HomeMy WebLinkAbout16958 �� CITY OF DIAMOND BAR
� DEPARTMENT OF COIvIIvIUT1ITY&DEVELOPMENT SERVICES EXPIRED
� �` 21825 E.Copley Drive
"-.� BUILDING PERMITgAPPLICATION .1UN 17 ?001 FIRM Y
o DDRIESS�Z2 G o c.o E� PR14,�bS DATE CATION �� (���� NUMBER I t" p,C
c� ISSUE TYPE OCC
APN LOT �RACT pATE CONST. GROUP
°C OWNER d
0
"" ADDRESS Z-2. O C D ZONING SETBACKS
W CITY - • ZIP' TEL3 6- FRONT RW ❑
S APPLICANT S/cVE�2 AA,(ydAI��O� TEL. REAR ❑
� SIDE/SIDESTREET RW O
� CONTRACTO S� ���r� SIDE ❑
a ADDRESS� PROPOSEDUSE E OL� LUODD S /
a CfTY �/f�/_A/L� ZIP ! TEI ��/!� /�_�Y L �. p
w ARCWENG/
z DESIGNER NO.DWEL NO. NO.
= C�ESS ZIP TEL. UNITS / STOFiIES 2' BEDROOMS ^
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
OOWNER-BUILDER DECLAFATION SFR/ADD/REM
p 1 MEAEBY AFFlRM VNOER FENALTY OF GEfWRY THAT I MI E%E!.IPT FROM THE WflTMCTOfiS LF Garage/Carport
LLJ CENSEUWLORTHEFdlOWWOREA50N(SEG7031.68USINESSAN�PROFESSIONSCODE:MIYCITYOR (n
U pOUNTYyJHICHREWIRESAPERMITTCICONSTRVCT,ALTEH.IIAPROVE,DEMOLISH,ORREPAIRµySTRUG W patiolDeck
� NRE FRpF TO RS ISSUANCE./�L50 REWIRES THE MVLIGWT FOR SUCH PERMIT TO FILE/151GNED
V� STA7EMEN1 T11AT HE OR SHE IS LICENSEO WRSUANT TO TNE PRWi510N5 OF THE CONTMCTOqS LI- w
� CENSE UW(CMMiER Y(COMMENqN(3 WITM SECTION 7o0o)OF DIV15�ON J OF THE 0U51NES5 ANO PR0• u' PaaVSpa
FESSIDNS COO�OR iHA7 HE OR SHE IS EXEIAPT TMEREFROti1 AND THE BASIS FOR THE ALLECED ExEUP•
� TIDN.ANYVKKATIONOFSECTIOti7071.SBYANYMGLICANTFORAVEAMITSU&lECTSTHEAPPLICANTTO Z Re•Roof
A CML VENALTY OF NOT 1dORE THAN iIVE MUNDHEO DOLLARS(5500�.):
� 04ASOWNEROFTHEFROPERTY.ORIAYEIAPLOYEESVnTHWACESASTNEIFl50LECOMPENSATION, O �mmerciat -
WILL DO TNE WORK,AND THE 57RUCTURE IS NOT INTENOE�OR OFFEREO FOR SALE 15EC.701�,BUSi• J
� NE55 ANO PROFESSIONS CODE:THE CONTHACTORS UCENSE LAW DOES NOT APP�V TO AN OWNER OF ?
