HomeMy WebLinkAbout12-1113 J�` CITY OF DIAMOND BAR / � DEPARTMENT OF COMMU1vITY&DEVELOPMENT SERVICES � 218I0 Copley Drive,Diamond Bar,CA 91765 PRESS � (909)839-7020 Fax(909)561-3117 Building Inspection Hotline(909)839-7027 ��������w BUILDING PERNIIT APPLICATION FIRMLY � JOBSITE "�03 S D� ,t..'/ �N /-� �� APPLICATIO /L r'� PERMIT�, P/C oADDRESS' DATE C NUMBE �� � # � ISSUE lYPE OGC APN LOT TRACT DATE CONST. GROUP °C OWNER � ZONING SETBACKS ' o ADDRESS FRONT RW ❑ ' gC�7�y ZIP TEL. REAR ❑ APPLICANT TEL. SIDE/SIDE STREET RW O � CONTRACTOR G Gli /}�� -[�{ SIDE � ¢ ADDRES �� � �• � PROPOSED USE � CITY � N � l�1- ZIP L EL - - w ARCH/ENG/ z DESIGNER NO.DWEL NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � Q OWNER-BUILDER DECIARATION � SFR/ADD/REM O p i HEREBV AFFlRM UNDER PEfULTY OF PER0.IFY THAT f MI IXEAIPT FiiO/A THE CONTiUCTOR4 LF G8f89BICBipOft � W CENSEW�'FORTHEFOLLOWM�RFf.SOF1(SEC.7o31.6BU5M1E55AND7FiOFESSIONSCOOEANYCRYOR � (n . U COUMVWHIqiREOUIRESAPERMITTOCONSTAUCS.ALTER,IMPROVE,DEMOLJSH,ORREVNRANYSTFiUC W PgS�OIDBCK wTUqE,pRIOR TO R3 GSSUANCE�L30 REOUiRES THE APPL�CAHT FON SUCH PERMR TO FILE A SIONED � STATEMFNT hUT HE OR SHE IS LICENSED PURSUNdT 70 7HE iR0`AS10N5 OF.THE'CONTRACTOR9 LF � P��, 8 � CEN3E UW(QUPTEA 9(CAMMENCWO WITVI SECTIDN�o00J OF DMSION J OF TME BVSWE59 M1D PftO � P Q FESSIDNSCOD�ORTHATHEORSHEISD�MPT7HEREFROMANDTNEBASISFOH7NEALLEOEDE%EA1V• V 7�pJ.ANY.VplAT10NOFSECTION70J1.6BYANYMPLICANTFORAPERMITSU&IECTSTHEMPLICANiTO Z. RaRoat � A CML PENALTY OF NOT MOflE TIiNJ�F1YE HUNDRED DOLLAflS�t500).): _ 0 ❑I,ASOWNEROFTHEPROVERTv.ORMYEMPLOYEESWITHSVAGESASTHEIRSOLECOMPENSAT70N, �� � �mmercial Z N7LL DO T11E WORK�ND THE S7RUCTURE 19 NOT INTENOED OR OFFFAE�FOR 9ALE(SEC.-7Mt,BUSF J � NESS AND 7RDFE5510N5 CODE:71�E GONTMC'TORS LJCENSE UW DOES NO7 A7PLv 70 AN ONMER OF ? PROPERTYW/�OBUILDSORIMPqOVESTHEREON,ANDW110DOES5U[:MWORKHI1d3ELFORHERSELFOA m � iTlfqU(iHHISORHEROWNEMVIOVEES.PROVIDEDTHATSUqIWPROVEMENTSARENOTP7TENDED�R . Q OFFFAEDFORSALEIF,HOWEVERTMEBUM1DINOORIMPROVEMEMIS.ALDWRMWONEVEAROFCOMPLE- Z TION,THE�OWNER$UILDEH WILL HAVE THE BURDFJ'7 OF PROVIN6 THAT�HE OR SHE DID NOT BIIIID OR � U,IPROVE WR TNE PURPOSE OG ShLE). ' ❑I,AS OwNER OF�T1E PROPEAN:A4 E%CIUuNELY CAN7FUC7�NU M�Ti LICENSm COIfTfUCTORS � TO CONSTRUCT THE Pf1WECT(SEG 70M.BUSINE55 AND PROFESSIONS CODE:THE CONTMCTOR.4 U- VflIUHtIOfI ADJ.AREA� � CENSEIAWDOE9NOTAPVlYTOANOIM�EROFA7ROPERTYNM1IOBUILD50RIA1PROVE9THEREON.AND . . NT1DC0 TSFORSUCMPROJECTSWRFIACOM�MCTOR�S)LICENSEDPURSUMIfTO7HEODMMC- QUAN7ITY DESGRIPTION FEE � O70R4 UCE E UW.). � �//(��� AM E7(EM � /�� � -n a�.C.FOR TlUS REASON U . � � '_ � � UATE . OWNER U. � UCENSED CONTRACTORS DECLARATION �w ��--�1 � � 1 HEREBY AFFIRAI UNDER FENAL'fY OF PERIURV TMAT IAM LICENSED UIJDER VROVISION9 OF CHAPTER � � d 91��CW6WITHSECTION7000)OFOM310N10FTHE0USINESS+WDPROFE�S Z . . . . . . X M1'LICENSE IS P1 FULI FORCE AND EFFECT. �`/��/ /' � m �+, `� % / � 0 LICENSE CLASS ��v LIC.NO.. ( v �L� � � � . V OATE CONTRACTOR � � - � Lil � WORKERS'COMPENSA710N DEGLARATION Q � � � V � 1 NER�Y AFFIRM UNDER PENALTV OF PERJIIRV ONE OF THE FOLLOW WO OECLAfUTIOMS: Z � 1 HAVE AND WILL MNNTAIN A CERi1FlCATE OF CONSEM TO SELF-IN5URE FOR WORKERS S � CONPENSATION,I•S PROVIDED BV SECTION J]00 OF SHE Ut80R CODE,FOR THE PERFOASAANCE w� . . OFTHE WORK FOR NM111CH THIS PERMIT 19155UED. � � _I HAVE�ND WILL AWHTAW WORKEAg'COMPENSATION INSURANCE.A4 REOUTAED BY SECTIDN Q a7oo OF-THE LABOA CODE,FOR THE VEFFORMMICE�OF iHE WOR1(K'OR Y1HIq1 THIS PE�MR�5, ISSUEO.MV WORKEAS'COAIPENShT10N INSURANCE CMAIER AND VOIiCY MIMBER ARE �CONSTRUCT�ON'. juwwER PLAIV REVIEW . 