HomeMy WebLinkAbout17437 (23) _ ----- -_. - —__--- ------_
-- �
�� CITY OF DIAMOND BAR � �� �`-"�. � Y� I
� � � DEPARTMENT OF CONII�M�Y 8c D VELOPMENT SERVICES �
21825 E.Copley Drive
(909)860-3195 fax(909)86I-3117 PRESS
������� BUILDINGPERMITAPPLICATION FIRMLY
o� JOBSITE �t /�,, /� APPLICATION PERMIT C,I /Cn
AODRESS�' / N� ��C W n •��l P� DATE 'l Zd D NUMBER ` 8 "��
� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER
� ADDRESS ZONING SETBACKS
0
z CITY ZIP TEL. FRONT RW O
g APPLICANT TEL. REAR p
� SIDE/SIDE STREET RW O
� CONTRACTOR C ' , !f' SIDE ❑
� ADDFIE S PROPOSEDUSE �Q C:�G �i�.
o CITY G ,ZIP� TEL�'"o�eaI ,
o ARCWENG! �
OESIGNER
i�ii NO.DWEL. N . NO.
n. ADDRESS
= CIN ZIP TEL. UNITS STORIES BEDROOMS
cn
�n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
o ONRJER•BU�LDER DECLARATION SFR/ADD/REM
p I HEREBV AFFIRM UNDER FENALTY OF OERAIRY TFUT t MI E%E1AFT FROM h1E CANTMCTORS LI• G3f890/CBfpOR
W CENSEUWFORTNEFOLLOWIN(iREA50N(SEC.70.t1.6BU51NE5SMJDVROFESSIONSCODE:�NYQTYOfl (f�
V COUNTYWMIRIREOUIRESAiERMfTTOCANSTRUCT,ALTEH,IMPqOVE,OEMOLISH,ORREPAIRANVSTRUC• W PdSIO/DBf.Ic
� 7UHE,PHIOR TO RS ISSl1ANCE.ALSO REWIRES THE APVIICMlT FOR SUCH iEHMIT TO FILE A SIGNEO w
� STATEMEM THAT HE OR SHE IS LICENSED WqSU�NT TO THE PRONSIONS OF iHE CANTRACTORS LI•
CENSE UW I�APTER i(COMMENCIN�WITH SECTION 70001 OF OIVISION]Df THE BUSINESS ANO PRa � PooUSpa
� FESSIONSCOOE)ORTHATHEORSHEISEXE4PTTHEREFRdAANDTNEBA5i5FOi7TNEALLEGEDE%EUP• (�
TIdJ.Ilf/VqLAT10NOFSfCTION70]1.68YANYAPPLICAMFORAOER1AIiSUBJECTSTNEAVPLICANTTO Z Re-Roof
A ClVIL PENALIV OF NOT MORE hIN!FIVE HUNORED DOlURS(f 500�.):
� OI.ASOYMEROFTHEPHOPERTY,ORMVEMVLOYEESWITHWAOE9A5THEIRSOLECOMPENSATqN, Cpmm0fCI8I -
Z WILLDO THE WORKµD TME STRUCiURE IS NOT INTENDED OR OFFEREO FOR SALE(SEC.7W1,BUSL �
N NESS AND iROFESSIONS OOOE:i11E CONTMCTORS UCENSE UW DOES NOT APPLY TO AN OWNEF OF �
VROVERTYN7q8URD50RIMPqOVE57HEREON,ANDNM1/ODOESSUp/WORNHIMSEIFORHERSELFOR
[L 7HROUCMHISORHEROWNEMPLOYEES,PROVIOE�THATSUp11MPROVEAIENTSARENOTMTENOEDOR m
W OFFEREDFORSI�LEIF,MOWEVER,7HEBUiIDINf30qIMPROVEMENTISSOIDWITHWONEYFAROFCOMRE•
� TION.THE OWNER�BUILOER WILL HAVE THE BUHOEN OF VPOVING THAT ME OR SHE DI�NOT BUILD OR
Z 11.1vPOVEFORTHEMIRPOSEOFSALE).
