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HomeMy WebLinkAbout18114 (19) CT1Y OF DIAMOND BAR �'� � DEPARTI�NT OF COIvIIv1UNTI'Y&DEVELOPMEM SERVICES � 21825 E.Copley Drive � (909)860-3195 Fax(909)861-3117 RESS �`'�� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE '�►�SB� v('J�I L�`i �ir() . -j} APPLICATION 'V'� PERMIT l��1� P/C 2.+ o ADDRESS DATE NUMBER i1 � APN LOT TRACT ISSUE TYPE OCC DATE CONST. GROUP p OWNER ��R-Db �� p ADDRESS ��- �/U,QlL� � ZONING SETBACKS z cmr P/d-'F�1'7e ZIP TEL. I• FRONT RW � g APPLICANT TEL. REAR ❑ SIDE/SIDESTREET RW ❑ � CONTRACTO ' � � �T� SIDE ❑ � ADDRESS PROPOSED USE �_ �� � CITY �� � ZIP TEL �� w ARCH/ENG! f�E��s �� ���.� z DESIGNER ��� a ADDRESS ✓O G / � NO.DWEL NO. NO. � CITY W' �/��� ZIP �/� TEL / !F UNITS STORIES BEOROOMS c�i� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER•BUILDER DECLARATION SFRlADDlREM O p I MEREBV AFFIRM UNDER PEWLLTY OF PEfWRY T/UT I AM E%EMFT iROM iHE COMIMCTORS L4 Garage/Cerport W CENSEUWFOHTHEFOLLOWINGREASON(SEG7071.68USINESSANDVROFESSqNSCODE:ANYCRYOR (n U COUNryWFqCHREOUIRESAGERAIRTOCONSTiYUCLAITERIMPROVE.DElAOUSH.ORREVAIRANYSTRIJG W P31i0/DeCk � NRE ORIDR TO RS ISSt/M10E.AL50 REWIqES THE APPIICANT iOR Sl1CH PERMIT TO FILE A SIGNE� w STAifMENT THAT HE OR SHE IS LICENSED PU0.5UANT TO THE DROVIStONS OF iHE CONTiUCTORS L4 � CENSEUW(CHAPTERi(COMMENCIlWWITHSECTbN7000)OFDMSION70FTHEBUSINESSANDPRO- � PooUSpa FESSIONSCODE�ORIH�THEORSHEISEXEMPTTHEREFROMANDTHEBASISFONTHEILLLEGEOE%EMP• (� � TpN.ANYVIOLATI0NOF5ECTION70�1.S8YANVAVMICANTFONAiERMIiSUBJECTSTFIEAP7LKANiTO Z Re-Rao1 J1CML ENALTY OG NOT MORE iMAN FIYE MUNDRED DOLURS�fsoo).g � ,�G�ASOWNEROFTHEPROPEIiTY,ORMYEAIPLOYEESMATHWAGESASTHEIR50LECOAIVEN5AT10N, � (�qmmerCl81 Z WILL DO THE WORK AND TME STRUCTURE IS NOT IMENDEO ON OFFERED FOR SALE(SEC.70N.BU51• J � NESS/�NO PROFESSIONS COOE:THE CONTRACTORS LICENSE UW OOES NOT�PPLY TO AN OWNER OF j DROPfRTY WHO BUILDS OR�APROVES 1NEREdJ,AND WHO�OES SUd1 WORK HIAISELF OR HERSELF Oq [L THROUGHHISORHEROWNEMPLOYEES,PROVIDEDTHATSUCHIMPROVEMEMSARENOTNTENDEDOR m W OFFEREDFORS/LLEIF,/iOWEVER7NE8NLDINaORIMPROVEMEMISSdDWfi}IINONEYEAROFCOMPLE- � TION,TME OWNER�BUIIDER VALL HAVE TME BURDEN OF PROVINQ THA7 HE OR SHE DID NOT BURD OR Z IMPFqYE FOR TME VUHP0.5E