HomeMy WebLinkAbout12-969 _�,� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES E�. 21810 Copley Drive,Diamond Bar,CA 91765 i (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ,�'""'. BUILDING PERMIT APPLICATION FIRMLY � JOBSITE . � �r �.G APPUCATIQN; PERMfT �� � P/C � o ADDRESS,-� DATE_�L_ NUMBER # ��-`'��q � APN LOT TRACT ISSUE Z TYpE G pCC DATE 3 r CONST. �/ � GROUP p OWNER S P p ADDR SS ZONING SETBACKS Z CITY IP �{. FRONT q�/y p g APPL ANT TEL. REAR p � SIDE/SIDE STREET RW O � CONTRACTO SIDE p ADDR SS � CITY ZI TEL/ PROPOSED USE w ARC NG/. 7�V�a l/_„'7S �� I z DESIGNER ��v / a ADDRESS � J • i � CITY ZIB TEL BEDROOMS � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � p� �OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HER�V AFFlRM UNDER'PENALT'OF PE{iIURV 7NAT 1 AM EXEMPT FROM THE CANTRACTORS U- G8f8 0/C9 Il W CFNSEUWFOR.7HEFOLLOWINOREASON(SEC.7631.6BUSINESSANDPROFESSIpNSCODE:ANYp7YOR , (n 9 � � U COIMTYMRiIQ1RE0UlAESAPERMITTOCON5TRUCT.ALTER,IMPROVE.DEA10lISH.ORREPNAANY3TRUG P8t10/DBCI( W 7URE,7RIOR TO RS ISSUANCE,ALSO qEOU1REg hIE MPLICAM FOR SUCH PERMIT TO FlLE A SIONED w � STATEMENT THA7 HE OR SHE IS 110ENSED.PURSUANT TO 7HE PROVISIONS�OF 7ME CONTMCiORS U- . . '� CENSE UW(CHMTER D(COMMENqN6 VATH SECT70N 7000)OF DIVI910N 3 OF THE BUSINESS AND PR6 � Pool/Spe FESSpNS COOE�OR THATHE OR SHE IS EXEMPTTHEREFROM AND THE BA515 FOR THEALLEOED EXEAIP- � (� V TION.MIV.VIOLATqNOFSECTION7W1.6BYANVAPPLICANTFOqAPERMITSU&IECTSTHEAPPLICANTTO Z RaRool . . � A CML�ENAL7Y OF NOT MORE THAN FNE HUNORED DOLURS(i5ao).r ❑4�V^OM7JEROFTHEPf�PERTV,ORMVE1dPLOVEESWI7HIVAGESASTHEIRSOLECOMPEN5AT10N, � � CpmmBfCiel Z WILL DO THE WORK AND 7HE STRUCTURE IS NOT INTENDED OFi OFFERED FOR SALE(SEC,�7ou,BU51� J f � NESS�A/JD PROFESSlON6 CODE:THE CONTRACTORS LICENSE UW DOES NOT A7PLV TO AN OWNER OF j � � PROPEHTYNM1iOBUILp$pqIMPROVESTHEREON,ANDN710DOESSUCHWOqKHIM3ELFORHERSELFOR ' - WTHROU(iNHI30RHEROWNEMCLOVEES,PROVIDED7HAT5UCHIlAPROVEMENTSARENOTWTENDEDOq m , Q OiFEFmPDR3ALEIF,HOWEVEFL7HE8lALDWOOROJPROVEMENTISSOLDWfTMNONEVEAROFOONPLE- Z TION.,THE�OWNER�BUILDER WILL MAVE THf BURDEN OF.VROVWG THAT HE OR SHE DID NOT&IILD OR . � B�IPROVE FOR THE PURP0.5E OF SALE� � w 04��WNEROFTHEPROPERfY,AMD(CLUSNELYCONTMCTWOWRHIICEN$EDCONTRACTORS � TO CANSTRUC7 THE PROJECT(9EC.70N,BUSINE59 M67 PROFESSION3 CODE:THE CONTRACTORS LI- V01U8t1Of1 ADJ.AREA' � W CENSE UW OOES NOTM7LY TOAN OWHER OFA PROVERT'WHD BUILDS OR IMPROVES THEREON,AND ' � WHOCOHIAACTSFORSUCHPR0.1ECfSWI'TYIACOHiRACTOR(5)LICENSE�WRSUAN7TOTHECONTMG qUqN7�7y DESCRIPTION 70RS UCENSE LAW.). FEE � 0 ❑I AM E%EMPT UNDER SEC. �B.8 RC.FOR THIS REASON � � U � DATE � ONRJER �� � - � � . . . V � � �1� � LICENSED CONTRACTORS DECLARATION � - � � � I HEREBY AFFlRM UNDER PENALTY OF VERNRY 7FIAT IAM LICENSED uNDER.PROViS10N9 OF C1iAF7ER � � p� 'Y(COMMENCIMO�WfTM SECTION 7000)OF DMSION 30F THE BUSINESS AND PROfE5510NS CODE,AND � � X MY�K�NSE IS W FULL iORCE AND EFFECT. Z LL1 wr' m � CENSE CLASS�!'�_ LIC.NO. 'v � - . V TE��7,`�I7, _ CONTRACTOR C • d . . W • � WORKERS'COMPENSATION DECLARATION � � � � - � � � 1 HEHEBYAFFIRM UNDER PENALTV OF.PERIURY ONE OF THE FOLLOWING OECLARATIONS; U � - � C!