Loading...
HomeMy WebLinkAbout17298 (19) �\ C1TY OF DIAMOND BAR EXPI RED � DEPARTMENT OF COMMUNi'IY&DEVELAPMENT SERVICES 21825 E.Copley Drive J U PJ 191� (909)860-3195 Fax(909)861•3117 PRESS `-•�' BU1LDIrG PERMIT APPLICATION FIRMLY o DDRESS ���� �.. �7'Y�_ /7/7iE� UI� DATECATf�N_ �,,_��` a� NUMB R/7�9� k/C "T � issue rvPE occ APN LOT ACT DATE CONST. GROUP p OWNER "" ADDRE S S � ZONING SETeACKS Z CITY ZIP E FRONT RW ❑ g APPLICANT TEL. REAR ❑ SIDE/SIDE STREET RW O � CONTRACTOR � �ry� SIDE p Q ADDRESS PROPOSED USE G� o CITY ZIP TE . � . , w ARCWENG! iz DESIGNER NO.DWEL. NO. NO. n. ADDRESS UNITS STORIES BEDROOMS = CITY ZIP TEL. N DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDEA DECLARAT�ON SFR/ADD/REM O p I HEREBY AFFlRM UNDER GENALTY OF VE0.NRV THAT I AM E%EMPT FROM THE COHiMCTORS L4 Garega�Carport J W CENSELAWiORTHEFOLLOWINOHEA50N15EC.7071.68U5WESSMl�PROFESSIqJSCODE:IM'GTYOR (n CJ COUNTYWHICIINEOUtRESADERMIT7OCON5TpUCT,ALTERMF1iOVE,D[MOLISM,ORREPAIRANYSTRUG W P0110/DOCk L TURE,PRIOR TO RS ISSUANCE.ALSO REWIRES TXE APGLIGNT FOR S�G11 GERMIT TO iILE A SICNED � STATEMENT TMAT HE OR SHE IS LICENSED PURSUANT TO TNE PROVISIONS OF THE CONTMCTOfiS l4 w � CENSE UW(CMAFTEli Y(COMMLNCIN6 YJITH SECTION 7000)OF DNISION�OF 7HE BUSINESS/JJO PRO� u' POOVSpO FESSIONSCOOE�ORh1ATMEORSHEISEXEMPTh1ER[FROMANUTHEBASISFORiHEALLECEDE%EM0. (� � TION.ANYVqLAT10NOF5EGTION70J1.6BYlWYAGVLICANTFOf1APERMITSUBJECTSTHEAVPLICANTTO Z R@•Rpp� A GYIL PEN�LiYOF NOT MORE TMAN fIVE YNNOHED DOUARS�f5a0).�: Z ❑I,ASOWNEROFTHEPROPERTY.ORGYEM7LDYEESWITHWAGESASTMEIRSOLECOMPENSATION, � COmmBfClal � WILL00 THE WORK AND THE STRUCTURE IS NOT INTENOED OR OFFERED FDR SALE(SEC.7W�,8U54 J HESS AND GROFESSIONS COOE:THE CONTMCTORS UCENSE UW pOES NOT AVPIV TO AN OWNEH Of N OROVERTYVMOBUILOSORIUPpOVESTHEREON,/JJONM1I0DOE55UdIWORKH�lASELFORNfRSELFOR = (L TNROUCHHISORHERONNEAIPLOVEES.DROVIDEDIHATSUCHIMPfiOVEIAENTSARENOTMEN�EDOR CD QOFFEREDFORSALEIF,HOWEVERTMEOUIIDW60qIMPROVEUENTI550lDVnTHiNONEVEAROFCOMVLE- Z TION,THE OwNER�BUILDER WILL HAVE TNE BURDEN OF PflOVW6 THAt ME OR SHE DID NOT BVILD OR � MPROVE FORTNE PURPOSE OF SALE�. ❑1,AS OWNEROF T/E PROPERiY,AM FJICLUSIVEIY CANTMCT WO Wlhl LICENSEU COMMCTORS � TO CONSTRUCT THE