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HomeMy WebLinkAbout16590 i _ _ �\ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNiTY tS.DEVELOPMENT SERVICES c u�_�` 21825 E.Copley Drive � (909)860-3195 Fax(909)861-3117 PRESS ''-�� BUILDING PLRAi1T APPLICATION FIR LY o� JOBSITE �D�,/ C� /-/� � APPLICATION �I OI PERMIT ����n P/C ADDRESS b � lr�� DATE NUMBER��IJ �� a � APN L T TRACT_ g� � D TEE �CONST. GROUP p OWNER '�1S � o ADDRES _ �• �� ZONING SETBACKS z CITY _� ZIP TEL.,Z,�y' FRONT RW ❑ g APPLICANT �r' TEL.��i���.p REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACT q G _ SIDE ❑ � ADDRESS . � CITY� _ `�_ ZIP,�1.��TEL ���� PROPOSED USE w ARCH/ENG! W ADDRESS�T NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES / _BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O 0 1 HERE9Y AFFIRA.1 UNDER CENALTY OF PEfWRY iHAT I AM E%EAriT FROA1 THE CONTRACTORS L4 GaragdCarport W CENSEUWLORTHEFOILOWiNCREASON�5EC.70a�.58USiNf55ANDPROFE55�ON5C0DE:ANYG7VOR (f� U COUNTYMh1ICMREWIRESAPERMITTOCON57RUCT,ALTER.IMPROVE.DEMOLISH,ORREPAIRANYSTRUG W PatiO/DBCII � � —� TURE,PRIOq TO ITS ISSUANCE,A150 REWIRFS THE MGUGWT FOR SUQI PERMIT TO FILE A SIG�ED_ _ W . STATEMENi iNAT ME OR SME IS LICENSED VURSVANT TO TME ifiOV15lONS OF 7HE CONTRACTORS lF �� CENSE LAW�CHAPTER 9(COMMENCWG WITM SECTqN 100'J)OF D�Y�SION]OF TME BUSINESS I1ND PR6 �- PooVSpa FESSIONSCOOEIORiHATHEOfiSHEISE%EMPTTMEHEFROMANDiHEBA515FORTMEALLEGEDEXEMP• (7 V TION.ANYVKKATqNOFSECTION70]7.7BYANYAPPLICANTFORAFERMITSt113JECT5iHEAPPLICANTiO Z pe.q�} A LML PENAL7V OF NOT MORE THAN FIVE MINDRED D011AHS�S50o).): QO�ASOWNEROFTHEPROPERTY,ORUYE��LOYEESWITHWACESASTHEiR50lECOMPENSATION, O CORIrtIBfGl.71 Z SNLL DO TH[WORK,AND THE STRUCTUFE IS NOT IMENDED OR OFFERED FOfi SALE(SEC.70�4 BU56 �J � NE54 AND iflOFE5510N5 CODE:TME CONTRACTORS UCENSE LAW DOES NOT APPLY TO AN OWNER OF � iROPERfY MAp BUILOS OR IMPROVES 7l1EREON,AND YN1D OOES SUQi WORK NIMS[LF OR HERSFLF ON WTHROUCHHiSORMEROWNEMPL0VEE5,PPqNDEDTHA75UCHWPROVEFIEMSAR[NOTINTENDEDOR C� 0 OFFEREDfORSALEIF.HOWEVERTNEBUIIDINGORIMPROYEMEMISSOLOWITNI40K[YEAROFCOMPLE• Z 710N,THE DNMER�BUILOER WILL NAVE 7ME BURDEN OF PROVw�THA7 NE OR SHE DiD 1�T BUILD OR � IUVROVEFORTNEVURPO5EOF5ALE1. w OI,ASOWNEROFiHEPROPERTV,MIEXCLUSNELVCONTRACTINGWITHLICENSEDOONTMCTORS Q TO CONSTRVCT TH[PRQIECT(SEG 70��.BUSINESS/WD PROFE5570N5 ODDE.THE COftiRACiORS LI- V�IUa110f1 _/IW.AREA W CENSEUWDOESNOTMPLYTOANON/NEROF11iROPERTTWHO6UILO50RIMPROVE57H[RCON,A�D � � YYIqCOMFi11C�5FOR5UCHVR0.IECTSWITHACONTMCTOq(5)UCENS[DPUHSWWTTOTHECONTRAG QUANTITY D[SCRIPTION FEE Y TORSUCENSEUW.