� Z � _I HAVE�AND WILL MNNiAW A CERTIFlCA7E oF Cq�SENT TO SELF�INSUqE FOR WOR)(Eq5• gy - � � Q COMPENSATION,AS PROVIDm BY SECTION 37000F 7HE LABOR CODE,FOR THE PERFORMANCE W OF lYIE NKfRK FOR WHMAi THIS PERMIT iS ISSUED. � � _IHAVEANDWILLM.UMAW.WOPo(EAS'COMPENSATIONWSURANCE.ASREOUIREDBI'SECTION ' � Q � 370o OF�THE LABOR CODE,FOR 7HE PERFORMANCE�OF THE WORN WR WHlq/iHIS PERIIIT IS f55UED.MY EA5 PENSATION I � RANCE C RIE D POl � M ER CANSTRUCTION� j � CARRIER Pn PLAtJ.REVIEW � � i Z aa�cr raiMeEa ELECTRIC �: � I ¢ � (nessecrar�r�IDr+oreEoons�r�aFnfPaxrrswr�a+Eru�n�noa.�uuK�oWOA�ss1 PLUMBING W . ` Z I CERTIFY THA7 1N THE PERFORMANCE OF THE WOPo(FOR WHICH TNt$PERAIIT�S LSSUED,1 MECHANICAL CJ SHALLNOTEMVLOVMIVPERSONBJANYMANNEq$pA5T08ECOME'SUBJECTTOTHE � � (n WORICERS'COMPENSATIONLAWSOFCALIFORNI/�ANDA6REE7HA71FISHOULDBECAME INSPECTIONFEE SU&/ECT TO THE V10AKERS'COMPENSATION PROVISIONS OF SECTION 37ao OF THE UBOR ' �' ` S CODE.I SHALL FORTHWIiH CAMPIV V.7TH 7HOSE PfiOVISqNS. ISSUANCE • v .. � p DATE APaI:ICnNT.: .SMIP W J'J WAHNINO:FAILURE TO SECURE WOflKERS'COMPENSATION COVERAGE IS UNLAWFUL,A/JD.SHALL BE ENEFiGY�P/C � � � SUfl1ECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FWES UP TO ONE HUNDRED h10USANU �ryERGY�PERMIT DOLURS(f100.0D0),W ADD1710N TO THE COST OF COMPENSATqN,DAMAOES A$PROVIDED PoR IN J SECTWN 37oe OF 7T1E LABOR CODE.IMERE57,AND ATTORNEY'3 FEES. � ' ' ' �yc� w RETENTION FEE: .(�v O . CONSTFiUCTION�IENDING AGENCY PRE-ALT FEE: �. 1 HEREBY AFFIRM UNDER PENAL7Y OF PERIURY THA7 THERE tS A CONSTRUC710N LENDWO AOENCY Z �FOR TNE PERFORMANCE OF THE WORK FOR WHICN 7HIS PERMR IS ISSUED(SEC.�3oH7,qV.C.). W TS LENDERS NAME � � � , S � LENDERSADDRESS � � � � .. �� 'ICEHTIFYhIA71�HAVEREADTHI9APPLICATIONAND57A7ETUThIEABOVEPlFORIAAT ISCOMECT. TOTAL FEES ��� �C� //�j.��,�� � IA EE7000AIPLVWITH CITV COUNTYOppWµ SANDSTATEUWSREI.�TQ BUI�DINO — ��� � ST ,�HER E P T �IS COUNTYTO R Uf�IE ' Z � Vi M (C� COMMENTS � CJ � m VE E(PR ¢ (o'lL-�Z- � N E E DA7E � G \�OV� `�� RECPT.NO. PAID BY ALIDATION WHITE—OepaAment Copy.YELLOW—Finence Capy.PINK—Assessor Copy,GOLDENROD--Ftle Copy,O EN—ApplicanYs Copy . CITY QF DIAMOND BAR INSPECTIOPV RECOFiD � . e , ��;� Q � " ' � � D ��: x y �_- , ,.w.� '� � .:a�, .� ��t , .S, � �� ; "� o D � '�'���i o � s SET BA�K i FLOORJOIST FTGS/FORMS/STEEL FHA REQMTS . � ELECTRIC GROUNd UNDER FL�OR DUCT . GRpUND PLUMBING i UNDER FLOOR CONQUIT SLAB GRADE fIREPLACE FOUNQATION TEMP POWER FIREPLACE BOND BEAM ' WATER SERV�CE MID HT.BOND BEAM • • ROOF SHEATHING 8 FT.BpND•BEAM FRAMING/VENTILATION _, �FINAL BOND BEAIvI ROOF COVER PRE-GRADING ROUGH HEATING BEN�HIfdG ROUGH ELECTRfC ROUGH GRAD(NG ROUGH PLUMBING �FINISH GRADING SHOWER/TUBTEST I POOL ELECTRIC EXT.LATH/SIDING POOL FENQNG WALL INSULATION POOL FINAL CEILING INSULATION j OFF SITE IMPS. DRYWALL NAILING I DEDICATIONS SEWER FI—NAL ENG. SEPTICTANK ` I LANDSCAPE/IRRIG. � SEEP PIT/L.L. ON SITE IMPS. GAS AIRTEST FINAL ZONING FINAL CONST. FIRE DEPT.FINAL FINAI HEAZING � HEALTH DEPT.FINAL FINAL ELECTRIC DEV.fEES PAID FINAL PLUMBING ENERGY FINAL PLANING i FINAL ENGINEERING . p � �OMMENTS , 0 a• '�0 a M+ �Y J ��'�` ...i/ �.�^ 1� , +�g} � � /�,,,`1��. , 7 C7� . .��� SEPTIC7ANK SIZE SEEP PIUU SIZE — �� � 1� . �' �a: ry, _