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HomeMy WebLinkAbout18082 CTR'OF DIAMOND BAR � �� � DEPARTMENT OF COIvIIvIiINTTY&DEVELOPMENT SERVICES � 21825 E.Copley Drive (909)860.3195 Fax(909)861-3117 PRESS "%o�' BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE � APPLICATION �23y �� PERMIT l�a Q�P/C ADDRESS Z����1 C.>OC..U�VS'�-1 �;t. DATE NUMBER ��`�7f � ISSUE TYPE OCC APN ' LOT�_ TRACT 3��1�1 DATE � Z.�J� CONST. GROUP o OWNER C�otvliviN 1 1J1)(�iT1�1f uT VT�Ocia ' � ADDRESS 1�a95 �. ML 4K�RRlw] AVF ZONING SETBACKS gCITY MO►ts'ERrS.FK ZIP�f115Y TEL.�.2.�8L'7S8R FRONT RW ❑ APPLICANT TEL. REAR ❑ � SIDE/SIDE STREEf RW ❑ � CONTRACTOR' SIDE ❑ o ADDRESS CITY ZIP TEL. PROPOSEO USE o ARCI-VENG/ , � DESIGNER NO.DWEL. NO. NO. n. ADDAESS UNITS STORIES BE�ROOMS � CITY ZIP TEL. � �n DESCRIPTION SQ.Fi. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLAFWTION SFFVADDIREM O � 0 I HEREBV AFFIRM UNDER PENALTY OF PEiLURY THAT 1 AA1 EXEMPT iROM THE CONiMCTORS Ll• G8298/C8tP0lI � W CENSEUWFORTHEFOLLONnN6REA50N(SEC.7W1.68USINESSANDiROFESSIONSCADE:ANYqTYOR (n U COVNTYWNIq1RE0UIRE5AVERMITTOCONS7RUCT,ALiERIMPROVE,DEMOLISH.ORRE7NRANY57RUC• W P0Si0/DeCk 7URE,PRIOR TO RS ISSUANCE,IL50 REOUIRES THE APPLICANT FOR SUCH PEHMIT 10 FlLE A SIGNEO W STATEAIENT THAT HE OR SHE IS UCENSED VURSUANT TO TME PRONSIONS OF THE COHiMCTORS L4 W � CENSE UW(dU7TER i(LOMMEHqNO WITH SECf10N 7000)OF DIVISION]OF THE BUSINESS AND PR0. � PoollSpa FESSIONSCODE)ORTIUTHEORSHEISE%E/APTTIIEREFROAIANOTMEBASISFORTNEIILLEGEDENEMV- (� VTqN.ANVVIOLATqNOFSECTION70]1.6BVANYAOP�ICANTFONAGERMITSUBlEMSTMEAPP�ICMITTO Z Re-Roof A CMl PENALTY OF NOt MORE THAN FNE HUNDREO DttURS�f 500).): Z0�,�501N�EROFTHEPfiOPERTY,OflMYEMPLOYEE3WITHWAGESA3THEIRSOLECOMDENSATION, O CpmmBfCldl WILL DO TME WORK,AND TME STRUCTURE IS NOT INTENDED OR OFFEREO FOR SALE(SEC.70��,BUSI• J N NE55lWD 7ROFESSIONS CODE:7HE CANTMCTORS LICENSE UW DOES NOT A�PLY TO AN OWNER OF � PROPEHiY WNO BUIIDS OR IMPROVES THEREON,ANO WViO DOES SUCH NlORK HIIASELF OR HERSEIF OR fL THROUGHHISORHEROIN�EMPLOYEES.GROVIDEDTHATSUd11MPROVEGENTSMENOiNTENOEDOR m QOiFEREDFORSALE.IF,HOWEVE0.TNE8UIL�INaORMPqOVEUEMI550LDWITMNONEYEAqOFCOMPLE- z TION,THE OWNER-BULDER WILL HAVE THE BURDEN OF PROVIN6 THAT HE OR SHE DiD