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HomeMy WebLinkAbout17690 (51) _�` CITY OF DIAMOND BAR '� DEPARTMENT OF COIvIIvfUNITY&DEVELOPMENT SERVICES Z�� 21825 E.Copley Drive - (909)860.3195 Fa�c(909)861-3117 PRESS ������ BUILDINGPERMITAPPLICATION FIRMLY o ADD ESS I2�� ���tl G ClI►�� �f�• DATE CATIO , � o L NUMB R I � � p,C � APN LOT TRACT ISSUE TYPE OCC DATE CONST. GROUP' p OWNE�� "' ADDRESS L � �^ ZONING SETBACKS z CITY. r �a1� ZIP ` TEL. - FRONT RW ❑❑ o APPLICANT; TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR SI�E p o CDDRESS Z�P TEL. PROPOSED USE k� -��c-e / ' �G 1� �, n oARCH/ENG/ �z DESIGNER NO.DWEL NO. NO. N ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � <n DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUIL�ER DECLARATION SFR/ADD�'REM O 1 HEREBY AFFlRM UNOER PEN/LLTY OF GERJURY TW�T I AM EXEMPT FR01A THE CONTMCfORS LF Garage/Carport W CENSEUWFOR7HEFOLLOWIN(3REASON(SEC.70.71.SBUSINESSAN�PROFESSIONSCOOE:ANYCRVOR (n C� COUNTYWHICHREOUIqESAVERIAITTOCONSTRUCT,ALTER�PROVE,DEMOUSM,OflREPA1qANYSTRUG W W NRE.PRpq TO RS ISSUANCE.ALSO REWIRES THE APPIICANT fOR SUCII GERMIT TO fILE A SICNED w PaliOlDeCk � STA7EUENT TNAT HE OR SHE l5 t10EN5ED PURSUANT TO THE PROVISiONS OF THE CONTMCTORS LI• CENSE UW(CNAPTER 0 f�MENCWO WITI5ECT10N 7000)OF pIVi510N]OF TXE BUSINESS AND Vq6 u- PooVSpa IiES510N5CO0E)ORiHATHEOqSHE15E%EMPTTHEREFROMA4DTHEBtiSISFOR7FIEALLE6EDEXEMP- C7 TION.ANYVIOUiqNOFSECT10N1071.5BYANVAVPLICMlTFORA�EiiMITSUBJECTSTMEAPPLICANTTO Z Re-Roo1 A CML PENpLTY OF NOT MORE TNAN FNE HUNDRED DOLURS(i5oo).): � BIASOWNEROFIT7EPf10PERTY.ORMYEMPLOYEESN1TNWAGESASTMEIRSOIECOMPEN5AT10N, � Commercial � Z YYILL DO THE WORK M!D THE STRUCTURE IS NOT INTENDED OR OFFERE�FOR SALE(SEC.70N,BU54 J ' � NESS M!D PROFESSIONS CODE:TME CONTMCTORS LICENSE UW DOES NOi APPLY TO AN OWNER OF = ' PROPEflTY NM1iO BULDS OR IMPROVES THEREON.AND VMO DOES SUCH YlOfiK HIMSELF OH HERSEIF OR � THROUf7HH�50RHEHOWNEuOLOYEES,DPOVIDEDTUT5UCH6APqOVEMEMS�RENOTIHTENDE00R m QOFFEREOiORSALE1F,IqWEVERiNEBUILDINCORIMPROVEAIENTI550LDWfTMNONEYEAROFCq.IPLE- ' Z TION.TME OWNER�BUIIDER WILL HAVE THE BURDEN OF PROVWO THAT ME OR SHE DID NOT BUILD Ofl = MP{IWEiOqTHEPUR005EOFSALE� O 4�OWNEROF THE iROPERTY,AM EXCLUSNELY CANTMGTINO W11M L�C[NSED