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HomeMy WebLinkAbout17679 _ .__ .�:__...: . ._ i.. _ _� _ : _ . �� CITY OF DIAMOND BAR DEPARTMENT OF COMMiINITY&.DEVELOPNiENT SERVICES 21825 E.Copley Drive (9D9)860-3195 Fax(909)861-3117 PRESS "'-�� BUILDING PERMIT APPLICATION FIRMLY N JOBSITE G 7� (� APPLICATION - PERMIT P/C o ADDRESS �� t �J 74m�n� v0.2. � DATE 2O DZ NUMBER 1767q N $ ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER �� p AODRESS PL� X. F.�Z� ZONING SETBACKS g CITYSj�R1�FJ �V����—_ ZIP TEL.�9 �'�Ig'I'�9i'� FRONT RW ❑ APPUCANT '�IC�C�►N BAMe'�S TEL,Sb'1-�o��I�� R�R � SIDFJSIDE STREEf RW O � CONTRACTOR �� � SIDE O � ADDRESS PpOPOSED USE o C�7y t ZIP�'S��TE - / o ARCH/ENG/ � DESIGNER NO.DWFL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY 21P TEL y DESCRIPTIQN S�.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER DECLARATION SFWAOD/REM O p I MEREBY AFFlRM UNDER PENALTY OF PERAIHY THAT I/UA E%EMVT FROM THE CONTNACTORS LI- � GaragelCarport W CENSEUWFORTHEFOlLOW710RFJ1SON(SEC.70�7.6BUSWESSANDPqOFESSI0NSO0DEANYCITVOR U COUNTYNrt11CHRE0U1HE5A7ERMITMCONSTRUCT,ALTE0.MPFtOVE.DEIA�USH.ORPEVMRANYSTRVP W P8t10lDBCk �� 7URE,GRqR TO RS ISSUANCE ALSD REWIRES iHE A7PLICANT FOR SUQ�PERMIT TO FILE�SiGNEU W STATEMENT iNAT HE OR SME tS 110ENSED PURSUANT TO TF1f PROVISIONS OF iHE COMIUCTORS LI� $ CENSE LAW(QiM7ERY(GOMMENCTlf3 YATH SECTION 7000)OF DIVISION iOF THE BUSINE55 M1D PRO• � P��PB � FESSqNSCOD�ORTHATHEORSHEISEXENVTTMEREfROAIANDTHEBA5ISFORTHEALLE6E0E%EAIP• 7�ON.ANYVIOUITIONOFSEC710N7071.6BYINYAPPLIGNfFORAiERMIT5UB1ECiSTNEAPPLICANTTO Z pe-Rool F, ACMLVEWLLTVOFNOTIAORETHANFNEMUNOREDDOLI.AHSIf5o01.t 0 OlASONR'7EROPiHEPflOVERiY,ORMVEMPLOYEESWiTNWA6ESA5ME1RSOlECOMPENSATION, ❑ �mmercia� - Z YALL 00 TNE WORK,AND THE STRUCTURE IS NOT INTEN�ED OR OFFERED FOR SALE ISEC.70a1,BU51• J NESS AND Pf10FES510NS CODE THE OONTMCTORS UCENSE UW DOES NOT APCLV TO AN OWNER OF N VROPERTYIMIOBUIL�SORIMPROVESTMEREON.ANDWNODOESSUG7WOKKMIMSEIFORNERSELFOR = � THROUCHHISORHEROWNEAIPLOYEES,PROVIDED711AiSUp11A1PROVEUENTSMENOTNI�ENDE00R m � OFFEREDFORSALEF,fqWEVER7NEBUlIDINGOR4APqOVEMEMIS� IYATMNONEYEAROFCOMPLE- z TION,TNE dNNER�BUILDER MnLL HAVE 7HE fiUR�EN OF VROVING iIUT HE OR SHE DID NOT BUIID OR = 4APROVE FORTHE VURPOSE OF SALE� �4�ONMER OF iME VROPEHiY.AM E%GLUSIVELY GON�RACTINO WRM LICENSED CONTMCTORS � TO CONSTRUCT 7HE PRQIECT(SEC.7Wt,BUSINESS ANO 7ROFESSION3 CODE:TNE OalTA�CTORS U• V21UeS1011 ADJ.AREA W CENSEMWDOESNOTAVPIYTOANONNEROFAPROVEP7YVMOBU0.DSORIMPfqYESTHEREON,NID .Z� NnqCONTMCTSFORSULMVNO.