HomeMy WebLinkAbout12-965 �F�! CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 218I0 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ����A�'���w BUILDING PERNIIT APPLICA�rioN FIRMLY � JOBSITE yy� *� yy� APPUCATION PERMIT P/C o ADDRESS ����"� LAL��1�1�►�J nI�—N�t� �1hQ- DATE � � � ?� NUMBER��� M � ISSUE 7YPE � ��� OCC � APN LOT TRACT DATE CONST.-���-�— GROUP p OWNER��Pn�OnD� L�A�L�'["�-.[�INS G�IuA �A> ZQNING SETBACKS o ADDRESS n����'r C{-LdG�—�Q- FRONT RW ❑ Z C17Y ZIP TE�������� REAR O g APPLICANT TE SIDE/SIDE STREET RW O � CONTRACTOR J SIDE 0 o CDDRESS Z�P TEL� PROPOSED USE�_IIL7'�r [+' 1'T'�'�� �LJP.2 '�7(JA�CD w ARCWENG/ �� ! z DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � -0WNER-BUILDER DECLARATION SFR/ADD/REM O � 1 HEREBV AFFlRM UNDER PENALTY.OF PERNRY 7HAT I AM E%E1APT FROM THE CONTRACTOR+LI- GaragelCarport W CENSEUWFONTHEFOLLOWINaREA50N(SEC.76'f1.68USINESSANDPROFESSIONSCODEANYCITYOR (n . . . U COLINfVWHICNRE0U1RE9�PEHMI7TO00N37RUCT,pLTEfLUAPROVE,DEMOlJSH�,ORREVAIHMfYS7RUC- w paib��eL�( ZNRE,VR10R TO RS ISSUANCE,AL50 REWuiES THE AVPLICANT FOfi SUCk�PERMR TO F�LE A SIONED � STATEMENT THAT HE OR SME LS IJCENSED,PUHSUNJT TO THE PqOVISIONS OF THE CONTRACTORS L)- � POOUSPB � CENSE LAW(CHAPTEA G I�µMENCIN(3 WITH SECTION 7000)OF DiViSqN 3 OF 7HE BUSINE55 AND VRO- Q FESSpNSCOD�ORTHATHEOpSHE15E%EMPTTIEREFROMAND7NEBASISFOR7HEALLEOEDE%EMP� V 7qry./JJYVqLA7qNOF5ECT10N70.77.68YANYAPVLICANT�FOHAPERMI7SU&lECTSTHEMPLICANTTO Z R8-ROOI � ACML VENALiY OF NO7 NORE 7HAN FIVE HUNDRED DO�l.ARS(fsoD).Y 0 ❑LASOWNEROF7HE�PROPERTI,oR1AYEtdPLOYEE9VA7HWA(3ESASTHEIRSOLECOMPENSATION, 0 Cpm(�gfCWl � Z WlLL DO THE WOAK�ND TME 9TRUCTURE IS NOT IN�ENOED.oR OFFERE�FOR 9ALE(SEc.7at,BU51- _I .. � NE53 AND PRDFESSIONS CODE TNE GOHTR�CTOf?S tlCENSE UW DOES NOT A7PLV TO AN OV/NER OF � PROPEPTYNO�DBU�IDSOHVdPROVESTHEREON.MIDWMODOESSUCHNONCHWSELFORHERSELFOR m [= T}iROU(iHHISORMEROWNEN7lOYEE3.PROVIDEDTHAT5U0ilYPROVEMEHTSAREMOTIMENDEDOR WQ OFFEREDFORSALEIF,FqWEYERTMEBUILDINOORWPROVEMENTIS.,OLDNRTHINONEVEAROFCOMPLE . Z TION,TIE�OWNER-BUILDER WILL HAVE TME BUROfl!OF VROVWG TNA7 HE OR SHE DIO NOT BUILD OR � IMPROVE FOR 7HE PURP0.4E OF SALE} C� w ❑4�OWNEROFTHEPROPERfV,AMEXClUSNEIYCONTfUCTWOWffHUCENSEUCONTRACTOH3 [� 70 COHSTfWCT TME 9RQIECT(SEC.7aM,BUSINESS ANO PROiE5510N5 CODE TME CONTMCTORS LI- V01U01i0f1� /iQ�.AREA � CENSEUIWDOE9NOTAPDLYTOANOWNEROFAPROPERiYWHOBUlA40RIMPiiOVE3TNEREON,AND . � NnlocoMMCT5FOR5UCMVR0.1ECfSWITHACONTRACTOR(5)UCENSEDPUR6UAHT70THECONTMG qUANTITY DESCRIPTION FEE � � 70R5 UCEtiSE LAWJ. � O ❑I AM E%EMPT UNDER SEC. B.a PC.FOR THIS REASON � � Q � DATE OWNER V. � LICENSED CONTBACTORS DECLARATION � � 1 HEREBY AFFINJ UMDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISION9 OF CHAPTER � � � p(COMMENGNO WI7}i SECTION'loao)OF DMSqN 7 OF 7HE BUSWESS AND PROFESSIONS CODE,ANU Z . _ X W LK:ENSE IS Pl FULL FORCE AND EFFEC7. m . , LlJ �,G+f� C�/ � UCENSE CLASS !