HomeMy WebLinkAbout17797 (17) . _ - --- _.--- _ ___. .
- - _ __------_-- - - -_-_---- -------- ---- -�
_�� CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNI"I'Y&DEVELOPMENT SERVICES /
��y 21825 E.Copley Drive
(909)860.3195 Fax(909)861-3117 , PRESS
; "'<:� BUILDING PERMIT APPLICATION ; FIRMLY
�
� :JOBSITE � I� ' 1� ,�5��� (7� APPUCATION PERMIT j �nPj P!C �� I
o �ADDRESS (. � �'"�� DATE D NUMBER�_ '' #
c� ISSUE ! TYPE OCC
APN LOT TRACT DATE ' CONST. GROUP
p OWNER �
o ADDRES� ZONING SETBACKS
g CITYs�/�. .13R✓L ZIP TEL. RE�RT Rw Q
�APPUCANT TEL. SIDE/SIDE STREET RW' O
� .CONTRACTOR '� L � C� SIDE ❑
� ADDRESS 2/3 S Ll.v Si � pROPOSEO USE
� 'CITY� ZIP_ n�� TEL.
o �ARCH/ENG/
� �ESIGNER �— NO.DWEL NO. NO.
a. 'ADDRESS UNITS ' STORIES BEDROOMS
� 'CITY 21P �EL.
c�i� , DESCRIPTION SQ.FT. FACTOR PSF ' ADJ.AREANALUATION
Q ONMER-BUILDER DECLARATION SFR/ADD/REM � �
O
p I HEREOY AFFIRAI UNOER PENALTV OF PERRIRY THAT I AM E%EMVT FiWAI THE CANTMCTORS t4 Garape/Carport �
W CENSEUWFORTHEFOLLOWINOREASON(SEC70.71.68USINESSANDVROFESSiONSCODE:ANVCITYOR (n
U ;pOUNryWHIC11RE0UIRE5APERM�TTOCONSTRUCT,ALTER,MPfpYE,OEMOLISN,ORREPAIRANVSTRUG W patlo/Deck �
� ;TURE.PR10R TO RS ISSUANCE,AL50 REWIRES TME APPUCANT FOR SUCH iERAIiT TO fILE A SICNEO w �
�STATEMEM THAT NE 011 SME IS LICENSEO PURSUANT TO TNE VROViSION3 OF T1�E CONiMCTOR3 ll•
� �CENSE UW(d1AP7ER Y(COMMENqNO YnTH SECT�DN 7000)OF DMSION f OF 7ME BUSINE55 AND ORO- V' POOVSpB �
:FESSIONSGODE)ORTHA7MEORSHEI9EXEMPTTHENEFROIAMlDTHEBASiSFORTHEALLEGEDE%EMP•
� •TION.ANYVtlLATIONOFSECTION7aJ1.69VANY/NPLICANTFONAPERAlIT5U61ECT5THEMPLM.�WTTO Z Re-Roo1 �
�AGMLFENAL7Y OF NOT MOqE THAH FIVE NUNDREO DOLLAFS({S00).):
�L IlS OWNER OF iME PROFERTY.OR MY EMPLOYEES WITH WAGES AS THEIRSOLE COMPENSATqN. O
Z ' Commereial i
�N'ILL DO THE WOiIK,AND THE 6TRUCTUqE IS NOT INTENDED OR OFFEREO FOR SALE(SEC.7W/,BU51� J
N �NE54 M1D iROFE5510N3 COOE:THE CONTR�CTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � ,
'GRODfRTYNM1IOBV0.DSOR14FROVE5TIEREON,/WD WIIODOESSUCHN�ORKMIA/SELFORMERSEIFOR
C= iTMROUCaMNISORHEROWNEMPLOYEES,iROVIOE��T5UC1/1MPROVEMEMSARENOTMENOEDOR m . � ,
� ,OFFEAEDFOqS�LE.IF,FIOWEVERTMEBIMDW(iORDAPROVEUENiISSdDwtTWNONEYEAqOFCOMGLE• � �
