HomeMy WebLinkAbout17794 �� CITY OF DIAMOND BAR
I i DEPARTMENT OF COivIIvIUNITY&DEVELOPMENT SERVICES
cy 21825 E.Copley Drive
(909)860.3195 Fax(909)661-3117 PRESS
��'�� BUILDINGPERMITAPPLICATION FIRMLY
� JOBSITE �1.'�J
o ADDRESS���� I�F� �� DATE CATION �,_����1 NUMBER I�� g'C ` �
V�
ISSUE TYPE OCC
-- APN L T 7RACT � DATE CONST. GROUP
p OWNER '
"' ADDRESS �7 ZONING SETBACKS
z CITYD IP TEL. � FRONT Ryy ❑
g APPLICANT - TEL. REAR p
�d SIDE/SIDE STREET RW O
� CONTRACTOR b�'-� � SIDE ❑
ADDRESS �
� CITY ZIP TEI. PROPOSED USE
o ARCHIENG/ . ,
� DESIGNER -� � NO.DWEL. NO. NO.
� CIDDRES ZIP T � UNITS STORIES BEDROOMS
�
cn DESCRIPTION �.Fi. FACTOR PSF ADJ.AREANALUATION
� OWNER-BUILDER pECLARATION SFR/ADD/REM •
�
p I HEREBV AFFIRM UNDER 7ENALN OF PERAIHY TMAT I MI E%E1AGT FRqA THE CONiMGTORS U• G2f3g2/C3lpOft
W CENSEUWFORiHEFOl1DWIN�REA50N(SEC.7a]7.681151NESSANOPROFESSIONSCOOE:ANVCRYOR (n
U WUNTyWHICHRfOUIRE5A0ERMITTOCONSTRUCT,ALTER��ROVEDEMOUSH,ORREPNRANYSTRUC- W PgIlO/DBCk
� TURE,VRIOR TO RS ISSUANCE ILL50 REOUIFES THE AFPLIGWT FOR SUCH PERMIi TO FILE A SIGNED W
S7A7EAIENT THAT HE OR SHE IS UCENSED PURSUANT TO 7HE PRO'n5iON5 OF TNE CONTMCiORS LI-
� CENSE UW(CIUVTER9(COMMENCWO WITX SECTION 70001 OF DIVISION 7 0F THE BUSINESS ANO VRO• � POOVSDa
� iES510NSCO0E)ORTHATHEORSHEISE%EA1PTiNEREFqDMANDTNEB�lS15FORiNEALLECEDEXEMP- (�
TKK7.ANYVIOUTIONOFSEGTION70]1.SBYMlYA7PLICANTFORA7ERMI75UBJECT57MEAPPLICMfTTO Z q�ppo�.
� ACML PENAL7V OF NOT YORE TNAN FNE NU�OREO DOLURS�f50D).��
� OI�OWNEROFTHEPROFERTY,ORAIYEMPLOYEESVATHWAGESASTHEIR30lECOMVEN5AT10N, 0 COmmBfCl01 �
Z W0.L DO iNE WOfil(,ANU THE STRUCTURE IS NOT INTENOED OR OFFEREO FOR SAIf(SEC 70u,BU51- J
� NESSAND PROFESSIONS COOE:THE CONTiLICTORS LICENSE IAW�OES NOT A7PLY TO�fl OWNEfl OF =
PROPEf1iYMTq BURDS OR IMPqOVES TMEREON,AND WMO OOES SUCH YVORK NIMSELF ORl7ERSELF OR
CC TTIROUGHNISOqHERONMEAICLOYEES,VRONOEDTHATSUClIIMPROVEAIEMSARENOTINTENDEDOR m
� OFFEREOiOR5ALEIF,NOWEVERTMEBUIDINOORMPHOVEMENTISSOIDWITMINOI:EYEAROFCOId%E�
Z TION,TME OwNER�BU�LDER WILL NAVE TNE BURDEN OF PROVw6 TU7 HE OR SNE D�D NOT BUiIA OR
� MPRWE FORTME PURPOSE OF SALEN
uJ �IIISOWNEROFTMEPROPEiiT1:AAlE%CLUSIVELYCONTMCTPl6 MLICENSEOCOMRACTORS
� TO CONSTRUCT TME PR0.IECT(SEG iW�,BUSINESS AND PROFE551 CODE:THE CONTMCTORS LI- VelU2tlon AQI.AREA
