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HomeMy WebLinkAbout12-1090 (6) _ ��.� CITY OF DIAMOND BAR DEPARTMEN'T OF COMMUNITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 PRESS � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 `�'�9�'��W gULLDING PERMIT APPLICATION FIRMLY � JOBSITE � f p�� �(?�� C� DATECATION�' �I��j NUMBER �' 1,D'7 DP/C o ADDRESSX�1� � ��/'TI"1CN 5R I� LVD DI�I L- � � issue � �_TYPE '� occ .- APN LOT TRACT DATE CONST. C�ROUP U OWNER IA�E�iO'�Rrt� 4 A1Sl�a�"� M K�r o ADDRES�S,-6"i� 1, � �1��'�A�� �7�� �WP��� ZONING SETBACKS �'-� �.DD ZIP TEL�JI�F ZZ7'�Z� FRONT RW ❑ � CITY . REAR � APPLICANT 7EL. SIDE/SIDE STREET RW O � CON7RACTOR SIDE � � ADDRESS ' PROPOSED,USE � � O CRy ���,v�i'� ZIP�Z,�� TEL w ARCHlENG! � � � z DESIGNER � NO.DWEL. � N�• � ADDRESS � UNITS STORIES BEDROOMS � CITY`?�L(,.���� - ZIP TEL. - i � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARAT�ON SFR/ADD/REM O 1 MER�Y AFLIAM UNDER VENALTV OF PERIURY TNAT 1 NA EXFIAP'i fROM THE CONTMCTORS�I� G8I8g0/CBfPOR W CENSEUWFORTHEFOILO�MINOREAuONl8EC.70.71.68U5PlESSANDPROFESS10N5CO0E:AHYC77YOR (n . C� COUMYWHICHREWIRESAPEWdITTOCONSTRUCT,ALTER�ROVE.DEMOLISKORREPAIRANYSTitUG LLJ Pa=�� �� NRE,7R�OR 7D ITS ISSUANCE,AL50 REW iNES T1iE APPLIGNT FOR 6UCH PERMR TO FlLE A SH3NED w STATE4ENf TFiAT HE OR SHE 19 UCENSED PURSUANT TO 7HE PROVISIONS�OF THE CONTMCTORS LL (L PQOUS 0 � CENSE UW(GiUPTER Y{ODMMENCWO Wlhi SEC�ION�000)OF DIYI910N 7 OF TME BUSME55 M1D PRP � P � FESSIpNSCOO�ORTHATHEORSHEISEXEMP7TIEREFHOAIANDTHEBASiSFORTHEALLEOEDEXEMP• V 7qN,ANYVqLAT10NOFSECTION7031.60VANVAV7lICANTFORAPERMITSUBJECT3TNEAPPLICANTTO Z RaRool � A CML PENALTY OF NOT MOHE TNAN FNE MUNDRED DOI.LARS�i500).): O ❑I,ASOWNEROF.7HEVROPER7Y.ORMVENPLOVEE3WfTHl4AGESASTHEIR60LECOMPEN5A710N, � (',pmmBfC121 Z WILL DO TNE WORK.AND TFiE STRUGTURE IS NOT INTENDED OR OFFEREO FOR 9�LE(SEc.7�,BUSH J . N NESS AND�RDFE5510N5 COOE THE CONTMC70RS LICENSE UW DOES NO7 APPLY 70 AN OWNER OF � , � PROPERTYW��IOBUiIASOHIMPROVESTNEREON.ANDMMODOESSUCNWOAKHWSELFORHERSElFOR m [[ niROIK'.H W$OR HER OWN EMVIOVE£S,PROVIDEO TFIAT SUq111APROVEMENTS ARE NOT WTENDED OH W OFFEqEDPoRSALE1F./iOWEVER7NEBURDiNUORWPROVEA�FNT15,'',OLDWITWNONEYEAROFCONRE- � TION,THE OWNER�BUILDER WILL HAVE 711E