HomeMy WebLinkAbout12-510 _�,�`_ CITY OF DIAMOND BAR
� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES _ �
21810 Copley Drive,Diamond Bar,CA 91765
� (909)839-7020 Fax(909)861 3117 Building Inspection 13otline(909)839 7027 PRESS
���''^° BUILDING PERMIT APPLICATION FIRMLY
� JOBSITE Uu+T�( G�3 T�RU''l��j APPLICATIONl..� �j PERMIT �p/C
o ADDHESS 'ZZ-�{QL EH 1.7d►1 M�D� D�AµQr.� B rE DATE l '�+' '(� NUMBER��51_ #
� ISSUE TYPE pCC
� AF'N LOT TRACT DATE CONST. GROUP
p OWNER f(�tAMAI,ID �AQ ��/A/�S !;/G,Q �.DA• ZONING SETBACKS
o ADDRESS �i�'� L'LVQ D,Q,
O CITY ZIP TEL�9'�j 1 R61�� FRONT pyy p .
�—� REAFi p
o APPLICANT TEL. S1DE/SIDE STREET RW ❑
� CONTRACTOR bJ / SIDE p
Q ADDRESS�.�) til 1 T#- S�'
� CITY �g-��,�1.�- ZIP�� TEL ��,�lf�j�C'�' PROPOSED USE �'
o ARCWENG/. -
z DESIGNER . '
w NO.DWEL NO. NO:
n, ADDRESS
� CISY ZIP TEL. UNITS STORIES BEDROOMS
cn
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNEF-BUILDER DECIARATION � SFR/ADD/REM
O
p I HEREBY AFFlRM VNDER PENAL7Y OF PERNRV 7HAT I Au D(EMPT FROM THE CON7MCTORS LL Garaga/Carport
W CENSEUWf-0RTHEFd.LOWWOREA$ON(SEC.7031.60USINESSMIDPROFESSIONSCOOE:ANYCRYOR (n
V COUHf1'WHN7IREOUIRE3APERMI7TOCONS7RUCT,AL7Eft,UAPROVE,DEMOLISH,ORREPAIAANYSTHUC- w � �
� TURE.PRIOR TO RS ISSUANCE,AL50 REWIAES THE MPLICAM FOR SUCH PERMR TO FlLE A SIONED w P8t10/DBCI(
STATEAIENT THAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROV4510N5 OF THE-CONTRACTORS LI�
� CENSE UW(CHAPTER Y(COMMENpNO YNTH SECTIDN 7000)OF OIVISION 7 OF iHE BUSINE59 AIJD�PRO- � PaoUSpa
FESSpNSCODE�Oq7W�THEOfISHEI3E%EMPTTHEREFROMMATHEBASISFORTHEALLEOEDEXEAIP- �
TION.MIY,VIOLATIONOFSECT�ON7U31.6BYANVAVVLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z RaRoo!
ACML PENALTY OF NOT A10RE THAN�FIVE HUNOFEO DOLURS(iboo).): -
0 ❑4�.40WNEROFTHEPROPER7V.OR/AYE1dPLOVEESWITHIVAGESASTHEIR50�ECOMPENSATION, 0 �pmmBfClal
Z NALL DO TFIE WORK AND THE 9TRUCNRE 13 NOT INTENDED OR OFFEAED FOR 3ALE(SEC,7ou,BUSF J � �
� NESS AIJD PROFESSIONS CODE:THE CONTRACTORS UCENSE�LAW DOES NOT A7PLV TO AN OWNER OF ? � �� �
PROPEFTfY WFiD BU0.D4 OR W PROVES THEREON,AND Vl1i0 DOES SUCH NORK 14MSELF OR HERSELF OR -
wTHROUGHW30RHEROWNEMVLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR . m .
0 OFFEAIDFORSALEIF,HOWEVERTMEBUILDINOORMPROVEMENTISSO�pWfTWNONEVEAqOFCONPLE-
Z TION.THE'ONTiER-BUILDER WILL HAVE THE BURDEN OF PROVW6 TryAT HE OR SHE DID NOT BUIID OR . . .
� WPROVEFORTHEPURPQSEOiSALE} �
W ❑I,ASOHMER OFTHE PROPEHfV,AM EKCLUSNELV CqNTRACTINO WfTH IICENSED CONTRACTORS .
Q TO WNSTRUCT THE PRQIECT(SEC.70N,�BUSINESS ANO PROFESSIONS CODE:TME�CONTRACTORS U- V0IU8IIOf1� " �
W CENSEUWDOESNOTM7LYTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESiHEREON,AND A�'��-
� W/IOCOMMCTSFORSUCHPROJECT9WffHACONTRACTOF�S)LICENSEDPURSUAM707HECONTRAG pUANTITY �DESCRIP'fION
70RS LICENSE LAW.). FEE �
� ❑�AM E77�MMPT IAJDER SEC. . B.8 P.C.FOR 7HI3 REASON �
' ?� U
� DATE � OWNER �H
Z U
�¢ � � UCENSED CONTRACTORS DECLARATION W � - � � � � � �
2 1 HEREBV AFFliUI UNDER PENALTV OF PE0.NRV THAT IAM�LICENSED UNDEH PROVISIONS OF CHAPTER � � � - �
p� 9(COAIMENCBI(i WITM SECTION 7000)OF DrvISION�OF THE BUS7NESS MlD PFOFESSIONS CODE,AND Z ' ��
X Ary LICENSE IS W FULL FORCE AND EFFECT. m
� �,��sE��ss D—G�9 ���.No. ����/ �.
