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HomeMy WebLinkAbout17755 (33) _�� CITY OF DIAMOND BAR DEPARTMENT OF COIvIIv1UNiTY&DEVELOPMENT SERVICES 21825 E.Coplry Drive (909)860-3 L95 Fax(909)861-3117 PRESS ��^�� BUILDING PERMIT APPLICATION FIRMLY oJOBSITE 7 ��' DATE CATION �' r,.y PERMIT p/� `� �8-- �7r,yc�nd.en. 3 ADDRESS NUMBER •1?7�SS # APN TYPE OCC ISSUE LOT TRACT OATE 3/ t t I �L CONST. GROUP p OWNER p ADDRESS Iini ZONING SEiBACKS z CITY — ZIP��TEL FRONT RW ❑ o APPLICAN � TEL •--C R�R O � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE � � ADDRESS � C� ZIP TEL. —C " PROPOSED USE — e Y o ARCWENG/ ` ` z� DESIGNER N0.DWEL NO. NO. / a. ADDRESS N UNITS STORIES BE OOMS N CIN ZIP TEL. N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION p SFR/ADDIAEM p I HERE9Y AFFlRAI UNDER CENALTY OF FEiWRY iNAT I A1A EXEIAPT FROM THE CON7MCTOqS U• Gdf89e/CHfpOA W CENSEUWFORTHEFOLLOWRI(iREASON(SEC.70]7.6BUSWCSSMlDPROFESSIONSCOOE:ANYQNOR (n V COUNTVWH�CHREOUIRESAOEFMRTOCONSTRUC7,ALTERIMPROVE.DEMOLISH,ORHEPAIRANYS7RUC• p8Ii0/DOCk w lURE,PRqR TO R9 iSSUANCE.AL50 REWIRES THE APPLICANT FOR SUCH VERMI7 TO FaE A SIGNED W .� STATEMEN7 THAT HE OR SHE IS LICENSED PURSUM7T TO THE PROVISIONS OF THE CONTMCTORS LI• � CENSE lAW(p1APTER Y(COIAMENqN6 WITH SECTION 7000)OF DINSqN�OF THE BUSINESS/ND PRO- � PooVSpa , FESSpNSCO��ORTMATHEOR5HEI5E%EAIPiiH[REFROMANDTHEBASISFORTHEALLEOEDEXEMP. (� TION.ANVYKK7lATqNOFSECT10N7071.6BYMIYAPPIICMlTFORAPE(iMIT5U61ECTSTNEAPPLICANTTO Z pe-Roo1 A CINL PENN.TY OF NOT MOfiE THAN LNE HUNOHEO DOLURS�SSoo).�: Z ❑I.ASOWNEROFTHEPROPERTY,ORAIVEMVLOYEESWITHWAGESASTHEIRSOIECOMPEN5A710N, 0 Commercial . NALLDO THE WORK,AND THE STRUCTURE IS NOT IN7ENDED OR OFFERED fOR SILE(SEC.70a�,BU54 J N NESS AND PROFESSIONS COOE:TNE CONTMCTORS UCENSE UW DOES NOT APPIY TO AN OWNER�F � PROPERtt VA/0 BUIIDS OR IMPROVES 7HEREON,ANO WHO DOES Sllp1 N+ORK MIMSELF Oq MERSELF OR W THROUCH MIS OR MEROWN EMG�OYEES,VROVIDEO THATSUCN MPROVEMEMSAflE NOT INTENDED OR LO 0 OFFEREDFOHSALEIF,HOYYEVEf�T1/EBULANGORIMPROVEMENTISSIXDWITMNONEYEAROFCOMPLE Z TION.7ME OWNERWdDER WILL HAVE TNE OURDEN OF PROVINO THAT HE OF SHE DID NOT BUIID OR pAPFiOVE FOq THE VUNPOSE OF SAIEI. �=jJ OI.ASO4YNEROfMEVROPERTY,MIE%CLUSNEIVCONTRACTIN6WITMLICENSEDCONfRACTORS ^ Q: TO CONSTRUCT TNE PROJECT(SEG 7W�.BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� VdlUeli011 _ R� ADJ.AFiEA �O L , W CENSEUWOOESNOTAPVLVTOANOWNEROFAPROPERTYWHOBURDSORIIAPROVESTHEREON,AND � 1N�OCONiMCTSFORSUC110ROJECTSWITHACANTMCTOR�S�IICENSEDPURSUAMTOTHECONTMG QUANTITY DESCRIPTION � TORSLICENSEUW.