HomeMy WebLinkAbout12-1087 �-�...:.a.
�` CITY OF DIAMOND I3AR .����{�i_�
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES _,�
21825 Copley Drive,Diamond Bar,CA 91765 - - PRESS
'~ (909}839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027��--- "'.""')
����w BUILDING PEI2MIT APPLICATION FIRMLY
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o ADORESS FJ �!
� ISSUE �1�- pNST.� �✓✓� GROUP
APN LOT TRACT DATE
p OWNER �
" ADDRESS ZONING SEfBACKS
o � FRONT RW ❑
Z C�7y�f1 ZIP QI�TEL. REAR ❑
' o APPLICANT TEL. SIDEJSIDE STREET RW O
� CONTRAC OR G'Z � Cl SIDE ❑
o ADDRES � � PROPOSED USE
CITY ZIP.� TEL.
w ARCH/ENG/ j�� ��
z DESIGNER NO.DWEL. NO. NO.
a ADDRESS UNITS STORIES BEDROOMS
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� DESCRIPTION SQ.Fl: FACTOR PSF ADJ.AREANALUATION
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Q OWNER-BUILDER DECLARATION SFR/ADD/REM
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0 I HEpEBV AFFIRM UNDER PENALTV OF PERIURV THAT I MI EXEMPT FROM TNE CONTRACTORS L4 Garege/Ceiport
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w NRE,PRIOH TO ITS ISSUANCE,ALSO REW IRES THE APPLICANT FOR SUCM PERMIT TO FILE A SIGNED w
� STATEMENT THAT HE OR SHE IS UCENSED PURSUAN7 TO THE PROVISIONS OF THE CONTRACTORS LI� {y POOUSPB
� CENSE UW(CNAPTER Y(COMMENCINO WITM SECTION 7000)OF DIVISION 30F THE 6USINESSAND PRO- �
FESSIONS CODE)OR 1HAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEOED EXEMP�
7qN„WV ypU�710N OF SECTION 7031.6 BV ANY APPLICANT FOR A PERMIT SU&lECTS THE APPUCANT TO Z Re-Root
� A CML PENALTY OF NOT MORE TNAN FIVE HUNDRED DOLLARS(f�).):
O ❑I,ASpWNEROFTHEPROPERTY,ORAIVEMPLOVEESWITHWAdESASTHEIRSOLECOMPENSATION, � (',pmm0fC181
Z WILL DO THE WORK,AND THE STFUC7URE IS NO7 INTENOED OR OfFEflED FOR SALE(SEC.7aa,BUSI- J
N NES^+AND PROFESSIONS CADE 7HE CONTRACTORS LICENSE LAW DOES NOT APPiV TO AN OWNER OF �
PROPERTYWHOBUIlO50i71M7ROVESTHEREON,MIDWHODOESSUCHWOf1KHIMSELFORHERSELFOR m
[[ THfiOWHNI50RHEROWNEAI7LOYEES,PROVIDEDTHATSUCMIMPROVEMEMSARENDTINTENDEDOR
W pFFEqEDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENT15SOLDWiTHINONEVEAROFCOMPLE-
0 TIdJ,THE OWNER�BUILDER WILL FIAVE TNE BUROEN OF PROVWO THAT ME OR SHE DID NDT BUILD OR
Z IAIPROVE FOR THE PURPOSE OF SALE). �
_ ❑I,AS OWNER OF THE PROPERTY.AM E%CIUSIVELV CANTRACTINO WfTN LICENSED CONTMCTORS
w 7p CONSTHUC7 THE PROJECT(SEC.7oU,BUSINESS AND PROFESSIONS CO�E:THE CONTRACTORS LI- V81U0��011 ADJ.AREA
� CENSEUWDOESNOTMPLYTOANOVRJEROFAPqOPER7VWHO8UIID50RIMPHOVESTHEREON,AND
N?qCANTMCTSFORSUCHPRQIECTSWITHACONTiiACTOR(S)LICENSEDPURSUANTTOTHECONTRAC� QUANTITY DESCRIPTION FEE
TORS LICENSE LAW.).