W CENSEUWDOESNOTAVPLYTOANONNEROFAPROPERTYWIqBUI ORIMPROVESTMEREON.AND
� N7qCANTMCTSFORSUCHVRO.IECTSWITHACONTMCTOR(S)LIC 5 PURSUANTTOTHECONTMF QUANTITY DESCRIPTION FEE
TORS UCENSE UW.). �/ ` `I ��T
Q OIAIAEXEMPTUNDERSEC. B.�P MiSREASON Q t'O`� : {l� .`(1 �`���� QI Q
� U
LL' DA7E ��t ONTIER � F¢-'
Z W ���
� LICENSE�CONT CTORS�ECLARATION W 6 �-
� IMEREBYAFFIRMUNOERPENALTYOFPERNRYTMATIAMLICENSEOUNOENFROVISIONSOFCHAFTEfl �
p. i(COMMENdH�WITH SECTION 7000)OF DNISiON 70FTNE BUSINESSAND PROFESSIONS COOE,AND Z
`X MY�ICENSE IS N FULL FORCE AND EFFECT, m ``
O � ta�
�, IICENSE CLASS LIC.NO. �
V DATE COMHACTOR d
W
� WORKERS'COMPENSATION DECLARATION a �
� IMEREBYAFFWMUNOERVEWLLiYOFPEfWRYONEOFTHEFOUAWINGDECUMTIONS: Z �
O _11UVEANDVAII►IAINTAINACERTIFIGTEOFCANSENTTOSELF�INSUREFORN/ORKERS' _
Q COMPENSATION,ASPROVDEDBYSECTiON3�o00FTMEUBORCODE,FORTHEPERFORMANCE W
Of TME WORK FOR WHICH TMIS DERMIi IS ISSUE�. �
W
�I IMVE AND VALL MAINTAM WORKERS'COIAPENSATKKJ INSUMNCE,AS REOUIRED BV SECTpN �
� �7aaOFT11ELA80RO0DEFOqTMEPERFORMANCEOFTMEWORKFORWHICHTH15PERMRIS
� ISSUED.GYWCflKERS'COMPENSATIONINSUflANCECARRIEflANOPOLICYNUTABERAiiE: CONSTRUCTION
�. CARRIER PLAN REVIEVY
� POLICYNUMBER ELEC7RIC O.l b
� (nissEciiowr�EvwieEmr.s�.ErmaFnE�isro�a�ru�mootu�s(sim�a��ss) PLUMBING �
Z ICEFTILVT/MTN1iHE7ERFORA/ANCEOFTMEWORKFORWFIICHTHI50EH1AITI515SUEO,1 MECHANICAL � V�
C'� SHALLNOTEMPLOYMlYOERSONM�M'MANNERSOASTOBECOMESU&IECTTOTHE /�'
� WORKERS'COMPENSATIONUWSOFGLIFORNIA,ANDAGREETHATIFISMIXILDBECOME INSPECTIONFEE (_
SUBIECT TO THE WORKERS CAMPENSATqN PROVISIONS OF SECTqN 77000F TNE IABOR (�
S COOE,ISHNIFORTHWITHCOMPLYWIMTHOSEPROVISIONS. ISSUANCE � �.t �,
� SMIP tJ �
p DATE: APPLICANT:
� ENERGY P/C �
WARNINO:FAILURE TO SECURE WOi1KER5'CAMPENSATqN COVEMGE IS UNUWFIII,AND SNAl1 BE
� SUBJ[CTMlEMPLOYEHTOdUMINALPEW�LTtESANDLMLFwESUPTOONEIWNORED7MOU5AND ENERGYPERMIT
DOlLAflS(i 700,000�.W/DDI7ION TO THE COST OF COMPENSATqN,DAM�GES AS PROViDED FOR IN
a6ECTION�7oBOFMELABORCODE,INTEREST,ANDATTOPNEY'SFEfS. RETENTIONFEE: �
� CONSTRUCTION LENDIN6 AGENCY PRE-ALT FEE:
O
� IHEREBYAFFIRMUNOEHPENALTYOFPERIUFYTMATiHEflEISACONSTRUCTIONLENOWfiAOENCY
Z FOR THE PERFORMANCE OF THE WOR1(iOR WHICH iH15 PERMIT IS ISSUED(SEG.30D7,CIV.C�.
