HomeMy WebLinkAbout17652 (17) � �
CITY OF DIAMOND BAR -�
��� � DEPARTMENT OF CO1vIlvIUNITY&DEVELOPMENT SERVICES ��
21625 E.Copley Drive
(909)860-3195 Fax(909)861-31 l7 PRESS
�"%����' BUILDINGPERMITAPPLICATION FIRMLY
� JOBSITE �2� J �� G , DATECATION���`� NUMBER ��W �'C � d-
o ADDRESS��-�
� ISSUE TYPE OGC
APN LOT T ACT DATE � � CONST. GROUP
p OWNER �C�K a '
o ADD SS ZONING SETBACKS
gCITY . ZIP 7. TEL. REAR RW nO
APPLICANT TEL. SIDElSIDE STREEf RW ❑
� CONTRACTO � SIDE ❑
o CDDRESS , � ZIP�j TELL / • , PROPOSED USE l'G- •!3• '� �
o ARCH/ENG/
� DESIGNER NO.DWEL. NO. NO.
� ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
cn
�n , DESCFiIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUILOER DECLARATION SFR/ADD/FEM
O
1 HEREBY AFFIRM UNDEH PENALTY OF PERIURY THAT 1 AM EXEMPT FROM THE GONTMCTORS L4 GBfepB/CBIpOR
W CENSEUWF011TMEFOLLOWINUNEASON(SEG70.'lt.6BUSME55ANDVROFES5lON5CODE:ANYC17YON (n
U COUN7YWHICHREOUIRESAVERMRTOCONSTRUCT,ALTEA.MPAOVE,DEMOUSH,ORREPAIRAM'STRU6 W Patio/Deck
� TURE.PRIDR TO RS ISSUANCE.AL50 REWIRES THE MPLIGNT FOR SUCH PE(iMIT TO FlLE A SIGNED W
STATEMENT TFWT HE Ofl 6HE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON7MCTOFi3 LF
� CENSE LAW(CMAPTER i ICOMMENCWO WIiM SECTION 7000�OF DMSqN J OF TNE BU51NE55 AN�PR6 u' PooVSpa
FESSpNSCOOE)ORTMATNEORSHEISEXEMPiTHEREFROMANOTHEBA515FORiHEALLEGEDE%EMP�
� TIDN.ANYVIOU7qNOFSECT�ON70.71.6BYANYMPLICANTFORAVEHM175UBJECTSTMEAVPIiGANiTO Z Re•Roof
ACMLPENALTV OF NOT MORE TNAN FNE HUNORED DOLURS�SSao�.�:
O 4A+`O�ER OF 7HE GROPERTV,Oq MV EAIPIOVEES WI7H wAGE5A5 7NEIR SOLE COMVENSATiON,
� � Commercial �
N7Ll DD TME WORK AN�TFIE STRUCiURE IS NOT INTENDED OR OFFEHED FOfi SALE(SEG 7ou.6tJ51- J
N HE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE lAW DOES NOT AGPLY TO AN OWNER OF ?