NOT BVll,p OR = MPROVE fOqTME PURPOSE OF SALE). W 04��14TIEFOF7HEPROPER7Y,IWEXCIUSIVELYCONTMCTWOWRHLICENSEDCONTMCTO(iS Q TO CONSTRIJCT TME PRO.IECT(SEG 7oaa,BUSINE55 AND PROFE59ON5 CODE:TME COrrtMC70R5 LI- V8N0Ii0f1 ADJ.AREA W GENSEUWDOESNOTAPPLYTOANOWNEHOFAPROPERiYWHOBU0.D50RIMPROVESiHEREON.AND � WF�OCONTMCTSFORSUG/VROIECTSWI7MACONTHACfOR(5)LICENSEOPURSWWTTOTHECDNiMG QUANTITY OESCRIPTION FEE � TORS LICENSE UW�. i � O I AA1 ptEMPT UNDER SEG B.6 P.G FOq THIS RE�SON ¢ REG 1 sTERS �S � ¢ 8��7 '�rs ZDATE � OWNER U RE S � � ' LICENSED COMTRACTORS DECLARATION �y � IHEREBV�FFIRMUNOERPENALTYOFPERJURYTNATIAAILICENSEDUNDERPROVISqNSOFCMAPTER � d Y�COAIAIENdlMWITHSECTION7000)OFDIVISION70FTHEBl15WE55AN�PROFE55iON5CO0E,AN� Z X AIY LICENSE IS M FULL FOPCE AND EFFECT. m � UCENSE CUSS C."'Z-� uc.No. 5 S O7 / 7 � 1--- V DATE S Z�-OZ CONTRACTOR�T�c-E C-r a w � I WORKERS'COMPENSATION DECLARATION - — - a � �'„�rJ/ - - 3 � p - � INEREBYAFFIRMUNDERPENKTYOFGEiWRYONEOFhIEFOLLOWINOGECLAMTIONS: Z O �' Q � _IHAVEMANALLMAINTAINACERTIFIGTEOFCONSENTTOSELF•INSUREFORWORKERS' = Y COMPEN4ATION,ASPROVWEDBYSECT10N77ooOFTHEUBORCOOE,FOR7HEPERFORMANCE U Q Oj�(ME WORK GOR WHICH 7HiS PERMIT IS ISSUEO. � � ��I HAVE M1D YJILLMAINTAIN WOR1(ERS'COMPENSATION INSURANCE,AS HEWIRED BY SECTION Q 970o OF THE LABOR CODE,FOR THE PERf-0RAIANCE OF THE WORK FOR WHiqi THIS PERMiT IS ISSUED.MVWORNERS'CdAPENSATIONINSURANCECARRIERINDVOLICYNUAABERME: CONSTRUCTION jCARRIER PLANREVIEW Z pa�crr�uMeEa ELECTRIC d 0 (iH55ECilONN�NOT6ECDI+PLEfEDOFi1fV6MT6PORONEFUaRED00l1ARSR100)ORLE551 PLUMBING Z ICEATIFY1HAiNTHEPERFORMMlCEOFTHENURNFORWMICHTHISPERMR5tS5UE0,1 MECHANICAL r I (} SMALLNOTEMVLOYANYPERSONWIWYMANNERSOASTOBECOIAESUBJECTTOTHE N WORKERS'COMPENSAiqNUW50FCALIFORNI,�NJOAGREETMAT�F151KK1lDBECAME INSPECTIONFEE S SUBJECTTO THE WORKERS'COMVENSATqN PFOVI510N5 OF SECTiON�70o OF iHE U�BOR COOE.ISHALLFORTHWt7HCOMPLYWiTHTNOSEPRONSIONS. ISSUANCE � . � SMIP p WTE: APPLICANT: � ' ENERGY P/C WAqNItW:FAILURE TO SEWHE WORKERS'COMPENSATpN COVERAGE IS UNLAwFUL�ND SMALLBE � �y SU&IECTAN EMPLOVERTO CRIMINAL PENALTIES AND CNIL FWES UP i00NE MUNDNED TFqU5M10 ENERGY PERMIT DOUMS(f 7 00.0001.W ADOITIqJ TO THE COST OF COMPENSATqN,DAMAGES�S VROV�DED fOR IN J SECTION�7080FTNEUBORCOOE.INTEREST,ANDATfOfUJEY5FEE5. RETENTIONFEE: � aw. I CONSTRUCTIONLENDINGAGENCY pRE•ALTFEE: O CL IHEREBYAFiIRMUNDERVENALNOFPERNRYTHATTMEREISALONSTRUCTIONIENDIN6AGENCY 0- FDaTNEVERFORMANCEOFiHEWORKf-0RWHICHTHISPERMITi5155UE015EG]OY7.CIV.C.