HomeMy WebLinkAbout17438 (17) �,` CITY OF DIAMOND BAR
� � DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES �
21825 E.Copley Drive ( �
(909)860-3I95 Fax(909)861-3117 PRESS
"%�� BUILDING PERMIT APPLICATION FIRMLY
Q A�D RESS 2 o S� � ��D t-�/ S ���v �� APPUCATION ����U 1QI PERMIT t Q P/C
p OATE NUMBER � 0 �F
� APN LOT TRACT DA EE l� " 3�--� I CONST. GROUP
p OWNER '
� ADDRESS ZONING SETBACKS
Z CITY ZIP TEI. FRONT RW p
g APPLICANT TEL. REAR ❑
� SIDE/SIDESTREET RW O
� CONTRACTOR' �� SIDE p
� ADD SS L� ���
� CITY ZIP TE . PROPOSED USE 1'�-(
w ARCH/ENG!
z DESIGNER '
w NO.DWEL. NO. NO.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
�
cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER•BWLDER DECLARATION SFRlADD/REM
O
I MEREBY AFFIRM UNDER PEWLLTY OF PERRIRY T11�T I AM E%EMPT iROM THE CON7MCTONS LI• Gdf998/COfpOR
W CENSEUWFORTHEFOLLQ�VINGREASON(SEC.7071.58USINESSAN�PROFESSqN5CO0E:ANYCITYOq (n
U COUMYWWCHREOUIRESAPENMITTOCONSTRUCi,ALTERIAIPROVE,DEAlOLISH,OqREPAiqANVS7RUC- W Pdtio/DeCk �
� NRE iRqR TO RS iSSUANCE.I150 REWIRES THE AFPLIGNT iOR SUCH PERAIIT TO FILE A SIGNED w
SUTEAIENT THAT HE OR SHE IS LICENSEO GURSUANT TO TME PROViS10N5 OF THE CONTPACTORS U•
� CENSE LAW(CHADTFR 0(MIJMENdNO WITH SECTION 7000)OF DIVISqN 3 OFTHE BUSINESS AND PRO- u- PooUSpa
FESSpNSCOD�0i1THAiHEORSHEISEXEMPTTHEREFROM/WOTHEBA515FORTHEILLIECEDE%EMP• (�
� TqN.ANYVIOLATI0NOF9ECT10N70]1.6BYANVAPPLICANTFORAVERMI75UB1EGi5THEAPPLICANTTO Z Re-Root
AGML VENALTY OFNOT MORE THAN FNE NUNDRED OOLURS�f5oo),�:
Z04ti^�NEROFTMEPROPERTY,ONMVEMPLOYEESNnTMWAGESASTHE1q50LECOMVEN5ATI0N, � QpTTBfCie� �
WILL DO THE WORK AND THE STRUCiUFE IS NOT INTENDED OH OFFERED FOR SALE(SEC.70��,BU51• J
N NESS AND PROFESSIONS CODE:THE CONTMCTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF ?