= 04�30N'NEROFTIIEGROPERTY,AAIE%CLUSIVELYCON7RACTINOVII7HLKENSEDCONTMCTORS
W
Q TO CONSTRVCT THE PR0.IECT(SEG 7a�,BUSMESS AND PROiESSIpJS CODE:TiE CONTMCTORS L4 VBIUflGOfI ADJ.AREA
W �NSEUWDOESNOTAPGLYTOANOYMEROFAPROPERTV1NqBUILD90flMPROYESTHEREON.AND
� NM1iOCONTMC73iOR5UpiVRQIEGTSWITHACONTMCiOR(5)LICENSEOPURSUAN7TOTHECONTRAG �UANTITY DESCRIPTION FEE
Y TORSUCENSELAW.).
� OIAME%EIAPTUNDERSEC. B.6V.C.FORTHISFEASON a
� U
li.. ¢
OA7E OWNER f-
O w
� UCENSED CONTRACTORS DECLARATION w
IMEREBYAFFIflMUNDERPENALTYOFiERNiIYTMATIAMLICENSEDUNDEFVROV1510NSOiCHMTEfl �
p. 91�M�ENCINOW(THSECTION7000)OFOMSION70FTNEBVSMESSAN�PROFESSiONSCODE,AND Z
�X MY LICENSE IS W FUIL FORC ANO EFFECT. m
� LICENSE CUSS L�C.N0. � j
V DATE�,1�� � Q CONT CTOR � , d
�W ! �
WORKERS'COMPENSA ION�DE AA TIO � �S' � U
N IHEHEBYAFFIRMUNOERPENALNOFPERNRYONEOFTHEfOLIOWIN6DECURAT10N�� Z
� _IHAYEANDWILLMAINTAINACERTiFIG1TEOFCONSENTTOSELF-INSUi1EiORMNRNERS' 2
CqAPENSATqN,ASVROVIDEOBYSECTION7l000FTMEWiORCODE.iOHTHEPERFpRM�HCE �U
Q HE WOiUC FOR WHIpiTH15 VERMIT IS ISSUED. �
_I HI.VE ANO YlILL M/UNTAM WORKERS'COMPENSATqN INSUfWlCE.�S REOUIRED BV SECTION
Q ]7ooOFTHELABORCOOE,FORiNEPERFORMANCEOFTHEWORKFQQ RWHICHTHISPERMRIS n,'��
� �SSUED.MYWORKE ' PENS ION�NSU RRIERANDi�LICYNUMBERARE: CONSTRUCTION ♦�V
/� , 1 !1
� GIRRIER �"L �/ �V\ PLANREVIEW i � ��
� iOLICYMIMBEN �Z'� � O ' ELECTRIC
Q
� (IHSSECi1d�NEmNOTBE001.6�LEfEDOFTEOERIXTIS�ORWEHlDREDOOUIfLSK��)a1LE44? PLUMBING
Z ICERTIFYTIATWTHEPERFORMANCEOFTHEWORKFORN}pCHTMSPERMITIS�SSUEO,I MECHANICAL
(} SMALLNOTEMPLOYANYPERSONINANYMANNERSO�STOBECOMESVBJECTTOTME
(n WOW(ERS'GOMVENSATIDNUWSOFCALIFORN10.�NDAGREETMATIFISHOUlDBECOME INSPECTIONFEE
SUB�ECTTOTHEWOWCERS'CqnvENSATiOt�l HOhS�Or OFSECT�DN 7o00FiHE OF
OE.I SHALLFORTHW COMPLV WITH TH SE PR IONS. ISSUANCE
p DATE:�D , p�PLICANT: SMIP
� WAFWIN6:FMURETOSECUREWORKERS'COMPENSATIONCOYERACEISUNUWFU4Nd SMAL�BE ENERGYP/C
�'y SUBJECTMIEMPLOVENTOCRIMIN�LPENALTIESANOCNILFWESUPTOONEHUNDREOTFqUSANO ENERGYPERMIT
DOLtARS(f100,000),W ADDITION TOTHE COST OF COMPENSA7qN,DAMAGES AS iROVIDEO FOR M
� SECTiON�7oeDFTHEUeORCOOE.iNTERES7,u�0A770RNEV5FEE3. RETENTIONFEE:
pCONSTRUCTION LEND�NG AGENCY PRE•ALT FEE:
� IHENEBVAFFIRMUNDEROENALTYOFPERIURVTIUTTHEREISACONSTRUCTIONLENDINfiAGENCV
FOR THE GEHFORA1MlCE OF THE WORK FOR WMICH THIS VERMIT IS ISSUED(SEC.�oY7,CIV.C.).
