HomeMy WebLinkAbout15555 CITY OF DIAMOND BAR EXPIRED
� / � .� ---�'� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
' W ait�o E.c�i�y��e s,�r�i90 MAR 2 0 2002
(909)86Q3195 Fax(909)861-3117 PRE$$
�����»'�� BUII.DING,PERMiT APPLICATION FIRMLY
o ADDR SS_.�L7DDo� r/T LGO�S V ��L1/ :_ 1��• DATECATION , � r NUMB R /C�C/-��/C ��
$ ISSUE TYPE OCC
� APN LOT TRACT DATE CONST. GROUP
°C OWNER
O
� ADDRESS ZONING SETBACKS
� CITY C ZIP TEL. _ _ R�R RW ❑
APPLICANT TEL. SIDE/SIDE STREET RW ❑
� CONTRACTOR B " DO SIDE ❑
p� ADDRESS O PROPOSED USE `1
� cirr R�J/t 2TE ziPq1�D TEL . - - �
o ARCH/ENG/ v-S"Q
DESIGNER D - .
NO.DWEL. NO. NO.
ADDRESS
� CITY ZIP q��� ��, _ UNITS STORIES BEDROOMS
�n f�."`j .t
cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUILDER DECLARATION SFR/ADD/REM
O
p I HEREBV AFFlRM UNDER PENALiV OF PERIURY THAT I AM E%EMPT FiiOM THE CONTRACTORS LI� G8f9eB/C8fPp/(
W CEHSEUWFOH7HEFOlLOWINOREA.90N(SEC.7031.6BUSINESSANDPROFESSIONSCOOE:ANYCI7VOR (/�
C.) �pUMTVNMMHREOUIRESAPFAAIRTOCONSTRUC7,ALTERI�IPROVE,DEMOLISH,ORREPNRMIYSTRUC� w
Z TURE,PRIOR TO RS ISSUANCE,PLSO REWIRES iHE APPLICANi FOH SUq1 PERMIT TO FILE A SIONED P81W/DBCK
� STATEMENT THAT NE OR SHE IS t10ENSEO PURSUAN7 TO hIE PROVISIONS OF THE CON7RACTOR3 L4 � .
� CQJ9E LAW(CHAPTER Y(COMMENqNO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOI/SP0
FE591DN5 COOE�OR iTMTHE OR SHE IS EJ(EMPT hiEREFROM AND 7HE BASIS FOR THE ALLEOED EXEMP- (3
TION.ANV VIOLATqN OF SECTION 7031.6 BV AHV MPLICANT FOR A PERMIT SUBJECTS THE MPLICMlT TO Z Re-Root
� ACML VENAL7Y OF NOT MORE THAN FNE HUNDRED DOLURS(iSOD).):
� OI,ASOWNEROFTIEPROPEHTV,ORMVEMPLOYEE9WI7HWAQESASTNEIRSOLECOMPENSATqN, O Comm0fCl81 . � , � '
WILL DO iHE WORI(,/�ND THE STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.7W4,&151- J
� � NESS AND PiqFE5S10N5 COOE:THE CONTMCTORS LICENSE UW DOES NOT MPLV TO AN OWNER OF � �
PiqPEHTY WHO BURDS OR W PROVES THEREON.AND WHO OOES SUCH WORN HIMSELF OR HERSELF OR
Q 7HROUGH HI9 OR HER OWN EM7LOYEES.FROVIDED THA75UCH IMPROVEMENTS ARE NOT PlTENDED OR m
� OFFER�PDR9ALEIF,FqN�EVERTMEBUIIDW�ORUIPROVEMENTISSOLDWfTHMONEVEAROFCOMPLE-
Z �'TION,THE ONMER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR
� WVROVE FOR THE PURPOSE OF SALE).
