THE CONTRACTORS U- V8IU9UOf1 ADJ.AREA � CENSE UW DOES NOTMPLV TO AN OWNER OF A PROPERTV MRIO BUILDS OR IMPROVES TNEREON,AND WVqOONTRACTSFORSUCliPROJECfSWITHACONTMCTOR(9�lICENSEDPURSUANTTOTHECONTRAG ounr�nrv DESCRIPTION FEE � 70RS 110ENSE UW.). C�� 0 ❑I AM El(pIPT UI�ER SEC. B.8 P.C.FOR THI$REASON � ' ��QI�� � `�+ �S �� JC ✓'� 3 � � //p do� C�R � Lo . 7� �� LL DATE OWNER (~j �{ �X S�'� W �� f/C7L� �c%/12�✓/"r ZO I � LICENSED CONTRACTORS DECLl+RATION W I � I HEREBY AFFIRM UHDER PENALT'OF PERAIM THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � �� � I_� � i(COANIENCYi(i WITH SECTION)000)OF DMSION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� — W LICENSE IS IN FULL FORCE AND EFFECT. m -� � LICENSE S - �/ LIC.NO. � -� � � �s,`� � � on� — Z'� � corrrancroa �L4ll GC� �P�. a , �� � WORKERS'COMPENSATION DECLARATION Q � I �n � , NI HER�Y AFFlRM UNDER PENALTV OF PERIURY ONE OF THE FOLLOWING DECLARATIONS: Z ., J��� , I � �IMAVE/VIDWILLAWNTAIHACEFfIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' . Q. COMPENSA710N,AS PROVIDED BV SEC710N s7oo OF THE U�BOR CODE,FOR THE 7EHFORMMICE � � � � �+�� `' �- O OF 7HE WORK FOR WHICH THIS PERMIT 19 ISSUED. � J� � ,• _I HAVE AND WILL MAINTNN WORKEFS'COMPENSATION INSUHANCE,!S REOUIRED BY SECTION Q 37000F TtE LABOH CADE,FOR THE VERFORMMlCE OF THE WORK F9R WHICH THIS PERMIT IS ISSUED.MY VNRKERS' PEN TION INSURANCE CARRIER AN/D�PyOJL�ICV NU/M�BER ARE: CONSTRUCTION � CARRIER �/" �-""'n/� PLANREVIEW � POI,ICY NUMBER i� "'OD �_�� ELECTRIC � (MSSEcfqNNE�r+o�ieEOJI.FiEr�oFlt-EaEA1.�rswaa4EFIUNMi�oatuLSgiro)oRLESs} PIUMBING . Z I CERTIFY THAT IN THE PERFORMANCE OF TME WORK FOR WHlqi 7HI5 PEFUIIT IS ISSUED,1 MECHANICAL (�' SHALL NOT EMPLOY ANV PERSON W ANY MMINER SO AS TO BECOME SU&IEC7 707HE � WOfiKERS'COMPENSATION LAWS OF CALIFORNIA ANO AOREE 7HAT IF I SHOULD BECOME INSPECTION FEE SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR ^� rj CODE,1 SHALL FOHTHWITH COMPLY WfTH 7TqSE PROVISqN ISSUANCE / � ��..��� — SMIP DATE:_y�� APPLICANT�� --�_ . � WARHINQ:FAILURE TO SECURE WORKEFS'GOMPENSATqN COVERAOE IS UNUWFUL AND SHALL BE ENEFGY P/C -�~��-.--_I� �y SU&IECTMlEMPLO'IERTOCAWWALPENALTIESANDGVILFWESUPTOONEHUNDREDTIiWSAND ENERGYPERMIT OOLLARS(t7ao,000�,IN ADDI110N TO THE COST OF COMPENSATION,DMIAOES AS PROVIDED FOR IN � SECTION 3700 OF 7HE UBOR CODE.INTEREST,AND ATTOiiNEV'S FEES. - RETENTION FEE: � �' O �CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PEN OF PERIURV THAT THERE IS A CONSTHUCTION LENDINO AGENCV FOR THE PERFORMANCE OF THE FOR WHICH THIS PERMIT IS ISSUED(SEC.�Oe7,qV.C.), , � . .""""