} FEE � ❑IAME7(EMPTUNDERSEG B.iP.GFORTHISREASON Q � U � DATE OWNER H Z U � LICENSED CONTRACTORS DECLARAT�ON W � I HEREBYAFFIRM UNDER PENALTY OF PEiWRV THAT I AM LICENSEO UNDEiI PROVISIONS OF CHMTEH � p. i(COAV.IENCINON77HSECTION70aa)OiDM510N�OfTHEBU31NES3ANDPROFE55iON5CODE,AND Z `u MY�ICENSEISNFULLFORCEANOEFFECT. m � UCENSE CUSS � UC.N0. � � � V DATE IZs' CONTMCiOR � d _ ..W � WORKERS'COMPENSATION DECLARATION ¢ � IH YAFFIqMUNDEHPENALTYOFVERNFYONEOFTHEFOLLOWW00ECUMTI0N5: Z � IHAVEANDWILLMAINTAINACERTIFICATEOFCONSEMiOSELF-INSUREFORWOPKERS' a VENSATqN,ASPRoviDE0BY5ECT10N77aoOFTHEUBOliCOOEfORTME7EAFORMANCE U Q OFTNE WOFLC FOR VMICM THIS PERMIT IS ISSUED. � Q �IHAVEANDWILLM�MTAINWORKERS'COMPENSATIONINSURANCE.ASREOUIREDBYSECTION � _^D� Q ]7000FTNELABORCOOE,fORTHEPERFORAIANCEOFTHEWORKFORWHIp/7HI5PERMITtS C� J ISSUED.MYWORKERS' PEN TIONINSru�r I�C�ECARR�IE ANOPOIICYNUMBERME: CONSTRUCTION J � CMIiIER �'it� ��i��'�'�P PLAN REVIEW � Z va�cYNur�BEa r2���"� ELECTRIC ¢ p (iHSSECipNN�N0T8EC0A�REfmOihEFEtIMis�OitOMEMI�Dl7EDOotLu�'iKloolORtFss1 PLUMBING W Z ICERTIFYTIUTINTHEPERfORA/ANCEOFTNEWORKFORWHICHTHISPERMITISI55UED,l MECHANICAL CJ SNALLNOTEMPlOYM/YPER50NWANVMANNER50A5TOBECOME5UE7JECTiOTHE � V10PotERS'COUGENSATqNUwSOFCALIFOHNI0.�NDAGREETHATIFIgMOULOBECAME INSPECTIONFEE SU0.IECT TO THE WOpKERS'CAMPENSIITION PHOVI510NS OF SECTION 770o OF THE VBOR ^� s cooE,i oarm�n�ca.+�.rwin�rHosE arnns•io•rrs. 'q ISSUANCE Z,� p DATE: /I ��PPLICANT:I �//�I r4�T SMIP � WARNINO: A4URETOSECUREWORKERS'CAMPENSATpNCOVEPAGEISUNUWM,ANDSHAL�BE ENERGYP/C •SD � SUBJECi EMP�OYERMCRIMINALPENALTIESMlDGMLFWESUPTOONEMVN�REDTMOUSMIO ENERGYPERMIT ¢ DOlURS(S1oa,000),W ADOITION TO TNE COST OF COMPENSATIDN,UAMACES AS VROVI�EO FOIi IN SECTqN�)OBOF7HELABORCOOE,INTEFESL�HDATTORNEY'SFEES. RETENTIONFEE: � � CONSTRUCTION LENO�NG AGENCY pqE•ALT FEE: � IHEREBYAFFIRMUNDER7ENALTYOFPERIURYTNATTHEREISACANSTXIKTIONLENDINCAGENCY FOR THE PEflFOHMANCE OF TME WORK FOR WMICM TMIS VERMIT�5 ISSVEO(SEC.70Y1,CIV.C.