�ECTSVATHACONTRACTOR�S�ULENSEDVlIRSUANTTOTHECONTMG QUANTITY DESCRIPTION FEE � TORSLICENSEUW.). � 1CIMIE7(EMPTUNDERSEC. B.1P.0.FORTHI REASON Q I � • W � F 1 6 " � C"� DATE �� OwNER V • � z W 2 0 �d UCENSED CONiRACTORS D LAR N w �f Cr IMEREBYAFFIFiMUNOEflPENKTYOFVEIWRYTHA7IAMLICENSEDUNDERPRONSqNSOFCFIMTER � "` a, Y(COMMENdN�WITH5ECT10N7000)OFOMSION]OFIHEBUSINESSMlOPROFESSIONSCODE.MID Z X MY LICENSE i5 IN FULL FOi10E MlD EFFECT. m LL1 � � UCENSE CUSS � __LIC.NO. �" • J V DATE Z CONTMCTOR a W . .. ._ .. . _ � WORKERS'CpMPENSATION DECLARATION . � � U � INEREBYAFflRMUNDERPENALTYOFFEIWRVONEOFTHEFOLLOWIN60ECUMTqNS: � N a G �IIIAVEANDWILLMNNTNNACERTIfICAiEOFCONSENTTOSEIf-INSUREFORWOHKERS' S � GOM7ENSA710N,ASPRONDEDBVSEC710N�7DOOFTHELABOHfAOE.FORiHEVERFORMANCE W OFTME WORK FOR WHICM TMIS iERMiT IS ISSUEO. � � _1/WVE ANO WILL MAINTAM WORKERS'COMPENSATqN INSURANCE,AS REWIRED BY SECTON Q 170oOFTHELABONC�DE,FORTHEPERFORIAANCEOFTHEWORKFORWHICHiH15PERMRIS � .� ISSUEO.MYMIOPo(ERS'COLIPENSATIONINSURANCECAFNERANDVOLICYNUMBER�RE: CONSTRUCT�ON ], GARRIER PLAN REVIEW � POLICY NU►IBER ELECTRIC � � (i}�SECIqNNE�N7fBEWl.r'LEfEDOFTfGERMf6FORONEH1tiiE004UASlt�O%ORLFSSy PLUMBING Z I CERTIiY THAT W THE PERFORNANCE OF iNE WONK FOR WHICH THIS VER41T IS 65UED,1 MECHANICAL C} SIMLL NOT EMVLOY M!'f PERSON N ANV AUNNER 50 AS TO BECOME SUBJECT TO THE y WOiL(ER5COMPENSATqNUWSOFGLLiFORNIA,AN�AGREETNATIFI5MIX1LD9ECOME INSPECTIONFEE I1 S SU&IECTTOTMEWORKER3'LOMPENSATIONPRONSIONSOFSECT�OND7000FTHEU100H �SSUANCE � � v- COOE,1 S WLL FORTMMTN CAMPLY WIiH THOSE PROVISIONS. � SMIP p DATE: APPLICAM: � ENERGY P/C WAPNINQ FMURE TO SECURE WORKERS'CdAPENSATqN COVERAGE IS UNUWFUL,ANO SNALLBE �y SUBJEC7/iNEMPLOYERMGfUMINALPENALTIESANDCMIiW[SUPTOONEFNNDREDTHOUSAND ENERGYPEFIMIT DOLLAHS(SiD0.000).IN AODITION TO iHE LOSTOF COMPENSATqN,DAMAGES AS GROVIOEO FOR IN a $EGTION]70!OF THE UBOR CODE,MTE{1EST,ANDATfORNEY'S FEES. R���ON FEE: � �O� a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � IMEREBYAFFIRMUNDERPEN�LTYOFPEM1Fi1'THATTHENEIS�CONSTRUCTIONLENDWOAGENCY � FOR T11E VERFORMANCE OF 1HE WOPo(FOH WMIGI TMIS PERMIT IS ISSUED(SEG 7w7,pY.G). � . Z W � LENDEH'S NM�E � LENDEfi'SADORE55 2 � ICERTIFYTHATIHAVEREADTM�SAPPLICATIONANDSUTETHAT7HEABOVENiORMATIONISCORRECT. T07AL FEES . 