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HomeMy WebLinkAbout12-940 _�` CITY OF DIAMOND BAR DEPARTMENT OF COMMiJNITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 PRESS (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 ����'���W BUILDING PERMIT APPLICATION FIRMLY ¢ ADDRIESS �g d N. L�i C-�iYl�/�c-� �Rr P�}. DATEICATIOIJ� I�. � Z NUMB RI`� ��` ' #/�al�4� c7 � ISSUE TYPE �^ OCC °.° APN LOT TRACT DATE ? L �-- CONST. I � GROUP °C OWNER o ADDRESS ZONING SETBACKS � ZIP TEL. FRONT RW ❑ Z CITY ' REAR O o APPUCANT TEL. SIDE/SIDE STREET RW O � CONTRACTOR GN � , SIDE ❑ � ADDRESS !tl$� '� ��2Ai1/�N S7 � -L�� PROPOSED USE RC. � CITY /aICS1�dt�b ZIP TEL�����Q � � ARCH/ENG! .�y , �.a n 'S zR DESIGNER L7 AO �111I�H - NO.DWEL NO. NO. �[ ADDRESS I UNITS STORIES BEDROOMS _, ciTv L�}Iir�c,vdoD ziP TEL.3 �'" DESCRIPTION S�.FT. FACTOF PSF ADJ.AREANAI.UATION oy � OWNER-BUfLDER DECIAAATION � SFR/ADD/REM O 0 �FIEiIEBY AFFlRIA IAJDER PEN/�LTY OF PE0.NRY tHAT 1 AM EXEMPT FitOM THE CONTRACTORS L4 Garege/Carport W CF115EUWFORTHEFOLLO�M�NfiREA50N(SEC.70.11.6BUSMESSANDPROFESSIONSCOOEANVCIiYOR (n � U COUHTYWHIpIREOUTAESAPERMI7TOCON9TRUC7ALTER�PROVE,DEMOlISH.ORREVAIRMIV9TRUG w Pa1i�� wNRE,PRIOfl TO RS�.SSUANCE,�LSO REOU�RES TFIE MPlICM1T FOR SUCM PERAIIT TO F1LE A&ONED � STATEMFHf THAT HE OR 6HE IS LICENSED.PURSUNdT TO TIiE PROV451DNS�OF TME C9MRACTOR9 ll� (J„ Ppp�S 8 � CENSE UW(��PTEN V�COMMENCW6 WITH SECTION 7000)OF DMSION 3 OF THE BUSINESS AND PR6 � P FESSqHS COO�OR 7HAT HE OR SHE IS EXFJAPT THEREFROM AND TME BA515 FOA THE ALLEOED E](EMP• TION.ANV.VIOLNTIONOFSfCTlON7031.5BYANYAV7LICANTFORAPERMITSUBJECTSTHEAPPLICANTTO . Z RB-ROOI � q Cry1t pEN/�LTY OF NOT idORE T}UN FNE MUNOREO�OLLAHS{SSOo�): � ❑4�OWNEROFTHEPROPERTY,ORMVEAIPLOYEE9N�THN'AGESASTHEIRSOLECOMPENSATION, O COrt11T8fC181 � Z WILL 00 TME WORK�ND THE 3TRUCTURE 19 NOT INTENDED OR OFFERED FOR 9ALE(SEC.70N,BU51� J N NESS ANU PROFESS�ONS COOE 7liE CONTMCTORS IICENSE uW DOES NOT MP�Y TO AN OM7iER OF ? � ppppEpJyy/HpgURO30RIMPqOVESTHEREON,ANDWHODOES5UCFIVAJRKHIMSELFORNERSELFOR m . � iryROUGH HIS OR HER OWN EMPLOVEES,VRONDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR QOFFERmFORSAIEIF.HOWEVERTMEBU0.DIN00R4/PROVEMEM1950LDWfTM�NOFIEYEAROFOOMPIE- . Z TqN,THE OWNER-BUILDER WILL HAVE TME 9URDEN OF PROVW�THAT HE�A SNE DIO NOT BURD OR � IMPROVE FOA THE PURA0.S£OF SALE} W ❑1,A90VMER OF THE PROPERTY,MI EXQUSNELY CONTFiACTPI�WITN LICENSED CONTRACT�RS [C TO CONSTRUCT TME PROJECf(SEC.70N.BUSINESS ANO PROFESSION9 CODE:TME CONTMCTOHS U- VBIU9tIOf1 S� • AW.AREA' � CHiSEUWDOESNDTAP9lY.TOAHOWNEFiOGAPflQPERNWYIO&JIIDSORtMPHOYESTHEREON,ANU NRIOCONTRACiSFORSUp1PRQ1ECfSWITHA00NTiUCTOR(S)LICENSEDGURSUANfTOT/iEGOMRAG pUANTTY DESGRIPl10N FEE . 70fiS 110EN5E LAW.). O ❑1 AY E%EMPT UNDER SEC. B.d V.C.FOR THIS REASON � cE p rH cc.�S � Q � DATE OWNER V. � Z W �¢ UCENSED CONTFACTORS DECLARATION - `� � � �C W I HEREBY AFFIfW UNDER FENALTY OF PERRIAV THAT IAA/LICENSED UNDEF VROV�SbNB OF CHAPTER d 9(C�1.WENCWO WITH SECTION 7000)Of DNISION J OF THE BUSINESS MID PROFE55lONS CODE,/Wp X M'LICENSE IS R/FULL FORCE AND EFFECT. LLI �ss 3 3 / � UCENSE C LIC.NO. � . U DATE 3� GONTHACTOR SA D 'D i�A 1 LJ � LLJ � WORKERS'COMPENSATION DECLARATION - � � � I HEREBY AFFIRM UNDER PENALTV OF PERIURY ONE OF THE FOLLOW W�DECURATIONS: � � _I NAVE AND VlILL►1NNTAIN A CERTIFICA7E oF CON5EN170 SELF-INSURE FOR WORKERS' � �COMPENS�TION.lu^PROVIDED BY SECTION 3700 Of THE U90H CODE.FOR TME PERFORMANCE . . . OF THE WORK FOR NM1tlCH Ti13 PF.RMIT 13 ISSUm. � _�H/�yE ANU WILL AWNTAIN.WOW(ERS'COMPENSA7qN MSURANCE;�.