HomeMy WebLinkAbout14339 CITY OF DIAMOND BAR • '
DEPARTMENT OF COMMLJIVITY&DEVELOPMENT SERVICES
: � 2��oE.cop�eyvrives�te�90 PRESS
(909)860-3195 Fax(909)g61-3117
��'� BUILDING PERMIT AppI,ICATION � ' • FIRMLY
� JOBSITE �) �j � APPLICATION I �. PERMIT P/C
Q ADDRESS�'�(� �MtJ� � _I�! ) �
o ��---v DATE NUMB p
� APN OT TRACT �SSUE TYPE OCC
� _ , DATE CONST. GROUP
OWNER
o ADDRESS ZONING SETBACKS
w CITY ZIP TEL. E���/n FRONT qyy ❑ •
� APPLICANT � TEL. 1, �L. REAR
❑
� SIDE/SIDE STREET RW ❑
CONTRACTOR SIDE ❑
ADDRESS
� CITY ZIP TEL. PROPOSED USE
o ARCH/ENG/
� DESIGNER NO.DWEL. NO. NO.
, ADDRESS UNITS STORIES BEDROOMS
= CITY ZIP TEL.
�
� DESCRIPTION 'SQ.Ff. FACTOR PSF ADJ.AREANALUATION
Q . OWNER-BUILDER DECLARATION
p SFR/ADD/REM
p I HER�Y AFFlRM WIDER PENALTV OF PEKrt1RY THA7 I AM EXEMPT FAOM THE�COHTRAC70RS LI� G8f6QB/C9fPOff � -
tlJ C@ISEIAWFORTHEFOLLOWWOREA.40N(SEC.70.11.68USINESSMIDPROFESSIONSCODE:ANYCITYOR (n
V COUHf'/MMIGIREOUWESAPERMR7000NSTRUCT,ALTE0.�IPROVE,DEMOLISH,ORREPAIRANVSTAUC- W P0t10/DBCk
� TURE.PRIOR TO RS 69UANCE.AL50 REW IRES 7HE MPLICAHi FOR SUCH PERMIT TO FlLE A SIONED w
� STA791EHT T}IAT ME OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CONTRACfOR3 LF �
� CENSE UW(CHAP7ER Y(COMMENCWO WITH SECTION 7000)OF DIVISWN a OF THE BUSINESS AND Pqp- � POOYSpB .
FE33qNSCOO�ORTHATHEORSHEISD�A1PThiEREFROMANDTNEBASISFORTHEALLEOEDEXEMp- �
TION.ANYVIDLATIONOFSECTION7W7.6BVANYMPLICANTFORAPERMITSU&IECT9THEAPPLICANTTO Z Re-Raof
F, ACIVIL 7ENALTY OF NOT MORE T/AN FNE HUNDRED DOILARS(t6o0).): �
� ❑4��N�NEROFTHEPROPER7Y,ORMYEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATqN,. (',pmmBfClel . � �
YfRL 00 THE WOiU(AND iHE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BUg4 � O
� lE93 AND PiqFESSIdJ3 CODE:THE CONTRACTOR4lJCEN3E UW DOES NOT APPLV TO AN OWNER OF � O
ViqPEHTV MR10 BULA4 OR IMPROVES THEREON,AND NR10 DOES SUC}1 WOqK HIMSELF OR HERSELF OR
Q THROUGH HS OR HER ONRI EMPLOVEES,CHOVIOm THAT SUCH BdPROVE4ENTS ARE NOT WTENDED Oq m
4J pFFEREpPDq6ALEIF,IpN�EyER7�¢gU�pg�ppqIMPROVEAIENTI550LDWfTHINONEVEAROFCOMRE-
Z �TION,THE OYYNERbUILDER WILL HAVE THE BURDEN OF PROVINO 7HAT HE OR SHE DID NOT BUILD OR
� pIPROVE FOR THE PURP0.4E OF BALE�
❑1.AS OMTIER OF THE PROPEfiTY.AM EXq.U51VELY COHTRACTINO N7TH UCENSED CONTRACTpqS
TO CONSTRUCT THE PROJEC7(9EC.)OW,BUSINESS AHD PROFESSIONS COOE:7HE CONiRACTOqS U- V91UetlOfl ADJ.AflEA
W CEN9EUWDOESNOTMPLYTOANONMEROFAPROPERTVWHOBUILDSORIMPROVE9TIEREON,AND
� N71000HTRAC78FORSUCHPR0.IECTSWRHACONTRACTOR(5)LICENSEDPURSUANTTO7HECONTRAC. � QUANTITY DESCRIPTION �E .
