HomeMy WebLinkAbout18041 (17) i
_ �
J� CITY OF DIAMOND BAR �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �
21625 E.Copley Drive
(909)860.3195 Fau(909)861-3117 PRESS
`'-c�` BUILDINGPERMITAPPLICATION � FIRMLY
� JOBSITE �Z33S �O �� APPLICATION G� ' �PERMIT � � P/C
o' ADDRESS C�� DA7E � NUMBER M
� APN TRACT
----;�i�/�- D TE �� v� ONST. GROUP
p .OWNER 1-/ " ,�� 1 �'�- ,�
,ADORESS ZONING SETBACKS
Z CITY ZIP TEL. FRONT RW O
g APPLICAN7 TEI. REAR ❑
SIDE/SIDESTREET RW ❑
� CONTRACTOR SIDE O
Q ADDpESS PROPOSED USE
� Ci'TY ZIP TEL. f
o ARCH/ENG/
� DESIGNER NO.�WEL NO. NO.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER•BUILDER DECIARATION SFRlAOD/REM
O
0 I HEREOY AFFI{UA UNDEH PENILLTY OF PERIURV TMAT IAM E%EMPT FRpA TME CONTMCiORS L4 Garage/CarycM1
W CENSEUWFOR7HEFOLLOWINOREASON(SEC.70�t.68U51NE5SAND0iqFE55�ONSCODE:ANYCITYOR (n
U OpUNryWHICHpE0U1HfSAPERMRTOCONSTRUCT.AlTF0.�P�.DEM0U5N.ORFEVAIRANYSTRUC- W P01i0/DBCk
W TURE Da10R TO R9 ISSUANCE.AISO REWIRES THE MVLICNdT fOR SULH FEfIMIT TO flLE A SIGNED W
� STA7EMENT TNAT HE 0�1 SNE IS LICENSED PURSUl1NT TO TNE PROVISIONS OF TME CONTRACTOfl4 ll�
� CENSEUW(CHAPiEROI���ENCW�WITH5ECT10N700o)DFDIVISION]OFIHEBUSINESSMIOPFo• u' POOUSpO
FESSiONS COD�OR THAT NE OR SME IS EXEMPTTIEREFROM AND THE BASIS FOR THE�LLEGED EXEMP•
� TqN.1lNYV10LAT10NOFSECT10N1W/.6BYANYAGVLICM1TfORAPEHM?SUBIECTSiHEAVPLICJ.NTiO z Re-Roof
F AdNLPENALTYOFNpTMORETHANFNEINN�REDD0.LAR5�f500�J:
� OlA50MMEROFiF1EFROPERTV,ORMVEMGLOYEESNnTHW�OESASTHEIRSOLECOMPENSATION, 0 GOmmefClal '
Z W1LL 00 THE WORK AND 7Hfi STRUCTURE i5 NO7IMEN�ED OR OFFERf D fOR SQE ISEC.7ou,BU54 J
NESS ANO GflOFESS10N5 CODE:TME CONTMCTORS UGENSE UW DOES NOT APPLY TD AN OWNER OF
N VROPER7YWIW8UILDSORIMCROYESTHEREpJ.M1DVrt10DOE55UCHWORKHIMSELFORHERSELFOq =�
CL THROUGNH�SOHHEROYMEIAPLOYEES.�AON�EDTIUTSVCHMPROVEMENTS�RENOTP7TENDEDOR m
W OFFEREDFORSALEIF,FqWEYERTMEBUILDwOORIMFFOVEMENi15^ �WRFIINONEYEAROFCOMPLE•
� TION.THE OWNER�BUILDER WILL HAVE THE BUFOFN OF DROVINa THAT HE OR SHE DID NOT BUILD OR
Z WV(dOVEFORTNEPUflPO5EOF51LLEy
= O�A90WNEHOFTHEPROPEIRY.AMEXCLUSIVELYCONTMCTINOWITHLICENSEDCONiRAC7OR5
W CEN9ENUWDOESNOTMPLYtiOSANdJYNEROFAPRO ERTYW1108UADSO�RIMPFIOVESTIE EON,IWD alU0lld1 ADJ.AREA
� WHOCOMMCTSFORSUCHCR0.IECTSWITHACONTMCTOH(5)UCENSEDVURSUANTTOTMECONfMG QUANTITY DESCRIPTION FEE
X TDRSLICENSELAW.�.
}� ❑I/UAEXEMPTUNDERSEC. B.dV.GfORT1115PEASON U
7
Q
LL" WTE OWNER V
�Q LICENSED CONTRACTORS DECUIRATION W
[L IHEREBYAFFlRMUNDEPPENALTYOFPERJURVTlu71AMLICENSE�UN�ERPROVI510NSOFCMAVTER V.
