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HomeMy WebLinkAbout12660 (14) _.� _ . . ._. _ . . . ; i �� CITY OF DIAMOND BAR� � � ' � DEPARTMENT OF COMMUNITY&DEVE ME E .�� . 21660 E.Copley Drive Suite 190 ' (909)660-3195 Fax(909)861-3117 PR ESS �'M'�� BUII.DING PERMIT APPLICATION . . - FIRMLY o� JOBSITE APPLICATION � q NUMB R 1��U A� ADDRESS DATE I I� �� -1 � g ISSUE �/ TYPE � • OCC APN LO _ TRACT - - DATE I I ��7_�9 CONST. GROUP °C OWNER � ZONING SEfBACKS . � CD SS ZI T ' FRONT ❑ APPLICANT TE . REAR �� ❑ � I SIDE/SIDESTREET RW O 1 CONTRACT SIDE p � ADD ESS 1 PROPOSED USE � CI7Y ZIP TE aPi ARCH/ENG/ ' . ��,, DESIGNER NO.DWEL. NO. NO. � C�DRESS Z�P TEL UNRS STORIES � BEDROOMS � u� DESCHIPTION ' SO.FT. FACTOR PSF ADJ.AREANALUATION ' p� . . OWNER-BUILDER DECLARATION SFRfADDIREM ' O 8 �NEREBY AFFiMA UNDER FEWLLTY Of PERAIRY TMAT 1 MI E%EMPT FROM THE WNiMCTORS ll- � � GBfegB/C�IPOR . . � � , � � CENSEUWFORTNEFplOWINOREA50N(SEC.76f1.6BU51NE55FNDiROFE5510N5CODE:ANYCITYOR� (n � � ' ' ����—.�--� COUNTYMMICHREOUIRESADEp1ARTOCONSTRUCf.ALTERdI7ROVE.�EA10lISH.ORREPNRMlYSTRUC•, _ _ TURE.PRiOR iC1 RS 6SUANCE Q50 REIXIWE9 ME APPLMJJlf FOR SUCH PERYIT TO FILE A 61GNED W ..P81b/DBCk—��--- .. ...._. ___ . __._,.._—.^—_ ��_.'_.__._.. ..___, •._ 67A7EMEM 7HAT HE OR 511E IS LICENSEO WRSUANT TO THE VROVISIONS OF THE CONiMCfORS U• � W ; � CENSE UW(�PTER Y(COMMENqNO WITH SECTION 7000)OF DINSION 7 OP THE BUSINESS AND PRO- V" PooVSpa ' FESSIONSCOD�ORT}NTHEORSHEISEXEMPTTHEREFHOMANDTHEBASISFORTHEALLEOEOE%EMP• .� C7 T10N.NIYVqlAT10NOFbECTqN7WtABYANYMVtICJW1iOR�PERMITbU&IECiSiHEMPLIGWiTO Z R9•ROOI �„� 11C7VIL►ENALT70FNOTMORETWWFIVEMINDR[DUQLARS(f5001.1: .. . . .... � p OlASO1MIEROFTHEPROPERTY.ORMYEAIVLOYEESNAiHWAGE5A5THEIRSOLECOMPENSATIDN., O �mmarclal - - . - ' . � NALL DO TIE NfORIC ANO THE STRUCillRE LS NOT INTENDED OH OFfERED FOR SALE(SEG 7a1�,BI151. J � NE53 AND VROFESSIONS COOE:T1E COHTRACTORS LICENSE UW OOES NOTAPPLY TO AN OYVNER OF j . . , , � PROPE(#TYWHOBU0.DSORMPROVESTIIEREON,ANDWHODOESSUCNMOIUCHIMSEIFORHERSELFOR � Q TNHOWMMSORHEROVMQ�PLOYEES,VROVIOEDTHATSUp1I1APROVEAIENTSMENOTR7TENDEDOR m . � OFFERmPoRSAIEIF,IqY/EVER7HEBUlDINOqiMPR011EMEMI5501DWITIYNONEYEAHOFGOMPLE• � TIOH.TIIE 01YNE1F9NLDER 1YILL NAVE TF�E BURDEN OF VROVPIO 711AT HE OR 611E OD NOT BUILD IXi = MPROVE FOR ME PURP06E OF SILEI. � '" � ' � ' � - � ., „� OlA30MMEROF7HEiROPEHTY,AAIEXCLUSNELYCOMMCTNOVRTHUCENSEDCONiMCTORS � TO CONSTFUCT TFIE VROJECT(SEC 7oa/,BU51HES5 AND VROFESSIONS WUE THE CONiRACTOR3 Ll- V81Ue110 ADJ.AREA CEHSE UW DOf4 NOT MVLY TO M!OWNER OF A Oq07ERTV N1p BURDS ON MPROVES THEREON.AND VAqCOf7IMCT9FOqSUCHPRQJECTSVATHACONTMCTOR(5)LICENSEDWPSUAMTOTHECONfM0. pUANTITY��� -DESCRIPTION � FEE � 70R..UCENSELAW} . . . . .._ . , �J . .. . . . . O I AM IXEMPT UNDER SEG B.t P.C.FCF TNIS REASCN Q 3 � � LL � � DATE ON'NER ' V . . � .... . , � LICENSED CONTRACTORS DECLARATION W . J � INEREBYAFFIf�IWDERVENQTYOFPERIUHYTHATIAAILICENSEDUNOEHVROVISqN50FCHAPTER�� Vr � � �(� 0�CdIYEN(7N0 WRN SECTION 7000)OF OMSIDN]OF THE BUSINE55 MIO PROFESSIONS CODE,AND Z � u� LIYLICEHSEISMFUILFQRCEANDEFFECL m l 0 UCENSE C S � LIC.NO. � . J , � ... V DATE � CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION � � � IMEREBYAFFIRAAUNDERiENALTYOFPERIURYONEOFTHEfOIIAWINODECLARAilONS: "'�'��� Z -� � ' � � �IHAVEAl�OM1LLI.WNTANACERTIFlCATEOFCON5ENT105ELF�NSUREiORNUHKERS' _ ; COMPENSA710N,I1S0i10VqEDBYSECT70NJ7o00FTHEU[30RCOOE,FORTHEPERFOMIANCE W � OFTHEWORKFORMMId/TWSiERM�TI5I55UED. � 0 _t MAVE AND WILL UAIMAW WORKERS'W►IOENSATION MSURANCE,J�S R[OUIR[D BY SECTION' QQ �7ao OF 1HE LA80R O00E,FOR 1HE PERFORMMlCE OF THE WORK iOR YVHtCH THIS PERMIT 15 �( . � ISSVEO.MY WORKERS'COMPENSATION NSURANCE CARR;ER MID POIICYNUM�£H ME ONSTRUCTION — - V 1� --_ . - -. _ .. _.. q o _ --- - - - ._ . . -- ---. __ _.---- -. ----- .. .. . _. .. � wwiEq � PLAN REVIEW � POLICYNUMBER ELECTRIC. . . 0 �nass[cror�rkmwreeoa.��moFn+E�rw�tsroAor+e�urneooxtusa+m)a+�css} PLUMBING Z ICERTIFYTWITNTFiEPERFORMANCEOFTHENUNKFORWHICHTHISVERIAITI5155UED.l MECHANICAL� '� C} SMALLNOTEMPLOYANYPERSONNANYMANNERSOASTOBECAMESUBJECTiUTHE � WORKERSd�MPENSATI0NUN50FCALiFORNi� REETHATIFISHIXR09[COMC INSP EE . `- SUBJE TOT EVrOiMERS'COMPENSATIONi SqNS CTqN77ooOF ELABOR' � •- �� � �� � � � �� �j E MCdAPLYWITH E 5.� ISSUAN D ' � SMIP / U �p OATE: APPLICANT. . . _ . � � WARHIN6:FALUN[TOSECUREWOR1cER5COMPEN5AT10NCOVERA0EI5U AWM.MIOS/U1LBE ENERGYP/C ��� , � SU&IECTANEMPLOYERTOCRIMPIA�PENALTIESMIDGMLfINESUVTOONEXUfqREDiHOUSAND � ENERGYPERMIT DOUARS(f loo,000),N pDDfT10N TO THE GOST OF COMPENSATqN,OAMAGES AS PROVIpCD FOft IN . ¢ SECTION770lOF1HEUfiOROODE,NTERESLMI�l1TTOFNEYSFEES. RETENTIONFEE: " oCONSTRUCTtONLEN0INGAGENCY PRE•ALTFEE: NOY � CL IMEREHYAFFlRM Ui�ERVENALTYOFPER1UfiYTMATTMEREtSACONS7RUCTIONLENDWaAGENCY ' � " � � n- FOR THE PER�ORIJANCE OF TH[WORK FOR WMIC11 THIS YERMIT IS RSUEO(SEC.7oY7,qV.C.�. ��OF DI � �E�E��E BUII,DING AND ET / � IENDER'SAODHESS � ICERTIFYTHATINAVEREADiHI3AVPLICATqNANDSTATEhUTTHEABOVEINFOFWATI0NI5CORRECT. TOTAL FEES �� � � � � �� W IAOPE4TOCOIAGLYNrtTHhLLCffYANDCOUNTYOHDWANCES/NOS7A1EL1WSRELATINOiOBUILDINO ' �� . � CONSTRUCTION,ANOMEREDVAUT110RQEREDRESENTATNESOFTHISCIXINTYTOEMEHUPONTNE I /��. y � IONED P RT'iOR 1 SPECTqN PURPOSES. M TS ' V�J J � � � m TTE E(PRl � ' rj�' '¢ I C!A/ . . .. . . � . N � —�-�— y 61U T 'O PE I Af� . � _ RECPT.NO. 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SET BACK ` i�c�c� � . .. .