TOR9 UCR6E UW.�.
0 ❑I AM�IPf UNDER 3EC. B.�P.C.FOR 7HI5 REASON � � - l L
3 �
� .
DATE OWNER U
� LICENSED CONTHACTORS DECLAAATION W � �
� I HEREBY AFFlRM UNDER PENAI.TY OF PERIUM 7FIA71 AM IICENSED UNDER PROVISIONS OF CMAPTER �
� i(COAIMENCWO 1NTH SECTqN 7000)OF DMSqN 90F THE BUSINE55 AND PROFESSIONS CODE,AND Z � '
MY LICENSE IS PI FULL FORCE AND EFFECT.
m
� LICENSE qASS LIC.NO. ' �
� DA7E CONTRACTOR d ,
W
� WORKERS'COMPENSATION DECLARATION � �
NI HEREBV AFFlRM UNDER PENALTY OF PERIURY ONE OF 711E FOLLOW WO DECURA710N9: Z
� _IHAVEANDWILLMAPITAMACENTIFlCATEOFCONSENT70SELFJNSUREFORWORKERS' a
COMPENSATqN,AS PROVIDm BY SEC710N 370o OF 7HE LABOFi CODE,f-0R THE PERFORMANCE W
QOF THE 4WPK FOR WHICH TTqS PERAIIT IS ISSUED. �
� _1 HAVEAND WILL AWNTAW WORKERS'COAIPENSATION INSURANCE,AS REWIRED BV SECTION �
QQ 370D OF THE LABOR CODE,FOR 7HE PERFORAIANCE OF THE WORN FOR WHICH 7HI5 PERMIT IS .
ISSUm.MV WORKERS'COMPENSATION IHSUFiANCE CARRIER M1D POLICV NUMBER ARE: CONSTRUCTION
jc,wwEa PU1N REVIEW
� ����ER ELECTRIC
� (11965Ec.'fqNN�raieEooAPLE7�OFnfPEfiARSFOaoMEHUwri�oai�"(ttro)oRLESs�. PLUMBING
W
Z I CERTIFY THA7 PI THE PERFORMANCE OF TME WORK FOR WHICN THIS PERMIT IS ISSUED,I MECHANICAL
(, SH�LL NOT EMPLOY ANY VERSON W ANY MANNER 50 AS TO BECOME SUBJECT TO7HE �
y WORKERS COMPENSATION UW3 OF CALIFORNIti AND AOREE THAT IF I SHWLD BECOME INSPECTION FEE
S SUBJECTTO THE WORKERS'COMPENSATIDN PROVISIONS OF SEC7qN 97000F THE LABOR
CODE,I SFIALL FOFiTNVlITI COMPLV WIT/7TiOSE PROVISIONS. ISSUANCE �
� • SMIP
p DATE: APRICANT: '
� " ENERGY P/C
WARNINO:FALURE TO SEWRE WORKERS'COMPENSATION COVEMf3E IS UNLAWFUL,AND SHALL BE
� SUBIECT AN EMPLOYER TO CRIMINAL 7ENALTIEB M1D CML FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT
DOLURS(f100,00D),IN MDITION TO THE COST OF COMPEN$ATIDN,DAMAOES AS PROVIDED FOR IN
¢ SECTION 370E OF 7HE UBOR CODE,IN7ERE5T,AND ATTORIJEI"5 FEES. RETENTION FEE:
d CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� I HEREBV AFFIRM UNDER PEHALT/OF PER1UfiV THAT THERE IS A CONSTRUCTION LENDIN(i AOENCV
Z FOR THE PERFORMANCE OF 7HE WORK FOR WN�CFI TMIS PERMIT IS ISSUED(SEC.30u7,GV.C.). -
W
� LFlIDEAS NAME
� LENDER'SADDRESS .