d •(OO�.�MENCINOWITXSECTION7000�OFDMSION�OFTHEBUSINESSIWDPROFESSIONSCODE,ANU Z
X MYUCEN561SNFULLFOHCEANDE�FECT. m
LLI �
0 LICENSE CLASS LIC.NO. J
�'j DATE CONTRACTOR d
W
� WORKEFlS'COMPENSATION DECUIRATION �
N IHEREBYAiFqiMUNDEFPENALTYOFFEiLR1RVONEOG7V1EFOLLOWINGOECtAMT10N5: U
� 4
A __IHAVEANOMnLIMAINTAtt7110ERTIFICATEOFCON5E1ffTOSELF-INSUREFORWOiLCERS' T
CpMPEN5ATI0N,A5PROVIDEDOYSECT10N11oCOiTHEUBOHCOOE.FORTHECERFORMMKE U
d OFTHE WORK FOH WHICM THIS DEPAIIT IS ISSUEA. �
0
_I MAVE AND MALL MMi7NN WORKERS'COMOQa5AT10N INSUMNCE.AS REOUIREO BY SECTqN
�4 �7000FiHELABORCOOE,FOHTHEPERWRMANCEOFTHEWORKiORNMICHTHISVERUITIS
ISSVEO.MVNURKER5CAA10ENSATIONINSURANCECARRIERANOiOLICYMIMBEflME: CONSTRUCTION
j �q�Eq PLAN REVIEW r�
2 PoucvNUNeER � ELECTRIC
.�
p �nasEcmar�mroreem�a�uoFi�r¢w.artsraaar+e�ooaulup+rola+tFssl PLUMBING
Z 1 CERTIFYTHAT IN ME PERFOFlMANCE OF THE WORN fOR WMICHTHIS PER4IT IS ISSUED.1 MECHANICAL
(,3 SNALLNOTEMPLOYANYVERSON�NANYMANNERSOASTOBEGOMESU9JECTtOTNE
� YIORKERS'COMVENSATqNlAW90FCALIFORNIAANOA6REETMA71F16M0UlDBECOME INSPECTIONFEE _
S SUBJECTTOTHE WOMERS'CdAPENSATION OROVISqN50F SECTIDN 37000F TME UBOR �
cooE,i sw�u coan+wirn cana�r wmi rHosE vRrnnsoras. 1SSUANCE
pDATE: APPLICANE SMIP �' � —
� ENERGY P/C
WARNINa FNW PE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNUWFUL.AND SHALLBE
�—y, SUBJECTANEMPLOYERTOCR�MINA{,PENALTIESANDCMLFWESUPTOONEHUNOFEOTiWSANO ENERGYPERMIT
DOLLARS�f100.000).W A�DITION TO TME COST OF COMPENSAilON.OAMACES AS PFOYIDEO FOfl IN
� SECT�ON77DeOFTMELABORCOOE,IN7EREST,ANDATTOiwEV5fEE5. R�NTIONFEE: �
pwi., CONSTRUCTION LENDING AGENCY pRE-ALT FEE:
O
� I HEREBYAFFlRM UNDER PENALiY Oi VERJURV THAT TMERE IS A CONSTRUCTION LENDINO A6ENCY
Z FORiHE PERFORMANCE OF THE WONK FOR WNICN TNIS GERMIT IS ISSUEU(SEC.�Ovl,LIV.G).
W
� LENOER'SNAME
� LENDER'SA�DRE55
WICEfl11FYTHAi1/4�VERE�DTHISMVLIC�TIONMI�STATETNATTHE�BOVENFORMAipNISCORRECL TOTAL FEES r�
� IAGREETOCOM%.VWITHALLCfTYANUCOUNTYON�INANCESINOSTATEU'NSRELATIN(STOBUI�ING ��� �� /
� CONSTRUCTION_/NIDHEREOYAUT1N)RIZEREPRESENrATNE50FTM15COUMYTOENTERUPONTNE � V
z ABOVE#IEMIONEDpNOPERTYFORINSVECfIONOURPO5E5. COMMENTS "��'
� � SybU-Qin� �
m �
'ERIAI7TE uee lvwrrr�
N TUHEO ERM�EE OATE
RECPT.NO. PAID BY VALIOATION
WHITE—Department Copy,YELLOW—Fmence Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—ApplicanCa Copy �
1 �� ��
_.� � ci-r�' OF DIAM�hlD BAR
� - - � ir�s��c-��oN REco��
' �� � �:��i�.� ��_'.����� ���"!. ��.�:�'oa����E��� �. �; �� : i � ���. �`
� � °�C ° �_ � ` y . _ f����, �.o ►��� �= �,- �' (�� �.�'�.� i
SET BACK , _�W. � FLO�R JOIST ' . � w��+ ' .
FTGS/FORMSlSTEEL � � FHA REQMTS
ELECTRIC GROUND ( UNDER FLOOR DUCT • - �
GROUND PLUMBING I UNDER FLOOR CUt�IDUIT I
SLAB GRAbE FIREPLACE FOUNDATION I I
TEMP POWER ' FIREPLACE BOND BEAM I
WATER SERVICE MID HT.BOND BEAM
ROOF SHEATHING I ' S FL BOND BEAM
FRAMINGNENTILIATION I FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING I BENCHING
ROUGH ELECTRIC I i RQUGH GRADING ,
ROUGH PLUMBING � FINISH GRADING
SHOWER/TUB TEST � j POOL ELECTRIC
EXT. LATH/SIDING � j POOL FENCING
WALL INSULATIDN POOL FINAL
CEILING INSULATION I OFF SITE IMPS.
DRYWALL NAILING , , I DEDICATIOFJS
SEWER ' ( FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG. �
SEEP PIT/LL � � ! ' ' � ON SITE IMPS.
GAS AIR TEST � � FINAL ZONING
FINAL CONST. ; �.Z� ; . FIRE DEPT. FINAL
_ /,y
FINAL HEATING f ! HEALTH pEPT. FINAL
FINAL ELECTRIC j ', i DEV.FEES PAID i
FINAL PLUMBING � j i ENERGY I
GJ�,;,,i'd G R a��_� � ,. ,
COMMENTS /t/D 0�+2�- St�''�- �t,q(�5�. �IoS --Cs?v'�. �" g�c��Q __ _
SEPTIC TAP�K SIZE
SEEP PIT/U SIZE
. IA�
'���� ' ���
-� i ' •
_ , ,
_ jl • •
;;�� -- • � '+ . •