0 po��cr rnin�sER � . ELECTRIC � � 0 � (1}eS5£Cf10NNFID4JpTBE00hilET�OFTEpFpM�ISFOqONEHUMq�ppLLPRSfraplpqLES51 PLUMBING � w �MECHANICAL Z I CERTIFV THAT W hiE PERFdiMANCE OF THE.WORK iOR N71tCN 7N13 7E WJ�T IS ISSUED,1 � SHALL NOT EAIPLOV ANV PERSON W ANY MANNER SO AS TO BECOME SUBJECT 70 THE' �WSPECTION FEE � WORKERS CAMPENSATION UM�S OF CPIIFORNIk AND AOREE THAT(F I SHOULD BECOf.�E , .. . S SUBIECT TO THE WORIIERS C�MPENSATION PRONSqNSOF SEC710N 3700 OF THE LABOR ISSUANCE CODE.I SHALL FOifTHVATN CW�P�Y WITH 7HOSE PROVISIONS. ��-� O SMIP p DATE: APPLICANTi . . . � w ENER6Y P/C � WAiWINO:�FAII,URETOSECVREWOHICERS'COMPENSA710NCOVERAGEISUNUWFUL.ANDSHALLBE ' � � � SUBJECT AN EMPIOYER 70 CAIM WAL VENALTIES AND CENL FW ES UP TOONE HUNORED h10USAFID ENERGY PERMIT � DOLLARS(5700.000).W ADD�TION TO iHE COST OF COMPENSATION.DAMA�ES AS PROVIDED FOR�N '�(�1, J BECTION370EOFTiEUBORCOOE.INTEREBT,ANDATfORNEYSFEE3. ' RETENTIONFEE: �C/ Q w� � CONSTRUC710N LENDING AGENCY � PRE-ALT FEE: �.. . . . . . . . . . . .. � Q 1 NER�YAFFIRM UNDER PENALTY OF PERIURV THAT THERE 19 ACONSTRVC7fON LENOWO AOEHCY . �Z� -FOR 7ME PERFORMANCE OF 7HE WORK FOfi WHICH THIS PERAIIT IS ISSUED(SEC:30�7,CN.G� . W . �- LEHDERB NAME . . . � LENDERSADDRE55 . . , w� �ICER7tFV7FIATIHAVEREAD7H13APR.ICATIONANDSTATETUTTHEABOVEWFORMAT10N�8CORRECT. TOTAL FEES ��,��D � 1 AOAEE TO COMVLV WI7H ALL Cf�V ANO COUNTY OqDWANCE3 AND STATE UN5 RELATWO TO BURdNO , � CQN5T0.UCTION.ANDHEf\EBV�UfFlORIZEREPRESENTATIVESOFTHISCWNTYTOENlEHUPONTHE Z ABOVE-MEMIONED PROPERTY FOR INSPECTION NRPO�S]ES �COMMENTS � �J 6� �.�I+, �,��,V s� � QPERMI77EE PoNn f.� !` � . . . . � �� � � 'S113 . ERMRTEE DA7E RECPT.NO. PAID BY VALIDATION � � WHITE—DepartmeM Copy.YELLOYY--Flnance CcPY.PINK—Assessor Copy.GOIDENRO�FIe Copy,GREEN—ApplicanYs Copy CITY OF DIANiOtVD BAR IIVSPEGTtOF� RECORD '{,J�� � g ���.�� ,�J'�',.r�A. � 0 �.;K 1;��,"�l;tr,. ° � :�����'��� ��i u A o .�s� .: � � :. :., . �. ., .. . . �. . . �..,i .:, . , �.. . w ..�• . � , , . . � �i..:�' � . .,.�� SEi"BACK FLOORJOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT � GR�UND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATlON TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BQND BEAM ROOF SHEATHING 8 FT.BOND BEAM FRAMING/VENTIlATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRAD(NG SHOWER/TUB TEST POOL ELECTRIC EXT.IATHLSlDING POOL FENCING WALL INSULATION POOL FINAI CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATION5 SEWER FINAL ENG. SEPTICTANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON 51TE IMPS. GAS AIRTEST ' FINAL ZONING FWAL CONST. � fIRE DEPT,fWAL F►NAL HEATING HERITH DEPT.FIfVAL FINAI ELECTRIC �, DEV.FEES PAID FINAL PLUMBING ENERGY . FINAL PLAtJING FINAL ENGINEERING • o p COMMENTS SEPTICTANKSIZE SEEP PIT/U SIZE �s � -- — :