HomeMy WebLinkAbout12-543 ^ _��_ CITY OF DIAMOND BAR �
DEPARTMENT OF COMMUNI'I'I'&DEVELOPMENT SERVICES
I 21810 Copley Drive,Diamond Bar,CA 91765 �
(909)839-7020 Fax(909)861-3117 Building Inspection Notline(909)839-7027 E$$
�''"'. BUILDING PERMIT APPLICATION FIRMLY
o� JOBSITE : �� �� / APPLICATIONL, � � � PERMIT � 3 p/C
ADDRESS 0 DATE �J NUMBER #
� APN LOT TRA T� ISSUE � 1 7yPE �C
DATE � � / 1� CONST. GROUP
p OWNE�A�'N'��1 �1
�` ADDRESS__. M`IML ZONING SETBACKS
0
z CITY ZIP TEL.<'1 irt a_.G� FRONT qyy �
� APPLICANT r TEL.= REAR 0
�� SIDE/SIDE STREET qyy p
CONTRACTOR SIDE �
ADDRES
O CRy L 7 PROPOSED USE
w ARCWE / u
z DESIGNER ^K� Q �A `�� NO.DWEL. NO.
a ADDRESS � NO.
� CITY Z�p �L UNITS STORIES BEDROOMS
�
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� �OWNEA-BUILDER DECIAAATION .
O SFR/ADD/REM
Q I HEA�V AFFlRM UlIDEA PEIULiY OF 7ERAIRV THAT t AN D(EAIPT FRpM THE OONTRACTORS L4 G9fe B/C8
W CENSEUWFORhiEFOILOWINOREASON(SEC.7031.68USMESSANDFqOFESSION50D0E:ANY�CT'OR � -9 �rt
C� COUldTYM�MICMREOUIRESAPERMITTOCON37AUCT,ALTER,IMPROVE,DEAqL15H2ORREVAIRANYSTRUG W Patlo/Deck
�� TURE.FRIOR TO�RS ISSUANCE,A�$p q[-OUjpES THE MPLICANT FOR 6UCH PERMIT TO FILE A SIONED w
� STA7EMENT THAT HE OR SHE IS LICENSED VURSUANT TO 7}IE PqOVISWNS OF 7HE COMMCTORS U-
� CEN9E UW(CHAV7ER Y(COMMENCINO VA7H SECTION 7000)OF ply�gqN 9 OF THE BUSME59 AND�PRO� � POOUSp3
_ � FESSqN5CO0E�OR7HATHEOH5HEISEXEMP77MEREFRO/AAND7HEBA515FORTHEALLEOEDEI(EA1P- (!j
V T�ON.ANVVIOlAT10NOFSECTION7Wt.68YANYMPLIGNTFORAPERMITSUaIECTSTHEAGPLICANiTO Z� RaRoot -
� ACML PEN�LiY OF FJpT MORE THAN.FNE HUNDRED DOLLAHS(1600).): .
� ❑6ASOWNEROFTHEPROPERTV,ORMYEMPLOYEESWITHIVA(iESASTHEIR50LECOMPENSATION, Q COrt1rt1BlC181
Z YALL DO THE V/ORI(AND THE BTRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BU51- J '
� NFSS AND PROFESSIONS CODE THE COPlTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNEH OF � �� .
FROPEpTY W/ip BUILAS OR IMVROVES THEREON,M1D WHO OOES SUCi1 WpRK HIMSELF OR HERSELF OR �
w TiWOlN3/1H1501iHEROWNEM�LOVEE3,PROVIDED7HATSUCHI►IPROVEMF1iT3ARENOTufTENDEDOR m �
0 OFFERmFORSALEIF,HOWEVER7/iEBUIIDWaORIMPROVEMENTI35pLpW/THWqdEYEAHOFCOAIPI'.E-
Z T/ON..THE�OWNER-BUILDER N711 HAVE T11E BURpEN OF PROVINO 7HA7�HE OR SHE DID NOT BUILD OR
= PIPROVE fOR THE PURP0.5E OF SALE). � . . . .
W �4�OWNEROFTHEPROPEHfV,AME7(q.USNEIYCONTRACTP1U5MfTHLICEN5EpC01�17qA�TORS
Q TO CONSTRUCi�THE 7ROJECT(SEC.70N.BUSINE55 M1D PROFESSIONS COpE:TiE.CONTRACTOR3 LI- VBIu8tI0f1 ADJ.AREA� . .
� CENSE UW DOE9 NOTMPLY TOAN OWNER OFA VROPERTV WFID BUp.D9 Oq IMPiiOVES THEREON,AND �
WF�DCONTMCT6FORBUCHPR0.1ECfSWIT1ACONTMC?OR�S)UCENSEDPURSUANTTOTHECOHTpAF QUANTITY DESCRIPTION �E .
� TORSl10EN3ELAWJ.
