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HomeMy WebLinkAbout11164 (5) .� ....._..,�.-...�.�_ . - ., . _. _- - �:q:,�-,.,.�r- ....- CTTY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT .;,,,w 21660 E.Copley Drive Suite 190 PRESS (909)860.3195 Fax(909��61=�%i17' . �'""" BUILDING PERMIT APPLICATION FI R M LY � JOBSITE r �c`��,.� ��;: APPLICATION �.,,�`� '� PERMIT C o ADDRESS ��-��� � 1-77l� DATE r'�x�� NUMBER # c� ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER Diamond Bar T�is Club H.O.A. ADDRESS C O CC%t1pYPh2riSiV2 PYOp. NI�t. .�.BOX 400 ZONING SETBACKS Z CITY ���y ZIP �� TEL�909) 598-3180 FRONT RW ❑ APPUCANT S �jp� TEL. fA(1A1 SA7_77'�4 REAR ❑' o '��-' ,,;.,,.:. SIDE/SIDE STREET RW ❑ � CONTRACTOR �j'�-� ���nQr �C• SIDE ❑ p� ADDRESS 15189 Sierra Bonita Iane 0 ��7y Chl.flO z�p 91710 TEL. �909) 597-7734 PROPOSED USE w ARCH/ENG! — iz DESIGNER ri/d NO.DWEL. NO. NO. n. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION OOWNER-BI:ILDER DECLARATION SFFVADDlREM p I HEREBY AFFIRM UNOER PENALTV OF PERJURY THAT I AM E%EMPT FROM THE CONTRACTOHS LI- � Garage/Carport W CENSELAWFORTHEFOLLOWINGREASONfSEC.7o31.5BU51NES5ANDPROFES310NSCODE:AN1'CITYOR U COUNTYWHICHREQUIqE5A7ERMITTOCONS7RUCT,AL7ER,IM7F0VE,DEMOLISH,ORREPAIRANY57AUC- �W PatiolDeck WTURE,PRIOH Tb ITS ISSUANCE,ALSO RC-0UIRES hiE APPUCAN7 FOR SUCH PERMIT TO FILE A SIGNED _ � ORS LI- STATEMENT THAT HE OR SHE IS U@EN$ED PURSUANT TO THE PROVISIONS OP THE CANTRACT � CENSE LAW(CHAPTER 9(CORIMENCING WITH SECTION 7000)OF DNISbN 3 Of THE'BU5INESS AND'Pi16- LL' POOVSp2 fES510NSCODE)OR7HATHEORSHEISEJCEMPTTHEREFROMANDTNEBASISFORTNEALLE6EDEXEMP- (� TION.ANYVIOLA710NOFSECTION7031.SBYANYAPPLICANTFORAPEHMITSU&IECTSTHEApPLICi1N7T0 � Re-Roof � A qVll PENAI.TY OF NOT MORE THAN FIVE Hl1NDRED DOlLARS(5500).): � --�-` '- ��" � ❑I,A5014NEROFTHEPROPEflN,ORMVEMPLOYEESWITHWAGE5A5THEIR50LECOMPENSATION, O COf11f110fCIflI Z WIIL DO THE WORK,AND THE STRUC7URE IS NOT IN7ENDE�OR OFFERED FOR SALE(SEC.7044,BUSI- J � NESS AND PROFESSIONS CADE:THE CONTRACTOHS UCENSE LAW OOES NOT APPLY TO AN OWNER OF = PROPERTV WHO BUILDS OR IMPROVES THEREON,ANO WHOOOES SUCH WORK HIMSELF OR HEF(SEIFOR � THROUGHHI50RHEROWNEMPLOVEES,PROVIDEOTHA7SUbHIMPROVEMEN7SARENOTINTENDEDOR � m 0 OFFFAE�FORSALE.IF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLAWITHINONEYEAROFCOMPLE- z TION,THE OWNER•BUILAER WILL HAVE THE BUPDEN OF PROVINO THAT HE QR SHE DID NOT BUILD OR _ �MPROVE FOR THE PURPOSE OF SALE). � O I,AS OWNER OF THE Pf10PERTV,AM E%CLUSNELY CONTRAC7ING WI7M LICENSED CONTRACTORS � TO CONSTRUCT THE PROJECT(SEC.)044,9USINESS AND PROFESSIONS CODE:THE CANTRACTORS U- V21118t1011 ADJ.AREA LL! CENSE LAW DOES NOT APPLYTOAN ONRJER OFA PROPERTY WND BUILDS OR IMPROVES THEREON.AND � WHOCONTRACTSFORSUCHVROJECTSWITNACONTRACTOA(S)LICENSEDPURSUANTTOTNECONTRAG QUANTITY DESCRIP710N � � - -� FEE TORS LICENSE IAW.