HomeMy WebLinkAbout13-688 �` _ CITY OF DIAMOND BAR � �
� DEPARTMENT OF CONIMUPIITY &DEVELOPMENT SERVICES
21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
��'^^'� BUILDING PERMIT APPLICATION FIRMLY .
� JOBSITE APPLICATION � / 3 PERMIT �3 P!C
o ADDRESS�rrn s.. �� C�(IYi1G� ��01� DATE NUMBER___'�� #
�o ISSUE �7 TYPE OCC
APN�S Z�� LOT TRACT DATE L � � CONST. GROUP
p OWNER I �
" ADDRESS 0 5• '1 ZONING SETBACKS
z CITY � ✓ ZIP I�IIV � TEL.�� I• �' FRONT RW ❑ •
� APPLICANT ' TEL REAR ❑
� SIDE/SIDE STREET RW ❑
z
� CONTRACTOR � hCQ �(iy)s SIDE ❑
ADDRESS Z22 . f-
� CITY IA ZIP Gb q TEL ��g PROPOSED USE I W T 1 4 I
w ARCWENG/
z DESIGNER
W NO.DWEL. NO. NO.
a ADORESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
� ��
cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
¢ OWNEH-BUILDER DECLARATION � �q/qpp/qEM
O
�
i HeaEer�wwa ur+o�venwTr oa r�suuav nur i ui ex�ar caou rHe ca�rra�croas u• Garage/Carport
W CFNSEUWFOH7HEFOlLOWIN6RE.LSON�SEC.)o]1.50USWESSNlOPROFESSbNSCODEANYUTYOR (/�
U �JNT'/WF��CI{qEWIAESAPERMRTOCONSTRUCT,ALTER�7ROVE.OEMOUSH,OpREPAIp/iN'/yTqUG w
w NRE,PRIOR TO RS LSSUAHCE,IL50 REWIAES 7HE APPIICAM FOR SUGi PEAMIT TO FllE A SIONEO w Patia/Deck
� STA7EAIENT THA7 HE OR SHE LS UCENSED PU0.SUAHT TO THE PROYISlONS OF iHE CONTMCTORS LL �
� c�se uw�auvrea a�caatiace+a w�nr sec��000�oa omswr�a ov n�auswEss�rm caa PooUSpa
Q FESSIONSCOO�ORT}UTHEOfl5HE19D(DAPTTNEREFf10AlANDiHEB/515FORTHEALLE6EDE%EIAP- C7 .
V TION.ANY VIOIATION OF SECTION 7a]1.5 BY ANY MPLIGAN7 FOR APERAUT SU&lECTS THE APPUCINT TO Z q�Rpd
A CMl PENALiY OF NOT MaRE THAN FlVE FNNORED OoILMS(f50o1.�:
� ❑4���'�NEROFT1iEPfiOPEH7Y.ORUYEMPLOVEESWfT}/14AaE5A5THEIHSOIECOMVEN5A710N, ❑ CpmmBfCial '
z YALL DO THE WOiiK MID 7HE STRUCTURE IS NOT IMENDED OR OFFEHEp Fpq gµ,E(SE4�o�s,BU51- J
� NE55 ANO PROFESSIONS COOE THE WMAACTOq3 UCENSE UW WES NOT AD7LY TO AN OWHER OF � " � i
7ROVERTV WFIO BUIL0.4 OR W PROVES TIEAEON.Ml0 WHO DOES SUCN WORK HUA3ELF Oq NERSELF OR
Q TIROUCN WS Oq HEq ONR!EMROYEES,VROVIOEU 7HAT SUtl711./PROVEMEHTS ME NOT B(TENOE�OR m �
w OFF6imFORS/�LEIF,HOWEVEi�7NE8UILDWCORGIGROVEM9fTI550lDN7T1fWONEYEAqOFCAMRE-
ZTION,THE OWNER�BUILDEA YALL VIAVE T1E BUf1OEN OF PqOV W/3 1NAT HE OR SHE D10 NOT 9UILO OR �
� W PROVE FOP THE PURP0.5E OF 511E�. I
w O L�.+`�Mrt1ER OF 7NE PROPEATY,AM EXClUSNELY CONiMCTP!(31MfTH LICENSED CONTRJ1CiOR5 -
� ¢ TO CANSTRUCT TIE PROJECT(SEC.70a1.9VSINE55 ANO PROFESSIONS COOE 7Y1E CONTRAGTOqS LL VelUallOfl A0.1.AREA
W CENSEUWDOESNOTMPLYTOANOWNFAOFA7HOPEA7YVIH08U4A40RIAIPROYE9THEqEOI�ANO
� WHOCANIA/�Cr5FOR3UCliPHOJECT9WfTHACONiRAROi1(S�LlCENSEOPUPSUAHfTOTHE00NTMG QUANTITY DESCRIPTION . FEE
� TOiLSIICENSELAW.�.