PR07ERTY 1NfD BUILpS OR W vROVES TNEREON,AND NMO OOES SUCN WO{iK MIMSELF OR HERSELF OR
2 TMROUCHHISORMEROMMEMVIOYEES,GfiOVIDEDTHATSUCNIMPROVEMENTSMENOTME�DEDOR m
� OFFEREDFORSALEIF,f10WEVERTMEBU0.DINaORIMPROVEMENfISSOIDWRMNONEYEAHOFCOMPLE-
Z TION.THE WINER�BUILOER YALL NAVE THE BURDEN OF PROVWO TFUT HE OR SHE DIO NOT BUILD OR
� IMPROVE FORTNE iURPOSE OF SALEJ. •
w 04ASOWNEROFTHEPROPER7Y,AMEXCLUSNEl1CANTMCTN6Wtf11lICENSEDGONTMCTORS
W EN�SENUWDOESNOTAVPLYTOANOWNEROFAPROPER7YW1108UILDSOflD1A1PROYE�REON.AND Valuatim ADJ.AREA
� NAqCONTMCTSFOHSULHDRQIECTSVAlHACONIRACTOii15)LICENSEDPURSUANTTOTHECONTMG QUANTI �ESCRIPTION FEE
� 70RSUCENSEUW} � .L/C �JIN
� O 1 MI IXEMPT UNOER SEC. 8.i P.C.fOR THIS REASON Q d
� U + �7�
LL , fL C L:- 'LG_• �
Z DATE OWNER V fLf a �`ryL� Z ^/
� � LICENSED CONTRACTORS DECLAFATION w rL(� f� 2� lpV•
� I HERfBV AFFIRM UNDER PENALTY OF OER1UiiY THAT IAA1 LICENSED UNDER PROVISIDNS OFCHAPTER �
p. Y(COMMENCINO YnTH SECiION 7000)OF DIVISION�OFTHE BUSINESS AND PROFESSiONS COD[,AND Z
X MY LICENSE IS IN FULL FOPCE AND EFFEGT. �,�J
� LICENSE CUSS � / `' LIC.NO. �� �" � • � ,
V DATE CONTRACTOR�LV7��_��� . d
W � ��
-� � :�WORKERS'COMPENSATION OECIAFiATION Q - .,_ . _
� IHEREBYAFFIRMUNOERPENALTYOFVEiWRYONEOFTHEFOLLOWING�ECUMTiONS: Z
a
O _INAVEANDWiIIMAM�INACERTIFtCATEOFCONSENTTOSELF�INSUREFORWORKERS' _ �
� COMPENSA710N,ASPWJVIOEDBYSECTIONJ7ooOFTHELABdiCOOE.FORTMEPERFORMANCE �U
OF THE WORK FOR WHIp1 THIS VEM�IT IS ISSVED. � .
O
_I HAVE AND 1MLL AUIMAIN WORKERS'GOMDENSATqN INSURANCE,AS REOUIRE�BY SECTION
QQ �7000FTHElABORCODE,FORTHEPERFORMlWCEOFTHEV10R1(FORNMIqiTHISPEWAiT15 �(,-_„� �`� l � � ��
ISSUED.MYYN�RKER�5CO�M7jEN�SATIONINSU GARRIEflANOPOtICYNUMBENARE: CONSTRUCTION � � �� �'��
� CAARIER�(JS_ L �L�N PLANREVIEW
� POLICYNUTA9ER�I,I��rI��(`L ELECTRIC � �
¢ �"r �
� (Ilv^SECf10HNEmNDTBE00M1FlE'fEDOF7VEPEW.R6inRONEFl1Di�FD00lUliSlttOo)ORLfSS} PLUMBING
Z I CERTIFY THAT IN THE VERFOfiMANCE OF iME WORK FOR WHIpI TM15 PERMiT I515SU ,I MECHANICAL T1�T• ��' �
C7 SHALLNOTEMPlOYANYPEH50NW�NYMANNER50ASTO8ECOMESU&IECTTOTM _----.• •^ �� '
� WORNERSCOMPENSATIONUWSOFLALIFORNI�MIOAGREETMATIFIS/IOUIDBE u INSPECT�ONFEE
S SUBJECTTOTHEWORNERS'CO�.�PENSATIONVRON SOFSECTION]7000fiH R ��-�
cooE. Nui RTMWi7HCOMVLYWITHTtqSED Wswus. ! ISSUANCE
0 � ��� SMIP •�«"�
p OATE: t' � APPIICANT: I
w ENERGYP/C ' `
-� WAANINa: URE SECUREWORKERS'COUPE COVEMGE4511NLA OSHALLBE
LL SUBJECTANEMPLOVERTOCRIMiNALPENALTtESAND IVILiINE5UPi00NfHU EDi1KH1SANJ ENERGYPERMIT I
DOl4,AR3(S70o,0001,IN ADDITION TO THE CAST OF COMPENSATqN.DAMACES AS PROVIDED FOR IN
� SECTION370lOFTMEIABORCODE,INTEREST.ANDATTORNEY'9FEE5. RETENTIONFEE: '���
a . CONSTRUCTION LEN�ING AGENCY PRE-ALT FEE: - - ' '"��''"� �
� INEREBYAFFIRMUNDERPENALTYOFPEiiNRY7HATTHEREISACANSiRUCTiONLENDWCACENCY �-�`,�'-�=S'-��--�---
� FOR TME PERFORMANCE OF THE WORK FOR WHICM THIS DERMIT IS ISSUED(SEC.�W7,CIV.C.�.
