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HomeMy WebLinkAbout12-128 ��_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES" � 21810 Copley Dnve,Diamond Bar,CA 9I765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702 1 PRESS ��'TM'� BUII,DING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION PERMIT P/C o ADDHESS� S�1'^�j Go��T'1/1 ��/"6ZC�o5 DATE NUMBER �# $ ISSUE n •1 ,TYPE OCC APN LOT TRACT DATE O d" o��CONST. - GROUP p OWNER� � ADDRESS ZONING S ACKS oCITY ZIP ��. FRONT RW ❑ APPLICANT TEL. REAR ❑ o S1DE/SIDE STREET RW O � CONTRACTOFjx�)C C �nna.!',K �.',,,.. Co rr�� A SIDE ❑ Q ADDRESS �1,"17 . .� <�s->5�.+ ,'��p� �- o � CITY ! A- 21P '��O TEL�L"15f)S�2-/S30 PROPOSEDUSE �\✓16''�"���M��'7�t" w ARCWENG/ 4 G �z DESIGNER NO.DWEL. • NO. `, NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER�ECLARATION � SFq/ADO/REM O 0 1 MEREBY AFFlRM UNDER�PEtULTY OF PE0.NRY THAT 1 AM E7(EMGT FqOfA THE CONiMCT00.5 LM Garege/Carport W CENSEUWFORTHEFOLLON�INOREASUN(SEC.7o31.6BUSINE55AND7ROFE5510H5CO0EANYCT'OR (� . U �pUNryWI{IGiREpU1RESAPERMITTOCONS7RUCT.ALTEH,tMPROVE,OEMOLISH.ORREFAIHM1Y5TqUG W P0S{OID8C1f . . � NRE,PRtOR TO RS ISSUANCE,AL50 RE[XlIRES THE APPLICANT FOR SUCH PEAMIT TO flLE A SIONED W STATEMENT THAT HE OR SHE IS LICENSED MIRSUANT TO THE PRON570ry5 OF THE CONTMCTORS li- � CENSE UW(CYLIPTER Y(COMMENCW4 NTTH SECTUN�000)OF OIVISION 3 OF TME BUSINE59 AND PHO �'�' PaoVSpe � FESSIONSCOOE)OR7NATHEORSHEISE%EMPT7HEfiEFROMANDTHEBASISFORTHEAI.LEOEDF�(EMP- (a . . V TqN.ANYV10lATqNOFSECTION7o31.e8VANYMPLICANTFORAPEMIITSUBJECTSTHEAPPIICANTTO Z� q�Rool A CML PEN7�L7Y OF NOT MORE TlIAN FlVE HlX1DRED QOUf�i15(lSOD).): Z ❑I,ASOWNEROFTHE7HOPERTY,ORMVEMPLOVEESWfTHIVAGE5AS7HE1R50LECOMPENSA710N, � � Commercfal� . - LNII DO THE WORI(AND THE BTRUCTURE IS NOT INTENOED.OR OFFEREO FOR 9�LLE(SEc.iO4�,BU54 �I N NESS AND PqOFE5510N5 COOE:THE CONTRACTORS UCENSE UW DOES NOT AVRY TO AN OWNER Of ? C `� � ' PR07EiRY NTIO BUILOS OR IMPROVE9 THEREON,AND WHO DOES SUCH WOFIK HIIASELF OR HERSELF OR Q THROU6H WS OR HEH OWN EMPLOYEES,PRONDED THAT SUCH IMPROVEMEMS ARE NOT(NTENDED OR . m � � QOFFEpmFOR3ALEIF.MOWEVER711EBUILqNOORIMPROVEMENTISSOLDWITMNONEVEAROFCOMPLE- Z TION,.TYfE'OMT�ER�BUIIDER WILL HAVE THE BURDEN OF vROVIN�TFIAT HE OR SHE DID NO7 9UILD OR � � . � IMPROVE FOR TME PURPOSE OF SALE7. . w ❑4ASOWNEROF7HEPROPERfY,AME7(q.USNELYCANTMCTWOWITHIICENSEDCONTRACTOR4 . ,. [C TO COHS7RUC1 THE PRQIECT(SEC.7UI1,BUSINESS AND PROFESSIONS CODE:THE CONTRACTOqS LI- V9IUHfWI1' ADJ.AREA. � CENSEUWDOESNOTAPPLYTOMiOWNEAOFAPROPERTYVh106UILD50RIMPROVESTHEREON,AND - WIqCONTRAG7SFOR5UCHPpOJEC73Wf7HACONTRAC70R(S)LICENSEDPURSUMITTOTHECONTRAG pUANT1TY� DESCHIPT'ION FEE . � T00.5 LIGENSE LAW.). 0 O I A1A E%EMPT UNDER 6EC. � B.8 P.C.FOR TWS REA$ON � � U tL � DATE oWNER � Z w ¢ LICENSED CONTRACTORS DECLARATION W � - � OC 1 HEREBY AFFlRII UNDER PENALTY OF PER0.IFY THAT IAM LICENSE�UNDEA PROVISIONS OF C}LIPTER � -' � Y(COMMF1iC1M0 1NTH SEC7�ON 7000)Of OIVISqN J OF THE 9USINESS M1D PROFESSIOti4 COOE./�N0 Z . . . . . . X`� W LICENSE IS IN FULL FORCE AND EFFECT. m LLI {� � ENSE CL0.SS !.7 LIC.NO. �I O��l� ' �� � , V ATE �l��Z CONTRACTOR 4- .. .. . . W � WORKERS'COMPENSATION DECIARATION � � � � � � � I HEREBV AFFIRIA UNDER PFNALTY OF PEFJUflY ONE OF THE FOLLOW410 DEQARATIONS: Z ' � _I HAVE AND