W
� LENOER'S NAME
� �ENDER'SADOftE55 �[
� ICERTIFYTMATIHAVEqEADTHI5A0PLIC�TIONANOSTATETH�TTHEABOVEWFOH/AATIONISCO(iqECT. TOTAL FEES (�J 1 �
� IAQflEETOCOMVLYN7TH�LLCfiYAN�COUNTYORDWANCE5AND5TATElAwSREUTINOTOBVILOtNG J
CONSTRUCTION.AND HERE9YAUTHORIZE REPRESENTATIVES OF iH15 GOUNTY i0 ENTEfl UPON 7HE �j�b
Z IIBOVE-MEMqNE PROPERTY iORINSPECTION PVRPO�SES. COMMENTS v—�
� J/�j �•
r1}�
m vEwM�r �vwr�r� ' r
N � ! -" Za L
N SiON REOF � EE TE
� RECPT.NO. ��� PAID BY Y VAUDATION
WHITE—Department Copy.YELLOW—Finance Copy.PINK—Assessor Capy,GOLDENROO—File Copy,GREEN—ApD�icant's Capy
._, _ �. . _ _. . . - - - .,
, ��i� oF �i,��r�rt�ttio �e�-r-�
ir�s���:iQa�� �E_c�;�a�
__...�..._.,.___ . ._� � � r__ r .._ ....._.�,_._..�._
..� __.._ _
�i�1���i'�.'_tf.�����Ir� P/��:l:= '1:��`�.� .'-"� '����.�. 1l�,f•�t:;�f. ii���l��. C���w'�=` ��1���•'.�:4e"�.Q�!k �
._._. _,..._-_-_, ____:.__.. _.._.__ .. ____...____ . . , .. ._..�. .. ..__._ _.---_.__ .._.._. .. _...,.._ __��..'�__.._,___ _..__'�..._..,..__.__.---
SET BACY. � ; j FLOOR J�IST .
-,-_-,,,--/-' - --._ _�1 .�-----�. _ � �—
FTGSIFORh15.'STEE��Z/�i� • � �NA REQP�ITS ; I _
ELECTRIC GROUND � �__ _' ', UfJDER �LOOR DUvT �r__ i
GR�UND PLUMBING i UPdDER FLOOR CUC�!D'JIT I I
��--- -- — -- -----
SLAB GRADE ___�_ FIHFPLACEFOUNDATION �
TEMP POWER � FIREPLACc BOND BEAM �
-,----
WATER SERVICE � I_ P�IID HT. �OND BEAP,1
ROdF SHEATHING ___�_! 8 FT�. BOND BEAM � '
FRAMINGNENTILIATION I�� 6'L� . � FINAL EOND EiEAM � i
ROOF COVER I � PRE-GRADING I
R�UGH HEATING _� � BE��cHir�G� I
ROUGH ELECTRlC $��(c�/E� ROUGH GRADING �
ROUGH PLUMBRJG � ( ' � FINISH uRADING
� SHOWER/TUB TEST ! �^ �_ _POOL ELECTRIC
� EXT. LATH/SIDING I I I POOL ENCING �
' WALL INSULATION �` --�� "�INAL �
CEIUNG IN�UL.f�TION i -,� � OFF SITE IR�PS.
DRYV'JALL NAILING � �f�� � �/�f- aEDICATIONS �
. ��.. �
SEWER �� �� � FINA!EfJG.
SEPTIC TANK �-� LANDSCAPE/IRRIG.
SEEP PIT/L.L. � �_—�- ON SITE IMPS.
GAS AIR TEST � I �F''IAL ZOP�ING
FINAL CONST. �i r!RE DEPT. FINA!
FIP•!AL HEATiNG .D ; ' HEAI.TH DEPT. FINAL
FIFJAL ELECTRIC �_`l.` DEV. FEES PAID
FINAL PLUMBING ', � � ENEP,GY
I '
-�--,..,......�.�..n.--�...-�-
i _____...._ s:l:_ r��r �._._ , ___. _.— . ._ ._ _.__
. . . . i . � . . ..
,. . . . _ _-_ _. i_ .. _. _ ._ . . . . _ . ._ .
connM�r�Ts
; SEPTIC TANK SIZE
�, SEEP PITN SIZE
� 4���
'���� I•e
� ,
�� . ,