Q �1 AY O(EN7T VNDEA SEG e.i P.C.FOq TMS REASON Q '
� U
� ¢
DATE OWNER H
Z U
�Q LJCENSED CONTRACTORS DECLAAATION w �
J
2 1 HERfBV AFFlRM UNDER PENALTY QF VER0.IRY T1AT IAM LILENSED UNDER 7fiOW510N5 oF C}UPTEH Z /1 lp,� i�p�
� ��COMAIENCWO WI7H SECTION 7000)OF OMSION]OF THE BUSWE55 NID PROFESSIONS COOE,M1D L �)V� ��
X M'/LICENSE IS W FUIL FORCE AND EFFECT.
`0 UCENSE CUSS C3 (� LiC,NO. _I�W j
U DATE GONTRACTOR C I d
� WORKEAS'COMPENSATION DECLARATION ��U��S� Q � �
� 1 HEA�Y AFGIRM UNDER PENALTY OF 7ERNfiY ONE OF 7HE FOLLOW WG OECUM710H5: Z �
� _I HAVE M!O WILL MAINTAW A CEATIFlCATE OF CANSENT TO SEWNSURE FOR WOfiNFAS =
COMVENSATIqJ,AS VROV10�BY SECTON]�oo OF T11E LABOR COOE,FOqTHE PERPoi1MANGE w
Q OF TIE WOPo(FOR WNKYI 7HIS PERMIT l4 ISSUED. �
Qw _IMAVEANDWILLAWMAWWORKERS'COMPENSATpNW9VRANCE,/SREOUIREDBYSECT�N
710o OF 7HE L�BOR COOE.FOfi TNE PERFORlIANCE OF 7HE WORN PoR WHK7i TMS PEAMR IS '
IS511�.MY WOAKEFLS C04PENSATION INSUfUNCE CAAfiIER ANO POIICI NUMBER ARE: CDNSTRUCTION
> c�ww��v�vl d-�-tra-iCtl Ink�+�uf�cC CompG� Puw aEviEw 2
Z voucrNun�eEa �IOf.f7d(� S� �/'�,�I ELECTFUC ..7
¢
p (nes5ecnor+r�IDr+oreea�tErIDOFn�v�r.�rsraRar+Erw�o�caau�sgimlaAtFss1 PLUMBING
ss
w
z I CERTIFY T1A7 W 7HE VERFORMANCE OF THE wOHlt FOR NM14tl1 THIS PEw11T I5 ISSUED,1 MECHANICAL . ��
CrS SHIV1 NOT QdPLOY ANY vER50N P!ANY YINNER 50 AS TO BECDME SLBJECT TO 7HE
� WORKERSCOAIPEW'ATIONlAW30FCALIFORNItiANDAGREETHATIFI51iOVlOBECOME INSPECTIONFEE
SU6IECT TO THE WORICERS COMP PROVISIONS OF SECTION�700 oF h1E UBOR � � �
OCOO I��71�.�HWIM CONPLY 7H SE PROVISIONS. ISSUANCE
p DAl'E (/r APPLICANT: _�I,YffC/YYUL SMIP
J WAANIN(7:FAWHE TO SEGLRE WOfYCERS CO�IPENSATION COVERAGE I5 UNLAWFUI,AND S/W.L 8E Eh1ERGY P/C
� SUBJECi AN EMPLOVER TO CAIMWIL PENALTIES IND tlNL FPlES UP TO ONE MUNORED iHOU".aANO
DOlLAHS(S1oo,000G W IDD1710N T07HE COST OF COMVEN5AT10N,OAA1A(lE5 AS 7ROVIDEO FOH W ENERGY PEAMIT
¢ SECT7oN 37oe OF TI�E USOa CODE Nf7ERE5'C u�U�77oFnEr4 FEEs � � i C�C7
RETENTION FEE:
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE
� I NER�Y AFF6iM UNDEH PENPLTY OF VERNH'/THAT 771ERE IS ACOKSTAUGT70N 1EH01NO AGQICY �
Z FOR TNE PEAF-0RMANCE OF TNE WOPo(FOR WMICH THIS PERM�T IS ISSVED lSEC 70s7.qV.GG
W
� LEHDERS WAIE
� LENOEti'SAOORE53 �-�ry.