WRl MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR Mqi1KEqS' � Q �COMPENSATION,/S PROVIDED BV SECTION 37000F TME LABOR COOE,FORTHE PERFORM1tNCE �U' Q OF THE WORN FOR VM1iICH THIS PERAUT IS ISSUED. � ' ' w _I HAVE AND WILL MAIMAW WORKEAS'COMPENSATION INSURANCE,�AS REOUIRED BY SECTION ' Q 37000F THE LABOR CODE,FOR THE PERFOAMANCE�OF THE WOPo(FOR WHM31 THIS PERNlT I5, ISSUED.IAY WORKERS'OOA4PENSATION INSURANCE CMRIEfl M!6 POLICY NUMBEH ME: CONSTRUCTION . - jcnrwiEA PLAN REVIEW `- ' - — -- Z � POLICY NUMBER C o 0 Z�J �I�T 5 — o�c 1 —7 y ELECTRIC ¢ p �rassct�N�rroreEoons�Ermocn+Eaew�rst�or+Er�a�oa�ulsioMoa�ssl PLUMBING w � Z �CEHSIFY THAS IN TiE PEFFORMAtJCE OF TME.WORK FOR WMICN THIS PEH3AIT IS ISSUED.1 MECHAIVICAL� � L} SIIALL NOT EMPLOY ANY PERSON W ANY MANNER 50 AS TO BECOME SU&IELT TO THE' d (,/) WORKERS'COMPENSATqNLAW50FCALIFOHNIA,ANDAGREETMATIFISHOULDBECOME INSPECTIONFEE ,v�• �b SU6IECT TO 7HE WOR1(ERS'COMPENSATION PROViS10N5 OF SECTION J7oo OF THE LABOR � - � . �j CODE.I SHALL FORTHWITH COAIPLY WITH TF105E PROVISWNS. ISSUANCE __ ��•. `d � � SMIP p DATE: APPLICANT: J WARNWO:�FALLURETOSEWREWORNERS'COMPENSA7IONCOVERAGEISUNUWFUI.AND9HALLBE ENERGY�P/C � SUB.�ECTAN EMPLOYER TO CAIMINAL PENALTIES ANO CML FlNES UP TOONE HUNDRED ThI0U5AND ENERGY�PERMIT ' OOlSARS(Slao,oW),!N AD01T10N TO THE COST OF COMPEt3SATlON,ON.UGES AS 7ROVIDED FbR IN /��� � 6ECTpN 310e OF 7HE UBOR CODE.P7TEREST,ANDATfORNEV'S FEES. ' RETENTION FEE: � � • W d� , CONSTRUCTION LENDING AGENCY -PRE-ALT FEE O . . . . . . .. � � 1 HEREBV AFFlRM UND£R FENALSY OF PERIURY THAT TNERE 19 A CONSTRt1CT10N LENOWp AOENCY �FOR THE PERFORAIANCE OF.7HE WORK FOR NMICiI TMIS PERMI7IS ISSUED(SEC:3097,CIU C.} � Z W • �- LENDEfZS NAME . . . . 1— LENDER'SADDRE55 � " , � �ICERTIFY7HATIHAVEREADTHISAPPLtCAT10NANDSTATETIATTHEABOVEMFORMAT10N19C0liRECL TOI'AL FEES �\�� � ` � I AGREE TO COAIPLY M7TH ALL GTY AND COUNTV ORDWANCES AND STATE UWS REl.ATINO 70 BULOINQ � CONSTpl/CT10Fl,AND HEREBV AUTHORRE REPRESENTATNES OF TMIS GWNTY TO EMER UPON THE � Z ABOVE-MENTIONEO PROPERTY FOR WSPECTION WRV0..E5. COMMENTS " _ � /-}/LC�1 t'4c/�(�S C-G m PERMITTEE E_fit ' . � ¢ J{ � �/��� .' . , . . . . . . � �/j SIONA�UR .E /fTTEE D E � RECPT.NO. P/UD BY VALIOATION WHITE—Depardnent Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GAEEt�ApplkanCa Copy CITV OF D1AMOfVD BAR IfVSPECTION REC(J{RD � . . , . � ° Q -�,+�".., B . � .. , . - p � , .. }�. .�.�. 'i ,.�„i.. �,� �.�.3�.�. D Q M, +�y D � .,,� ..., .e ..... � O � !M1� SET BACK j FLOOR JOIST ^ FTGS/FORMS/STEEI FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT T GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERUICE MID HT.BOND BEAM ROOF SHEATHING 8 FT.BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM ROOF COVER PRE-GRAQING ROUGH HEA7ING BENCHING ROUGH ELECTRIC ROUGH GRADfNG ROUGH PLUMBING FINISN GRADING SHOWER(TU8 TEST PpOL ELECTRIC EXT.LATH/SIDlNG POOL FENCING WALL lNSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. QRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTICTANK LANDSCAPE/IRRIG. SEEP PIT/L.L. Ofd SITE IMPS. GAS AIRTEST FINAL ZONING FINAL C�NST. FIRE DEPT.�INAL FINAL HEATING HEALTH DEPT.FINAL FINAL ELECTRIC ' DEV.FEES PAID FINAL PLUMBING EMERGY F1NAL PLANING FINAL ENGINEERING p e COMMENTS SEPTICTANK5IZE SEEP PIT/U SIZE ` ��'� 1 :'�,