BURDEN OF Pi10VP/6 THAT�HE OR SHE DID NOT BUIID OR - - - � Z WPROVE fORTHE PURPOSE OF SAIE} ' - � _ ❑4 Ag OwNER OFTHE PROPERTV.AM E%QUSNEIY COMRACTINO WITH IICENSED CONTN�CTOiLS � - �- ' ' � Q TO CONSTRULT THE PRQIECT(SEC.70W.BUSINE55/VJD PROfE5510NS CODE:TME CONTMCTOii3 LI- V0IU8fI0f1 AD�•AREA' W CENSEUWDOESNOTMPLYTOANOWNEROFAPROVERTVWHOBUILDSORU,IPROVESiHEREON,AND ZWHOCONTRACTSFORSUCHPROJECT9WIh1AWM�RACTOR�3)LICENSEDPURSUANTTOTMECONTRAG ounrmrr DESCRIP710N FEE � Y 70RS UCENSELAW.�. � O I MI EXEMVT UNDER 6EC. B.8 P.C.FOR TWS HEASON U � Q � OATE . . . � OWNER ~ U Z W � LICENSED CONTRACTORS DECLAFATION �-� � - � � � 1 HEREBY AFFIRN UNDER PENAL7Y OF PERJURV THAT I AM�LICENSED UNDER PROVISKKJS OF GFIAPTER Vr � � y(COMMENCW(iWITFlSECTWN7000)aFDIY1S10N]OFTHEBUStNESSANDPROFES510NSCO0E,MlD Z. �' X yY UCEN9E 19 IN FIAL FORCE AND EFfECT. m ' " � LICENSE CLA S �.•�`�"C)� . A C.�IC.NO. "'�Dn���,�'.�{� �� � . .. U DATE J- ?/ CONTRACTOR OC (!aM�ILV�U d . . . W � WORKERS'COMPENSATION DECIAFiATION � �• � U � I HERE6YAFF�NM UNDER PENAITV OF PERJURY ONE OF THE FOLLOWIN6 DECIAfUTIONS: ZZ t� H �. Q _I HAVE AND WILL MAIN7AIN A CERTIFICA7E�F CONSENT TO SELF-W3URE FOR WORKERS Q COMpENSATION,AS PROVIDED BV SECTION 370D Of THE UBOR CODE,FOR TME PERFORA4ANCE W� OF THE WORK FOR WHICH THI9 PERMIT IS ISSUED. � � w I HAVEAND WILL MAPJTA1N�WiDRKERS'�COMPENSATION INSURANCE,A3 REWIRED BV SECTION Q 37ao OF 7HE LABOR CbDE,FOR THE 7ERFORMANCE OF THE WORI(FOR WHICH THIS PERAIR IS, `�L.� , d` � ISSUED.MY WORNFAS'CAAIPENSA710N INSURANCE CMAIER�AND VOLICY NUTABER ARE: �CONSTRUCTION- � CARRiER .S`�41r hvn/D PUW AEVIEW ZZ� POIICY�NUMeER �IRZtiD � � � ELECTRIC Q (fFtlsSEctICNNF81t�1o70EaoA�lE7�oFT#aEp.tfl3WaaNEHlx�Of+EnOouMsltlm)aalESs} PLUMBING � . . . . . w 1 CERTIFV.THAT IN 7HE PERFOW.IANCE OF TFiE.WORK FOR WHICM TNIS PERM�T iS LSSUED,1 �MECHANICAL� Z � (�J SHALL NOT EAI7LOY ANY 7ER.AN W ANY MMINER SO ro secanE sue�eci To nae �INSPECTION FEE� � WORKERS'COidPEN5AT10N IAWS OF CALIFQFiN1A D A(iREE TFU7 IF 1 SFIOl1lD BECAME .... . A .. S uUBJECTT THEWDAKERS'COMVENSATIONPROVI SOFSECTION77000FTHEUBOF ISSUANCE �T'�� ('.ODE.I S fORTHWITH COMPLV WITH THOSE P S . � �'� �L n�icntai: SMIP � � O s p DATE: . . . � � ENERGY P/C . _ . WARNINO:FAIIURE TO SECURE WONCER5 