PROVERTY NkiO BU0.DS OR IMPROVES TIEREON,AND W/IO DOES SUGI4MORK HIMSEIFOR HERSELF Op
CL 7HRWCS111ESORHEROVMEMPLOYEES,PROVIDEOTiATSUq11uPFOVEMLNTSARENOTIMENDEDOR m
� OFFEREDFORSALE.IF110WEVER717EBULDINOORWPROVEMEM�SOIDWITNINONEYEAROFCOMPLE•
Z TqN,THE OWNER�BUIIDER WILL/UVE TME BURDEN OF VROV�NO T/1AT HE OR SNE DID NO7 BUILD Oq
� MPROVE FOR TME iURP0.5E OF SALE}
W Ot�OwNEHOFTHEDROPERTY,MIE%CLUSNELYCON7RACTINGVnTHIICENSEDCON7RACTORS
� TO CONSTRUCT THE iROJECT(SEC.7oN,BUSINE55 AND PR�FESSIONS CODE:THE COflTMGTOR3 LI- V71Ufl11011 ADJ.ARFA
W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTVWf10Bl1RD90RIlAP1iOVE57NEREON.ANO
� N71000HfMCTSFORSUCHPROJECTSWITNA00NTMCTOR�S)LICENSEDPURSUANTtOiNECOMMG pUANTITY DESCRIPTION FEE
Y TORS LICENSE UW.�
� ❑IAM EXEMPT UNDER SEC. 8.6 V.C.FOR THIS REASON v '
�
LL' D�TE OVMER �
Z W
� LICENSED CONTRACTOHS DECLARATION W
� IHEREBYAFFUiMUNDERPENALTYOFPEiWRYTMATIAA1lIGENSEDUNOERPPOVISIONSOFCHAVTER �
p. •(COMMENCW6WrtH5ECTqN7o0olOFDM510N70FTME8U51NE55ANDPROiES5lON5CO0E,AND Z
X MYLiCENSE IS IN i C�M1D EfFECL / �
LtJ C� f �
� UCENS`E CI.AS1 �� LIC.NO. / �L �
.. �'j DATE,+C^I1.�O.�. CONTRACTOR �'�7A�C0�� d . . . . . .
W
� WORKERS'COMPENSATION DECLARATION a �
= U
� IHEREOVAFFIPMUNDEi1PEN/LNOFFEiLNRYONEOFTFIEFOLLOWW6DECUMTIONS: Z
Q
0 �I1IAVEANDWILLMAWTNNACERTIFICAiEOfCONSENTT09ELF-INSUREFORWORKERS' _
� COMGENSATION,AS Pf10V10ED BV SECTiON 7�ooOF TME LABOR COOE.FOR TME VERFORIIANCE �U
Q TME WORK FOR WHICH THIS PERMI?IS ISSUW. .�
I NAVE AND WILL MAINiNN WORKERS'COM1IPENSATION MSUAANCE.AS REW�RE�BY SEGI�ON
Q 970o OF THE LABOR COO�fOfl THE PEA�FiMNNCE OF THE WORK FOR NhiICH THIS PERMIT IS �"
ISSUED.1.('/VIORK RS'E COMPENSATIO��SURANCE RIERAN�POIICYNUAIBERME� CONSTRUCTION _ I n
� CARiUEq_5.S/a7��LxT'C_� .Y 1 PVW REVIEW .
� POIICV M1IABER y�z� � b ELECTRIC
o fnss5ecrbr+r�mr+oreeae.s�rmoFn�rEw�+rswnoneMro�+Enwu+�nsR+�o�+tcssl PLUMBING
Z ICEiR�FYTMATIN7HEPERFORMANCEOFTHEYVOfiKFOHWMICHTHISPERA11TI5155UED,1 MECHANICAL
(} SHALLNOTFMttOYANYVERSONINMIYMANNERSOA5TO8ECOMESUBJECTT07ME
� NORKERS'COMPENSA7iONUW50FCALIFORNiAANDAGREETINTIFISMOULDBECOME INSPECTIONFEE _�
S SVBJECTTOIHEN'ORKERS'COMPENSATiONPROV1510N50FSECTKK�1770oOFTHEIABOR
cooe,i swu.�sonrr+wirn ca.�v�r win+nase rrro�nsar�s. ISSUANCE
� SMIP �.�
p DATE: APPLICANT.