PROPERTY NT10 BUILDS OR IMPROVES iHEREON,M10 V'MO DOES SUGIINUHK MIMSELF OR HERSEIF OR
(G THRIXJGHHISORNEROWNEA/7lOVEES.DROVIDEDTMATSUCHIIAPROVEAIEN7SARENOTWTENDE00R m
pOfFERE0FOR5AlEIF,/10WEVEi�7HEBU4DINGORMVROVEMENTI550lDWITHINONEYEAROFCOMPLE�
Z TqN.TNE OWNER�BUIIDER VALL MAVE TME BUPDEN OF CROVINO THAT HE OR SNE DID NOi BUILD OR
= IMPPOVEFORTMEPURPOSEOFSALEF
O L Il5 OWNER OF TME PRO?ERTY.M1 E%CLUSIVELY LONTMCTWG WIM LICENSED CONTMCTORS
� TO CONSTRUCT iHE PpOIECT(SEC,70��.BUSINESS AND VROFESSIONS CODE:TNE CONTMCTOFS U� V�I118S10R A�J.AREA
LL1 CENSEUWDOESNOTMPL�TOANOYMEROF�PROFERTYMRIOBUItD50RIMPROVESTNEREON,AND
� WNOCON7MCTSFORSUCHVR0.IECTSWITHACONTMCTOR(S�LICENSEDFURSUANT707HECONTRAG �UANTITY DESCRIPTION FEE
Y TORSUCENSEIAWJ.
� O 1 M1 EXEMPT UNOEH SEC. B.a V.C.FOR THiS REASON U
�
W �.�..
DATE OYMER
Z W
� UCENSED GONTRACTORS DECLARATION W
� IHERE9YAFFWMUNOENPENAIiYOFVERNRYTHATIM�LICENSEOUNDEflVROV1510N50FCHAPTER �
p. i�COM1AENCINOWITHSECT10N700o)OFDMSION70FTHEBUSINESSAN�PROFES iONSCODE,ANO Z
u� MY LICENSE R W FULL ND EFFECT. m
� UCENSE)CIASS� �� UC.NO. ��� J ,
� V DASG�I GONTRACTOR � �-
W � "
� WORKERS'COMPENSATION DECIARATION 4
� IHERE9YAFFIRMUNDEHPENIILTYOFPERNRVONEOFTHEFOLLOMANGDECURATIONS: U
� Z
Q
� _IHAVEANOWILLMANTAINACERTIFICA7EOFGONSENTiOSELF-MSUREFORWORKERS' 2
COMPENSATION,A9iROVIDEDBY5EC710N�]OOOFTHEUDORCOOE,FORiHEPERFOqMANCE W
OF TME WOR1(FOR WHICH TFIIS DEFAl1T IS ISSl1EO. �
�
W _IHAVEANOWILLMAINTAINWORKERS'COMPENSATqNINSUMNCE,I3REW�REDBVSECTION ���
d 77D0 OF TME LA80R COOE,FOR iME PERFORMANLE OF ME WOPK FOR WMILMTMIS PERMIT IS
� �SSUED.MYriORKERS'COAIPENSATIONINSURNNCECARRIEHANOPOLICVNUI.�BERARE: CONSTRUCTION
Q
�, CAARIER PLAN REVIEW
� iOLICYNUMBEH e�ecTaie
Q (�HSS[CIIONNEmNOTBECU.QLf7EDCF1/EPERMTISfORONEF41'L%'EDDCl1Ai15RfaoJOqlE55} PLUMBING
Z 1 CERTIFV 1HAT W 7ME PERFORMANCE OF THE WORK FOR WHIW TMIS PERMR IS�SSUED,I MECHANICAL
('} . SIULLNOTEMPLOYANYPERSONWANVMANNEFSOASTOBECOMESU&IECTTOTME
� WORKERS'COMPENSATIONUWSOFCAUFOFW�AANOAGREETMATIFISHWLDBELOME INS?ECTIONFEE --- -
5 6UBJECTTOTMEWORKERS'MA�OENSATIONOFOVISIONSOFSECTION�7000FiMEUBOR � ���\ ' "i'I-=-�V� ��_
.O
CODE.ISMALLFORTNWITHC0IAPLYWITM OSEPRONSqN3. ISSUANCE
p OATE: g-t�'-al APPIIGANT: _ � SMIP �
� ENERGY P/C
WApNING:iA1LUNETOSEIXIREWORKERS'CO ENSATIONCOVERAGEISUNUWF�A.,,ANOSMALIBE
� SU&IECTANEMPIOVEflTOCRIMW/LLPENAIT SANDCMLFWESUPTOONENUNOREDTHOUSAND ENERGYPEHMIT
OOLUfiS(f f 00,0007,PI/DDITION TO TME C0.5'OF CAMPENS�TION,DAMACES AS PROVIOEO iOR IN
� SECTqN]�OB OF TME LABOR COOE,INTERESi AND ATTORNEYS FEES. HETENTION FEE: D���`_ i
��i �
a CONSTRUCTION LENDING AGENCY PR6AlT FEE: --'-"" ' -
O
� IHEREBYAFFIRMUNOERPENALTYOFPERIURVTHATTMEREISACONSTRVCTIONLENOWaAGENCV
0- FOR THE PERFORMANCE QF THE WORK FOfl WH1LN TNiS PERMIT I5155UED(SEC,JDY7,CIV.CJ.