OF SALE� Q= yfL ASONMEROFiHEPROPEiti1;AME%0.USNELYCONiMCTIN6WITHLICENSEDCONTMCTORS TOtONSiHUGT 7HE iROJECT�SEC.7a�,BUSINE55 AND PROFESSIONS CODE:THE CONTMCTORS U• ValUatiOn , ADJ.AREA W CENSEUWDOESNOTMPLYTOANOWNEROFAPHOFERNVrtiOBUILD50fiIMPROVESTMEREON,AND .Z� W11000NTMCTSFORSUf]iDROJECTSWIIHACONTMCiOR(5)IICENSEDPURSUANTTOTHECONTRAP QUANTITY DESCRIPTION FEE Y TORSL10EN5EUW.). '�.� � O I AM E%EYPT UNDER SEC. B.t P.C.FOH iH15 REASON U � � Q DATE OWNER V W �6 ', UCENSED CONTRACTORS DECLARATION i j CL IHEREBYAFFIRMUNDERPENALTVOFPfiLVRY1HATIAMUCENSEDUNOERPROVI5iON50FCHAP7ER U. p� Y(COMMENCINQ WITH 9ECTqN 7000)OF DN1510N�OF THE BUSMESS�V1D PROFESSIONS CODE,/1ND Z u� MY UCENSE IS N FULL FORGE AND EFFEGT. m o (p2s2/SD � UCENSE CLASS IIC.NO. J V DAiE � collTRAc7oR d W � ,�WORKERS'CAMPENSATIONDECLAFIATION a � U N IHEREBYAFFIRMUNDERPENALNOFVERNRYONEOFTHEFOLLOWINGDECURATIONS: � Z a Ll �IHAVEANDWILLtANNTAINACERTIFICATEOFCONSENTTOSEIF�INSUREFORWOPoCERS' _ � COMPENSATqN,ASFROYIDEDBY5ECT10N7f000FTHELA80RCO0E,FORTHEPERFORMANCE IU OFTNEINORKFORMMICIiTNISDERMI7151S5UED. � � O �I HAVE AND N1LL IAAINTAM WORKERS'CAAIPENSATION INSl1RANCE,AS RE�UIHED BY SECTION �' Q �To00FTHElABOHCODE,FOATHEPERFORMANCEOFTNEWORKfORWHICHiFI15PERMITIS ISSUED.MVWORKERS'COMPENSATIONINSUiW10ECARR'�ERANOVOIICYNUMeENME: CONSTRUCTION � j �qqiEq PLAN REVIEW � vaicrrruueErr ELECTRIC � �nussEcnor+NEIDwrseoax3�EoaFnfvEw.�rswaor��rouuasa�aryoatFssl PLUMBING Z ICEFTIFYTHA7NiHEFERFOHAIAl10EOFTHEWORKiORwMICHiHISPEpMITI5155UE0,1 MECHANICAL �` � ---- - (�} SHALLNOTEA�PLOYANYVERSONNANYMANNERSOASTOBECOMESUBIECTIOTME �r"'_l\ .�, . I,��� N WORKERS'COMPENSATIONUWSOFCALIfORNIA,ANDACREETMATtFIS/10ULDBECOME INSPECTIONFEE S SUB.IECTTO THE WORKERS'C01.1PENSATION PROVISIONSOF SECTION�7000F THE l/�BOR CODE.I SHALL FORTHVATH COMPLY WITH THOSE OROVISIONS. ISSUANCE p �ATE: I' APPIICANT. SMIP � r � � ENERGY P/C � WI�W.IIN6:�ALURE TO SECURE WORKEPS'COMPENSATIDN COVEMCE IS UNLAWFUL AND SMALL BE � SUBJECTANEMPLOYEA70CRitA1NALPEWLLTiES/WDCNiLFWE5UV70CNEHUNDREOTHOUSAND ENER6YPERMIT � OOLLARS(f 1oa.000).W ADDtT10N TO THE COST OF ODIAPENSATqN,DAAUGES AS PROw0E0 FOR IN ___ � SECTION 370E Of TME LABOR CODE.INTEREST,ANO�TfORNE�"5 FEES. RETENTION FEE: i`"" �'' -a a CONSTRUCTION LENDING AGENCY ppE-ALT FEE: � IHEREBYAFFIRMUNDERPENALTYOFPEPJVRVTHATiMEREISACONSTRUCTIONLENOW6�GENCY � � FOR THE GERFORMIWCE Of THE WORK FOR N'Mlp/THIS CERMIT IS ISSVED(SEC.7oY7,dV.C.