�. Z W � LENOERS NM1E F—� LENDERSAODRESS w ICERTIFYTHATINAVERFIDTHISAPPUCATION/WDSTATETFIATTHEABOVEWFOiUTATqNI3COAIiECT. TOTALFEES � J� � � IAGREETOCOMPLYV✓THALLGTYANDLOUNTYOROINANCESANDSTATEUWSNEUTINGTOBUIIDING � CANSTRUCTION,ANOMEREBV�UTMORIZEREPRESENTATIVESOFTMISCOVNTYTOENTERUPONTME � Z ABOVE�MENTIONED VRDPERTY FOq INSPECTqN PURVO5E5. COMMENTS � � ` �/G m oERMITfE N E�PpIM) ¢ 0'z� � Vj SIGN U -Of PERM�TT _ TE � RECPT.NO. _PAID BV � � VALIDA710N WHITE—Department Copy,YELLOW—Finonce Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy .,,:,.:.,.,,:. �,.._. , . . _,.,.:. � , - , . .. .,. . , . P...'� 'i�.. '.::.T.�1.L.!"ia.�a����J.w .�.�t'^l.... .;. � .,. ... ., .,-.,� r ...C'. .��•... ..... '. - .... . .. . .i ��� . . . . � � . , � , . . .. •�.. .. �. Ci1Tl �A l�'1'r ���t��1�� ��.�i {��<CJ�'� .�r����� ��.ri��i� �.__...,._,.._.._._..._... . - �,.. _. . '�F �k ,--.^ .�' �:'G' 1 �I'a-e '6!l 1�G . . _ �-- (►�l-'���=,.�'�rl��►I t) ' F�'� ... c c �� I E- . � �� cy��r_. i�►���{:I�c�'ro : � � �,� ; �- �� �-, , ��:� � ____-- ------.__.�________. _�.._ _.____ ...__. _.... _--.---- . .._._ _____ ._.._.__ .---__�_.__.______�_- __�.. SET BACK I ; .. _ � FLOOR JOIST . � - � � FTGS,�FORP�IS/STEEL ! _ �'^ ' FHA REQUITS � ELECTRIC GROUNO � ' � UNDER FLOOR DUC� GROUND PLUMBING i urdDER FLOOR cU��DUIT I SLAB GRADE FIREPLACE FOUNDATION I TEMP POWER � I FIREPLAGE BOND BEAM WATER SERVICE I PAID Hl. BOND BEAP�� ROOF SN�ATHING / �j.� f3 FT. BOND EEAM I FRAP�ilNGNENTILtATION I � � FINAL SOND BEAh4 I ROOF COVER ��(� PRE-GRADING ; ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH uRADING SHOWER/TUB TEST � POOL ELECTRIC EXT. Lf1TH/SIDING POOL FEPJCING � WALL IPJSULATION POaL FINAL � CEILING IN�ULATION OFF SITE IMPS. DRYWALL NAILIPJG DEDICATIONS SEVJER FINAL ENG. SEPTIC TANK LANDSCAPEIIRRIG. SEEP PIT/L.L. - ON SITE IMPS. � GAS AIR TEST FINAL ZOPJIPJG FINAL CONST. � F!RE bEPT. FINA'_ FINAL HEATING HEALTH DEPT. FINAL � FINAL ELECTRIC DEV. FEES PAID FINAL PLU�v1B!NG �i EfJERGY � . ---„-...'....-,-,..-..-�_.-�-----_._._... �t,:�r� t.,��.��:r,.,�. � connnnEr�-rs _ _ , SEPTIC TANK SIZE � SEEP PIT/U SIZE -----.---------, `)�I� ; '�}� _ . I � � _ �