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HomeMy WebLinkAbout12-424 --- __ -- _ _ C��t�� CITY OF DIAMOND BAR Q 1 � �'2 -�--��'— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �.� Q 6 I 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ���^'� BUII.DING PERNIIT APPLICATION . FIRMLY � JOBSITE , � � � /L�W���d� � � . APPLICATIOAI _�-�I� NUMBER��~ �/C o ADDAESS rr DATE '�! � ISSUE � r�1 _ i -7 TYPE � OCC r APN LOT TRACT DATE `'f �0 �� CONST.� /k O GROUP p OWNER M �� 4 _ p ADDRESS � ^. ZONING SEBACKS � CITY NC i G ZIP CO TEL.C7I� FRONT RW ❑ APPLICANT TEI.�/j�''._�-I'� REAR ❑ SIDE/SIDE STREET RW D � CONTRACTOR � �1'�(/'' S{DE ❑ � ADDRESS .T '� � CITY ZIP _ TEL PROPOSED USE Q ¢�� ^ �� � � cn �� � w ARCH/ENG/ z DESIGNER NO.DWEL. NO. / 1 NO. e a ADDRESS UNITS � STORIES ___(___ BEDROOMS�, � CITY ZIP TEL. N DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION cn � OWNER-BUILDEfl D£CLARATION SFR/ADD/REM O p 1 HEREBY AFFlRM UNDER PEN/�I.TY OF P£H.lURY THAT I AM EXEMPT FROY THE CONTMCIOiiS Lf- Geraga/Cerport W CFJISE UW FOR THE FOILOWINO REASON(SEC.7N7.6 BUSINESSAND PROFESSION9 COOE ANY CfTV OR . (n U CpUNTVWFi1RiREWIRESAPEFtMITTOCON97NUCT,ALTER.WPROVE.OEMOLISH,ORREPAtRM1YST{iUG W PatlolDeck W 7Up£PRIOR TO�RS ISSUANCE,�1LS0 FEOU�RES THE APPLICANT FOR SUCH PERMIT TO Fl�E A SIONEO w � STATEMEM THAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CONTMCTOq9 11- � CENSE UW(CHADTER D{COMMENCINa WITN SECTION]000)OF DIVISION 7 OF THE BUSINESS NJD PR6 � PooUSpa ^ FESSqNSCOOE�ORiTiATHEORSHEISD(EMPTTHEREFROMANDTHEBASISFORTHEALLEOEDE%EA1P- � 710N.ANYVIOlAT10NOF5EC�lON703t68VANVAVPLIGNTFORAPERMI7SU&IECTSTHEAPPLICANT70 Z R9-ROOf � ACML 7£NKTI OF NOT MORE THAN FNE HUNDREO DOLLARS(l500).): - . . � ❑I,ASOWNEROFTHEPROPER7Y,oRMYEMPLOVEE9N7T1iWAGESAS'fHEIR50lECOMPENSATION, � CORIrtIBfCi81 - WILL DO THE WORK AND?HE STRUC7URE IS NOT INTENDED OR OFFERED fOR SAI.E(sEC.7ou,BUSE J NE55 AHD PROFESSIONS CODE 7HE CONTiUCTORS LICENSE UW DOES NOT MPLV TO AN OMMER OF � PROPERTYNR108UILD90RIYPROVESTYIEREOµ�7lOWIIODOESSUCHWORKHIMSELFORHERSELFOR m Q THROUQH HIS OR HER OWN EMROYEES,FRONOED THAT SUCH WPROVEM[NTS ARE NOT fNTENDED OR LU OFFEREDFOR^uALEIF.FqWEVERIMEBIALDWOORIMVROVEAIENTISuOIDWRHINDNEYEAROFCOMPIE 0 TION,TFIE-OWNER-BUILDER WILL MAVE TFIE BURDEN OF.PROVWO THAT HE OR�SHE DI�NOT BUILD OR - - Z IMPROVEFOPTHEVURPOSEOFSAIE} � _ ❑I,ASOWNEROFiHEPROPERTV,AMEXCLUSNELVCONTMCTWON7THUCENSEDOONTRACTOH3 - � � Q TO CONSTRUGT THE PRQIECT(SEC.7oN.BUSINESS ANO PROEESSlON3 CODE:THE�CONTMCTOR9 LI- V8IU0lI0fl ADJ.AREA� W CENSE UW DOES NO7 APPLV TOAN OWNER OF A VROPER7Y WND BUILAS OF IMPAOVES THEREON,AND . . � NR1000NTMCT5FOR8UC11VROJECTSWfTHACONTRACTOR�S�LICENSEDPUAbUMfT707HECONTfUP pUANT�TV DESCFIPTION FEE � � TORS LICENSE LAW.). �.J O .ZI-I AM E%EMPT UNDER 6EC. B.8 P.C.FOR THIS REASAN Q � U ¢ � DATE � ' I Z OWNER .V . � UCENSED CONTRACTORS DECLARATION J � � 1 NEREBY AFFINII UNDER PENALTV OF PERJUHV TFIAT IAM LICENSED UNDER PROVISION$OF CMAPTER � � a(COMMFNGNO N7iH SECTION 7oou)OF OIVI510N 7 OF TNE BUSINESS AND PROFE5510NS CODE,AND Z I.IY LICENSE IS M FULL FORCE AND EFF LLI m 0 UCENSE CLASS LIC.NO. �� � � � V DATE CONTRACTOR a . . . . LiJ � WORKERS'COMPENSATION DECLARATION � " � � � -� � � � U N 1 HEREBV AFFIRM UNOER PENAIri OF CERNHY ONE OF TFIE FOLIOWIN�DEClARA710N5: ' � ZQ � I HAVE�AND W1LL MAINTAIN