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HomeMy WebLinkAbout12-966 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 Hotline(909)839-7027 PRESS ,�'""', BUII.DING PER11�T APPLICATION FIRMLY JOBSITE �IQ1 '*FlF� �ISB o ADDRESS ZL�O I �RIG uJ P�/ nl MN(�rl�� DATE CATION ( � 7j NUMBER��� �/C � APN LOT TRACT �SSUE TypE pCC DATE CONST. � GROUP p OWNE�Ps�'�D+L� t►►nli_ j�N,,;� C1,fn 4�.C) o ADDRESS ZONING SEfBACKS z CITY ZIP TEL G��x�/" " _" FRONT qyy � � APPLICANT TEL. REAR � z .-� SIDFJSIDE STREET RW ❑ � CONTRACTOR�L�W C'lAtl i � $�CL//LEJ SIDE p ADDRESS � o CITY[�'tl��f:llo.- ZIP�TEL PROPOSED USE��_� (g�I`�� ����-�� o ARCH/ENG/ �z DESIGNER NO.DWEL ` NO. NO. a ADDRESS � CITY ZIP TEL . UNITS STORIES BEDROOMS � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADDIREM p 1 HEREBV AFFlFM UNDER�PEtULTY.OF PERR/RY THAT I AII E7(EMPT FHOM 7HE CONTRACTDRS LL G8f8g0/CefpOR W CEMSEUWFOR7HEf-0LLOWIN(3REASON(SEC.7o31.60V5WESSANDPROFE5510NSCO0E�NYClTYOR (n C� WUHTYNTi1q1RE0UIfiESAPERAIITTOCO/J37RUCT,ALTEf�IMPROVE.DEMOlJSH:ORREPAIRANYSTRUG W PatlO/DgCk �� NRE,PRqR TO�RS ISSUANCE,ALSO REOUIRES hiE APPLICANi FOp 6UC/1 pERMR TO FlLE A SI(3NED W STATENQlT 7HAT ME OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRAC'fORS LL , 0CENSE UW(C/I�CTER Y�COMMENCINO WITH SECTION 7000)OF DIVISION 7 OF THE�BU91NE59 AND PRP � POOUSpO - GE9310NS COO�OR THATHE OR SNE IS D(EMPTTNEREFROM AND iHE BA515 FOR THEALLEOED E%EMP- � (� V TION.ANYVIOLATIONOFSECTION7o31.68VANYAVVLICANT�f-0qAPERMITSUBJECT3hiEAPPUCANTTO . Z R0-ROOI � � � A CML PENALTY OF NOT AbRE THAN FIVE HUNORED DOLLMS(f6oD)J: � - 0 04ASOWNEROFTHEPROPER7V,OqMYEMPIOYEESWITHIVADE9ASTHEIRSOLECOMPENSATIDN, � � COR11fIBfCi31 Z Y.RLL DO THE WORK,AND TiE STRUCTURE 19 NOT INTENOm OR OFFERED FOR 3ALE(SEC.�7aN,BU51• J � � NESS AND PROFESSIONS CODE THE CONTMCTORS UCENSE UW DOES NOT MVLV TO AN OWNER OF � PROPEHiYNTiOBURpgORIMPROVESTHEREON,ANDNMOOpE55UCHWORICHWSELFORHEHSELFOR � � iHRW6HH130RHEROWNEMFLOVEE3.7ROVIDmTHATSUCHUAPqpyEMENTSARENOTINTENDEDOq m - Q OFFEREDFORSALEIF,HOWEVERTMEBUIlDP1liORpAPROVEMFNTISSOIDWfTMNONEVEAROFCONPLE- � TIDI'7..THE OWNER�&11LDER WILL MAVE THE BURDEN OF PROVIN6 7HAT HE OR SHE DID NOT BUILD OR IMPROVE FOR 7HE PURPQSE OF SALE� � � , � W ❑I,ASOWNEROF�THE PROPEHTY,/UI E%QUSNELV CONTRAC7P10 WIfN LICENSEU CONTRACTORS � TO CONSTRUC7 THE PRO,IECT(SEG 7oN,�BUSINE55 AND PROFESSIONS CODE:iHE CONTRACTOR4 LI- VBluet{Of1 �I� qp�pR� ' = CENSELAWDOESNOTMVIYTOANOWNEROFAPROPERTVNTID9UIL0.90RU1PROVE9THERC-0N,AND � WFrOCOMRAC75FORSUpiPqp.jECiSWRHACONTRACTOR�S)LICENSmPUFi6UAHfTO7HECOHTfUG Q�Jq�,�T�Ty DESCRIPTION TORS LICENSE LAW.). �E . 0 O I AM EXEMPT UNDER SEC. . B.8 P.G FOR THIS REASON � � U � DATE ONRJER � f- 0 U �¢ LICENSED CONTqACTORS DECLARATION � w� � � - � CL I HEREBY AFFIRAI UNOER PENALiY OF PERRIFY THAT I AM�LICENSED UNDEA FfipV151pNS OF CHAPTER � - - � Y(COMMENC7NO WfTH SECTtON 7000)OF DIVISKKJ]OF THE BUSINESS AND PROFESSIONS CODE,AND Z . � X� A1Y IICEN9E IS IN FULL FORCE AND EFFECT. m LL1 n � LICENSE CLASS e���S UC.NO..