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HomeMy WebLinkAbout09-99 ���_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �'9^'� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE -}� APPLICATION , PERMIT p/C ADDRESS ��� ���Qi(/�1..Q/l_i.ttrtYtf� D� DATE C NUMBER� p � � ISSUE 7ypE OCC APN OT TRACT DATE CONST. GROUP I p OWNER p ADDRESS ZONING SETBACKS FRONT � CITY .lfsci"►ZIP��ly�TEL. REAR RW � I APPLICANT TEL. ❑ ,�d. SIDE/SIDE STREET RW O � CONTRACT -+�G. SIDE p ADDRE O � � � CITY � TEL. � PROPOSED USE '�" - w ARCWENG/ z DESIGNER G w NO.DWEL. NO. GJ NO. � ADDRESS u� UNITS STORIES �� BEDROOMS N CITY ZIP TEL. I � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION I p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFlRM UNDER PENALTV OF PERNRV THAT I AM E%EMPT FROM THE CONTMCTORS Ll- G8f8 B/Ce A � 9 � W CENSELAWFORTHEFOLLOWIMOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCITYOR (n CJ COUNTVWHICHRE�LIIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W P0�i0/DBCk � TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCN VERMIT TO FILE A SIQNED w � STATEMENT THAT HE OR SHE IS 110EN5ED PURSUANT TO THE PROVISIONS OF THE CONTMCTORS LI- � CENSE UW(CHAPTER e(COMMENCMa WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND Pq0- � POOVSPB , � FE5910NSCODE)ORhIATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALlEOEDEXEMP- � TION.ANVVqLAT10NOFSECTION7031.68YANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500�.): 0 ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOVEESWIiHWA4E5ASTHEIRSOLECOMPEN5AT10N, 0 COfI1R16fC181 Z WILI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7Wa,BUSI- J � NESS AND PROFESSIONS COOE:THE CONTRACTORS UCENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPE{iTY Mhq BUILDS OR IAIPROVES 7HERC-0N,AND WHO DOES SUCN WORK HIMSELF OR HERSELF OR w THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMEMS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWRMINONEVEAROFCOMPLE� Z TION,THE OWNER�BUILDER WILL HAVE THE BUFDEN OF PROVINO THAT HE OR SHE OID NOT BUIID OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPEHTV,AMEX0.USIVELYCONTMCTINOWRHLICENSEDCONTRACTORS Q TO CqNSTRUCT THE PR0.IECT(SEC.7oN,BUSINE55 AND PROFESSIONS CODE:THE CONiMCTORS LI- V8IU8�lOf1 qp�.qqE,q W CENSELAWDOESNOTMPLVTOANONTJEROFAPROPERTVWMOBUILDSOqIMPROVESTMEREON.AND � WMOCONTRACTSFORSUCH7R0.1ECTSWITNACONTRACTOR�S)LICENSEDPURSUANTTOTHECANTqAC- QUANTITY DESCRIPTION Y TORS LICENSE LAW.�. FEE 0 ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � DATE OWNER ¢ � �Q LICENSED CONTRACTORS DECLARATION w 2 I HEREBV AFFIRAI UNDER PENALTY OF PERJURY THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � d D(COMMENCING WITH SECTION 7000)OF DIVISION 3 OG THE BUSINESS AND PROFESSKKJS CADE,AND Z ' X IAY LICENSE IS M FULL FO�qC-Er AND EFFECT. `� UCENSE CLASS `�-� �� LIC.N0. �/�S �� � U DATE� CONTRACTO �� �„ a W � � � ..,WORKERS'COMPENSATION DECLARATION -� Ja U a ` D / U � I HER BY AFFIRM U DER PENALTV OF PERIURV ONE OF THE FOLLOWING DECURATIONS: C!J Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a 2 COMPENSATqN,AS PROVIDED BV SECTION 37000F THE IABOR CODE,FOR THE PERFORMMICE U OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � � _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOIJIRED BV SECTION Q 3700 OF THE R CODE,FOR THE PERFORMANCE OF THE WOqK FOR WHICH THIS PERMIT IS /���' ISSUED.MY MPENSATqN INS CE CARRIE AND P ICY.N BER AR]E: CONSTRUCTION � CARRIER �� 0�/' PLAN REVIEW ' T— ZaouCYNUMBER � LECTRIC ¢ 0 (fHISSECIqNNE�NOTBECOMFi.ETIDOFhEPEMTfISFORONEM1tiMmDCLLAiLS(t1 �oa�Ess �LUMBING w Z I CERTIFY THAT IN THE PERFOFMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C7 SHALL NOT EMPLOY ANY PEPSON IN ANY MANNER SO AS TO BECAME SUBJECT TO THE (n WORKERS'COMPENSATION LAWS OF CALIFORN10.AND AOREE THAT IF I SFiOULD BECAME INSPECTION FEE SUBJECTTOTHEWOHKERS'COMPEN PROVISIONSOFSECTION370o THELABOR (�� O ) CODE,I SHALL FORTHWITH COMPLY ITH T E PROVISIONS. ISSUANCE p DlfE!� APPLICA SMIP ` n� w ,�—(.[� J WARNIN6;FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS 11NLAWFUL,AND SHALL BE ENERGY P/C J � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCMLFWESUOTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLAAS(f I OO,000).IN ADDI710N TO THE COST OF COMPENSATqN,DAMA�ES AS PROVIDED FOR IN w SECTqN 37oe OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE: O CONSTRUCTION LENDING AGENCY PRE•ALT FEE: •� � 1 HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDINO AOENCV Z FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.�. W � LENDER'S NAME F– LENDER'SADORESS w I CERTIFV THAT I HAVE READ THIS APPUCATqN AND STATE THAT THE ABOVE INFORMATqN IS CORAECT. TOTAL FE ES ��.n , J, � � � I AGREE TO COMPLV N7TH ALL CI7Y AND COUNTV ORDINANCES AND STATE UWS RELATINO TO BUILDINO G.J�J� �` � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE " �O -(' O Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS ' � A� � � � � /✓�� m P R E NAME(PRIPIT) . Q r N f,/) E ' DATE � RECPT.NO. PAID BY VALIDATION I WHITE—Department Copy,YELLOW--Flnance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Appllcanfs Copy ; CITY O� D1�►�IO�D �AR INS9��C�'IOi� 6�IECORD �:�a�a�c��oa - �= �o� ��. �� oa�p�c�4oa , ::«� oa�Q��400a , o ����� = oa�p��:� ._ : SET BACK FLOOR JOIST • FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT ' GROUND PLUMBWG UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATIDN � TEMF POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING /�� -- 8 FT. BOND BEAM FRAMINGNENTILATION � FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATWG BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST PQOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATIQN OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPEIIRRIG. SEEP PIT/L.L. ON SITE IMPS. - GAS AIR TEST FINAL ZONING FINALCONST. FIRE DEPT. FINAL FINA�HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY �'�o ' COMME(VTS � �'��'E�!'tNE�t �VO D r--=- �FE�1TM�Rou� SEPTIC TANK SIZE SEEP PIT/U SIZE a c� a � �� � a -