HomeMy WebLinkAbout16578 CIIY OF DIAMOND BAR �
�v�,m �
�� DEPARTMENf OF CONIIvIUNTIY&.DEVELOPMENT SERVICES
I I
E. �Y` 21825 E.Copley Drive
(909)860-3195 Fa�c(909)861-3117 PRESS
��'-::� S LDIN P R1�iITAPPLICATION F LY
� JOBSITE ( _ PPLICATION� i� v PEflMIT P/C
o ADDRESS `D DATE �/ NUMBER q
ISSUE O CONST. GROUP
� APN ' LOT TRACT DATE
p OWNER � �
� ADDRESS ZONING SETBACKS '
z CITY ' ZIP TEL. FRONT RW ❑
� APPLICANT TEL. REAR ❑
� SIDE/SIDE STREET RW ❑
� CONTRACT '►t(i ( �} SIDE ' O
� ADD SS ' PROPOSED USE �
� CITY ZIP�,(� TEL��
w ARCH/ENG/ �
iz DESIGNER ' NO.DWEL. NO. NO.
n. ADDRESS UNITS STORIES BEDROOMS
� CRY ' ZIP TEL.
� DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION
p� I ONMER-B W LDER DECLARATION SFR/ADD/REM
O '
p 1 HEHEBY AFFIRM UNDEN PENALTY OF PERAIFY T1NT I/�u E%EMPT FROM THE CONTRACTORS ll• Gdrd99/C3fpOR
W CENSEUWFOqTHEFOLLW�fNGREA50N(SEC.70.71.SBUSiNESSANOPROFE5510NSCO0E:ANYpTYOR (n
U COUNTYWHICHREOUIRESAVERMITTOCONSTRUCLALTERIMPROVE,DEMOLISM.ORREPAIRANYS7RUC- W PdIi0/DOCk
Z TURE.PRIOR TO RS ISSUANCE,AL50 REOUIRES TME ADPLICAt.R fOR SUCH PERMIT TO FIIE A SIGNE�
� S7ATEMENT THAT HE OR SHE IS UCENSED OURSUANT TO TME OROVISIONS OF THE COMMCTONS W W
� CENSE UW(CH�PTER Y(C01.7MENCINd WITH SECTiON 7000)OF DIVISqN�OF TME BUSINESS AND VR0. � PooUSpa
FESSIONS COD�OR iHAT HE OR SHE IS EXEMPT THEREFROM IND THE BA515 FOR TME ILLLEGED ENEMP-
VT10N.ANYVIOlA710NOF5ECilON703i.5BYANYAPPLICANiFORACERMIT3UBJECTSTHEAPPLICANTTO Z Re�Rool
A CML iENALTY OFNOT MORE THAN FIVE NUNDREO DOLURS(5500),}
Z ❑L�OWNEROFTHEPROPERT'.ORMYEMPLOYEESWITHWAGESASTHEIFSOLECOMPENSATION, 0 CpmT9rCi01 -
WILL DO THE WORK/J10 THE STRUCTUFE IS NOT INTENDEO OP OFFEREO fOR SALE(5EC.70a1,BU51• J
NE55 M1O DROFESSIONS CA�E:THE CONTMCTORS IICENSE LAW OOES NOT AGPLY TO AN OVlNER OF
� CROPERTYWNOBUILOSORp.1�ROVESTHEREON.AYDriM1IODOESSUCHWORKHIMSEIFORHE0.5ELFOR �
� THROUCHHISORHEROWNEMPLOYEES,PRONOEDTNATSUCHWPROVEI.IENTSARENOTMENDEDOR m
QOFFEREDFORSKE.IF,fIOWEVERTNEBVILDiKQORIMPROVEMEMIS50LDWRHINONEYEAROFCAMRE-
Z TqN.THE OWNER�BUILDER VfILL FUVE THE BUROEN OF PROVIN6 THAT HE OR SHE OID NOT BVILD OR
� IMPROVEFORTNEPURP0.SEOFSALE).