� ❑I AM E7(EMVT UNDER 6EC. B.8 P.C.FOR THIS REASON
� U
� DA7E � OWNER - ��
U
� LICENSED CONTRACTORS DECLARATION W � � � - -
� I HEREBV AfflRM UNDER PEIULTY OF PEiUURV THAT IAM�LICENSED UNDEH PROVISION9 OF GIAPTER � �
� Y(COMMENCuq WIiH SECTION 7000)OF DIVISION]OF THE BUSINESS AND PROFESSqNS OODE,ANU Z
��� W L�CENSE IS IN FULL FORCE D EFFECT. �
Z m
� IJCENSE CLASS�� LIC.NO., �
U~ � I /�-Wie ,j
�TE . CONiRACTOR a . .. .
u�
� „ WORKEAS'COMPENSATION DEC ION � � - -� - �
� 1 HEREBYAFFIRAI UNDER PENAL7V OF PERJUHY ONE OF 7HE (3 DEClARA710NS: U
(� Z
� _I HAVE AND.WILL 1,WNTAIN A CERTIFlCA7E OF CONSENf TO SELF-INSURE FOR WORKEqS•,�, � -
COMPENSATION,A9 PROVIpEp BV SECTION 37a00F THE LABOR COOE,FOq THE PERFORMANCE U'
OF THE WORK FOR WHKxi THIS PERMR IS ISSUED. � � � g
�
I HAVE AND WILL 1.WNTAIN WOR1(ERS'COMPEryBATqN INSURANCE,qg qEWIRED BY SECTIDN
Q 37000F THE UBOR CODE,FOR THE PERFORMMICE�OF THE WOPo(FOR WHlp/THIS PERMIT IS.
�eo.nrv woaxeas cae6�s�rroN iNsuriwce oiawEa�wn voucv ra►�e�,w6: CONSTRIICTION. .
� CAAPoER PLANAEVIEW
�Z a�cvr�u�ER ELECTRIC
¢
W (IHIssEcila�NE�wiBECOAPlE7IDaFnEPEwRiSWRa+El1�X�Di�Dav�Ff+OqoFLE3s} PLUMBING � . . . ;S'q .��`
Z I CERTIFV THAT W THE PERFORMANCE OF TiE WOfU(fOR WHIq1 iHl9 PERMIT IS ISSUED,I MECFIANICAL
CS SHALL NOT EMPLOY M1Y PERSON W ANV IAANNER 50 A9 TO BECOh1E SUBJECT 70 THE � �
Cn WORKERS'COMPENSATqN UWS Of CALIFORNIA�ND AGREE TUT IF I SHOULp BECOME INSPECTION FEE
S SUBIECT TO THE WOfiKERS COId7ENSATION PROVI51 S OF SECTION J7o00F THE UBOR � 1 I�
CODE.I SHALL FORTMYI7H Cph1pLV Wlhl THOSE P ONS. ISSUANCE
�
p DATE�T� APPLICANE .SMIP . . . .
w ENERGY P/C
� WARNIN(iFA1LURE70SECUREWORKEHS'COMFEN COVERAGEISUNLAWFUI,/iNp.SHALLBE
�y SUBJECTANEMPLOYER70CqIMW�1PENALTIES' MLFWESUPTOONEHUNDREDTFqUSANO ENERGYPERMIT
D�LLMS.(Stao,DDo),�WMDI710NTOTHECOS70 MPENSATION,DAMAOESASPROVIDEDFORIN
� 6ECipN 370e OF 7HE LABOR CODE,INTEREST. ATfORNEY'3 FEES. ' RETENTION FEE: a �1
� QONSTRUCTION LENDING AGENCY PRE-ALT FEE �
� 1 HEREBYAFFlRM UNDER'PENALTV OF PERIUHV THAT THEAE�IS A CONSTRUCTION I.ENDINO AOENCV
�Z� �FOR TNE PERFORMANCE OF THE WOR1C fOR WHIGI7H15 PERMIT 1915SUED�SEC:�3ov7,qV.C,�.
W
��. LENDERSNAME , . . .
� LENDER'S�WDRE53 '
W �ICEfZTIFY71ihTIHAVEq DTHt9APPl,ICATIONM1pgTATETHATTHEABOVEINFORIAATIpJ19CORRECT. TOTAL FEES ��. 1'T'
� I A6REE TO COMPLY CT'AND COUNTV ORDINANCES AND STATE UWS REUTBKi TO BURDWO
� CONSTRUCfION, BY AUTHORIZE REPRESENTATNES OF T1nS COUNTV 70 ENiEH UPON THE �
Z ABOVE- D ERTY FOR INSPECTION FURPOSES
p COMMENTS '
J
�
m p�' E(P �
!A /
� -SKiNATUREOFPERMfTT E DAT �
� � RECPT•NO• � PAID BY � VALIDATION
� W►11TE—Department Capy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN--ApplfcanCg Copy � � � - ' �
CITY OF D1�4MOfVD BAR
lI�SPECTIOP� Q�ECORD
b. .�
�� .,�� � .xr B ' .�b �, o � � �" , ",'' 8 � +...: p' �� �-�. � :�;
L br�` a
SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND lJNDER FLOOR DUCT
GR�UND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID NT.BOND BEAPl1 •
ROOF SHEATHIfVG 8 FT.&OND 3EAM
FRAMING/VENTILATION �FIfdAL BONQ BEAM
ROOF COVER PRE-GRAOING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ' f Ri7UGH GRADING
ROUGHPlUM61NG " fL.; � FINISHGRADING
SHOWER�fUBTEST i i POOLELECTRlC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANOSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAI CaNST. FIRE DEPT,FINAL
FINAL HEATING HEALTH DEPT.FlNAL
FfNAL ELECTRIC DEV.FEES PAID
FINAL PLUMBING ENERGY
FINAL PLANWG •
FINALENGINEERING • � `p a�x �
�OMMENTS
SEPTICTANK SIZE
SEEP PIT/U SIZE
,�
.}
z
+ —
� y �.;� -
h 3
7� 'y�� ��yy� .
i-�'Anf�( ��Y'
�i.
ry'�/��. ��r�k�Sr,.��,i .
�t.'.�.:�t!:,Tat4es��' .
�-�
�.