GOMPENSATION CAVEMCiE IS UNUWFUL. SMALL BE �—y SUBJECT AN EMPIOYER TO CRIM W�L FENAL71E5 M!D pVIL FlNES UP TOONE HUNDRED THOUH�1dU ENEflGV PERMIT DOLLARS(5500.000),a1 ADDt710N i0 THE COST OF COMVENSATqN,DAMAOES AS PROVIDED FOH IN ♦^� J 6EC710N a7oe OF 7HE LABOH CODE.IMEREST.ANDAiTORNEY'S FEES. � RETENTION FEE: � � w . � W� � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � a o Pj�� 1 � 00 � I HEREBY AFFIRM UNDER PENALTV OF PERIURY THAT THERE IS A CONSTRUCTION LENDWO AOENCY �-� .FOR TIE PERFORMMICE OF TFIE WORK FOR wHICH 7H15 PERMfT IS ISSUED(SEC.3oe7.CJV.C.} . Z W �� LENDER'S�NAME .. . . F�- LENDERBAODFIES3 T C � � �C£RTIFYTHATIHAVEREADTHISMPLICATIONAND�STATETFUThiE.�OVEPIFORMATIONI9CORAECT. TO 1'AL FCES ,� � ,�� W 1 Al3AEE TO COMPLY N7TH ALL CfTY AND COUNTY ORDWANCES AND STATE UWS REU7M(i TO BU4DINO � CONSTHUCTION,NiDHEREHVA1f�F10RlZEREPRESEN�ATNE50fT1115COUNSYTOETRERUPOt1T1iE � Z� ABOVE-►IEN710NED PR07ERTV FOR WSPECTqN FURPOSES. � COMMENTS ' � S � � m vEwainEE r�n� � , �Z � SIONANRE OF PERNR7EE DAT RECPT.NO. PAID BY VALIDATION � . � � WHITE—Department Copy,YELLOW—Finence CaPy.PINK—Assessa Copy.GOLDENROD—Flle Copy,6REEIJ—ApplicanYa Copy . . . . .. CITY QF DIAM4IVD BAR Ii�SPECTtON RECOFiD ' `� b� � ��' ' � ti+� ��� � '� '?���t�- 0 a�' '~ g " gY � � -. � , y,:, , e '�� SET BACK ___ __ ;FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS I ELEC7RIC GROUNb j UNDER FLOOR DUCT GROUND PLUMBING i UNQER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNOATION ��. TEMP POWER FIREPLACE BOM11D BEAM WATER SERVICE MID HT.BOND E3EAM ROOF SHEATHING 8 FT.BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM ROOF COVER �PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGN PLUM8ING �FINISH GRADING SHOWER/TU8 TEST PQOL E�ECTRIC EXT.LATH/S!DlNG POOL FENClNG WALL INSULATION �POOL FINAL CEILING INSUlAT10N OFF SITE IMPS. DRYWALL NAILING _ _ _ DEDICATIONS SEWER _ FINAL ENG. SEPTICTANK �LANDSCAPE/IRRIG. SEEP PIT/L.L. j ON 51TE IMPS. GAS AIRTEST FINAL ZONING FINAL CONST. � � FIRE DEPT.FINAL fINAL HEATING �HEALTH DEPT.FINAL FINAL ELECTRIC 'DEV.FEES PAID fINAL PLUM8ING ENERGY FINAL PLANING FINAL ENGINEERING . � � COMMENTS � � :,.. 4 �-;� a �t.. . —� � --�;. �.._.._.. SEPTIC7ANKSIZE SEEP PIT/U SIZE - y ' r� ;u�:�` Y � K��• � -