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HomeMy WebLinkAbout16281 ��� CITY OF DIAMOND BAR EXPIRED DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES Zi�o E.c�iey nri��s�c�i90 A PRESS � (909)SGO-3195 Fax(909)861-3117 HPR 2 5 ?003. I ���', BUII.DING PERMIT APPLICATION _ FIRMLY N' JOBSITE �j / APPLICATION PERMIT P/C o ADDRES� �/�I DATE � NUMBER # � ISSUE /S TYPE OCC APN LOT TRACT DATE �� CONST. GROUP p OWNEA (y�Y. J�'1�,TL �7 is il�L' ��-' p ADDRESS � � ' ZONING SETBACKS z CITY ZIP 1ir�� TEL�E��' ^�`+� . FRONT RW ❑ g APPLICANT. � � TEL.` y�'S Lt-<<i%YL REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE ❑ gADDRESS PROPOSED USE��/1���j�//.'� �o!% _S� L�f/�//)ClC!✓`S CfTY ZIP TEL. -�—� w ARCH/ENG/ DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS � STORIES BEDROOMS � CITY ZIP TEL. � v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION ¢ OWNER-BUILDER DECLARATION SFR/ADD/REM O � 1 HEREBV AFFlRM UNDEH PENPLTV OF PERRIRY THAT I MI E%EMPT FROM THE CONTRACTORS LI� Gflf99B/C9fPOff C8ISEUWFORTHEFOLLOWINOREASON(SEC.7o91.6BUSMESSANDPROFES510N5CODE:PNVp7VOR (n COUNTYWHICHREWIRESAPERMff7000N31TiUCT,ALTERIMPROVE,DEMOLISH,ORREPAIRANYSTRUG W P8t10/DBCk TURE,VRIOR TO 1T9 199UANCE,�LSO REWIRES THE MPLICANT FOR SUCFI PERMfT 70 FlLE A SIONED w S7ATEMENT TiA7 HE OR SHE IS LJCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS lb � CENSE UW�CHAPTER Y(COMMENCNO WfTH SECTION 7000)OF DMSION 3 OF THE BUSINESS AND PRO- � POOUSFIB FESSqN9CODE)OR7}UTHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORhIEALLEOEDE%EMP- (rJ TqN.ANV VIOLATION OF SECTION 70J1.6 BV ANYMPLICMlT FOR A PERMIT SU&IECTS TNE APPLICANT TO Z Re-Roof � ACML PENALTY OF NOT MORE TH�71 FlVE HUNDRED DOLURS(f500).): O �4�OWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAOESASTHEIRSOLECOMPENSATION, � CORIrtIBfC19I . � ' Z WILL DO THE WOPo(M1D THE STRUCNRE IS NOT INTEN�ED OR OFFEHED FOR SALE(SEC.7041,BUSI- J N NE93 AND PROFESSIONS CODE 7HE CONTRACTOPS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPEHfV WFp BU6DS OR IMPROVES THEREON,AND WHO DOES SUp7 WORK HIMSELF OR HERSELF OR S TMROUGH WS OR HER OWN EMPLOYEE3.PROVIOED THAT SUGI IMPROVEMENTS ARE NOT INTENDm OR m Q ,OFFERmFORSALEIF,IIDWEVEq7HE8UILDINOORIMPROVEM@RISSOIDWfTHINONEVEAFiOFCOYPLE Z 'TIOf/,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE OID NOT BUILD OR � W PROVE FOR THE PURPOSE OF SALEj. � ❑1,AS OWNER OF THE PiiOPEHTY,AA1 EXCLUSIVELY CONTMCfINO WfTH IICENSED COMRACTORS 70 CONSTRUCT T1E PROJECT(SEC.7M1,BUSINESS AND PROFESSIONS CODE:THE CXINTRACTORS LI� VBIU8II0l1 ADJ.AREA CENSE UW DOES NOT APPLY TO MI OWNER OF A PROPER7Y MRiO BUILDS OR IMPROVES 7HEREON,AND � WFqCONTMCfSFORSUCMPROJECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTIECONTMG pUANTITY DESCRIPTION FEE � � 70R5 LICENSE UWJ. ❑I AM IXEIIPT UNDER SEC. B.8 P. .FOR THIS REASON J 0 Q 3 � � o �� � U w F LICENSED CO TRACTORS DECLARATI(�N � � w I HEREBY AFFIAIA UNDER PENALTY OF PERIURY THAT I AM LICENSED UNDER VROVISIONS OF CHA7TER � , � Y(COMYENCWO WITH SECTION 7000)Of ONISION 3 OF THE BUSINESS AND PROFESSIONS COOE,AND Z �� W LICENSE t5 RI FUIL FORCE M1D EFFECT. m ��. LICENSE CLASS LIC.NO. j t� DATE CONTfiACTOH d LL � WORKERS'COMPENSATION DECLARATION � � � 1 HER�Y AFFIRM UNDER PENALTV OF PERIURY ONE OF THE FOLLOWINO DECLAMTIONS: Z � _IHAVEANDWILLMAPITAWACEqTIFlCA7EOFCONSENTTOSELF�INSUREFORWORKERS' $ Q COMPBISATION,AS PROVIDED BY SECTION 37000F THE 1A80R CODE.FOH THE PERFORMANCE U OF TIiE WORK FOR WHICFI THIS PERMIT IS ISSUED. W � _I MAVEAND WILLAIAINTAW WORKERS'COMPENSATION INSURANCE.AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE.FOR 