2L�-+� vO W IAGREETOCOMVLYWITHALLCITYANOCOUNTYOfl�WANCESANOSTATEUWSREUTINaTOBUILDINO � CONSTRUL710N.ANUHEHEBYAUT170NIZEREPRESENT�TIVESOFM�SCOUMYTOENTERUPONTHE ZABOVE-MENT�ONFDPROPERTYFORINSP[CTqNWRVOSES. - COMMENTS � � � rC J ��/l/L��^ � � PE E AA1 IPHINTI , � .VZ J� � � � N SIC �OFP I EE . DAT S HECPT.N0. P/UD BY VALIOATION �- WHITE—Department Copy.YELLOW—Finance Copy,PINK—Assessa Copy.GOLDENRO ile Copy.GREEN—Applicant's Copy 1 .tr';',1"' ,'+'rl'r;�f«.j;S,. ^�-r�S":�N.t.:7i`..:i.�Ti,% . ,-. ^:r4in�.���C,.mT:,•...--�r�.r..i� ... rtip.�'.�:::.��^L:;c«,.!,x..r.,., r -��. . ....,.r ..r,^� ,....� .' ,.. v..u� . , +� -y�:... .�,..,z .:-:_ «,��� ..,,�. C1TY OF DIAM(Jf�D BAR IP�lSPEC�"iOtV RECd1�D y � o �: ... o;,�i��� �� �. ����k.a�,.� . .- ��� ��� (� � :; .. o �'�� ._ .. � -� o=� '�� Y -�� - ��----_.'°'".�._.......�.�.�-�.�___.._ '..�Y.. -. I. . . � . ���� ..�.,,�r �„ � � �' � � ��� �-�� �' - 1. �� ..�.�;`�. ..� __ _ .. SET BACK � � '.� • FLDOR JOIST, � . � FTGS/FORMS/STEEL , FHA RE�PATS ELECTRIC GFiOUND � UNDER FLOOR DUCT GROUND PLUMBING � UNDER FLOOR CU�IDUIT � � SLAB GRADE FIREPLACE FOUNDATI�N � I� ' ' TEMP POWER FIREPLACE BOND BEANt . WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT.SOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER � PRE-GRADING ; ROUGH HEATING BENCHING I ROUGH ELECTRIC RDUGH GRADING � ROUGH PLUMBING " I FINISH GRADING • SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING � POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING ( DEDICATIONS SEWER � FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PITlL.L. ON SITE IMPS. GAS AIR TEST � FINAL ZONING FINAL CONST. � „ .� � ,'GIRE DEPT. FINA!_ ' FINAL HEATING HEALTH DEPT: FINAL . . FI�JAL ELECTRIC � � -�1, - DEV. FEES PAID FINAL PLUMBING ; ENERGY i � �c �n.[':iC'� �i� C�i r -- - - - . .- -- — ---_. . _._�- --�---- COMMENTS - � SEPTIC TANK SIZE SEEP PITlU SIZE I�,��.._._.._.`_....�'�.,...� y��� �.� -�� .. � _. . ._ . . . .k . .. . � . _ �.�- . _ .. ,- � . ` , . � �, � . � ,