. Z :TION,THE ONNER-0URDER MALL NAVE THE BUR�EN OF FROVINO TMAT ME OR SHE D�D NOT BUItD OR
_ �qAPROVE FOR THE FUNPOSE OF SAIE�. � �
W 04ASONMEROFTMEPROPERTV,AME%ClUSNELYCON�MCTWOW17HUCENSEDCONTRACTORS
STO LONSTRUCT 7NE VRUIECf(SEC.7W�,BUSINESS/w0 PNOFESSIONS CODE:TME CONTMCTORS U- VBIu9tiOf1 ADJ,AREA ��`
� .CENSEUwDOESNOTMPLVTO�NOWNEROFAVROPERTVWNOBU1LOSORIMPROVESTHERE01{AND
�VAqCONiRACTSFORSUCMPROJECf5N7THACOHfMCTOR(S�UCENSEOVURSUANTT0T11EODNTMG QUANTITY DESCRIPTION I^ FEE
� ��TORSLICENSEIAW}. . �
� OIAMEXEMPTUN�ERSEG 8.1PCFORTHISREASON Q C �. I�• t,�
� F il I
Z D�TE ONNER V �� L,J �
W II I��
F ; LICENSE�CONTRACTORS DECIARATION w :. �. .I I I
� �IHEREBYAFFIfWUNDERPENALTVOFPERJURYTHATIAMUCENSEDUNDERPROVI5iON50FCFUPiER � �.•', . i
d :Y(COIAAIENCINO WTiH SECTION tODO)OF�NISp�]OFTHE BUSINE55 M10 PROFESSIONS OOOE,AND
X �.MY LICENSE IS N Fl1Ll FORCE ANO EFFECL/��//� Z OLT�._ � . �� �.�
11OJ . � D •_ � / � �/ ^� m ( 1
LICENSE CLA55 LIC.NO._1 ����'••1 j + � i
��-(fx9
. �V "DATE ������7 'COMRACTORf ' J ' , ; �
W )
� WOFiKERS'COMPENSAT�ON RATI .� a � y `
N �I HEREBYAiFIHM UNOER VENALTY Of PERIURYONE OF h1E OYANO DECLA�TION�:,)� ) V � � r '
0 _IHAVEANONALLMAIMAWACERTIFICATEOFCONSENTTOSELF•INSUREFORWcny.E.�r U! � ''�
� � COMPENSATqN,ASPROVIDEDBYSECT10Na7ooOFTHEUBOACOOE,FORTNEPiRFOF�.IANCE • y - �� �
OF THE WOiiN FOR WHldl THIS VERIAIT IS ISSUED. � / � il '
C
�IHAVEANOMALLWUMAINWORKERS'COIADENSATIONINSUMNCE.ASHEWIfiEDBYSECTION � � ��i 1
� i7000FTHEUBORCOOE,FORTMEiEfiFOFMANCEOFTME�'/ORKFORYMICH7HI9PERMITIS .
� ISSUEO.MYNqRKERS'C06�PENSATqNINSURANCECARRIENANOPOLICYNUMBERARE: CONSTRUCTION
j . GRRIER PLAN REVIEW '� i
� vaicvnuMeer+ ELECTRIC
� (fFa55ECIlONNEmNDT8E00E1PlE1mOFTLEP6MT6WHONEMLlIJPEDOOlUi6ffIWJOFiLFSS� PLUMBING �
Z � I CERitFV 7MAT IN THE GERFOPIAANCE OF iHE WORN FOR WNldi THIS PEHMIT IS ISSUED,1 MECHANICAL '�
(,'} SXALL NOT EMPLOY ANY PERSON W ANY MANNER SOAS i0 BECOME SVBJECT TOTHE � I
� WORNERSLOMPENSATIDNLAWSOFCALIFORNIRANUAGREETHA7ffISF1DUL�BECOME INSPECTIONFEE �
S SU&IECTTOTNEN'ORNERS'COMPENSATqN RONSIONSOFSECTqN�7ooOFTHEUBOR ' t , �
COOE ISH �oan�wirnca,�ttrwirnr sEPAousrons. ISSUANCE
� ATE:�PPLICANT. � SMIP �^i
. . ..._.. _..._... _"_ ... ...