�. Z W � LENOER'S NAME � F= LENDER'SADDRE55 ' r //''�� w ICERTIFYTHATIHAYEREADTi15APPUCATiONANDSTATETMATTHEABOVEINFORMAT10NISCORRECT. TOTAL FEES J� .�� � � � IAGREETOCOMPLYWITHALLCITYANDCOUNTYOPD'NANCESANDSTATEUwSREUTIN�TOBUILDINO LONSTRUCTION,AND MEREBV AUT110RRE REPRESENTATNES OF THIS COUrliV TO ENTER UPON TME ZABOVE•MENTqNEO GROVERTY ORINSP CTqN P nvoses. COMMENTS o , � � -S � - m PE MITiE NA►1E RINT) �r�7,� � � b y � � C �� � 61G VREOFPE0.MTE DATE � RECPT.�0. PAID BY S VALIDATION �, WHITE—Departmenl Copy.YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—Applicant's Copy �� ��� , , , . .. - „ . ... .. . - � . . . - , . . ,.:. - �._, ----- - �--- -- . . , . ... �iT4�' O� GIt�I��i�f�D Bf�P. 6f���F=���I�P�! �EC�;�� I.�E�:�-�;:rC����� '�? �'F:_T���v��'�;,;�7 �����__._.�._. i�'f7.' ��, �i�a►�l �� c"��t�.ii� ,�►i�-7a��'��`e�=� �_�_�_---�� _..___�__._.._ _ __._ _... , _. _.._ �_.__.�._ _.._______.___.._.___ _ _ _ . SET BAC1: ' i _ � .. _. ----- _� .-.--_..__..___ _.__ ___�_� � I FLOOR JOIST" I FTGS/FORMS,�STEEL � —f�/��y��- -- ---�� FHA REQI�ITS ' ELECTRIC GROUND _ _ � I UNDER FLOOR DUCT � —� GRDUND PLUMBING __ �_i UNDER FLOOR CU^�IDU1T � � � ------ SLAB GRADE I FIREPLACE FOUNDATIOfJ I TEMP POWER I FIREPLACE BOND 6EAM WATER SERVICE _ _ AdID HT. E'aND BE�P.1 1 ROOF SHEATHING 8 FL BON� 6EAPA FRAMINGNENTILIATION��_j'�QZ �� FINAL BOND BEAM _ ROOF COVER � ' PFic-GRAOING � ROUGH HEATIPJG BENCHING I ROUGH ELECTRIC ROUGti GRADING ROUGH PLUPJ�BING i � � FINISH GRADING SHOVJEFi�UB TEST j I POOL ELECTRIC EXT. LATH/SIDItJG I I PaOL FENCI�dG WALL INSULATION POOL FINAL � CEILING IN�ULATION I OFF SITE IMPS. � DRYWALL NAILWG � DEDICATIONS SEWER ! � FINAL ENG. SEPTIC TANK . LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE ItriPS. GAS AIR TEST � FINAL ZONING FINAL CONST. �/�; �1RE �EPT. FINA! FINAL HEATING � l � HEALTH DEPT. FINAL FINAL ELECTRIC � DEV.FEES PAID FINAL PLUMBING � ENERGY � � � �,�- , .ra.-.�-.�._.--_.,...__�_.'__r_ -�`•'' x� r,- �1`'p-__��_.._----�-�- I _._ __. J. .._-_.-- COMMENTS SEPTIG TANK SIZE � SEEP PIT/U SIZE --��� --__ ; I��� � ��