�•".. � LENDERS NAME F— LENDER'SADDRESS � I CERTIFY THAT I MAVE READ THIS MPIICATqN AND STA7E THAT TiE ABOVE INFORMATION IS CORAECT. TOTAL FE ES • W I AOREE TO COMPLV YATH ALL CI7Y AND COUNTV ORDINANCES ANO STATE UWS REUTNO TO BUILDWO � CONSTRUCTION,AND HEREBv AUTHORIZE FiEPRESEMATIVES OF THIS CIXINTV TO ENT�ER UPON THE . ZNBOVE-MENTK7NED PROPERTV FOR INSPECTION PURPOSES. COMMENTS ' � _ ��0 C_-� w Z � SIONA7URE OF PERMfTTEE DAT . � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finence CopY.PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy COTV O� C80�ilfiO�H) ��� A�S6�.EcCTB�� 6�3E���� �a 0 � �' p i ;�:: e' � ,�o~ ��' o Q p p i�„ ^"�o O SET BAGK � ' FLOOR JOIS�`.�;..�.� ..., ��i� ,, � ,,-.,t.,.,= � .. .. ,�i,. FT'GS/FORMS/STEEL FHA REQMTS �"' ` ELECTRIC GROUND ' UNDER FLOOR DUCT _ . GROUND PLUMBING UNDER F•LOOR�CCSNDI'tIT° f �%r� ;, ti,; .:_�,. ,.;.••.,:.: — ' .^._' I t �.�� I SLAB GRADE FIREPLA �E:�FO t�DATkON.�;'� ;�, �-" • y • ;/ ; ���t r TEMP POWER FIREPLAC BC7ND 6��4M -•�.� l��, .: - • - WATER SER�iICE MID HT. BOND BEA�A ,, .`� •,�� ; ��.�. .,�`;•'�, ROOFSHEATHING 8Fi'. BONI);BE M,-:'..•:,� � �`.-�'.:'•�;'�; _ =..� _ FRAiV11NG/VENTlLiATION FINAL BOND BEAM` � ' ' ' ' � ' ROOF COVER PRE-GRADlNG ROUGH NEATING � BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUNIBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATit"�N • POOL FINAL ' � CEILiNC INSULATION ' OFF SITE IMPS. 7RYWALL NAILING DEDICATlONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. ' SEEP P!T/LL. dN S17E IMPS. ' • GAS Nl�i TE�T FlNAL ZONING FIP•1AL CONST. '+�• �::,�:= �. ;; .,,�,,,._,;.. FIRE DEPT. FINAL FI�f1L HEATWG �'�, �5�:' .'•,: ;-,•='` `.:`�`• HEALTH DEPT. FiNAL � Fih!A1_ELECTRIC '"'• ' - � t-�� '' �= - � DEV. FEES PAID � t=1?�l�?L PLUM$iNG � _ . _ Et�IERGY ' . _ �.' ..-�-,. � ._ .. P_._ , � ... .. �, -• . o O :.,1..� .��. I -�..'�.� _-,.._.." - , .. � . �.1��'.✓ . .. !:�':�1....., . �` ..- •�'.'� ..i �i{�b1n��i`���rJ .•.::�. l , . . •� • . . ; ,�i� -- � ��' ' Rh���� -1: - ' , . . -� -� ` . . ,�'�'��: '�'�,_.� �-..'.�:�t�\ � � �, - - — � ' . ..._. .. . .. :. - _ _ - ..� ". _. .�.� -. , � ' _. ,.. -- � . ... � ._.-_ �; .� ... ! - ..... •- .__�_ . _ -..�_._ . ` ,i `. _..�_._..__.__._ SEPTIC TANK SIpE ,�. � -- -- SEEP PIT/U SIZ� — —�- — t� �V'-Y ��:�-��' � � r�� _ / ^� �b „� �...u��;�y��{��,� ',' �, '�> p �; ���(y�' '�p'` ���' ��n �:.F .3't a1L'I s� � • t�'a" f3�, ,�,�{ '.{�+V.� P�qt�,'. �„a��.p, . ' i�a _. '� , � . 4d � .. �� 'f 3l €f'`y�' ,� ��,�4 b `{ ti � _. . ' . , `-. . ,Y- t �' �§�;+a«�'�`� .. ' 1� �' ���,"' a§.. .�:a �°�� . -----___�_._