�W :WARNIN6:FA0.0 TOSECURENbRKERS'CqA SATIONCOVERAG ISUNUWFUL,ANDS lBE ENERGYP/C �' � f
i5U8JECTMlEMPLOYEHTOCRIMINALPENALTIESIWDqYtLfINESUP700NEHUNDHEDTHOUSAND ENERGYPERMIT �� �
'DOLURS(f loo.000).W ADDiT10N TO THE COST OF ODIdPENSATION,OAAUGES/S PROVIUED FOR IN �
� ;SEGTION�7ooOF7NEUBORCODE.INTEREST,ANDA7TORNEY'9FEE3. RETENTIONF�E:(1 n �' ��` � � F
a, CONSTRUCTION LEN�ING AGENCY � � ��� � '� E
. PRE•ALTFEE: ���
CC '111EREBVAFFIRMUNDERVENALTYOFVERIURViHATTHEREISACONSTFUCTIONLENO�NOAGENCY ' ' II ��� I . i
n- ��FORTME PERFORMANCE OFT11E WORN PoR WH1d1 TMIS VERMITIS ISSUEO(SEC.7007,CN.C). � �� ":��, I � I
. � LENDfR'SNAUE '�-�'� '�',� � ;'��. �,�'I I
� � .LENDER'S/DDRE55
� �ICERTIFYTHATIHAVEREADTMISAPVLICATqNIlNDSTATET/UITTHE�OYENiOPMA7qNISCORRECT. TOTAL FEES �li �' I
� '�IACHEE TO COIAVLY NATN AlL GTV M70 COUNTY DADINANCES ANO STATE UWS REUTINQ TO BU0.01N4 . j
CONSTRUCTION,ANDHEREBVAUfNORIZEREPiIESENTATIVE50FTMSCOUNTYTOENTFFUPONh1E �II�I�I
� ,/1BOVE•MEM�fOOVERTY iOfl INSPECT�W=PoSES. �L'.��'p�y� COMMENTS ' '
o �.�S �-- � " hd ' � �� � i i
. Q ;PERMI7TEENAMEfP NT) � � � �'�.'I.` .
� � {�ia�q��l' � � � . R i �.� i
SIGNATU ��O fiM� EE OATE i
N �
� RECPT.NO. PAID BY ����� VALIDAT�ON �
- WHITE—Department opy.YE OW—Finance Copy.PINK—Assessor Copy.GOLDENROD—File Copy.GREEN--ApplicanYs Copy �.
�
, . . .. � •- - . . .�.� .. . . .: . ._.. ��,; . ..-..--. �, . •., ,.� .. � _ , _ . . . � . . ,
CITY OF DIAN90f�lD BAR
INSREC�"ION REC�RD
El►' ��� � Q � .� _ � �:d�. il��-��h����� - '[►�� �k;����� ; .. _ o ; ��,.. . _. i[� ;.I o
- ,� � J� � ..�'�. _ �W _ � �� �� �.= ���.�:�,��r
SET BACK . ; . ! ` �� J FLOOR JOIST ' y - . .
FTGS/FQFMS/STEEL I FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CU�IDUIT
• ' SLAB GRADE FIREPLACE FOUNDATION
7EMP POWER FIREPLACE BOND BEAM
WATER SERVICE I MID HT. BOND BEAM •-
ROOF SHEATHING I ' � '- ' I 8 FT'. BOPJD BEAM
FAAMINGNENTILIATION i I FINAL BOND BEAM
RO�F COVER i I I PRE-GRADING
ROUGH HEATING I BENCHING
ROUGH ELECTRIC � (!Z I ROUGH GRADING
ROUGH PLUMBING I � FINISH GRADING I
SH�WER/TUB TEST � POOL ELECTRIC
EXT. LATHISIDING POOL FENCING �
WALL INSULATION POOL FINAL �
CEILING INSULATION OFF SITE IMPS.
ORYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PITlL.L. � ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. :,,._.-� .. _'.._ F�RE DEPT.FINAL
FINAL HEATING % ' � - HEALTH DEPT. FiNAL
FINAL ELECTRIC I�, 2 ���-��. �--' • �'"""'r DEV.FEES PAID
FINAL PLUMBING �� � I ENcRGY
, �,G �', ���.�1Q C C1 . ' .. ,: '
COMMENTS •
.. . ., . , . 1_
i
SEPTIC TANK SIZE
SEEP PIT/U 51ZE
{� "-"'�'-�
__
���1� k�( .
� 1 .
;
�
;� , .
' ___ � _ ___- �