HomeMy WebLinkAbout18108 CTI'Y OF DIAMOND BAR
`�----�� — DEPARTIvIENT OF COMMUNTTY&DEVELOPMENT SERVICES �I
21825 E.Copley Drive ' �
(909)860-3195 Fa�c(909)861-3117 "� PRESS
��'%o�� BUILDING PERMIT APPLICATION FIRMLY
� � JOBSITE 24089 Goldrush
, o ADDRESS APPLICATION 5/15/02 PERMIT �h P�C 02-166 �
DATE NUMBER �v #
' � ISSUE TYpE pCC
APN LOT 6 TRACT ' DATE � Y CONST. GROUP
p OWNER �xa�ri�� Goldrush Invest Grp ,
o ADDRESS_ XXXXXI.S9S S. McPherrin Ave ZONING SETBACKS
gcirv Monterey Pk ZIP 9175�F.TEL.6Z6.827.488 FRONT Rw ❑
APPLICANT �10�bv�C.�G1 Cl.u.�.� '�TEL. SO–�3B REAR ❑
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ADDRESS Sr86 Sc�Y'V�•_.
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o CITY _�Q`v�t'S ZIP 9?.570 TEL. _�SO-S3�f�
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z DESIGNER 1:V4e�o i o e.:•I" C�'Yc�y�p_�\
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� �n c �x � � DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION
p� _ OWNER-BUILDER DECLARATION SFR/ADD/REM
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p I HEREBY AFFIRAI UNDER PENALT/OF PERJURY THAT I AM E%EMPT FROM THE COMRACTORS LI� GefO 6/C9 R
W CENSE UW FOR THE FOLLOWINO REASON(SEC.7o31.5 BUSINESSAND PROFESSIONS CODE:ANY CITV OR (n 9 �
U CWNTVWHICHqEOUIRESAPERMITTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIRANYSTqUC- w
w TURE,PRIOR TO ITS ISSUMICE,AL50 REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck
� STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PRdVI510NS OF THE CONTRACTOFS LI� �
CENSE UW(CHAPTER B(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESSlWD PRO� POOUSpe
� FESSIONSCODE)ORTHATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALLEOEDEXEMP� (�
TION.ANV VIOlAT10N OF SECTION 7031.5 BY ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLIGNT TO Z Re-Roof
A GVIL PENALTY OF NOT MORE 7HAN FIVE HUNDRED DOLLARS(t500�.):
� ❑I.ASOWNEROFTHEPROPER7Y,ORMVEMPLOVEESWI7HWAQESASTHEIRSOLECOMPENSATION, Q COrtImBfCiBI
Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOH SALE(SEC.7M�,BU51� J
� NESS AND PROFESSIONS CODE:THE CONTRACTORS UCENSE LAW DOES NOT APPLY TO AN OWNER OF �
PROPERTV NM110 BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
� THROUGH HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m
Q OFFERE�FORSALEIF,HOWEVERTMEBUILDINGORIMPFlOVEMENTISSOLDWITHINONEYEAROFCOMPLE-
Z TION,THE OWNER-BUILDER WILL HAVE THE 6URDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR
� IMVROVE FOR THE PURPOSE OF SAL�. •
W ❑I,ASOWNEROFTHEPROPEHTV,AMEXCLUSIVELVCANTRACTINOWITNLICENSEDCONTRACTORS
� TO CONSTRUCT THE PROJECT(SEC.70U,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� V81U2�1Of1 ADJ.AREA
W CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTMEREON,MID
= W/10CANT TSFORSUCHPR0.IECTSWITHACON7MCTOR(S)LICENSEDPURSUANTTOTHECONTRAG ' FEE
� � . QUANTITY DESCRIPTION
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� IAMEXEMPTUNDERSEC. B:BP.C.FRTHISREASON Q � POO1 Electric 54•lO
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LL DATE OWNER H
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� LICENSED CONTRACTORS DECLAFATION W
� I HEREBY AFFIRIA UNDER PEN�LTV OF FERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER Z 1 P-Tr a
� Y(COMMENCING WITH SECTION 7000)OF DIVISKKJ J OF THE BUSINESS AND PROFESSIONS CODE,AND
�� MY LICENSE IS IN FULL FORCE AND EFFECT.