iROJECT(SEG 70N,BUSiNESS ANO PROFESSIONS CODE:T1E COMMCTOflS LI- vdIU821011 �— ADJ.AREA W CENSEUWDOESNOTAPPLVTOANON'NEROFAPROVEHT'YMOBUILDSORMPROVESTXEREON,AN� � VY11000NTRACTSFOHSUpiVR0.1ECiSWItHACONTRACTOR�S�UCENSEDFURSUANiTO7HECON7MG Ol1ANTITY DESCRIPTION FEE Y TORS LICENSE UW.). � O I AM E%EMPT UNOER SEC. B.6 O.C.FOR THIS REASON U � l� �-�.. DATE ONMER V Z W � UCENSED CONTRACTORS DECLARAT�ON w � IHEREBVAFFIRMUNDERPENALTVOFCE0.1UitYTHATIAIALICENSEDUNDEflPROY1510N50FCHAVTER � p„ Y(COM/AENCW�WITHSECTION�000)OFDIVISION�OFTNEBUSINESSANO�ROFESSIONSCOOE,AND Z X MV LICENSE IS IN FULL FORCE M1D EFFECT. t� LICENSE CUSS LIC.ND. C����� j V DATE I� '�� CONTRACTOR - "- a W � WORNERS'COMPENSATION DECLARATION a = U � 1 HEREBYAFFIRM UNOER PENALTV OF PERAIR`/ONE OF 7HE FOLLOWiNG OECLAMTqNS: `� a � �IHAVEMIDYALLMA�MAINACERTIFICATEOFCONSENTTOSEIF•INSUREFORWORNERS' _ COMPENSATION.ASPRONOEDBYSECTION77000FiHELtBORCODE.FOR7HEPERFORM,WCE W OF tHE WORN FOR NM1/lpl T/IS GERMIT IS ISSUE�. � G W _IMAVEANDWILL�IMTAINWORKERS'COMPENSATIONINSUMNCE,ASREWIREDBYSECTION /� I� Q ]7000FiHE UBOH COOE,FOR THE PERFORMANCE OF TME WORK FOR WHlpi TMIS PERMIT IS I-/� +� ISSUED.AIY WORKERS CAMPENSATqN INSURANCE CARRIER M1D POLICY NVIABER ARE: CONSTRUCTION �[T Q � CARRIER PLAN REVIEW� � va�crNur.+eea ELECTRIC � �nssEcna+rkmrareeoor.s�ooaneveatirrsroAor+e�ooa.wisK+oqar��ss7. PLUMBING Z ICER7IFVTHATPlTHEPERFORMANCEDFTMEWORKFORWNICHiHISPEHMITI5155UED,l MECHANICAL CJ SHALL NOT EAIDLOY ANY VERSON IN ANV MANNER SOAS TO BECOME SUBJECTTO THE —�/f ^ N WORKERS'COMPENSATIONUWSOiCALIFORNI0.ANDAGREETNATIFISFIDUIDBECAME INSPECTIONFEE 's-�"'� .'1 '�-�" �" S SUBJECTTOTNEWORI(ERS'CdAPENSATqNpPON510N50F5ECibN770DOFTHEUBOR _ "�.//'"`�.\ ! �. ' .._�_. eooe,�sw�u roar�rvnn�eoe�atir Hnni r�ase vAo�sia+s. ISSUANCE {� � //7��Q/ -- � � SMIP nnT r. j; �nn� .D Lp DATE:i�r f_ APPLICANT: . I V� 1 �. v J WARNINO:iAILU(iETOSECVREV/ORKERS'001APEN5 bNCOV RAGEISUNUWFUL,µ05HALLBE ENERGYP/C / � SUBJECTANEMPLOYERTOCRIMINALPENALTIESANDpVILFINESUPTOONENUNDREOTHOUSANO ENERGYPERMIT I L � DOLLAflS(f100.000),IN AD�ITIONTO TNE COSTOF COMPENSATION.ONdACES AS PRWWED FOF IN T � SEGTqN]70eOFTHEUBORCO�E,INTEREST,ANDATfORNEY4FEE5. RETEPITIONFEE: T�� �. ....,."