���,�� � . wDATE��— I L CONTAACTOR � d . . � WORKEFiS'COMPENSATION DECLAFATION Q� - - � - � � 1 HEREBY AFFIqM UNDER PENALTY OF.VERJURV ONE OF THE FOLLOW{NG DECIARAT10N5: V � ' � (� Z � _IHAVEANDWILLMAINfAIHALERTIFlCATEOFCONSEMTOSELFWSUREFORWORKEq3• � - COIdPEN5A710N,AS PROVIpEU 8Y SECTION 37U0'OF h1E UBOR CODE,FOR TME PEAFpRM�WCE U OFTNE WORK FOR WHICH THI9 PERMIT t9155UED. W � � w HAVEANDWILLMAWTAWWORKERS'�COAIPENSATqNMSUq/WCE;ASREWIREDBYSECTION Q �7U7 OF TNE LABOR CODE.FOR THE PERFORMANCE oF THE WORN FOR WHICH THIS PERMI713. �� � / / ISSUED.MYwOPo(EASCOAIPENSATIONINSURANCECAqqIERMg1POlICYNUMBERARE �CONSTRUCTION: T:. j CARRIER C����� �A� �1��/1"4�C� PLAN AEVIEW � . . �Z POLICV NUMBER � �A(�_�(�.',�71,T�'7/ _ ELECTRIC ¢ p (���+�ID�'pTeE� �E�rswaa+E�oa�ufs�m)oat�ss} PIUMBING w Z I CERTIFV TUT IN THE PEHFOH E OFTH WORK FOR WNICN THIS PERAIR tSISSUED,I MECHANICAL C7 SHALL NOT EAIPLOY M1Y 7ERSON ANY ER SOAS TO BECOME SUBJECT TO TiE ' ' (/) WORKERS COMPENSATbN U OF CALI. IA AND ACiREE 7HAT IF I SHOUID BECOME INSPEC710N FEE SU&IECT TO TFIE WONICERS' ENSA71 ONSIONS OF SEC710N 370o OF THE LABOR , � � � O cooE.i sruu war�+win�cou r wi E aRo ,y�iDris. ,� ISSUANCE � ! n_i�' p DaTE:�Z"APPL�c . �/" .SMIP �_ �-j,� W "'� WARNIN4�fA4LRE 70 SECURE WORKERS PENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENEROY P/C � J �y SU&IECTANEMVLOYERTOCRIMWALPENALTIESANDpVILFWESUPTOONEHUNDREDiFIOUSAND ENERGYPERMIT DOLLAH9(f100,000),W ADDITqN TOTHE COST OF COMVENSATION,DAMAOES AS PROV�EO FDR IN J SEC710N 37oB OF 7HE LABOR CODE,WTEREST ANUATfORNEY3 FEES, � w RETENTION FEE: 0 ' . CONSTRUCTIO,N IENDING AGENCY pq��Ai T f�E�. %LC �. 1 HEREBY AFFlRM UNDER�VENAITY OF PERIURY THAT THEf1E IS ACONSTRUCTION LENDMO AOENCY r/7��� , �FOR THE PERFORMANCE OF 7HE WOPoC FOR WHICH 7HI5 PERMI7IS ISSUED(SEC:��oe7,qV,C.). Z W �.Z�. LENDERS�NAME . . . i F- LENDER'SAODRE55 �� � ' . �- �ICERTIFYTHATIHAVEREADT1u9APPLICATIONANDSTATEhUT7HEABOVEMFORMATIONISCORRECT. TOTAL FEES ��7. � 1 A6REE 70 COMPLY N7iH ALL CfTY AND COUNTY ORDWANCES AND STATE UWS RELATWO TO BUaDIN(i � � CONSTHUCT�ON,ANp HEREBV AIfTHORIZE REPRESENTATIVES OF 7H1S COUNTV TO EMER UPON 7HE � z ABOVEMENTIONE�PROPER7Y FOR INSPECTION PURP0.5E5. COMMENTS � � J' � m PEAMI E NM1E(PPoHn . Q � � � � �510 PERMITTEE ATE � � RECPT.NO. PAID BY VALIDATION WHITE-Depertmen[Copy,YELLOW—Flnanca Copy,PINK—Assessor Copy,GOLDENROD—File Copy,(iREEN—Applkk:anCs Copy . u CITY 4F D{AM�PVD BAR II�SPECTIOIV RIEGORD .,. .. p. ... . µ. . . o� •..�'. , � � � u�, it 0 � � e_ Q p,, � �r a 0 � . - .., , . . a, . .. SET BACK FLOOR JO(ST Fl"GS/FORMS;STEEL fHA REQMTS ELECTRIC GROUNQ UNDER FLOOR DUCT GROUND PWMBING UNDER.FLOOR CON�UIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ROOF SHEATHIMG —�/— '2 � �i`"'� 8 FT.BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM ROOF COVER PRE-GRAOING ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRADiNG ROUGH PLUMBING FINISH GRADlNG SHOWER/TUSTEST PpOL ELECTRIC EXT.LATH/SIDING POOL FENCING WRLL INSULATION �P�OL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTICTANK �Li ANDSCAPE/IRRIG. SEEP PIT/L.L: ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. �-�� FfRE DEPT.FINAL fINAL HEAT�NG HEALTH DEPT.FINAL FINAL ELECTRIC �DEV.FEES PAID FINAL PLt1MBING ElVERGY FINAL PLAIJING INAL ENGINEERING • A o .e, .�: COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE y �,, , � ��, :��, :w f� �6�' �. ;'7"` :� _ . --_