Z
w
� IEN�ER'S NM1E � -
� LENOERSADDRE55 '
W ILERTIFYTHATINAVEREADTHISAPPLICATqNAND57ATETHATTHEABOYEWFONAIATqN15COAREM. TOTAL FEES . �I 34' SC�
� IAGREETOCOMPLYVfRMALLCITYANDCOUNTYORDiNANCE5/WDSTATEUWSREUTIN4TOBUIL�ING � o
CONSTflUCTION.ANDHEREBVAUiF10R�ZERE0RE5ENTATIYE50FTHi3COUNTVTOENTERUPONTHE �� `'
ZABOVE-�ENTIONEO PFOPERTY fORINSPECTION MIRPOSES. COMMENTS
� � v SZ-�'�✓!' �'zM
m VERIAIiTEENAMEIPRINT)
� t� �� �
� SIGNATUREO PERMITTE DATE
� RECPT.�O. PAID BY VALIOATION
WHITE—Depart ent Copy,YELLOW—Finance Copy,PINK—Assassor Copy,GOLDENROD—File Capy.GREEN—Applicant's Copy
`.
ci�r� QF E�I�fJ1C3f�"D F3f.�
' 9f�.Ss-c�iL'.:"s_�Qf� f;�CC1�C3
I►��'1.a.:e:�f�.l►`� � �:� '�t'm ...��I`ykVF�Y f' ���^y .._..��.. ����'i..� �c`t',(�������__._..�ox i��ic -__ il►rf-y;��c'-�c�=� '
_. _ �... - �
________.--=----.. __.�_._....._.. . ... _.._ __� ._ . _. . .__ . ._ _ , , ... _. __ _ _...-_- -- _.._.,... _ �.._r..=.,_w�_—
SET BACf: - i ; '� __�� FLOOR JOIST '� . - �.
FT'GS/FORMS,�STEEL j_ , F� HA REQ^�1TS ' I
ELECTRIC GROUND � I _ f i UPJDER FLOOR DUCT 1}
GROUND PLUMBING i I I UfJDER FLOOR CUf�iDUIT I
SLAB GRADE I � FIREPLACE FOUNDATION
TEMP POWER I i � FIREPLACE BOND BEAM
V�JATER SERVICE I � � PJIID HT. BOND BEAh�7 �
ROOF SHEATHING � _� I II FT. B�CdD B�gM � '
FRAMINGNENTILIATION I I FINAL E30ND E3EAtv1 I
ROOF COVER I PRE-GRADING
ROUGH HEATING � BEf�1CHING
ROUGH ELECTR(C ROUGH GRADING
ROUGH PLUhfBING , FINISH uRADING
SHOWER/TUB TEST ' POOL ELECTRI�
EXT.LATHlSIDING POOL FENCING
WALL INSULATION POQL FINAL
CEILING IN�ULATION OFF 51TE IPI�PS.
DRYWALL NAILIPdG DEDICATIONS .
SEWER FINAL ENG. �
SEPTIC TANK LANDSCAPE/IRRIG. �
SEEP PIT/L.L. ON S►TE IifPS.
GAS AIR TEST _ � ---;� � , FINAL ZOMNG
_._.-_..:
FINAL CONST. � ��L�r�y ,�` �� '�IHC u�� ;. '�'"'h',
FINAL HEATING � }; � HEF,LTH DEPT. FINAL
FINAL ELECTRIC ` � DEV. FEES PAID
FINAL PLUMBING j ENERGY
� �
..�--..-r�_�_____.____._.._
::j ;) �(t c --- -------� �
CUMMENTS _ --- ------ ---
,' - .;
SEPTIC TANK SIZE
SEEP PIT/U SIZE
���� �
�
�
`��� e i
• ��, ', '''�
� ' � ' . .