HomeMy WebLinkAbout12-755 (6)CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21810 Copley Drive,Diamond Bar,CA 91765
909)839-7020 Fax(909)8613117 Building Inspection Hotline(909)839-7027 PRESS
BUII.DING PERMIT APPLICATION FIRMLY
JOBSITE APPLICATI N PERMIT ,i C p/C 2
o ADDRESS J,.no A a,,,e.vD „DATE_ I 1 a NUMBER J a-'-I S
APN .f3'7 i LOT' TRACT 9(1.{
DATEE
I Tr 7 ONSt E GROUPpOWNER _/__r 7Lbf,(J/9irr il,p QB/..
p ADDRESS,/Z$f1 "(1O ff3"Q/y([g' ZONINCa SETBACKS
w
4 .-
TT 9/7/C' FRONTZCITY Q Airyb , ZIP TEL.
REAR
RW
APPLICANT 'Z'rF(NQ r TEI.I 4•-73n.n SIDE/SIDE STREET RW
CONTRACTOR SIDE
ADDRE
o CITY . ZIP ' /TEL 1/i 7f PROPOSED USE
o ARCH/ENG/
z DESIGNER pE rS.P.¢ D6' d.
w NO.DWEL. NO.NO:n. ADDRESSaf[/,il+Q s'oL_ L,
C T1''//,J'/L/.i/ ZIR 4 P TELy a/H-.3Tc"-.4
UNITS STORIES BEDROOMS
DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATIONOOWNER-BUILDER DECLARATION
SFR/ADD/REM I
1 HEREBY AFFlRM UNDEq PEry/1'ry pF PERNRV hIAT I AII D(FJ.IPT FROA1 THE CONT{UCTOAS U- Ge 9.
I
W CENSEUWFOqhiEFOLLOWIN(iREA50N(SEC.7o31.68U5WESSANDPROFESSiONSCODEANYClTYOR C COUNTYWHMJiREWIRESAPERA1fTTOCON9TRUCT,AL7Ep,IMpppyE,pEMqJSH,ORREPAIRANYS7RUG-.-w p8ti0/DBCkLNRE,PRIOR TO RS ISSUANCE,ALSO REOUIRES THE MPLICAHf FOR 6UCH PERMR TO FIIE A SIONED WSTATEMEMiHATHEORS11EISUCENSEDPURSUAHT70hiEPROVIStONSOFTHE-CONTMC70RS ll-
CENSE UW(CHAPTER B(COMMENpNO WI7H SECTqN 7000)OF DMSION 7 OF THE BUSINESS AND PR0. . u' POOUSp9
FESSIONSCODE OqTHATHEORSHEI9E%EMPTTHEREFROMANpTHEBASI5FOR7HEALLEOEDE%EAIP' ( T10N.ANYVIOLATIONOFSECTION7o7t.6BVANYAPPLICAN7FORAPERMRSUBJECT57NEAPPIICANTTO Z RaRoolACIVILPENIWT'OF NpT MOqE i11NN FNE HUNDRED DOLLARS(lbop)j;
Z
1,1SOWNEROFTHEVROPERTY,ORMYEMPLOYEESWIh11VAOESASTHEIRSOLECpMPENSATqN, CpmmBfC131N7LLDOTNEWORK,AND THE BTRUCTURE IS NOT IMENDED,Oq OFFERED FOR 9ALE(SEC.7oM,BU51- J
NESS i1ND PROFESSIONS CODE THE CON7qACTOR3 LICENSE LAW DOES N07 MPIY TO AN OWNER OF ?
PROPEHTY NTp gUl p$pq IMPROVES THEREON.AND WHO DOES SUq1 NpqN HW SEI.F OR MERSELF OR
THAOlN3HH190RHEROWNEMCLOVEE3,GROVIDEDTHATSUCHIMPROyEAIEPJJSARENOTINTENDEDOR . m
0 OFFERmPORSALE.F.MONIEVERTHEBURDINOORIMVROVEMENTISSOLpWfTMNONEYEAqOFCONPIE-
T DN.7ME OWNER BUILDER WILL HAVE i11E BURDEN OF PROVPIO T{AT HE OR SHE DID NOT&IIID OR
IMPROVE FOR THE PURP0.5E OF SALE).
W I.ASOWNEROFTHEPROPERTY,AAIIXCIUSNELYCANTfUCTINOWfTNLICENSEDCONTRACTOfiSCTOCONSTRUCTTHEPRQIEGT(SEC.70M,BUSINESS ANO PROFESSIq13 CppE:hIE CONTRACTOR3 U- V8IU8I OIr L
ApJ,AREACENSEUWDOESNOTAPPLYTOANOWNEROFAPROPEpT'WF1pgUdDSORWPROVE67HEREON,AND
MRIDCONTRACTSPDASUCHPROJECTSWfh1ACOHTRAC7pq(5)LICENSEDPUR6UAMTOTHECOHTMG Q J/(.JT DESCRIPTION EroasucENseuw,>.
Q 1 AY E%EAIPT UNDER SEC. B.d P.C.FOR TMIS REASON
U
DATE ONMER
Z U.