_..._._:_. ._.__. .._ � d CONSTRUCT�ON LENDING AGENCY PRE•ALT FEE: O CC IHEREBVAFFIRMUNDERPENALT/OFPERNMTNATTHEREISACONSTRIKTIONLENOW�AGENCY �- FOR TM[PEi1FOR1AANCE OF THE WORK FOR WHICH 7NIS VERAUT IS ISSUED(SEC.bY1,CIV.C.). � Z W � LENDER'SNAME � LENOER'SADDRE55 � W ICE(1TIFYTHATIHAVEREADTNISAPVLICATIONANDSTATETIUTTMEABOVEINFORIAATqNISCORRECL TOTAL FEES /�? � d IACREETOCOMPLYN7THALLCffYANDCOUNTYORDiNANCES/JlDSTATELAWSRELATINGTOBUILD�Nfi � CONSTRUCTION.AND HEREBY AUh10RIZE R[PRESENTATIVES OF THIS COVNTY TO ENTER UPON THE ZABOYE�MENTIONED iROPERTY FOR INSVECTION PURPOSES. COMMENTS 0 J � �a PERMITTEENAME�vWNT) � y SIGNATURf OF PERAIITTEE �ATE T RECPT.ND. PAID BY • VAUDATION �- WHITE—Department Copy.YELLOW—Finance Copy.PINK—Assessa Copy,GOLOENRO�File Copy,GREEN—Applicant's Gopy .. _ ,.,.. _ . . _ . . . .. ..,. . _ . ... , , _. , .. . . � . .,� .:.. „� - - - .._ . . . _. _ . .,. ., . � .- .. �_� .X �.,,... . . . . ... . c���F c�r �i�,r��ar�� ��,c� �r,�s�cc:��or� ��cor�� il►°!-'�.a�?�'1n1ca►E Try,�i f�� Ii�F-`1 a':c,Cc�:d;_.._.------ IRS.�`i'��t�-C��';1►�1 r,��t�'� ,N��-���c��o'�_�� � _ _ . . _ .__. .___ __.----_�___.__. _____.. . ..__ _____�------_____._____�._.__.�_r__._ �._.._____�_J�__._____.__._._.. _.. -�--.- --- SET BACK � _, , � � FLOOR J�15T '' ( -- - - - - � FiGS/FORMS/STEEL ' ' FHA REQMTS ELECTRIC GROUN� j UNDER FLOOR DUCT , I • GROUND PLUMBI�JG I Uh1DER FLOOR CbP,IDUIT SLAB GRADE FIREPLAC� FOUfJDATiON TEMP POWER I FIREPLACE BOPJD BEAM WATER SERVICE I MID HT. BOND BEAP�1 ROOF SHEATHMG 0• � ��� 8 �T. B�IvD;BEA��1 —� --�.,�1 f!, FRAMINGNENTILIATION I ' FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING I ROUGH ELECTRIC ROUGH GRADING � ROUGN PLUFSBING FINISH GAADING � SHO�"JER,rI"U8 TEST 1 POOL ELECTRIC EXT. LATH/SIDING ; POOL FENCING WALL INSULATION POOL FINAL I CEILING IN�ULATION � OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FIPJAL ENG. SEPTIC TANK , LANDSCAPE/IRRIG. SEEP PITlL.L. � ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FIP4AL HEAT►NG � HEALTH DEPT. FIf�JAL F1NAL ELECTRIC j DEV. FEES PAID FINAL PLUMBING EPdERGY � I , T:f.yf'�:.�^:�'�Vlt'�r���.._.w_._____.i � COfJIMENTS , . SEPTIC TANK SIZE SEEP PIT/U SIZE �p__._.,__.._..� ,,p�,� ��I �� ,