A CEHfIFIGATE OF CONSEM TO SELF-WSURE FOH WORKERS' $ � COMPENSATION.h9 PROVIDED BY SECTION 37W OF TME LABOR CODE,FOR�FIE PERFORAIANCE W .. . . . pF 7}fE WORK FOR WHIGi THIS PERMIT F3 ISSUED. � � w _I HAVEAND WILL MAINTAW�WORI(ERS'COMPENSATION INSURANCE;AS REOUIRED BV SECTION � � � Q 37000F THE LABOR CODE,FOR'fHE PERFORMAIJGE�OF THE WOiil(FOR WHIp1 THIS PERMfT�5 ���� , . ISSUm.A1V WORKERS'COMPEHSATtOP71N5URANCE CMRIER-AND 70.t�'NUMBER ME CONSTRUCTION. jCARRIER PLANAEVIEW Z ��Y��A ELECTRIC ¢ o �navsEcr�n�r+oreEoon�r�oFn+Eaew�rswaor+er�mocu�as(s�m)a+� P,LUMBING Z {CERTIFY TNA7 W THE VERFORMAIJCE OF 71�E WONK FOR WFUpi TH19 PERAIIT IS ISSUED,1 MECHANICAL (,'} $11ALL NOT EMPLOv ANY PERSON IN ANY Ml�WJER 50AS TO BECOME SUBJECT TO THE � � WORKEAS'COMPENSATqNUW50FCALIFORNIA,ANDA0REE7HATIFISHOUlUBECAME INSPECTIONFEE SU&IECT TO THE VJORKERS'CdAPENSATION PROVISIONS OF SECTION a7o00F THE LABOR . s CODE,I SHAIL FORTHWITH COMPLY WITH TNOSE PROVISIDNS. ISSUANCE �- � SMIP p DATE: APPLICANL� . W ENERGY P/C � WARNIN6�FAIWREToSEWREWORKEFIS'COMPENSA7�ONCAVERAGEISUNUWFIIL,ANUSHALLBE � - - � � SU&IECT AN EMPLOVER TO CRIId�NAL VENAL71E5 AND qVIL FwES UP TO ONE HUNORED 7110USAND �ER�Y PERMIT D(7LV�R5(5100.000),W ADD7TONTOTHE C0.ST OF COMPENSATION,DAMA6E5 AS PAOVIDED PoR IN . � .. D 7L R � SEC710N]7oeOF7HELA80RCODE,INTEREST.ANDATfORNEY'SFfES. FIETENTION�FEE: , a CONSTRUCTION LENDING AGENCY PHE-ALT FEE: O � 1 HEREBY AGFlRM UNDEA�PENALTV OF PERIURY THAT THEAE IS ACONSTRUCTION LENDIHO AOEHCY � FOR THE PERFQ�ANCE OF THE wORK f-0F WHIC71 THIS VERAIR IS ISSUED(SEC.3oD7,dV.CJ. , � LENDEAS NAME / �!J!h� . . . . . . . . ' . F- LENDERSADDRE55 � � � �ICEATIFYTHATIHAVEREADTHI9APP�ICATqNANOSTATETHATTHEABOVEWfOiWATqNISCARRECL TOTA�FEES w I ACiREE TO COMPLV WIiH ALL CITV AND COIMiY ORDWANCEs AND STATE UWS RELATWO TO BUILDIN(i � CONSTRUCTION.AND HEREBV AUR10fU2E HEPHESENTATIYES OF THIS COUN�Y70 EHlERUPON 7NE ' � ZABOVE-MENTIONED VROPERTV FOR INSPECTION VURPOSES. COMMENTS ' 0 = r�-F h���h�. L4 a-- �. m PERM)TTEENMIE(7R1Ni) � �_/ � j o"_�Z Uj S OF PE E DATE � RECPT.NO. .—PAID 8Y VALIDATION WHITE—Depertment Copy,YELLOW—Flnance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN--AppUcanYs Copy CITY. OF Dl/�MOND BAR IfVSPECTiOR! RECOFiD , _ �,s�� ' � ':,n B � ' '� '�� , � �� , ,k , a� '' � � � � ' � , �� �, ",; _ ���. @ � , __ ��� ,_ ,._ .. �" _.. _ . ,�: , r ..N,� 5..Y' '-ry.. . . . . . ..... SET BACK I FLOORJOIST FTGS/FORMS/STEEL r-F—H—A REQMTS ELECTRIC GROUND UN� DER FLOOR DUCT GROUND PWMBING UNDER FLOOR CONDUlT SLAB GRADE FIREPLACE FOUtJDATION � TEfviP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ROOF SHEATHING 8 FT.BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ' ROUGH HEATING BEN�HING __ ROUGH ELECTRK j ROUGH GRADING ROUGN PLUMBING FIN�SH GRADING SHOWER/TUB TEST PpOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALI INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. �RYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTICTANK LANDSCAPE/IRRIG. SEEP PIT/L.L. . ON SITE IMPS. GAS AIRTEST FINAL ZONING FINAL CONST. FfRE DEPT.FINAL FINAL HEATING HEALTH DEPT".FIfVAL FINAL ELECTRIC DEV.fEES PAID FINAL PLUMBING ENERGY FINAL PLANING FINAL ENGINEERING • � p �«;. " COMMENTS E � SEPTlC TANK SIZE SEEP PIT/U SIZE ,:'4,' � �,;: .qy:r :i�,.iL �t�t .-.. � 'i�� � �g�. �G., �°' �� �. � �= ,1� _ �