�. o -' 1 E1ect.rical Pedestal � �I AM EXEMPT UNDER SEG B.8 P.C.FOR THIS REASON Q � � LL DATE ONMER _ F"' Z W � LICENSED CON7RACTORS DECLARATION � W � I HEREBY AFFIRM UNOER PENAL'T1'OF PEHJVRY THAT I AM LICENSED UNDER PROVISIONS OF CHAP7ER � d 9(COMMENCINGWITHSECTION700D��DIYISION�OFTHEBUSINESSAN�PROFESSIONSCADE,AND Z �X MY 4iCENSE IS IN FULL FORCE AN�EFFEC7, m 0 UGENSECLASS C10 uc.No. 729����"- � H J U DATE GONTRAC70R �� �- W I,J��. � WORKERS'COMPENSATION DECLARATION a _ ,�� � � 1 HEREBV AFFlRM UNOER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: `—" a O _1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSEN770 SELF�INSURE FOR WOPKERS' S COFAPENSATION,AS PqOVIDED BV SECTION 370o OF THE LABOR COOE,FOR THE PEFFORMANCE U a OF THE WORK FOR WHICH THIS PERlAIT IS ISSUED. � 0 w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQLIIRED BY SEClION Q 37D0 OF THE LABOR CODE.FOR THE PERf-0RMANCE OF THE WORN FOF WHICH THIS PERMIT IS � ISSUE'q.MY WORNERg'r�o�IPENSATIOJ�J INSUF�ANCE CARRIEP AN�POUCV NUA78ER ARE: CONSTRUCTION , a R2pL1l�11C IriUQT1CLl'ty Of �iTl. �J,-�''1•� p�pN REVIEW � > CARFIER Z POLICYNUMBER ��42��—n� � (�`��(," ✓ � Q Q (TNISSEC710NNE�NOTBECOMPLETEDOFTHEPEPMfTlSFOFONEHINJDREDWLLAfiS(5100)OR�ESS�. PIUMBING W Z I CERTIFVTHAT INTHE PERFORMANCE OFTHE W4RK FOR WHICH 7HIS PEflMIT IS ISSt1ED,I MECHANICA� C.S' SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 TO 8 COME SUBJECTTO THE � WORNERS'COMPENSATIONLAWSOFCALIFOflIJIA, AGR THATIFISHOULDBECOME INSPECTIONFEE � = SUBJECT TO THE WORKERS'CAMPENSATI N P IONS EC710N 370 F THE LABOH t CADE,ISHALIFOPTFIVJITHCOMPLYWITH PROVIS N. ISSUANCE � SMIP p DATE: '- Z'~ APPLICANT: .. � W ENERGY P/C �, ..� r,� , + J WARNING�FAILt1RE 70 SECl1RE WORKERS'COMPENSATIDN ERAGE IS UNLAWFUL,AN�SHALL BE � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANOGVIL ESUPTOONEHUNDRE�THOUSAN� ENEFGYPERMIT OOU.ARS(Stoo.000).IN AODITION TO THE COSTOF COMPENSATION,DAMAGES AS PROVIpEO FOR IN J SECTION37o80F7MELABORCODE,INtEREST,ANOATTORNEY'SFEES. RETENTIONFEE: � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBY AFFIfiM UNOER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AGENCV � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.�.� Z W � LENDER'3 NAME , �" ' ' F- LENDER'SADORESS ____. � I CER71fY THAT�HAVE REI1D THISAPPLICATION AN�STATE TMAT THEABOVE INFOFlMATION IS CORRECi. T�TAL FEES �/� W I AGREE TO COMPLV WITiI ALl C�TY PNO COUNTYORDINANCES AND STATE'LAWS REIATING TO BUILOING �1[O i � CONSTFUCTION.ArDHEREBYAUTHOR2EREPRESEMATIVE50F7HI5COUNTYTOENTERUPON7HE � � A80VE-MENiKKJ PROPERTV FOR INSPECTION PURPOSES. COMMENTS �' �a�+�, ,.+ ,.;�:� ili.�- � � 0 i,r' J i�li : QPER NAMEI�a ZI ! � ... 