�. Z W � LENOER'S NAME F- LENDER'SADORE55 �� W ICERTIFYiNATIHAVEREADTH15APPLICATIONMIDSTATETHATTHEA80VEMFORIAMTION�SCORRECT. TOTAL FEES � �� �+� � I�CREETOCOMttvNnTHALLCRVANDCOUNTYORDINANCE5MIDSTATEUWSREUTWGTO8U0.�IN6 � CANSTRUC7ION.AND HEREBVAUiHORRE REDRESEN7ATIVES OF 711IS COUNTY TO EMER UPON TNE ZABOVE�MENTqNEOPROPERTYFORINSPECTIONPURVOSfS. COMMENTS � -�AM�S l�i ��c.Fy ¢ iERMITT r�E(PiUNn T y S�Z7�V� y SIDNA -RMITiEE OAtE - � , RECPT.NO. _PAID BY VALIDATION �I WHITE—Depatlment Copy.YELLOW—Finance Copy,PINK—Assessor Copy,GOLDEN OD--File Capy,GREEN—ApplicanTs Copy .... .. ,... .�:.� ,;..�:.-.. ._,. . ..,,�� ..��.. . c , , � .. �- , � . .. .. . ;�. ,.y .. -- ._,. -.. -- ���;ei� �1�� Lf��41�l1.J�ti.J �HI-1 ��`.��1��E In�t ������ �I►��-'��a�c�,�^(c��ltif � rb��t'=, -..._i������:�� �sa.i-..,__.1►��.7r�_1c:i�'Icj��f � ry �-i'-. ����F-�:a�c�t'.o�� I SETBACK. �_.._.___�....--- _..._, i ,FLO _.___ ,._._..._..�.___.__ . _ . _ .__ ----._�. _ . ._. __.... ._._._.____.___ __._..__ ..�_._ 1 OR JOIST FTGS/FORh1S/STEEL � I FHA REQPI1TS � ELECTRIC GAOUND � UIJDER FLOOR DUCT GROUND PLU�A6ING I UPJ�ER FLOOR CUI�IDUIT�� _ SLAB GRADE _ FIREPLACE �OUNDATION I � TEMP POWER FIREPLACE BOND BEAM � WATER SERVICE P,41D HT. EOND BEAP�4 ROOF SHEATHING 8 FT. BON� BEAPA FRAMING,NEPJTILIATION I FINAL BOND BEAM ROOF COVER PRe-GRA�ING I AOUGH HEATING BENCHING I ROUGH ELECTRIC ROUGH GRADING � ROUGH PLU�JIBIiJG � FINISH GRAOING SHOWERlTUB TEST � POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FIP�A� CEILING IN�ULATIOfJ OFF SITE IMPS. DRYV'JALL NAILING � DEDICATIONS SEWER FINAL EPJG. SEPTIC TANK . � LANDSCAPE/IRRIG. � SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST , FINAL ZONING FINAL CONST. � �./� ! �lRE DEPT. FINA! FIPJAL HEATING �}"J/p�I_+�', (�l � HEALTH DEPT. FINAL FIIJAL ELECTRIC 1 � �J � DEV. FEES PAID FINAL PLUMBING ENERGY _��u�"°�._z'�'��'�`�'"''...___—_.—_� c�r�nr,nErvTs � - _ _ _- - - _ SEPTIC TANK SIZE SEEP PIT/U SIZE —.�.� �v� i I �,r�r�r - �i � I � � - . ..�_.— —.'________. .__�..� �,. ..