Z
W
� LENDERS NAME
� LENDE{YSADDRE55
� TOTAL FEES �SSr--
� ICERTIFYTNATIlUVEHEADTMI511PPLICATqNA�DSTATETIUITTHEA80VEWFORMATqNISCARRECT.
W IAGREETOCAMPLVN17NALLCRYANDCOUNTYORDIWWLESANOSTATEUWSREUTINOTOBU0.DIN0
� CONSTRUCTION,ANOHEREBYAUTIIORIZEPEFRESENTATIVESOFTHISCOUNTYTOENTERUPONiME
Z ABOVE�MEN7qNEDiPOPERTYFORINSPECTIONVURPOSES.
0 � � �� COMMENTS
�
� PERMITTEE YE(PRI � 1 � n //� �D • O 1
�� �\ �
(n S�orU7U df'PERIA�T7EE ATE
� RECPT.N0. PAID BY VALiDATION
WHITE—Department Copy,YELLOW—Finance Copy,PINK—AssessorCopy,GOLDENRO�File Copy,GREEN—Applicant's Copy
� � _ . .. ... .-.- .• � ... , � '�! ' r.l' ' . .��• r. .. : . '- ' ^ .. � 7: . - .. . ��- . . ':� r.�r'l:'� '�4.. . . r . n �;G�• � , . .
..... .,. ....�... .. .. ........ .. �.. .i..,. �.. . . �. -.-._..�. .
� l t ,•
�4 1'�ir' C��'�f�31/�1'JiQ�t� �31�:f�
livtSi�G:lGP� R�COd;G
�►'E�-'7:�.=�e�Dlle�,)►i Y r��:y=�,_„_II►�k-'�.�=E.��r�)'� � IR�F'1;��c�,-i'II��I,�l.�_.,_...._._—�r,�r�� I��.'i;,I�c��e��
t
.._____�__-- _--- ..__.---- . ._ �.._ .-----.__: . --.. __._ �____�: _ .. ..___.__._._____ --------------._. _�._�.._ .._
SET BACK � ! � ', ' I I FLOOR JQIST� ,. I
FTGSIFORP�IS!STEEL �� �_ FHA REQ'�1T5._.._
FLECTRIC GROUND UNDER FLOOR DUCT�''—
GROUND PLUMBING 1 Ut�DER FLOO�'CC?:�I�IJIT i
SLAB GRADE i FIREPLACE FOUNDATION
TEMP POWER l _ __ _ FIREPLACE BOPJD BEAP�I �
WATER SERVICE MID HT. F30ND BEAh1
ROOF SHEATHING , 8 FT.BQND B�M �
FRAMING/VENTILIATION I ' FINAL BOND BEAM
ROOF COVER j PRE-GRA�ING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING 1 � FINISH GRADWG
SH�VJER/TUB TEST � POOL ELECTRIC
EXT. LATN/SIDING PDOL FENCING
WALL INSULATION POOL FI�dAL I
CEILING INSULA.TION OFF SITE IMPS.
pRYWALL NAIUNG � DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/LL ' ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. �IRE DEPT. FIPJA�
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FIfdAL PLUMBING � E�JFRGY
�
.„.�_�.�� rr�,� L���rt�-_.._T��.._.
cor,nnnErvTs . .�� ' '"� �
SEPTIC TANK SIZE
SEEP PIT/U 51ZE
-�----,
1►`�� '
I
i
���� ::;;
s
V , .
��