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� LICENSECUISS C��S LIC.NO. �y�� � 1 Water Pi in S stem
U DATE �-������ CONTRACTOR � K � a
� � WORKERS'COMPENSATIONDECLARATION Q 1 Pool Heater �
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� � ,I�HEREBV AFFIRM UNDER PENALTV OF PE0.IURY ONE OF THE FOLLOWING DECIARATIONS: Z
0 IMAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORNERS' a
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�� COMPENSATION,AS PROVIDED BV SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE U
Q OF THE WOH7(FOR WHICN THIS PERMIT IS ISSUED. �
w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION ^O
O 3700 0F THE LABOR COOE,FOR THE PERFORMANCE OF THE WORK FOR WHICH iHIS PERMIT 15 � �
J �ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER AqE: CONSTRUCTION
� CARRIER PLAN REVIEW
ZPOLICV NUMBER ELECTRIC
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Z �CERTIFV THAT IN 7HE PERFORMANCE OF THE WORN FOR WHIC}1 THIS PERAIIT IS ISSUED.I MECHANICAL
(} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE
N WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I SHOUL�BECOME INSPECTION FEE
, � SU&IECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION J7000F THE IABOR
COD¢,�SHALL FORTHWITH COMPLV WITH THOSE P ISSUANCE �
p DATE:�SliZ�g�:��2APPLICANT SMIP
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J WARNINO:FAILURE TO SEWRE MlOF7KER5'COMP SATION CAV E IS UNLAWFUI.,AND SHALL BE ENERGY P/C
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� � SUBJECTPN EMPLOVER TO CRIMWAL PENALTIES'AND CNIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT
DOLLARS(St00,000),IN ADDITION TO THE COSTOF COMPENSATqN,DAMAOES AS PROVIDED FOR IN ,']
� SECTION37080FTHELABORCODE,MTEREST,ANDATTORNEV5FEE5. RETENTIONFEE: v . �
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENALTV OF PERJURV 7}UT THERE IS A CANSTRUCTION LENDING AGENCY
FOH TME PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30v7,CIV.CJ. �
Z
W
� LENDER5 NAME � .
1-- LENDERSADDRESS �
� I CERTIFY THAT I HAVE READ THIS APPLICATpN AND STATE THAT THE ABOVE INFORMATKKJ IS CARRECT. TOTAL FE ES � �
w I AGREE TO COMPLV WITH ALL CfTY AND COUNTY ORDINANCESlWD STATE UWS RELATING TO BUILDING �O r V
d.
� CONSTRUCTION,AND HEREBV AUTFIORIZE REPRESENTATIVES OF THIS CWNTV TO ENTER UPON THE
Z ABOVE-MENTqNED PROPERTV FOR INSPECTION PURPOSES. � COMMENTS
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m PEFMITTEE NAME(PRINn '
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� SIGNATUREOF . DATE " - �'
= RECPT.NO. PAID BY VALIDATION
~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,G L EN File Copy,GREEN—ApplicanYs Copy
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GRUUND PLUMBING � � UNDER FLOOR CU�IDUIT
S�AB GRADE FlREPLACE FOUNDATION
TEMP POWER FIREPL�CE BOND BEAM
WATER SERVICE � MID HT. BOND BEAM
ROOF SHEA7HING ^ � 8 F-G BC)ND BEAM
FRAMIfVGNENTILIATiOM FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PI.UNIBING FI�JISH GRADING
SHOWER/TUB 7EST POOL EC.ECTRIC /
EXT. LATH/SIDING PO�L FENCING `�/ �_���_
WALL INSULATION - POOL FINAL ��f•� _ •�
CEILIfVG IPVSULATION QFF S1TE IMPS. �
DRYWl�LL.NAILING DEDICATIOhlS ,
SEWER � � FiNAL ENG. �
SEPTIC TANK � � LANDSCAPEII�tRIG.
SEEP PIT/LL. �� pN SITE lMPS.
GAS AIR TEST FINAL ZONING
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FINAL ELECTRIC DEV. FEES PAID
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