� ❑4�OWNER OFTHE PROPEHf1:AM IXCLUSIVE�V CONTRACTINO WfTFi LICENSED COMRACTOR3
TO CONSTRULT THE P{iO.IECT(SEC.7oN,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� V9IU8fIOfl ADJ.AREA
CENSE UW DOES NOT AVPLY TO AN ON7JER OF A PROPERiY M/Fq BUtlDS Op IMPROVES THEREON,AND
� MM1qCONTRACT9FORSUqiPRQIECT3WIT/ACOMMCTOR(S)LICENSmPURSUANTTOTHECONTMG OUANTITY DES IPTION �E ,
� .70R4 LICBI3E UWJ. . .
❑I AM EXEMPT UNDER SEC. B.8 F.C.FOR THIS REASON �
3 c�
� �
DATE OMMER
0 w
� LICENSED CONTRACTORS DECLARATION W
� I HEREBYAFFIR/J UNDER PENALTV OF VERIURV THAT 1 AM UCENSED UNDER PROVISqNS OF CHAPTER �
� Y(COMMENCINO N/IiH SECTION 7000)OF DMSION J OF THE BUSINESS AND PROFESSIONS CODE,AND Z
�� MY LICEN3E IS W FUIL FORCE AND EFFECT. m
� LICENSE CLASS LIC.NO. � j .
V DATE CONTRACTOR d
LL
� WOAKERS'COMPENSATION DECLAFATION , Q � .
NI HEREBY AFFIqM UNDER PENALTV OF PE0.1UfiY ONE OF THE FOLLOWINO DEClARA710NS: Z
� _1 HAVE AND WILL MAINTNN A CER(IFICATE OF CONSENT TO SELF-INSURE FOR WORKEFiS' a �'
S
COAIPENSATION,AS PROVIDED BV SECTION 37ao OF 7HE UBOfi CODE,FOR THE PERFORMANCE U
OF THE WORK FOR N711CH THIS PERMIT f3 ISSUED. W
0 � /'�
_I HAVE AND WILL MAVJTAIH WORKERS'COMPENSATION INSURANCE,AS REQUIqED BV SECTION /�� I /_�
Q 37000F THE UBOR COOE,FOR THE PERFOiU1MlCE OF THE WORK WR WHICH THIS PERMR IS � � ��Y
� ISSUm.MV WORI(ERS'COMPENSATION INSURANCE CARRIER M1D POLtCV NUMBEF ME: CONSTRUCTION � �� ���
> caaAieR � PLAN REVIEW �
0 POI.ICV NUMBER -
Z ELECTRIC
¢
� (nassEcnalr�Hoiseoo�.R�oFnEa�tswt�a+E�000u.us�sim�aq�ssy PLUMBING
Z I CERTIFY THAT Pl THE PERFORMANCE OF THE M/ORK FOR NM1iICH THIS PERMIT IS ISSUED.I MECHANICAL • aa�-
(} SHALL NOT EMPLOY ANV PERSON W ANY MANNER SOAS TO BECOME SU&IECT TO THE /� [�(�I[��
(/� WORKERS'COMPENSATION UWS OF CALIFORNIA,AND AQREE THAT IF I SHOUID BECOME INSPECTION FEE L�`7�A AY/�"
S SU&IECTTO TME WOFiKERS'COM7ENSA710N PROVISIONS OF SECTION 3700 OF hIE L/�BOR
CODE,I SWLL FORTMMTH CAMPLY Wlhl TH0.5E PROVISIONS. ISSUANCE
� SMIP
p DATE: � APPIICANT:
W ENERGY P/C Y ,-
� WARNINO:FARURE TO SEWRE WOfiKERS'COMPENSATION COVERAGE IS UNUWFUL,AND SHALL BE T �f(
�y SUBJECTMIEMPLOVEqTOCAWfNALPENALTIESANDCIVILFINESUPTOONEMUNDREDTHOUSAND ENERGYPERMIT � �I�V I1F 1 JIAlo+� �
OOlLARS(f100.000),IN ADDITION TO THE C0.5T OF COMPENSATION,DAMAOES AS PROVIDED FOR IN �� '
� SECTqN 970!OF T/E LABOR CODE,INTEREST,M1D ATTORNEYS FEES. A�ENTION FEE: 77 T� . D S�
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � '
� 1 HEREBV AFFIRM UNDER PENALTV OF PERIUfiY THAT THERE IS A CONSTRUCTION LENDINO AOENCY � � � �
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.]OY7,CIV.C.). � . ,
2
w
� LEPIDEH'S NAME - � � �
� LENDERSADDRESS '
� I CERTIFY TMAT I HAVE REID THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FEES �
W I AOREE TO COMPLV WfTH ALL CfTV AND COUNTV ORDINANCES AND S7A7E UN5 HEUTINO TO BUUDIN6
� CONSTHUCTION,AND HEREBV AUTHOfiIZE PEPRESENTATNES OF THIS COUNTV TO EN7ER UPON 7HE ' n`
ZABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENT � �' ��
�
J /n(1/��P'rj(r I Fl . • �
' � �I ��lla l.�/ /
N �` C� 'r Pp� • •/I / //�::� :/ � .