�i c. � � � `� FLOOR JOIST � ' ' ' � �-- . r I ° � . � , Fi'GSlFORMS/STEEL = �; '�— — , FHA REQMTS ._.. .. _. . .._. _ _ _. . . . _ . _. . • ELECTRIC GROUND - _ - ` _ -' -� .� � .. - UNDER FLOOR DUCT "' -"� ' ' � • ; --- GROUND PLUMBING ° • UNDER FLOOR CO�ID.UIT_.. � ' ' � ' ; ' . . . . .. . - ... ,-i<� _, .. . . - : , ; ��i• . ., SLAB GRAD �� , -� -- - _ . .. . . __. . - ; ; FIREP.LACE FOUNDATION �� .i ''.: �� ' ' TEMP POWER -- -- : " .. __. ._.. .. ,. ,..; - ��:. , , i FIREPLACE BOND BEAM __. . ... ..._ ._._ . ... . � WATER SERVI � ;'�l't-f�u_ -- --__ --. . _.:.._. MID HT. BOND BEAM- : : .�: . :.:.._.: .. + �,:..: :•.:,�. .. .� , r _ ROOFSHEATHING - -- ---.. .. .. ._ ... . ... .:. ..... . . SFT.BOND•BEAM - _. ; ., . . .. . .-,-., `.� , � .: ;. FRAMINGNENTILIATION . FINAL BOND BEAM ` ' � ROOF COVER � ,. '. � '�" ' �PRE-GRADING � � � � � ROUGH HEATING _ .._ .- - ..... ............ .. - BENCHING. . . . . ;.. : � _. _ _ _ -- - - - „- ROUGH ELECTRIC �- -- . � •. .'� � ROUGH GRADING . � ,. . . i '.: ROUGH PLUMBING i-- - � - --- �- ���- � .. FINISH GRADING ' ' _.._. _. _._ , .._.. .,:. . , �POOL ELECTRIC , . � SHOWER/TUB TEST i - � EXT.LATH/SIDING ; ; POOL FENCING ' '• � � WALL INSULATION � �• ' � �` � POOL FINAL .. • � � ' CEILING INSULATION . . OFF SITE IMPS. � � DRYWALL NAILING I � DEDICATIONS' ' ' ' " ' •� SEWER _.._._. . � �' . ' _... __... FINAL ENG. , � ,_ __ _... __ . . 1 � -SEPTIC TANK._ __ . '� -_ __ _ _ _ _ . .� _1':'. .:;. __ LANDSCAPEJIRRIG. , , , . � ' . ., .. , ,, . i . � ' ON SITE IMPS. SEEP-PIT/L:L: ..:..:-- , .., . _ ` .; , . , GAS AIR TEST. --. ... --- _.. .. ... ... . .. ..._ .. . .: .. FINAL ZONING � .,, � - : FINALCONST._... .. . _ ..._._.. . _ .__ . .. . FIREDEPT. FINAL . . - - - I '; FINAL HEATING �-- �- - - -"- " � � HEALTH DEPT. FINAL � .°' FINAL ELECTRIC -- - ��" � ��� ' DEV. FEES PAID _... _ . - � � � , � FINAL PLUMBING I ENERGY . . � ' I - i --� �-, � � , . . � , ' �, �'+e • , � - �;. � .:: � � � r � .,._�_� . . . . . .. _. COMMENT _ _ . _.... _ .. . _ ' , �`. ,.. . ,.. S � , . . � . � ,. , . . . . ._ . . . -- .. . , � ; . � _ i , i t:��' z�P _ �^•��' I .. .. , . . ; � . . ; _._. .. . _ --- _ . . . -.. . _ . . : . ::.: i ; . ; � . „ . ; , -- . . , � � � �-� _ - . - - ; • . � i �t1 ,t --• �..,.: : i ; \ i � .,,. , Z� ( � � �~ � I . _ _ ,. �i��;�� . . , ti: I i �� . . � ' � ' .. , � . �i, � i. SEPTIC TANK SIZE - --. - , � 1 ' . .. � � , , ; . ,... . SEEP.PITIU SIZE ??�-'�,: �: . . , yJ .. , �� � � � . , , � � , � cIti�1jc)i.:.��tc_r�ii�Y.,.��� ', i��GK�. .�.n�.��,.. ._-�-- .. . � � � � . . i_ .. . , ... � � -- , , 1 � ;, , -- � � � � , , .. . � � . � : . r��_ ; ,, ;�i � � .. ' i � , ,.,, , " , . � ,.±'_ ' :..�,'. . 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