fANTMCTORS Q TO CONSTRUCT THE VRQIECT�SEC.7a�.BV5INE55 AND VROFESSIONS CODE:TME CONiRl1CTOR5 LI• V01U31iDI1 GG�C� ADJ.AREA W CENSEUWDOESNOTAVRYTOANOWNEROFAPROPERTYYVM09UIlD50HM7ROVE57MEREON,MIU Z NTIOCONTMCTSFOHSUCHVH0.IECTSMAiHACONfRACTOF(S�LICENSEDVURSUA4TTOTHECOMfUG QUANTITY DESCRIPTION �E Y TORS UCENSE UW.). � IxIAAA EXEMPT UNDER SEG B.t D.C.FOR THIS REASON Q � U LL DATE Z-2 � Z OWNER � V .. �Q LICENSED CONTRACTOiiS DEC TION W CL I HEREBYAFFIRM UNDER PENALTY OF FERIURY THAT IAM UCENSED UNDER VHONSIONS OF CHAVTER �. p,. OIWMMENCWOWITHSECTION70W)OFDIVISION�OFTHEBUSINESSANDPROFESSiONSCODE,ANO Z X YY LICENSE IS IN FULL FOaCE AND EFFECT. � LL � UCENSE CUSS LIC.NO. j ,. V DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION Q NI HEREBVAFFIRM UNDER PENILLTY OF PERJURY ONE OF iHE FttIOWING DECtAMTqNS: Z � _IHAYEANDWILLMNNTAINACERTIFICATEOFGONSENTTOSElNNSUREFORWCJRKERS' _ . COMPENSATpN.AS PROVIDED BY SECltON 17a00F THE UBOR CODE.FOR 7NE GERFORMANCE W O OF THE WORK FOR WMICH TMIS OERMIT IS ISSUED. � �I HAYE M1D WILL MAIMAiN WOFiKERS'COMPENSATIOH INSUiUNCE.AS RE WIRED Bv SECTION 6 0 J7o00FTNElABORCOOE,FORTNEGERFORMANGEOFMEWORKFORWMICIITMISPERMITIS r� � ISSUED.MYYIORKERS'COAIPENSATIONINSURIWCECMRIERANDPOLICYNUMBEHARE: CONSTRUCTION / J � CARRIER PLAN FlEVIEW � 0 PqJCVNUMBER Z ELECTRIC ¢ (MSSECiIONNEmHOTBEO�.�LEIIDOFhEPERw(TISPoRONEHU,OREDDdU1uR�00)OHIE",»F PLUMBING --_.- � --- ------ W ^ �_.��_/.',_�"\ .1 1 ! 1��i Z 1 LERTIiYTHAT W THE VERFORMANCE OF TNE WOPK FOR WHIp1 h115 PERMIT 451SSUED,I MECHANICAL U' SHALL NOT FM7LOY M1Y PERSON W ANV MANNER 50 AS TO BECOME SUBJECTTO THE �p WORKERS'COAIPENSATIONLAWSOFGLIFORNItiANDAGREETMATIFISMOULDBECOME INSPECTIONFEE �_ � S SU&IECTTOlHEWqRI(ERS'fAMVENSATIONVPOV1510NSOF5ECT10N7T000FTHEUBOR _ � "' CODE,IS/ULLFORTHl41THCOMPLVWITNhqSEPRONSIONS. ISSUANCE � � f � SMIP ` K! ( •S� p DATE: APPLICANT: ����J'� � WARNINO:FAILURETOSECUREWOqNERS'COM7ENSATIONCOVERAGEISUNUWFUL,ANDSNALLBE ENERGYP/C �jj� I �y SUUJECfANFMPIOVERTOCRIINWALGENALTIESANOCMLFINESUVTOONEHUNDREDTIqUSM1D f^ " " --^ -"""�'�' —� DOLLARS�f100,000),IN ADDITIpJ TO THE COST OF LOMPENSATqN,OALUGES AS PROVIOED FOR IN ENERGY PERMIT � SECTIDN�7DlOFTHEUBORCODE,INTEREST.AN�ATTORNEY5iEE5. RETENTIONFEE: /• d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IMENEBVAiFIR4UNDERDENALTVOFOfRIURYTHATTHEREISACONSTRUCTIONLENDIN�AGENCV Z FOR ME VERFOHMANCE OF 7ilE wORK FOR WNIp17N15 PEiWIT IS ISSUEO(SEC.