� � I CEFiTIFV TU1T I HAVE READ THIS APPLICATION AND STATE THAT TME ABOVE PIFORMATION IS CORRECT. TOTAL FE ES � �
� I AOREE 70 COMPLV N7TH AI.L CRY AND COUHTY ORDWANCES M10 STATE LAWS REUTINO TO BU0.DIN(7
CONSTRUCTION,AND HEREBY AUT110RIZE REPRESENTATNES OF 7HI5 COUNTY TO ENTER UPOH THE �y /� �- ^
ZABOVE IONEDP RT'FORINSPECTqNPURPO5E5. 1/�, �
COMMENTS - V V l ���
9 F
� � �� ' �v
a �
�
� gq� DATE
� � RECPT.NO. PAID BY VALIDATION '
WHITE-0epertment Copy,YELLOW—Finenoe Copy,PINK—Asaeesor Copy.GOLDENRO�File Copy,GREEI�ApplicanPs Copy
. �
CITV OF DIAMOND BAR � �-
If�S�ECTIOfV RECORD '
� � -
{� ;. � � � � s � s ■ � � f � � �
. , .
SET BACK � . , , � : FLOOR JOIST ,i ,.
FTGS/FORMS/STEEL FHA REQMTS � -- -
ELECTRIC GROUND ' UNDER FLOOR DUCT -
GROUND PLUMBING UNDER FLOOR CU�IDUIT'., ._ • • •
SLAB GRADE FIREPL�ACE FOUNDATION ` • � '- - - - �- -
TEMP POWER FIREPLACE BOND BEAM , • ' '"` `'. - -' - '
WATER SERVICE MID HT. BOND BEAM
ROOF SHEATHING. ' � 8 FT. BOND BEAM
FRAMINGNENTILIATION � FINAL BOND BEAM '
ROOF COVER PRE-GRADING
ROUGH HEATING - BENCNING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRlC
EXT. LATH/SIDING._•,�,;�',:;; `' POOL FENCING
WALL INSULATION'•° POOL FINAL
CEIUNG INSULATION��,�'` '� OFF SlTE IMPS.
DRYWAL�NAILING u DEDICATIONS
SEWER FINAL ENG. '
SEPTIC TANK . _ LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.�
GAS AIR•TEST, r - FINAL ZONING
�FINAL CONST. � - - " - � FIRE DEPT. FINAL
FINAL'HEATING : • � ' HEALTH DEPT. FINAL
FINAL'ELECTRIC '-;' `^, ,' ,'-'�.'_'__- __ _ ; DEV. FEES PAID , •'
FINAI PLUMBING ENERGY •
:. � :'� � ��. � �:�' .
CONiMIEiVTS
SEPTIC TANK SIZE ' ' � �
SEEP PIT/U SIZE
�_ ��
� ,
� 4 ��,;���r,� �':�� �_� � � �
. ¢
"�: �: ����, ,�'�+v�-�,��q����
r-; ��,� awe 4� �4�'�"��'P,'`s`',,�''��',: ' . .
k. �,
�s� � da�{�,�.���¢`�vi � � . . . � ..
r
�Et y
� �?»�r a� ��"':�y�;i+}, d;�t"�'$S�,-,, � � � ..
' ..r -�.; �. �-.-� � . . . �
"�' Iw� � ����f �^�`�� � '�',,� . � . _ .
'ti j� . . � . ' ' . .. .� _� _
� 1 1` � � _ � ' ' � 1
�� �fs i��'��td�,.�;T'�#�'��:;�� . . . ' . -, � . . � .
,3 S,: - ��i�
t '