O l�OWNEROF THE PROPEHTY,AM E%QUSIVEL�CAHTRACTINO NATM LICENSED CRYTRACTORS
Q TO CONSTRUCT TME PRO.IECT fSEC.7011,BUSINESS ANJ PROFESSIONS CODE:THE CONTRACTORS U� VelU8ti0f1 ADJ.AREA
W CENSEUWDOESNOTMPL�TOANOWNEROFAPROFEfl1YN'FIOBURDSORMPROVCSiHEREON,ANO
� N11000NTRACTSiORSUp/DR61ECT5WITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTiUG QUANTITV �ESCRIPTION FEE
Y TORS UCENSE UW.). 'i
¢ O 1 AA1 EXEMPT UNDEH SEC. B.1 7.C.FOR THiS RE/�SON Q �
� U �
� � �
DATE OWNER U ,
Z W
F¢ � UCENSED CONTRACTORS OECLARATION w
CL IHEREBY��FIRMUNDEFiPENALTVOFPERri1RYlNATIlu1LICENSE�UNDERPROV15�ON50FCHAPTER V. �
� Y(COMMENCINOWITHSECTqN7000)OFONISION�OF7HEBUS�NESSANOPROFES �ONSCOOE,AYD Z
MY LICENSE IS N FULL FORC AND FFECT, �
LLI
m
� �ICENSE S � � LIC.NO. � � �
� J
V DATE O� � COHTMCTOfi � a
W
� �,WORKERS'COMPENSA710N DECLARATION Q
� U
� IHEREBYAFFlRMUNDERPENALTYOFVERJURYON[OFTMEPoLIAWINGDECUM710N5:
� a M
� �I HhVE ANO WILL MAINTNN A CEFTIFICATE OF CONSEM TO SE�F�NSURE FOR VJORKERS' = A�
� COIAPENSATqN,115CROV�DEDBYSECTION77o00FTNEUt30RCO0E,FORTHEPERFppNANCE W
OF THE WORK fOH WHICH THIS FERMIT IS ISSUED. � � .,
w _I HAVE AND WILL MAINTAM WORKERS'COA,PENSATbN INSURANCE,AS RE�UIPED BY SECiION
Q ]7a00FTHEUBORCOOE,FORTHEOERFOFMANCEOFTHEWORKFORWHICHTNISPERMITIS
� 155UEO.MYWO�RKE�RS'JC�O�MPENSATIONINSURANCEYL�MR�ERMlDPOLiCYNUMBERME: CONSTRUCTION
CARRiER��tZl L� ��J�/ PLAN REVIEYJ
� POIICYNUMBER r���� ��I� ELECTRIC
� (fH53ECT10NNEEDNOTBEOG.PIMEDOFhfPEiM.'R6WRONEH�PF'��^LL/�RtOCJOqLESSI PLUMBING .
Z 1 CERTIFY TNAT N THE PERFORMANCE OF THE ORK FOR WHiCH TMIS PERMrt IS ISSUE�,1 MECHANICAL
(�7 SWLLLNOTEA7PLOVANVPERSONNANYMANN 150ASTOBELOMESUBJECTTO7HE �
� WORKERS'CdAPENSATIONLAW50FCALIFORNIR. DAGREEiHATIFISNOULDBECOME INS?ECTIONFEE
S SUBJECTTOTHEWORKERS'COMPENS�TIONDRD ^KKJSOFSECTION7000FTHELABOR -
��,��j�DE,ISHAl1.FORTNWITHCOMPLYWITHTMOSEi Yi510N5. � ISSUANCE
� yr^I /' SMIP
p DATE..��L{L.J._ APPLICANT.
w ENERGYP/C BY�
� WMNINC:FAILURETOSECUREVJORKERS'CAUPEh. iON UGEISUNUWFUL.ANDSHALLBE �-'�`�-'R-----�-�-
� SU6JECTANEMPLOYERTOLRIMINALPENAlTIESANDCIVI�FihESUPTOONEHUNDREDTHOU5AN0 ENERGYPERMIT
DOLIARS(f t00,ODa).IN ADDITION TO TH[COST OF CDIAPENSATIDN,DAMACES/S PROVIDEO FOR p!