Q
� g��� AT��— RECPT.NO. PAID BY VALIDATION
� WHITE—Department Copy,YELLOW--Ffnance Copy,PINK—Assessor Copy,GOLDENROD--FIIe Copy,GREEN—Appli t's Co
PY
i;.,s:a���i�::� CITY OF DOA{1�IC)IVD �AR
�,. „ �� ��;;.� IP�S9�ECTIOR9 RECC.1�iD " ;
i��, � ;�� ;�,�;. ��
. ,, ;. . .� r�. �... �
� �� a�.�� � �� `M'�� ■ ,,. � m v+ n a�� �.."+ ,�.,«, s.
� ; .,�-D �� g � � �;� � •,:=..'p .���, o�
� ```,� ����p
SET BACK , t l ?.� � ... 4i✓ ;. FLOOR JOIST -
FTGS/FORM5/STEE� e FHA REQMTS "
ELECTRIC GROUND UNDER FLOOR QUCT
GROUND PLUMBING UNDER FLOOR CGt�DU1T
SLAB GRADE FIREPLACE FOUNDATION .
TEMP POWER � FIREPLAGE BOtdQ BEAM
WATER SERVICE MID HT. BOND BEAM •
ROOF SHEATHING � -' � • '`'•<� ' � 8 FL BOND BEAM ' • � '
FRAMINGNENTILIATION FfNAL BOND BEAM '
ROOF COVER PRE-GRADING '
ROUGH HEATlNG BENCHING � '
ROUGH ELECTRIC _ ROUGH GRADING
ROUGH PLUNIBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. IATHISIDING POOL FENCING
WALL INSULATION POOL FINAL
. CEILING INSULATION QFF SITE IMPS.
DAYWAL.L NAILING ., �- ,:, ;. ,,,_ ,, . DEDICATIONS ,
SEWER ' � FiNAL ENG.
SEPTIC TANK '"h LANt7SCAPE/IRRIG.
SEEP Pf�/L.L. ;' ' �;.. ON SITE lMPS.
GAS A1R TFST F11�AL ZONING ---
F1UR�CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL ,
FitJAL ELECTRIC DEV. FEES PAID ' �`
� FlI�JAL PLUMgING ENERGY
__ o a�p 'p .�_ � ,
b �d
� CO�filViENTS ���,� PPRw�o uws . 'm -_s� � .�R¢- � - -
_�-�-� e � �
� � - ,
SEPTIC TANK SIZE
SEEP PIT/U SIZE
d(fl `'.� ` ``��.5 y �„� g �
�'�`G{°? +'� 'ti{�J� �`f w`y��t*�;"
���{ ;�. '�. z�c
* ,�p�o �r ,�ay '�. ��.
� +�'��F1t� �w4 =.L���"'! ���Y2�'k.s
r� �` �
���`���'�ur�� -�';��.� .
���- �, ��;,� .�,,�_,
,��+a;N �„�o-�? s�' �9
�_ • a"` .�' ,� �`^�+y
'��'� f`` d�` ��:: �«
�� ���:" «� .y
-�,� .� �a�. 4 �;1.� �},.
��`,���v����:!� '�'e��a �' ,
��' ' �
�`�����z �a .� > ��,,,, ,'�, - , . — ' -
�� y �` �`F � w
�k ��`s. ���> I , . � ,
`t. F� �.
