HomeMy WebLinkAbout16651 _._ i _ .. _ � _ . . . .
�� CTTY OF DIAMOND BAR
i DEPARTMENT OF COMMUNiTY&DEVELOPMENT SERVICES
��` 21825 E.Copley Drive
(909)860-3195 Fax(909)861-3117 PRESS
�'%�� � BUILDING PERMITAPPLICAT[ON FIRM Y
o� JOBSITE � L� l/� APPLICATION I •/1 PERMIT L�j P/C
ADDRESS � Y� DATE �l NUMBER �J 1f
$ ISSUE TYPE OCC
APN LO TRACT DATE CONST. GROUP
o OWNER
� ADDRE S � ZONING SETBACKS
0
z CIN �'K-�'►''� ZIP TE aD FRONT Ryv ❑
g APPLICANT TEL REAR p
zd SIDEl51DE STREET RW O
� CONTRACTQR SIDE p
ADDRESS �
� CITY ZIP�EL.;� PROPOSED USE
w ARCH/ENG/
z DESIGNER�l jI�
nW. ADDRESS � NO.DWEL NO. 2 NO.
� CIN 2IP TEL. UNITS STORIES BEDROOMS
N
N DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD�AEM
O
p 1 HEREBY AFFlRM UNDEN PENALTY OF PERIURY TUT 1 AM E7cEMPT FROY THE CONTRACTORS L4 GarageJCarpon
W CENSEUWFORTHEFOLLOWsI[fREA50N(SEC.7o]1.SBUSWESSIWOOqOFES510N5CO0E:ANYCITYOR (n
C.) COlN1TYNR11d/REOUIftESA�fRA11TTOCONSTRUCT,ALTEi�IMPROVE.DEMOLISH,OqflEPNRlWVSTRU6 W Palio/Deck -- �
�� TURE.PRpR TO RS ISSUANCE.K50 REOVIRES THE APPLIGUlT FOR SUp1 PERAIIT TO FIIE A SIGNED w . . .. . . ".''-"'"-"'-�'�"-' -----'-�-'..—-�-�------..... . . .
� S7ATEMEM 7HAT ME OR SHE IS UCENSED PURSU/WT TO THE PROYISIONS OF T1E CONiMC70R5 L4 �
� CENSE UW(C1IAPTER Y(COMMENCINO W17M SECTION 7000)OF DIYISqN]OF THE BUSINESS AND PR0. PooVSpa
� fE55qN5CO0�OH7MATHEORSHEISE%EM7TTHENEFROMANDTHEBASISFOAiHEALLEGEDE7(EMP• (�J
TqN.AM'VIOLATqNOFSECTION707t.SBVANYMPLICMlTFORAPERMITSUB1ECi5TNEAP7l1CANTTO Z Re-Root 1
A CML PENALT'OF NOT 110RE 7HAN FNE HUN�FED OOLURS�SSoo)��
0 OL�..^OWNEROFTHE70.0PERTY,ORMVEMPLOYEESWITIWACESASiHEIRSOLECOMPEN5A7pN, O Commercial -
Z NALL DO THE WORK,AND iHE STHUCTURE IS NOT INTENDED OR OFiEREO FOR SALE(SEG 7a�,BUSI• �J
N NESS ANO GROFESSIONS COOE:THE CON7MCTORS IICENSE Uw DOES NOT APPLY TO AN OWN[R OF �
►ROPERTY N710 BUILp50R I/AVROVES 711EREON.I�N�WF10 DOES Sup7 WORK HIMSELF OR MERSELF OH
� TMROUCHMSOHHEROWNEIAVLOYEES,7ROVIDEDiHATSUp11MGR0VElAENTSARENOTMiENJEDOR m
w OFFEHEDiORSALEIF,MOWEVERINEBUIL01N00RMPROVEMENTIS50lDYAiHINQVEYEAROFCONP�6
� TION.TME OWNEF�BUILDER WILL HAVE TNE BUROEN OF VROVWC T/uT ME OR SME DiD NOT BUILD OR
z tlAPROVEiORTMEPURPO5EOF5ALE4
W OL�OWNEROFTHEPROPERTV.AME%QUSIVELYCONTNACTWCNn7HLICENSEDCOMMCTORS
� TO CONSTRUCTTHE VR0.IEGT(SEC.70N BUSINESS AND PROFESSIONS COD[:THE CONTMCTORS LI- VdI11BIlOfI ADJ.AREA
W CENSELAWDOESNOTAPPLYTOANOMMEFOFAVflOPEflttYA10BUILDSORMPROVESTMEREON,ANO
� WMOCONTHNCTSFORSUR/GR0.1EG75WIT/1ACONTMCTOR�S)UCENSEDPURSWWTTOTHECONTMG QUANTITY DC-SCRIPTION FEE
� TORSLICENSEUW.�.