�097,CIV.G). W � LENDER'SNAAIE � �ENDER'SADORESS ¢ ICERTIFVTHATINAVEREAOTHISAPDLICATqNANDSTATETHATTHEABOVENFORMATIONISCORRECT. TOTAL FEES /D� �v W 1AGREEiOCOMPLVYATMALLCITVANOCIXINTYORDINANCESANOSTATEUWSREUTNGTOBURDIN6 � CONSTqUCT10N,ANOHEREBVAUT110RREREPRESENTATNE50FTMISCOUNTYTOENlERUPONTME Z ABOVE-MEMIONEDPROPERT/FORINSPECTIONPURPOSES. 1 COMMENTS 0 � t�' � ¢ PERM�iTEENAME( iNn r cn ) c� Z—�—C (J� SIGNATUNEOFPERMITTEE Y DATE � FlECPT.�9. PAID BY �' VALIDATION WhiITE—Department Copy.YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENFiOD—File Copy.GREEN—Applicanl's Copy . � . - � . .� . . .... , ..�. . .. . � , , � .� ., . , . . ...w; :a�*�� ....�_ , . . .�r.-r- �..--...,.;.., . . - . � - , � ,;.i•,. � .-._ •. . ., �� ,. ci-r�° �� ��,��r�fo�aQ �rl.r� IP'�S��C�iO��i �i�CO�Cy �I�k-'S��=l�.�'Coa1�l � ----���'l��-_.�1►��� �."�4' r�1�s –____--I���'i�:� �`. Cle�l►`I � ���1.r�. I��E-�:��c�i�o"1�{ '� _�___.__..._._____..___----.—._. _::_. __._._.. .__– . .. ._.� ...___-.---__.____..�..._ .____.___...._. _ ---._.___.�__.____._-.,�--._._____�____ SET BACK f � � � � � FLOOR JOIST � Ff'GS/FORMSiSTEEL � I FHA REQD�1TS _ ELECTRIC GROUND � Y UNDER FLOOR DUCT GROUND PLUMBING � I i Ut�dDER F�.00R CUf�IDUIT � j SLAB GRADE I __ 1 FIr�EPLACE FaUh1DATI0�d i TEMP POWER � FIREPLACE BOND BEAM WATER SERVICE / � MID HT.�OND BEAF.1 ROOF SHEATHING _ ��p/Qy f3 FT. BOND QEAh1 FRAh�INGNENTILIATION I � FIfJAL E30ND BEAM ROOF COVER ���`��Z y�� _ PRE-GRADR�G I ROUGH HEATING BENCNING I ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING � A FIPdISH GRADING SHOWERRUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FEf�CING WALL INSULATION POOL FINAL CEILING IfJ�ULATiON �FF SITE IMPS. ORYWALL NAILIPJG DEDICATIONS 1 SEWER FIPJAL E�dG. ' SEPTIC TANK LAPdDSCAPE/IRRIG. � SEEP PIT/L.L. ` OfJ SITE It�1PS. GAS AIR TEST � FINAL ZONING FINAL CONST. ! . �IRE DEPT. FIPdA'_ FINAL HEATIhJG i HEALTH QEPT. FINAL F1NAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY +s 1.'.r.c l'�:.:�; �---- COMMENTS SEPTIC TANK SIZE SEEP PITIU 51ZE _____ I'�p�.._.._ ; -- � , ,r�t� �tl;, �, , _. . .. � . : .