� ENERGY P/C
WARNIN(i:fAILUHE TO SEQIRE VYORKEflS'COMPENSATION COVERAGE IS UNUWFUI.AND SHALL BE
� SIAIECTAN EMP�OVERTO CRIMINAL PENALTIESAND CMLFWES UP TOONE NUNDRED 71qU5ANO ENERGY PERMIT
�S lf 700.000).MI MDITION TO THE COST OF COMPENSATION.DAMAGES/S PROVIDED FOR IN
� SECTqN]l0!OF THE U100R CODE,NTEREST,ANO ATfORNEYS FEES. RETENTION FEE:
aW. CONSTRUCTION LENDING AGENCY PFiE-ALT PEE:
O
� IHEflEBYAFFlRMUNDERGENALTYOFPERIURYT/UTTHEHEISACONSTRUCTbNLENDWOACENCV
z fOR THE GEFiORMANCE OFTIIE WORN FOR WMIpi TMS VEfUA1T IS ISSUED(SEG.10D7,LIV.G}
W
� LENDER'S N�A1E
� IENDER'SAOORE55 ��
¢ ICER7IFYTHATIHAVEREADTH�SAPttIG1TIONANDSTATETHAiTHEABOVEWFONAATIDNISCORRECL TOTAL FEES S � �� �
� IAGREETOCOA�PLVWITMAU,GTYANDCOUNiYOROINANCESANDSTATEUWSAEUTWOTOBULDIN6 r`l
CONSiqUCTION,AND MEREBV AUf/10R12E REPRESENTATIVES OF TNIS COUNTY TO ENTEN UDON iHE [��W
Z VE•MEMIONEDCROPEflTYFORINSPECTIONPURPOSES. �
o �
COMMENTS �
�
¢ aMI7TEE NAL1E(DRI
�
y EOFPERMITiEE DATE
� PECPT.NO. PAID BY VALIDATION
WHITE—Departmant Copy,YELLOW—Financa Copy,PINK—Assessa Capy.GOLDENROD—File Copy,GREEN—Applicant'a Copy
�� ..^,s. 3 e..;....�•.�,l�.•aR.r.;r`�•r��'��U+..e.rri�r�•,.�.y.,,.�;..T..r:.p�1:'r�v-.Y'W':..,:�n!wSlt�'[.-,r,.�,.qA.1� .. __. _._._ _ . . _. , ... .. , . .cr . . i . . �... .. .
�!�"Y �� DiAMOND BAR
� 1�aSpEC�'1fJN I�ECC)(�D
�,. _ �---�-----�� .�--�-�----�
����+�����t�►J i���.�� ar►���.����.�d��r� . '.[►��.3"�i.d(���►�.� :: ��'.�.r� �1.��.�;�:�� a��
,-_v _._. . ,�...._ .�. _�._W _ �.__ .. .
SET BACK � ��� W; y_� FLOOR JOIST ' � __ ' . _
FTGS/FOflMS/STEEL � � • FHA REQMTS �
ELECTRIC GROUND � UNDER FLOOR DUCT --�
GFiOUND PLUMBWG I UNDER�LOOR CUf�IDUIT . •
SLAB GRADE FIREPLACE FOUNDATION � '
TEMP POWER � � FIREPLACE BOND BEAM
WATER SERVICE. MID HT.E30ND BEAM
ROOF SHEATHING I ' ' e FT. BONQ BEAP�I. �
FRAMINGNENTILIATI�N I FINAL BOND BEAM �
ROOF COVER � PRE-GRADING
FIOUGH HEATING BENCHING
ROUGH ELECTFiIC � f ' I ROUGH GRADING
ROUGH PLUMBING i i ; FINISH GRADING I
SHOWERRUB TEST � POOL EIECTRIC �
�
EXT.I�TH/SIDING � �POOL FENCING
WALL INSULATION i POOL FINAL
CEILING IN�ULATION OFF SITE iMPS. !
DRYWALL NAILING QEDICATIONS �
SEWER FINAL ENG.
SEPTIC TANK � .-. _ � LANDSCAPEIIRRIG.
SEEP PITlL.L. I ON 51TE IP,APS.
GASAIRTEST- � _/ „L�— � FINALZONING
FINAL CONST. �/`�/6'� ��IRE DEPT. FINA!
FINAL HEATING ; j HEALTH DEPT. FINAL � ;
FINAL ELECTRIC ; ! DEV. FEES PAID
FINAL PLUMF3ING i i ENERGY
� ..
, °��^;,E��e��]�,��.�: �
_.�..,.:..�..:'.•–
. _.. .. _,,;,r..,: ,
� _ _ ...__ . __ _ ..._ ___ `.
+ COMMENTS
SEPTIC TANK SIZE , _.
SEEP PIT%U SIZE
_
_ ���a�_ �: _ ��
_ . ,;
_ �
��i�- .-� �,��' .
.. I . .
�.r.. �_..r_. -�I . _ . -