O ❑I AM E%EMP7 UNDER SEC. B.a P.C.FOR THIS REASON U
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LL' DATE OwNEF V
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� LICENSED CONTRACTORS OECLARATION -�
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1 HEREBY AFFIHIA UN�ER PENALTY OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTEF Vi
d G(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55�ND PROFESSKKJS CODE,AND Z
X YY LICENSE IS W FULL FORCE ANO EFFECT. m
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� WORKERS'COMPENSATION DECLARATION �
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� 1 HEREBY AfFIRM UNDER PENALTV OF AERlURV ON6 OF THE FOLLOWING DECIARATIONS�.
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� I NAVE AND WILL MAINTAIN ACEHTIFICATE OF CONSEIJTTO SELF�INSURE FOR WOfiKERS' S
� COAIPENSATION,AS PROVIDED BY SECTION 37o00F THE UBOR CODE.FOR THE PERFORMANCE W
OF THE WORK FOR WHICH TNIS PERMIT IS ISSUED. �
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W / 1 HAVE AND WILL MAINTAW WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION
Q 370o OF 7NE I/�BOR CODE.FOR THE PERFOFlAIANCE OF THE WORK FOR WNICH THIS PEFMIT IS
ISSUE�-MV R ERS,'��,,op_M�PENSAy�n INSII/a��y'CE CAFRIER AND POLICV NUMBERARE: CONSTRUCTION
� CARRIER �•� / ��v1 PLAN AEVIEW
0 POLICV NUMBER_I_��,�,Z.�z ELECTRIC
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Q (nlssEciaNNE�NOTeEOJA1PLErEoaFn�PEFiMfTISFORONErII.rDtiEo0dlAasls�rolORlEss} PLUMBING —
W MECHANICAL
Z I CERTIFV 7}UT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I
(J SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE INSPECTION FEE
� WORNERS'COMPENSATION LAWS OF CALIFORNIA,AND�aREE THAT IF I SHOULD BECOME
SUBJEGT TO THE VJOFKERS'COMPENSATION 7ROVISIONS OF SECTION 370o OF THE IABOR �J�� ��
? ISSUANCE '�
CADE.1 SHALL ORTHWI7H COMPLY WIT HOSE P VISIONS.
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p DATE: /L APPLICANT. . �
w ENERGY P/C
-� WARNINO:FAILURE TO SECURE W�RICEFS'COMPENSATION CAVE AOE IS UNLAWFUL,AND SHAIL BE
J SUO.IECT AN EMPLOYEF TO CRIMINAL PENALTIES AND CMI.FINES UP�O ONE NUNORED THOUSAND
� DOLLAFiS(5700,000).IN/�DDITION TO TNE COST OF CAMPENSATION.DAMAGES AS PROVI�ED FOR IN ENERGY PERMIT
J SECTION 3708 OF THE LABOH COOE,INTEREST,AND ATTOfU1El"S FEES. RETENTION FEE: .
�
w CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
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� I H[REBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDINO AGENCV
d FOF THE PERf-0RMANCE OF THE WOPK FOR WHICH THIS PERM171S ISSUED(SEC.7087,CIV.C.�.
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� LENDER'S NAME
� LENDER'SADDRE55 /^-
� I CERTIFV THAT I HAVE READ THIS APPLICATION A/JD STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES V//
w I AGREE TO COMPLV WITH ALL qTY/WD COUNTY�ORDINANCES AND STpTE UN5 REUTINO TO BUILDINO ` ��
� CONSTFUCTION,AND.HEREBV AUTNORIZE REPRESENTATIVES OF THIS COUNTY 70 ENTER U70N THE
ZA90VE�MENTIONED PROPEFlTV.�FOR�NSPEyTION PURPOS[5.••' �L� CQMMENTS �
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m PERMITT AME(PPI .. ` / J
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N SIONA OF PERMI " ' ATE qECPT.NO. PAIO BY VALlDAT10N
� WHITE-0epartment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GO E ROP–Flle Copy,GREEN—ApplicanYs Copy
CO�V O� DIA�/iO�D �AR
IWSC��C�'IOi� RECORD
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SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM ,
ROOF SHEATHING 8 Ff. BOND BEAM
FRAMINGNENTILATION FINAL BOND SEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING .
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FfNISH GRADING �
SHOWERlfUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAIUNG DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC � - � ' DEV. FEES PAID � � '
FINAL PLUMBING ENERGY
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COMMENTS
SEPTIC TANK SIZE
SEEP PiT/U SIZE
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