� � ❑IAIA EIfEA1GT UNDER SEC. B.i P.C.FOH TMIS REASON a � U W ¢ Z DAiE oWNER � O W Q LICENSED CONTRACTOFS DECIARATION w [C IHERCBVAFFIRAIVNDERDENALTVOFPE0.JURYTHATIAMLICENSEDUN7ERPROV15qNSOFCMAPTER � � p. Y(CqAMENdNCVNiHSECTION7000�OFO�VISION]OFTHEBUSINESS�UlDiflOFE55qN5CODE,AYD Z OMY UCENSE IS N FULI FORCEAND EFFECT. ��/� _ LICENSE CUSS �UC.NO. z V DATE���_� COMMCTOR���S�f�'�,(_ a � W � WORKERS'COMPENSATION DECLARATION a � IHEREBYAFFIRMUNDERPENALTYOFPERIURYONEOFTHEFOLlON1NGDECUMT10N5: Z � _IWIVEANDWILLMAMTAINACERTIFICATEOFCONSENTTOSELFd1.5UR[FORNORKERS' _ COMPENSATqN,J4SVHOviOEDBv5ECt10N77o00FTHElABORCODE,FORTMEVERiORM�NCE U Q OFTHEWORKFO�NM1IICHh115PERMITISISSUED. � QW ,�M7AVEANDWILLMAINTA:NWORKERS'COMPENSATIONINSURAI�CE.ASREOUiREDBVSECT10N ///��� //� 77000F iHE LAf10R CODE,FOR TME PERFORMMlCE OF THE WORK F lriMlpl}�115 VERMiT 15 �O� {�Y ) J 155UED.MYWORK�N5�.710NI ;URANCECAn�'ERANBV�_ICYNUMOERARE: CONSTRUCTION Z � /�/ j -CMRiER �� �� - �PLANREVIEW � o aa�cv NN"°ER— ��� �'7=l"/ ELECTRIC z ¢ � (f165ECTqNNEmNOTBECOM1iiEfE�Ofh[PEit.R6PolIONLIML%L�DOl1AR5(Si0L�0filE55} PLUMBING Z IC[R7IFYTHAiNTHEPERFORMMlCEOFTMEWORKFORWHICHTHISPERA1iTI51S5UE0,1 MECHANICAL _ [,�} SHALL NOT EMPLOVANY VERSON W ANY MANNER SOAS TO BCCAME SVBJECT TO TNE (n WORKERS'CdAPE SATKKJ UWS OF CALIFOi1Nl/�M!'J AGREE iMAT IF I SFIOULD BECOML INS?ECTION FEE � S SUBJECT OTHE ORNERS'COMPENSATIONPR 'JISiON50F5ECTION77o0 FTHEUI3 R ��u/j(i]n+y�rncor.+rtrwirni�a� PR �.c s. ISSUANCE MA��� p DATE: I v',acv��cnMr: � SMIP J WARNING:FARURE TO SECURE WORKERS'COMPENSATON CAVERAGE IS UNUWF�,�VlD SMALLBE ENERGY P/C � SUftIECTANEA!PLOYERTOCRIMINALPENALTI[SANDCMLFwESUPTOONEMUNDREDTMOUS0.Y0 ENERGYPERMIT �y' DOIURS If 700.000).!!IDDITiON TO THE COST OF COMPENSATpN,DAMAGES AS PROVIO[0 FOR IN ¢ SEGTION770EOFTHEUBORCOOE.WTENESLANDA7TOHYEYSFEES. RETENTIONFEE: �� � ------- a CONSTFlUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFIRAIUNDERVENALiYOFPEHJURVTHqTTH[REISACONSTRUCiiONLEN0INGACCNCY FORTHE FERiORMANCE OF THE WOFK