UCENSED CONTRACTORS DECLARATION
w
OC I HEREBYAFFIRM UNDER PEWLLTV OF PERIURV THAT I AM LICENSED UNDER PfiOVI510N3 OF CHMTER
D COMMENCIMO N7TH SECTION 7000j OF OMSION J OF THE BUSINESS AND PROFESSIONS CODE,AND ZIAYLICENSEi3PlFULLFORCEANDEFFECT.
UCENSE S LIC.NO. < _7 (._).
U TE CONTRACTOR "7 d
LLI C..
WORKERS'COMPENSATION DECLARATION
I HEREBV AFFIRM UNDER PENALTY OF pEfiIURY ONE OF THE FOLLOWINa DEClAMT10N5: VC/ Z
I HAVE ANp WILL MAINTAIN A CERTIFICATE OF CONSENT TO SEIF INSURE Fpp WpW(•
2Q
COMPENSATION.Ag PROVIDED BV SEC710N 37000F 7HE UBOR CODE,FOq TNE PERFORMANCE C7:
OF THE VJORK FOR V/HICH THIS PERMIT IS I$$UED.
IMAVEANDWILLMAINTAWWOR)(EAg'COMPENSA71oNWSUqANCE:ti4REWIREDBYSECTION
Q37000FTHELABORCODE.FORTHE'PERFORAIANCE oFTHEWORKFORWHIq/THISPEpMI71S.
asuEo.n r wowc r crnnras iNsuwwc6 cuuiEa wu.raiu:v rau ae iwE CONS7RUCTION. T
j CAARIER
rJ
C',6y G 1 NSiI// fJd/, PLAN.REVIEW I . `'1
POI V NUMBER,7 C I. .•
EY'I1 ELECTRIC
nessEcrqror+r+oreEoona EnoFngaa n,tt sFoaor+EM wr oaulsg aoloa ss} PLUMBING
wZ 1 CERTIFY.THAi R/THE PERFORAIANCE OF TME WORI(FOR WHICli 7H4S PERMR tS ISSUED.I MECHANICAL
CJ SMALLNOTEM7LOYANVVERSONINANI'MANNERSOASTOBECOME'SU&IECTTOTHE'
NbRKERS'CAMPENSAT1pNlqW$pFCP11FOiW11ANDA6REETHATIFISHOVLOBECOME INSPECTIONFEE
SU9IECTTOTHEWORKERS'COMPENSATIDNPROVISqNSOFSECT10N37000FTHEUBOROcooesrw. arriwini coMp r win nwsE pao isb++s. ISSUANCE
DATE:APPLICANi:SMIP S
ENERGY P/CWARMN4FAILURETOSECUREWOR!(ER5 COMPENSAT COVERA(iE IS UNLAWFUL,ANp y1AL BE
y "U6)ECfANEMPLOVER70CRIMWAL7ENALTIESANDpVILFlNESUPTOONEHUN REDTHOUSANp
ENERGYPERMITDOLURS(S10D,Ooo),W ApDITON 70THE COST OF COMVENSA7pN,DAAUOES AS PROVIDED FOR W
6ECTIDN 370e OF 7HE UBOR CODE,WTEREST,ANDAiTORNEV'S FEES. '
RETENTION FEE: Q , ('pW
O CONSTRUCTION LENDINGAGEN6Y PRE-ALT F(E'E:
1 HEREBYAFGIRAI UNUER PENALTY OF PERAIRV 7HAT 7HERE 19 A CONSTRUC710N LENDWO AOENCV 5 C Qd' FOq THE PERFORMANCE OF THE WOR)(FOR NM1i1CN 7HI5 PERAlI71S ISSUED(SEC:30W,qV.CJ.ZW
LEFIDERS NAME
F- LENDER'SADDRE55
wicear rnu riwweaennrH s vot Twr+urosr rEn nrrr eovewcora+rroN scoaaEc. TOTAL FEES , " x
1 AUREE i0 COMPLY WITH ALL CT'AND COUNTY ppDMANCES AND STATE UN5 qEUTINO TO BU0.D W 6
CONSTHUCT ON,AND HEREBY AUTHORIZE REPRESENTA7NES OF tTpS COUMTY TO EHTER UPON THE
ABOVE-MENTqNED VROPERTY FOR INSPECTION OURPOSES
p COMMENTS '
J
m P RM EIPRINn . .
p 1S o
J - EOF PERM A7E
RECPT.NO. I PAID BY ALIDATION
WHITE—Depertment Copy,YELLOW—Flnence Copy,PINK—Assessor Copy,GOLDENRO FIIe Copy;6REEN—AppllcanPs Copy
CITY fJF Dlr4nJIOf D AR
INSPECTION REC4RD
o e , '
i .5 o
y Q;.T'
SET BACK FLOOR JOIST
FTG$/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PWMBING j UNOER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT.BOND BEAM
ROOF SHEATHING 8 FT.BOND BEAM
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING I FINISH GRADING
SHOWER/TUBTEST POOL ELECTRIC
EXT.LATH/SIDING PQOL FENCING
WALL INSULATION POOL FINAL
CEILING IfJSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTICTANK LANOSCAPE/RRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT.FINAL
FINAL EIECTRIC QEV.FEES PAID
FINAL PLUMBING EIVERGY
FINAL PLANING
FINAL ENGINEERING
COMMENTS f
SEPTICTANK SIZE
SEEP PIT/U SIZE