� wrE_�Za"—IZ CONTRACTOR a
� WORKERS'COMPENSATION DECLARATION Q -� � � � - �� � � -
� U
N 1 HEREBYAFFIiW UNDER PENALTY OF PERJUFtV ONE Of THE FOLLOWWO DECLARATqNS: Z � � � .
� �NAVE� WILLMIUNTAINACERTIFlCATEOFCONSEMTOSELF-INSUREFORWORKEiiS' g1 � �
�^ CO .ENSATIO/J,AS VROVIDED BY SECTION 3700 0F THE UBOR CODE,FOR THE PERWRMANCE V
7HE WORN FOq N7i1CH THIS PERAl1T IS IS$UEp. W
� �
� I HAVE AND WILL AWNTAIN WORKERS'COMPENSATION WSURANCE,AS REWIRED BY SECTION - �
. Q J7oo OF THE LABOR�CODE.iOR 7HE PERFORMANCE oF THE WOPo(FOR WHIp17HIS PERMR IS �� . �
�SSUFD.MVWORNERS'COMPENSATIONINSURANCECARWEH�AI�POLICYNUMBERME: CONSTRUCTION� '
� CAARIER wsu..s ��c� �u��vc.��r�� PLAN.REVIEW . .
Z aot�cr nin.meA . a 3 00� ��i.3!!I/ ELECTRIC
¢
p (nissEctqr+r�r+o'reEoo�.Er�oF7rEVE3a.rrswaa&Hu�onmoauis(siao�oratFss} .PLUMBING ' .
w
Z �CERTIFV THA7 P17HE PERFORMANCE OF THE WORK FOR WMICl17HIS PERAIIT IS ISSUED,1 ��ECHANICAL
CJ SHAI.L NOT EMPLOY ANV PERSON W ANNER SOAS 70 BECOME SU&IECT TO THE
�(/� WOPo(ERSCOMPENSATqNLAW50F 'I iWIA,ANDAGREETMTIFISHOUIDBECAME INSPECTIONFEE
SUBIECTTOTHEWOFNERS'COM7 SAT � VISIONSOFSECTION37o00FTHEUBOR
s caoe.isww.FORrr�win�coua� NnniT Evao sw . ISSUANCE �j�1. t_� ..
p `T���nPPuc �SMIP . . . � � 8f{-
DATE
W
� WARNINa FMLRE TO SECVRE WORKERS PENSATION COVERAGE IS UNUWFUL,AND SHALL BE ENERGY�P/C
�y SU�ECT AN EMPLOYER 70 CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED THOUSAND ENEROY�PERMIT
DOLURS(5700.000),W ADDITION TO THE COST OF COMPENSATqN,DM1A6E5 AS PROVIDED�FOR IN
J SECTqN 37oa OF 7HE LABOFi CppE,�t�(JEREST,AHD ATfORNEYS FEES. � � ' � �
�¢ � . RETEN'fION FEE: o� . (YJ
O . CONSTRUCTION LENDING AGENCY � �PRE-ALT FEE
� I HEREBY AFFlRM UNDER�PENALTY OF PERIURV iHAT THERE IS ACONSiRUCT10N LENDINO AOEHCY '��� , ���
�Z- �FOR hIE PEHFORMANCE OF.THE WOR)(FOR WHICN 7HIS pERM1T IS ISSUED(SEC:�3oW,qV,C,). .
W
��. LENDER'S NAME . . . . . •
� IENDER'SAODRESS �
�� ICERTIFYTHATIHAVEFEADTW9APPl1CATIONANDSTATETHATTHEABOVEINFORMAT10N19CORt1ECL TOTAL FEES �' 1 \
� I AUHEE TO COMPLY WITH ALL CfTV ANU COUNTV ORDWANCES AND STA7E UWS RELATIN(i TO BUCDIN6
� COKS7RUCTION,AND HEHEBY AUTHORIZE REPRESEN7ATIVES OF T115 COUHTY TO ENTER UPON THE �
Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PUqPOSES. COMMENTS �'
� � �
J'
� PERMITTE NAMEI � . .
N ��G
Uj SH3NATU OF P DATE
� RECPT.NO. PAID BY VALIDATiON
WHITE-0epaAment Copy,YELLOW—Flnance Copy.PINK=Assessar Copy.GOLDENFiOD—F.71e�Copy;�REEN—AppltcanCs Copy . . . . .
CITY 4F Di�4MOND B�4R
INSPECTION REC�RD
; , . . . �� �: ,r ,� �- �� z� - -
r'� . � :� � o � s .� D � B � e �,-`e
SET BACK �FLOOR JOIST
FTGS/FORMS/STEEL I FHA REQMTS
ELECTRIC GROUNQ UNDER FLOOR DUCT
GROUNQ PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BO(JD BEAM
WATER SERUICE MID HT:BOND BEAM
ROOF SHEATHING .S Z('I �L I 8 FT.BOND BEAM
FRAMING/VENTILATION FIIJAL BOND BEAM
ROOF COVER PRE-GRADING _
ROUGH HE,4TING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISN GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT.�ATH/SIDING POOL FENCING
WALL INSULATION �POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG. _
SEPTIC TANK LANDSCAPEIIRRIG.
SEEP PIT/L.L. ON SITE IMPS. �
GAS AIRTEST FINAL ZONING
FINAL CONST. I FIRE DEPT.FINAL
-�
FINAL HEATING HEALTH DEPT.FINAL
FINAL ELECTRI� QEV.FEES PAID
FINAL PLUM8ING ENERGY
FINAL PLANING
FWAL ENGINEERING ' • B
C�MMENTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
;, , ��ff
,