� ❑1 AM EYEIAPT UNDER SEC. B.i P.C.FOR THIS REASON Q
� U
ZOATE OWNER V
O W
� LICENSED CONTRACTOfiS DECLARATION —�
� w
IHEREBYAFFIR4UNDERPEIULTYOFGE0.NRVTHATIAAILICENSEDUNDERPROVISIONSOFCHAPTER �
p, a�C01AA�ENCNOWR115ECTION70oo)OFDMSION�OFTHEBUSINESSANDPROFESSiONSCODE,IWD Z
X MY IICENSE IS W ML FORCEAND EFFECT, m
� LICENSE '� LIC.NO. � .
'� V DaTE_, cONTMCTOFl a
W
� WOpKERS'COMPENSATION DECLAMTION Q
N IHEREBYAFFIRMUNDENVENALTYOFOEft1UNY0NE0FTHEFOLIOW.NCDECLAMT10N5: Z .
� _IfUVEANDNALLMNNTAINACERTIFlCATEOFGONSENTTOSELNNSUREFORWOHKERS' _
Q COMPENS�TION,AS FROVIDED BY SECTION�70o OF TNE LABOH CODE.FORTME PERFOqMANCE W
O OFT RKFORWMICHTHISPERMITISISSUE�. �
0 W IHAVEANDN'ILLMAIMAMWORKERS'COMPENSATIONINSUtLWCE.A5RE0U1REDBYSECfION {� /// \
7�ooOFTHELABORCODE,iORTM[GERFORMANCEOFiH WORICFORwMIpfiHISVERMRIS �(���, /�)
� 65UED.MYYlDiU(ER'COMP 15ATIONIN ANCECAR FANDPOLICYNUM�ERARE: CONSTRUCTION _ �/ V�1
� CARRIEF PLAN REVIEW - . .
Z POLICYNVIABER V � l ELECTRIC
Q
0 (MSSCCTIDNNEmNOTBE00�N'LEfEDOF7IEPERM�T6fi�RON[11J�UaED00L1ARSgiOC)ORlE55} PLUMBING
Z ICERTFYTHATNTHEPERFORMANCEOFTNEWOPI(FORwHICHTHISOERuiTiSLSSUED.I MECHANICAL
(7 511ALLN0T EMPLOV ANY OERSON IN ANY AIANNER 50 S TO BECOAIE SUBJECT TO7ME
N M/ORKERS'GOMPENSATIONLAWSOFCALIFOHNIA,A FCREEiH�TIF15 DBECOME INSPECTION
SUBIEG7 TO THE WORKERS'COMPENSATKKJ V qNS OF .TION 77 TNE OR
CODE/.y�6�JHA�ty FORTHWITMCOMPLIWITHTN05 OVIS ISSUANCE ~, f' ` ♦
p DATE:�)��Y�_ APPLICAM: �� SMIP J� {'
J WARNINO:FARURETOSELUREWOWfERS'COMPENSATIONGOVERAGEISUNLAWFUL,ANDSHkLBE ENERGYP _
� SU&IECTANEMPLO�EHTOGRIMINALPENALTIESANOCMLFwESUPTOONEMUN�REDTHOU51V7D ENERGYPE MIT
DOLURS(t10a.000),N ADDITION TO THE COSi OF COAIPENSATIDN,OAMAGES AS PROVIDED FOR IN
� SECTqN770lOFTNELABORCOOE,RITEREST.MlDATTORNEV'SFEES. RETENTION �r.
a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: --"''r----'�
O '
� IHEREBVAFFIRMUNDERVENALTVOFPE0.NRYTNATTHEREISACONSTRUCiIONLENOWGAGENCY
FORTHE FERiORMANCE Of TME WORK FOR)/MIJ�H THIS PERMiT IS ISSUEO(SEC.7oG7,CIV.C.�.