� I CERTIFY TViAT I HAVE iiEAD T1Y9 A7PIJCAT�ON AND STATE 7HA7 THE A00VE YIFONAATION IS COFiiECT. TOTAL F E E S !�b�� Z
� 6REE TO COMPLY VJITH AIJ.CfTV ANO COUNTY OPOPIANCES MID STATE UWS HELATW G TO 8U4DIN0
Pi1CT70N,AND HER�Y AUMORQE PEPRESENTA7NE5 OF 7HI5 COUNTY 70 EMER UVON THE �
ABOVE IXTKNlED VROPEATY FOR MSPECTpN PURPQaES.
COMMENTS
� �lU
�
m v E �
� r3
� Su3NA E EE DATE
�� RECPT.NO. PAID BY VALIDATION
� en[Capy,YELLOW--�Finarxe Co{ry,PINK—Assessor Copy,GOLpENR�Ie Copy,GREFIJ—ApplfpnCs Copy
�o`�''s� �� ��€������3� ���
yi`5���-�i.`:"5 i�.��r; �a����k��
s r:�r ' a�-��+s�-..;�-��s�r�� r'°�t;�,y n. , _ ,
a...'1�I i�, � � 3' v. � ty i� .�•� �f` "� 4 ���d� c e � .ry� ' _i�s'�. 3 a,� `�' 9�sl��'�i nd-x*q-� �������4C'"'� �-" � ' - _'
...�.�. 1 ` � � �1 . 1 t J� l � � ��� E �vJ� �xfi��. Yt���W.���' y�W��9 tA"-14{� � � p•�e �
� �,,. ��, 4.-.i ' a� i:wr..�.���F y e� '���n�,��?ka�h. �� �} � ��f� 9�z .
:_ - �.,...•Sr ��1��� Y.�.,...w �' �;v:` -f �m a _�,.F-��..,� � "��;..-. "'�:f�.s �.����3=.tT'��:c:3rv�`L:m '�.�.'`--.� �` +�P'� - T�
`:E'—E�r�'N -- --- - .-- � - ---- I �LOORJGIST
- — - -- -------- ---�---- ----- �
--- ----- - -
FTGSiFJki�lS'�TEEL--- - --i j FHA REQFAT>
----—
- - -- ------------------�-- -
-----
-, ------ ------�------- ----...---�--- ------
FLK_I�RIC r,RG}UPdQ _ � UPdDEA�LOOR DUCT I
GFiOUi.!D FLUfvi61N� _ -� ---_� _---- � ,U��1GER FLOOR�ONQUIT---i�
SLfi6 GF�^,�E _ � __ I _ _� FIREPLACE FpUPdpATIUPd
��ENi�PO`eVCR —t
� � _ FIREPLACE°OfvQ 6E(1h� —�— �
V!ATER 1ERVICE _ � I P>llD HT.BOfdD BEAh9 '
ROOF SHEATHIfdG __ I 3 FT.BOND BcP.h9
FRANIif•!G/VEf•1TILA.TION � FINAL BONO 6EAM
ROOF COVER �PRE-GRADI�IG _ _ Y __ _
ROUGH HEATING___ _____ �BE CI�IP�G _ _
ROUGH cLECTRIC ROUGH GRADING
_ ROUGH FLUfviBI�1G � FINISH GRADING
SH04'dERlTUE3 TEST PGOL ELECTRIC
EXT.LATH/SIDING POOL FENCING
�rVALL INSULATION FOOL FI�lAL
CEIU�dG 1�lSULATION CFF SITE ItvIFS.
DRYb�/ALL NAILING DEDICP.TIO�15
SE�i/EF ------ �-- - ---- FINAL ENG. �
SEPTICTP,Nh: � ----t--- -- -- —
-------i—_-- - _-- LA.NDSCAPE/IRRIG---- ----.
SEEP PITiL.L. ON SITc IMPS. �
GAS AIR TEST FINAL ZONING
fI�AL CONST. FIRE DEPT.FIPdA.L
FINAL HEATIrJG HEP,LTH DEPT.FINAL
FIi�1f\L ELECTRIC � DEV.FEES P�ID
FINP.L PLUNIBING EhdERGY
FINA.L PLANING
FINAL ENGINEERIPdG � c�• � ,� "'"
COMMENTS _..—_. -- ------- -- — —
S�PTICTANKSIZE
SEEP PIT/U SIZE — - — --