7NE PERFORMANCE OF THE WORK FOR WHIpi THIS PERMR IS �((� ^ ISSUm,NY WORICERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBEF ME: CONSTRUCTION L]�' �� Q > c�t+aER � PLAN REVIEW �Z va.icr wuMeEa ELECTRIC Q o (tV65sEcrnNrlE�NoreEaor.PLET�ocnECErMrsFORONEV4�oREnoou,U�s(Sloo)oqLFcc; PLUMBING Z I CERTIFV THAT IN THE PERFORMANCE OF THE N'ORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C!3 SWLLL NOT EMPLOV ANY PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE n � WORKERS'COMPENSATqN LAWS OF CALIFORNIA,AND A6REE TNAT IF I SHOUID BECAME INSPECTION FEE ` S SU&IECT TO THE WORKERS'COMPENSATION PROVISqNS OF SECTpN 370D OF TNE UBOR .. .__„._ .` CODE,1 SHALL FORTHWITH COMPLV WITH 7HOSE PROVISIONS. ISSUANCE � SMIP Q p DATE: � APPLICANT: � WARNINO:FA0.URE TO SECURE WORKERS'COMPENSA710N COVERA6E IS UNUWFUL,AND SHALL BE ENERGY P/C � SUBIECTANEMPLOYERTOCRIMINALPENALTIESANDCNILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOlURS(i100.000),M ADDI710N TO THE COST OF COMPENSATqN,DAMAQES AS PROVIDED FOR IN � SECTION 370e OF 7HE UBOR CODE,fNTEREST,AND ATfORNEV'S FEES. ' RETENTION FEE: • OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: ��-_ � I HERE9V AFFIRM UNDER PENhLTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDINO AGENCV ' � � ' . Z WR THE PERFORMANCE OF THE WORK FOR WHIGi TMIS PERMIT IS ISSUED(SEC.�OG7,GV.C.�. , W � LENDER'S NAME � . � . . . ,. • F— LENDER'SADORESS "� � I CERTIFV TMAT I MAVE READ THIS APPLICATION AND STATE THAT TIE ABOVE RJFORMATqN IS ODRRECT. TOTAL FE ES � . , ' 'S"7,��O� ' � I AOREE TO COMPLY N7TH ALL CfTV AND CWNTV ORDINANCES AND STATE UWS REU71N6 TO BU0.DING , , � � CONSTRUCTION,M1D HEREBV AUTHORIZE REPFESENTATIVES OF 7HI5 COUNiV 70 ENTER UPON hiE . Z ABOVE-MEMqNED PROPERN FOH INSPECTION PURP0.5ES. COMMENTS � '� ' � ' � � � � � � r QPEFMITTEE � E(PR' ' '' ' .. , � � ` 1 v � SICiNA7UREOFPERMIT7EE DA7E � � � RECPT.N0. PAID BY � VAUDATION- WHITE—Depertment Copy,YELLOW--Finence Copy,PINK—Asaessw Copy,GOLDENROD�ile Copy,GREEN—Npplicant's Copy �����5��� CITV OF Do�a6l�O�ID �A�i IF�9SPECY'OOdV RECf�F3D � ��� ; �� 9�G � �. . ,., , . , ,, . t . . � � O �.a��.w;, � � �g .� e 0 ��t'�'`� 0 0 '''` �'-- p�"� �� o � � . 7,. . .5' . � . SET BACK � � �`- FLOOR JOIST �, ��_ , � � FTGS/FORMS/STEE'L "• . � � FHA REQMT�� � " ' " � ` ' �� � , ELECTRIC GROUND � - � ' UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOA CUM1IDUIT ' SlAB GRADE FIREPLACE FOUNDATIOfV TEMP POWER FIREPL'.ACE BONQ BEAM WATER SERVICE MIQ HT. BOND BEAM R�OF SHEATH(NG ' 8 FT. BOND BEAM FRAMINGNENTI�tATION y�Z'J� - FtNAL BOND BEAM ROOF COVF_R PRE-GRADING :.; ROUGH HEATING � BENCNfNG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADiNG SHOWER/TUB TEST POOL ELECTRIC EXT. IATH/SIDING POOL FENCING WALL INSULATION POOL FINAL GEILING INSULATION (aFF SITE IMPS. DRYWALI NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK �ANDSCAPE/IAROG. SEEP PIT/I�.L. � • ON SITE IMPS. � � GAS AIR TEST FINAL ZONING FlNAL CC)NST. FIRE DEP7. FINAL FINAL HEATING HEALTH DEPT. FINAL _ . FINAL ELECTRIC DEV. FEES PAID - �=1�1AL PLUMBING ENERGY � __� -_ _`— o � �� .�r-_ S COfVIMENTS . , _ ,..,:- _ - . – �::� . � - _ � _____—_ SEPTIC TANK SIZE :, �� ., . SEEP PIT/U SIZE� � � � ' � r '" wZ"'t�`8���4 ;�"yYt� ��� .�'ei . _. �, 4 �[�.'� s � �t:' `-4 �v�'Z R �. �'4 firp . . __ �� A�';i�� '��fti d e� � J , . i� , r��, ; ,yy�yy��at#�� ,�µ�R�r� �� � . w yj`` r . "d;� ��� ��f r '.` A �:��j F�'. . 'v�'1a A 'e' l��. 1 �`. Q' . 7�V , l.� r����,f ��,}�jfy'. , ej �'� C � ,�; �.�'� �� '�"'�� ����'� • . - � ----- ._.�_ Y.�( � �v���� P . r J � �.+ • " 4 , l " '