� SECTION�70lOFTHE4100RGODE,INTEFEST,/J:DATTORNEY'SFEES. RETENTIONFEE:
d '�. CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� IHEREBVAFFIRMUNOERFENALTVOFPERNRVTHATTNEREISACONSTRUCi1dJLENDING►CENCY
FOR TME PERFORMANCE OF iHE WORI(FOR YMICH THIS PERMIT IS ISSUED(SEC.70�1,CIV.C.).
W � �
� LENDER5 NM�E
� lEN0ER5ADDRE55 ��
w1 CERTIFY TMAT I MAVE AEA�TMIS�OPUCA7pN ANO S7ATE RIAT 7ME ABOVE W�ORMATiON IS COFRECL TOTAL FEES ��• �
� 111GREETOCOMGL N1THALLCT/ANDOJl1NTYORDINANCE5AND5TATEUWSRCUTM6TOBUIIDINC
CONSTRUCTIIXJ.A�)NEREBYAUTHORIZEREPflESEMAiNE50FTHI5COUNTVTOENTERUPONTHE
ZABOYE�MEMIONE PRO[RTYFORINSPECTIONPURPOSES. COMMENTS
� � �4d�!
m
¢ VERMITTEE NAME( lIDlT) C.� �� ��] �(�
� � —v
� SiGNATUFEOFPERMITTEE DATE
� , RECPL NO. P141D BY . _VALIDATION
, WHITE—Oepartment Copy.YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—Appli nt's Copy
.. . .._-• ..::�ti.� ..+.�..• �,..;.....�.�..� �...+,.... ., .. �:. . .�• ��. , ...,z�� � -.�.+� . ., ". .. . ,.:T � .. _ r��.. r.� � ,' _ . . . .�
ci-��� UF DI/aPti�Of�D F�'-�F�
, IfLSPEC i lO(u� P.'�COf�D
_____ _____��'__�___._.� _______.____ ..�.._.._. _
� -- __ _ _ . _ -
I�r���-1�:�`'I!Cc.�1�1° ��''�f'=- 'I�'k-'�'I�c`"rf)P� I►�l+'1Ra c`��r�tc��ii6 D��t •_ II►� 'i'l�e`�'e
. _ C _� �., .__ ��
_____-_---_..._.�._____�.�_ _ ._._____. ._._.. _._._.__s._-- -.__. ..___.__�_._._-.—_- __---.--__�_- ----____________ _�_` _�.�________
5ET BACK -� ___�_ ' ' FL-OOR JOIST - i
FTGS/FORMS'STEEL �.—B--v) , FHA REQh�1TS" ' ' • I
ELECTRIC GROUND ? UNDER FLOOR DUCT'
GRQUND PLURABING G-1�—Jf U�dDER FLOOR CUI�IDUIT
SLAB GRADE ���LACE FOUNDATION �
TED�1P POWER FIREPLACE BOPdD BEAM �
WATER SERVICE MID HT. QOND BEAM
ROOF SHEATHING 8 Fi'. BOP�D BEAP�i
FRAMINGNENTILIATION FINAL BOh�D BEAM I
ROOF COVER PRE-GRADiNG
ROUGH HEATING BENCHING
ROUGH ELECTRIC I ROUGH GRADING
ROUGH PLUMBING yz��� FINISH GRADING
SHOWER/TUB TEST �� POOL ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
pRYWALL NAILING DEDICATIONS
SEb'UER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. OfJ SITE IMPS.
GAS AIR TEST ' FINAL ZONING
FINAL CONST. � - FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC . DEV. FEES PAID
FINAL PLUMBING ��p _ , ENERGY
�c��a._� _l b o� - —
T f�" �' i'�: f'i2(f, _. __ ,._. ---
COMMENTS
SEPTIC TANtK SIZE
SEEP PIT/U SIZE
i��l j
i
,
�'��f �=i
'I
�
�� I . .