'f` : ii ��.... � � S�ONA RE F I E . . . DATE - . . ' �i�� , g� � = RECPT.NO. PAID BY VAL��ATIbN ~ WHITE—DepaRment Copy,YELLOW—Finance Copy,PINK—Assessor Copg GOLDENROD--File Copy,GREEN—Applicanfs Copy b,: ,_ ,... .�:., �. ,.. r>> .:,.. . � ,,,,, , ,. .:,,�, ,„,: � ;.�n,� .�, s...�:.. „� . �. >t ,,, _ C��"�°.l�F Di1��lll�OVD �/�R' ,: ��.: .".��2�� ,, . ' � 6IrIS��C'Tl�i�i R���F�D �:,�, ': .. �' ' n� h�« . w� � � . . 1 • � � o. .. ..� � ', l n � s . . ._ .. _...._. _,._. . .. .. . ..,..... _ :_,,:: ._..... ._ SET�d�CK ' � .. , i F�OOR�OiST W � ___ FTG s/FOF�MSI�TEEL. " _ � '; FHA FiEQMTS _ �LECTRIG GRC3l1fVD � ; IJNGER FLDOR DUCT ._ _ , ,_, GR�UND E'L�J�ABlt�dG ' �� I UN�ER FLOOR CO�iDUtl` � - �- �� � SL�1�t�RADE -. � .. ` r � ! F�REPL�ICE FOUNDATION. -'` ',; _�.___ �'EMP PO�i�R _ . - � - ' , Fi�iEPLACE BONC7 BEAM — --- -- ._ , VifA7ER SERVICE _ . _ _. � . NilD HT. BCJIVD E3ERM ' Fi(SC�F S�iEA7iiif�C _ 8 F't. BOt�G BEAA/i � ', .,:`, ,, a s=; FRAMfi�Ca/tlENT14�EATI�N `'';, _ ' '�I�{P,L BC3i�1L>3ERM ' : -- — - �:� Rt7O�C�VER ..__ ._. - ____ . . PRE-£�RAblNG . - �. R :: .;, . --. �.--------- _ . _. _ __ ....� �OU�F!#•l�A�TING ' ' _ .-; �.:.~''" ; : �E(VCHIfV� . _ _.._ _ ..._ � _____ ___ __._.�:a,__ RO@JUi-��LEC�Rl� __ _ �--';__. i :., ` ROUG�-i GFiAbING , :., _ ROUGN Pi�UM�I�iG �,. ___ _..�._ ``Y,,' � FINlSH GFt,�C1lNG. ,, ;, � ! _._.� .___�_ .' , . �!-lC3V�lERCi"UB TES7 = __._ �,_.._ �. ___ __ PQC7L Et�ECTRIC , � " . . ___._v� .____ _ .___ �_ . � , � - ,, ::� r : �XT. LA�`FEf�fI7i�IG _. `�( j POt�L F�NCING � _--_ — : �V�9�L IfVS�LA,T10fV � _ . __; . �OOL:FIt�AL t _.. . . . . .. . "r.. � . , ( ; CE6LING I�SU�AT'If3N C3FF SITE IM!'S, � ': []RYW�LL l�fAlLI9�G D�DiGATlC1NS _ �.__�__ _ __, SE'JVER — � i `: FII�liL E':1iG.. ,:. . ; ; _ ____ ---- __�__ SE('7IC TAi�!( ------ — ` , ' .,_�...', ' LANDSC6aPE'/l�tRlia. SEEP PII�lL.t. ' `', `-.. ' : C1N,51TE i��tPS. � -_.. � � � CatSS AIR'TEST '. _ � �'INfol,ZC�NING , . _ ._._-- ---_—_� �I�AL C{JtVSi: __ _ � �IRE DE�I' FIlVAL — � ' �BNAI.HE�ITING " _ __._._ . I HEAsTN DEPT. FINAI.,��;., _. _�.. , ._. _ ___ __�______��._____ •r`= , `��� , �INALELECTR�C 4/��1�iJ �l�J°�'_____ � � DEV. FEES PAiD � ; ,_,, 4 '_. � ..... .. _`�_ .�.�_._.,.� �IIUAL 3?LUi4tIB1N(a.. .. j j j EIV�RGY , . :' .. '�- ' ,.. � -----_ �-.-__�� _._..� __ . .. .. _ . ._..__. � , i ,,,, . � _ • ,.. :.� �s ..;;� ; � _ __ _. _.. _ , -- , � � � , � ____. � _ . .... ,.: � ... _ ._. _ _ ;. . , .: , . . , " CC�MIVIEhiT� ' . ,. ,. , z:�-: •s>: -,: I :,. , -- .� , ,. , , , _ __ .. . __. _ _ _ — ; � w,:,�� . ; . <: . - . ;;.: ;, ; __ _ _ ._ - . - : , �- . � � , ,. :, _...,,� _ ,.. .. ,.: ;. ,. t , ; . , , : . , . � .. _ . . �..._ r ,�. . ��.�.. _. _.__ . . ._ - ,....�,;�� �� � : ;� .. . , H. ' .. . ,. 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