F R WHICH THIS GERMIT IS ISSUED(SEC.7o97,CIV.C.). W $ LENOE�iSN.UAE� F F- LENDER'S/�DORE54 ' .,,J ` Q ICERTIFYTHATIMAVEREA'JiHISAVPLIGTIONINDSTATET1uTiNEA�OVEI�:FOH1AA7pNI5CpRqECL TOTAL FEES - /� Q�J W IAGRCET000I.IPLVWITHALLCITVANDCOUNTYORDINANCESANDSTATEUWSRELATWCTODUIIDING �J � � CANSTPVLTION,/WOHEfiEBVAUTNORIZER[PRESENTATIVESOFTMISLWNTYTOEMERUPONTHE Z AOOVE�MENTIONEDPflOPEHTYFORINSGECTIO�+GVRPO5E5. o �` '' /�� � COMh1ENT5 � �t'��_I� m PERMITiEENAA�'.,FLNTj. ¢ � � � _ (n SIGNATVR F DATE . '\, � ' R[CPT.NO. 'PAID DY _� VALIDATION WHITE—Depanmenl Copy,Y[ILOW—Finance Copy,PINK—Assessor Copy,GOLDENRO Fila Copy,GREEN—ApplicanCs Copy �_..............�.ynx�.i�.��..�.�..�..r...�..:x�..^.�•....r-:...-.�.�.r....�.�+r„q . rr.�S•..•v`•..t.T.C....�Ym'j�Y,:C�!.�rw... `��'.h1'n.,,'w!7wr'"�.3t�..n•�•���,p��n•�..... ,'.,��wv ., � .r•' ,' „ .. _ . , . . .T. � CITI' OF DI�f��IOf�D B!-�R ItJSPEC e 10I� RECORD '1►�k-'i��E:'I!1J11' ���1:.tC=�. �I►rl-y:i_c;�'E.):� l►'�-'i�a �►`i �I.��' 'I►�.�-����f:,Cga;,� ; ��:,,��e� -- _._----------�----.__�._______._...-_•.---.._.�.__-=:......__.----�----=---=-----.. -- ----- �------_ _--_—•- - SET BACK '� '•I ;--� � ` FL�OR JOIS7"� `� ;��_�. I�. , . ��_ , •. ` FTGS/FORMS/STEEL � �___ = FHA REO?�1TS '. '� ELECTRIC GR�UND � � U�dDER FLOOR DUCT � . ,� . ',� •. GROUND PLUP1161NG UNDER FLOOR CUP,!DUIT �• � � I'• • ' SLAB GRADE _� FIREPLACE FOU��DATION ' TEMP POWER I I FIREPLACE BOP�D 6�Ah4 WATER SERVICE hAID HT. E�OND BEA��1 � ROOF SHEATHING L"�a"� II FT.BONp 6EA"l � FRAMINGNENTILIATIOPJ� I FINAL BOND BEAM � ROOF COVER G Z��— PRE-GRADING ROUGH HEATIfdG BENCHING ROUGH ELECTFiIC I ROUGH GRADING ROUGH PLUMBING I FINISH GRADIPJG SHOWER�TUB TEST I POOL ELECTRIC EXT.l�'+TH/SIDING POOL FEIVCING • 4"JALL INSULATIOPJ POOL FINAL CEILING INBULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEVVER FINAL ENG. SEPTIC TANK _ ' LANDSCAPE/IRRIG. SEEP PIT/L.L. `' --` ' ON SITE IMPS. GAS AIR TEST FINAL ZOP4ING FINAL CONST. �='jp-�{ � FIRE DEPT.FINAL FINAL HEATING _ . HEALTH DEPT. FIPJAL FINAL ELECTRIC � � DEV. FEES PAID FINAL PLUMBING - ENERGY : . • c �-Qi c�r c�I�Xr. - .�:.�:,�...��:� _. COMMENTS . • �� � � � , _ . . �,, , . . . SEPTIC TAPdK SIZE � SEEP PIT/U SIZE ��w . . �i'f = i , . . . . . • . ; -� ' . , • ,:; , _ . ._ -------..._.___._...._...._._.a �