Z
W
� LENDER'3 NM1E
1,_ LENDERSADORE55
WICERTIFYTHATINAVERE�DTHISAPPLICATIONANDSTATETMATTME�BOVEINFORM�TqNISCORRECT. TOTAL FEES I �I� � U
� IAGREETOCdAVLVWITHALLCITYANDCOUN7YOROINANCE5AND5TATEUW5PEUI�NOTOBUILD�NO \j'
CONSTRUCTION,AND MEREBY AUTHORRE PEPRESEN7ATIVES OF THi3 CWNN TO EMER UPON THE
ZABOVF-MENiIONED7qOPERTVFORINSPECTIONVURiO5E5. COMMENTS
� rtb/1�AriVA�✓�•- C.,Ol�I�I
m VE ITTEE NAME(VRI17T)
¢ Js-��' �/y/�/
�
Uj 5,NATUNEOFVEWAITTEE . OAT
S RECPT.N0. PAID BV VAlI0A710N '
~ WHITE—Department Copy.YELLOW—Financa Copy.PINK—Assessor CopX GOLDENROD--File Copy,GREEN—Applicant'sCopy
',�,;�s�..'.�.cj.1Y �iti. ,:r,l�:,y� � 1-.,,i4 .,.�+� .�-�r,:r .. � � '�"i�. .., . .`rx.• r. , ,. . � ... � .. ,.a�„ � .,.�;�.- .. ..,. . .. -.... ._.. � ..7.,. .
... �.�,yq,.,. . ... r 'S':'` 9 i i ."',• -..
,. , ,,,,,. ..._ . „ .. .... _
. , • ��, . �. �4., ..
cir�' OF Dlf-�MO«D BAR
lf�1S�EC i iOP�i RECORD
il►��7�a=���'�`l�l�� �� �t��:t'-' ,I�F-'��a�Cc�['c��� ��I►`,E-'�:�_,c5�s'C.cl►`t �e�i�.�'� :I��F-���c�r'��:�
,._ .--__�____ _____.__-_._--- __..__._...___ ..___._.. ___ _---..._._____�_.__.__________------=----�_...._----- ---- —
SET SACK , __�_ � � FLOOR JOIST � . _
FTGS/FORP�AS/STEEL � FHA REQMTS I
ELECTRIC GROUND Urd�ER FLOOR DUCT t
GROUND PLUMBIfJG i UNDER FLOOR CUP��.DUIT ;
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER I FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM
ROOF SHEATHING • 8 Fi'. BOND BEAM
FRAMINGNENTILIATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTFiIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SH�WERlTUB TEST POOL ELECTRIC
EXT. LATHlSIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL PJAILING DEDICATIDNS
SEWER FINAL ENG.
SEPTIC TANK - UINDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS. '
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL H�ATING HEALTH DEPT. FINAL
FlPJAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
c1:I��' �I: �;lc;r
. .�. _.�i .��. . _3.... _ __ _.' "�
COMMENTS
SEPTIC TANK SIZE •.
SEEP PIT/U SIZE
I'�� �-1
�
�
`��4� =�
� � � ; � ; ', `