' , w /./
� IENDERSNAME� %7 T
� IENDER'SAD�RE54 �'
� TOTAL FEES
¢ 1 CEHTIFY ilui I NAVE qEAD THIS AVPtJGTiON 11ND STATE THAT THE�BOYE INFORUATbN IS COnRECT.
� IACRGETOCOMPLVWITHALICITYANDCOUNTYORDINANCESANDSTATEUWSRELATWCTOBUIL01N0 �1--�
� CONSTRUCTION,/WDHEREBVAUTHOWZEREPRESENTATNESOFiNISCWNTYTOEMENUPONTHE
Z ABOVE�MENTIONEDCflOPEflTYFORINSGECTIONPURPO5E5. COMMENTS '
0 �
�
m PERMI .NAM (7 n
¢ O
� �
� SiG nT ITf UA E
� RECPT.N0. PAID BY VALIDATION
WHITE—Departmenl Copy,YELLOW—Finence Copy,PINK—Assassor Copy,GOLDENROD--File Copy.GREEN—ApplicanCs Copy
....�.i 7„`�r'n�. ..,�_�...:.- J � C. . S . . . ...... . ,...._ . .. .�. , .. ,.
.
.�.. .� ��.�i�._;..�.. �_ �. - ..f�.....;.:�:l':'t" .r... . .41� . � .-�.��r��,i:, ,'n: ••z�;.t,.,,,�.. , , . . . . ...�•=• . .
...... . ..:,.-.�. •- ,•.�
. , ....., . ..... . .. ...
, , r.,
ci-r�r c��= �iAr�►or�� a���
If�SPEC i iOt�d f=eEGDRD
1►�E-'�R�=�E;�rl�a►`� ��t��r� ..—:1►`kc�1=;c���'c�o�.____-- .I���:i��Wr`;o,Cc7���..�__. ,��)�E�(� :�►�(:�a�i:��'�I.•�
. _ . _ . . _
•�---------------------......... .... . ..-..__.._.�.---._...:.., .. ......_ . ._ _ -- �=—�-------- ___._ ._�_.._---
- - -�-
SET BACY I I I I FLaOR JOIST�,�, . �� , • '�
.:1.
FTGS/FORMS/STEEL I T•-� FHA REQ"�1TS __I
ELECTRIC GROUMD j _ • �� UNDER FLOOR DUCT '
GROUND PLUPl161NG I UPlDER FLOOR CU�IDUIT � ' • �
SLAB GRADE I FIREPLACE FOtJNDATION I I � � '
TEMP POWER � '_� FIREPLACc�BOND BEAh1 � _ •
WATER SERVICE ; i M!D HT. �OND B�F,�A �'
ROOF SHEATHING _ _ �� ___ � � E3 FT. BOND•BEAN; � � I . • _
FRAh11NG,NEtJTILIATIOPd� , � FINAL BOND BEAt�1 � �
ROOF COVER `I�� ��'• ��o � FRE-GRADING j
ROUGH HEATING " I BENCHING -
ROUGH ELECTRIC f ROUGH GRADING
ROUGH PLUh161fJG FINISH GRADING
SH0�1/ERlTUB TEST POOL EL�CTRIC
EXT. LATH!SIDING I POOL FENCING
�"JALL INSULATION `�.,� , { POOL FINAL
CEILING INSULF,TION OFF SITE IP.�IPS.
DRYWALL PJAILIPJG DEDICATIONS
SEUJER FIyAL ENG.
SEPTIC TANK � � '' . L�INDSCAPE/IRRIG. �
SEEP PITlL.L. `� ' ON SITE IP,1PS. �
GAS AIR TEST - FINAL ZONING
FINAL CONST. {� FlRE DEPT. FIPJAL
FINAL HEF.TIPdG � ���� _ �� HEALTH DEPT. FINAL �
FINAL ELECTRIC �� � �EV. FEES PAID �
FINlIL PLUh�1BING � � ,�� E�dERGY
- � �
� .-......,..,.-�--.-�,�=---�—:-��—,—r-
- ----�--•------���—._—,_ �cjz�c�R��.�..:�.c?I�,c .._._.,_._ . - _
COMMENTS �
,
-'�-�. -
SEPTIC TAPJK SIZE
SEEP PIT/U SIZE
� :�� ;
i
' i
i
I
y��� _i
�
.
� .�.;-- .
� '•i_ 1 ' �