���� LIC.NO.. �/ /10/I �� � U DATE Q. '1�1 '7 COMRACTOR a . . W � � WORKEAS'COMPENSATION DECLARATION ¢ N. U � 1 H£AEBY AFFtHN UNDER VE)iALTY OF VERJURY ONE OF THE FOLLOW WG DECUMTIONS: Z Q' O _I HAVE AND WILL IdAIMAW A CEHTIFiCATE OF CONSFM TO SELFINSURE FOR WORKERS' z Q CpMp@7$A7pN,AS VROVmm BY 6ECTION 37UOOF THE LA80R CODE,FOR THE VERFORMANCE �U' OF hIE WORK FOR NM1iICH THIS PERMIT IS ISSUED. � � W i HAVE AND WILL LWNTNN�WORKEA9'COM�ENSATION INSUpANCE,AS REOU�RED BY SECTION Z��j` ' O 3700 OF 7HE IABOR COOE,FOR THE PERFORMANCE OF THE WORK FOR WHI017HIS PERMI7 iS -� IS$UEp-My WpiU(�EprS�'C�OiAPpI5A7qN INSURANCE CARRIER AND VOLICV NUMBERARE CONSTRUCTION�� j cuaw� l/`(��� L0.�.S�A/CPi PLANREVIEW Z voi�crHUMeEa�a�.��,S�d 1�I ��-- ELECTRIC Q PlUM81NG o �nassEcrior+w�wTaEoo�,FrIDov s�oaone�Dr+�oawua�amaA�Fssl w 1 CERTIFYTHhT W THE PERFORrAA1JGE 7HE RK FOR WHICHTHIS PEiW�T L4155UE0,1 MECHANICAL Z �j SHALLNO7EMPLovANYVER50Nw MANN SOA5709ECOME�SUBJEC7TOTHE INSPECTIONFEE � WORKERS'CAMPENSATIOH LAWS OF !�I AND AGREf TFUT IF I SHOV�D BECAAIE ., . . . S sUBJEC7TOTHEWORKERSCOM7 9ATqN SIONSOFSECTION�7000F LABOR ISSUANCE - cooe.i swvs FomEtvntr�cw�a�v na T aov�s�o . � C� O SMIP � � pLL1 DATE:. � 7.i I�L�APPLICANT: . . � J WARNMCi FAIWRE TO SECURE W�RKERS'CO PENSA710N COVERAGE IS UNUWFUL,AI�SHALL BE ENERGY P/C . J � SU&IECT AN EMPLOYERTO CRIMPIAL PENALilES AND CMl FWES UP TO ONE HUNOfiEO TFIOUSANU �ERGY PEAMIT . _ DOLLARS(S10D,000),W ADDITION TO TNE C0.>T OF COMPENSATION,DAMAOES AS PROVIDED FOR IN J 6ECTION 370E OF THE LABOFi CODE,W7EflEST,AND ATfORNEYS FEES. ' RETENTION FEE: . Q W CONSTRUCTION�IENDING AGENCY �PytF�ALT�EF� d � 1 HEREBV AFFlWA UNDER PENAL7Y OF PERIURY iHAT 7HERE IS ACONSTRUCTION LENDWO M3ENCY �1�� Z f-0R 7NE PERFORMANCE OF THE WONK FOR N?iICH THIS PERAIR IS ISSUED(SEC.3087,CIY.G). W � �� LENDERSNPME ' {= LENDER'SADDRESS ' - � 7�t �/] U � ICER76V7}iATIHAVEREAD7HISMPUCATIONANDSTA7ETUTiNEABOVEPIFORMAT10N�9COMECT. TOTAL FEES • G/.,7 !' ,/� w I A(3AEE 70 COAAPLV WITH ALl CT'AND COIFRY OROWANCES AND STATE UWS REU7MO 70 BUILOINO � CON$7TIUCTIpN,AND HEREBV AIITHORIZE REPRESENTATNES OF TH15 COUMY TO EMER UPCN1 iHE ZABOVE-MENTpNED�ROPER7Y FOR WSPECT�ON VVRPOSES. �MMENTS � � � n�nlO\ � . � l.p�N J ¢ PE ITTEEN (PRINT) . /A_y �f�� . . . - � �V � uj S NA7URE E . W7E �C RECPT.tJO. PAID B VALJDATVON E""" WHITE—DepaRment Copy,YELLOW—Finence Copy.PINK—Assessor Copy�60LDENROD--File Copy.OREEN—ApPlfcanCa Copy CITY OF D1AMOfVD �AR INSPECTIOI� RECQRD , � , , .ti . .. -; . , . rt , . o.. r {. , _ . . � � � � x o Q o a�„J Ca S_ � � 0 � , _ o - � _� SET BACK -- ------ --- �FLOOR JOiST FTGS/FORMS/STEEL I FHA REQtviTS ELECTRIC GROUND rUNDER FLOOR DUCT GROIJND PLUMBING �UNDER FLOOR CONDUlT SLAB GRADE I FlREPLACE FOUNDATION TEMP POWER I FIREPLACE BOND BEAM WATER SERVICE !Mip NT.BOND BEAM ' ROOF SHEATHING � ' S ` �8 FT.`BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM` _ _ ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC I ROUGH GRADING ROUGH PLUN161NG FINfSH GRADING SHOWER/TUBTEST POOL ELECTRIC EXT.LATHJSIDING POOL FENCING WALL INSULATION POOL FINAL CEIUNG INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. 5EPTICTANK � LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. ' 7` FIRE DEPT.FINAL FINAL HEATING HEALTH DEPT.FfNAL FINAL ELECTRIC DEV.FEES PAID FINAL PIUMBiNG ENERGY FINAL PLANING FINAL ENGINEERING � o 0 connME�vrs SEPTICTANKSIZE SEEP PIT/U S1ZE — — � F' ( - _�;A. �� � V� � ` ' ��u '�p{Y 3 iY"�1�.'�r��'�d r,,�.�-. „L. �...,-�.:;� �