+^REOUIRED BY SECTIDN Q 37000f�iHE LABOFl CODE.FOR THE PERFORMMICE OF THE WORN FOR WNIp1 TMIS PEAMIT�8. �3�-�( ISSUEp.Ary WpRKEAS'COIAPENSRTiON INSUMNCE CMRIER/�ND POIICY NUMBER ME CONSTRUCTION�� � �R�Eq PLFW REVIEW O �-Z�U 0 aaicvNuraeEa ELECTRIC � ' J opruss[cnarr�IDr+oreEoona�r�oFn��rsFor+a��oocusasR�oo�oa�ssl ?LUMBING — - w MECHANICAL `� Z I CERTIFYTMAT IN THE PEPFOAAAANCE OF THE WORX�OR WMIp1 TN13 PERM�7 IS LSSUED,1 (J SHALL NOT EMPLOY M1Y CERSON W ANY NANNER SOAS TO BECOME SU&IECT 70 THE � VARKERS'COAIPENSATION LAWS OF GLIFORNI AND AGREE THAT IF I 5/40ULD BECOAIE �NSPECTION FEE SU&IECTTO W�AKERS'COAIPEN9AT P ISIONSOFSEC710N37000FTHE ISSUANCE � �'-� OCOUE I SHALL F7�MWI7H COMPLV WI iH0 E ROVIS . � p oA7E:D �I Z App��,�{: .SMIP � � w ENERGY P!C —� WARMN4 FA9.LRE TO SEd1RE W'ORKER5 COMFENSA710N COVERAGE IS UNLAWFUL,A7JD SMALL BE � - - � J SU&lEC7AN EMPLOYER To CRIMIIUL PENAL7IES AN�CIVIL FMES UP TOONE HUNDfiED 7t1DUSAND LL pp�{,ARg(=1pp,pppj,IN Ap�IT10N TOTME COST OF CAMPENSATfON,DAA/AGES IS PHOVIDFD FOR�N �EROY PERMIT J SECTION 370e OF iHE LABOR COOE.INTENEST,ANDATTORNEYS FEES. � RETENTION FEE: . Q w CONSTRUC710N LENDING AGENGY PyE�T FEE:,,, �- a �L �� � 1 HEHEeY AFFlHM UNDER PENALiV OF PERri)AY THAT THEFE 18 ACANSTAUCTION LENDWO AOENCY �,1 � �� Z �FOR THE PERf4FU1ANCE OF 71�E wORK FOR wHlp1 THIS VERMIT IS 155UED(SEC.3087.CfV.C.} W � LENDEH'S NAME . . . . � LENDERBADDRE55 � � � I CERTIFV hIAT I HAVE READ 7HI9 APRICATION AND STATE TIATTHE ABOVE�NFORlMTION�S CORHECi. TO�AL FEES. ���, s g ' w �p(aqEE7p�q,�p�yypTT{/�J.CITYANDCOUNTYORDINMICESANDSTATEUWSRELATWOTOBUILDIN(i � CdHSTRUCfION.ANO HEREBV AUiHOR�ZE HEPRESENTATNES OF TM�S COl1NiV 70 ENlER UPON iNE ZABWE-MEMIONED VROPERTY FOR INSPECTION PURP0.SES COMMENTS "� �. ' � v , N m VERM� E lvaiuTl . _ � � 3� �� � �SttiNA PE - p RECPT.NO. PAID BY VALIDATION � WHITE--aepartrnent Copy,YELLOW—Finance Copy.P�NK—Assessw Copy,GOLDENROD--FIIe Copy,GREEN—AppltcanYs Copy CITY QF DIAMOfVD �BAR � a � . iNSPECTIt�PV RECORD •r s,_ _ '� p� D P. ; �`;,. � ' i �� ., . . , , , , , � ��,. .�. � „', � . ' - o ` .r .. ,, h.�., � � .r u��.�. � � . D {- .•., 0 Q k SETBACK FLOORJOIST . _ FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDEk flOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FlREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BONU BEAM ROOF SHEATHING 8 Ff.BONQ BEAM � FRAMING/VENTILATION � � ' FINAL BOND BEAM R�_ PRE-GRADING ROUGH HEATING ' BENCHING � ROUGH ELECTRI� � � � ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FlNAL CEILING INSULATION QFF SITE IMPS. DRYWALL NAILItdG Q� �Z DEDICATIONS SEWER FINAL ENG. SEPTICTANK LANDSCAPE/IRRIG. 5EEP PIT/L.L. ;�, ON SITE IMPS. GAS AIR TEST '' ' FINAL ZONING FINAL CQNST. fIRE DEPT.FINAL FINAL HEATING HEALTH DERT.FINAL FINAL ELECTRIC DEV.FEES PAID FINAL PLUMBING ENERGY FINAL PLANING , FINAL ENGINEERING • � � COMMENTS `�, c�� �3� �2. � � � �._� . SEPTICTANKSIZE SEEP PIT/U SIZE -- i ���; rt � � f+ — i � i � ,