HomeMy WebLinkAbout18148 (17) . . _ ._ _ . . _.-------------
J� CITY OF DIAMOND BAR
} DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21825 E.Copley Dcive
'�` (909)860-3195Fax(909)861-3117 ' PRESS
`»�'� BUILDINGPERMITAPPLICATION FIRMLY
;
� JOBSITE f� r.. APPLICATION PERMIT ,I��`�""` P/C
o ADDRESS " � �_ DATE ' �NUMBER F �
� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER �� ' SUI'Y�.��N�ii
20NING SETBAC S
� C�TM S � � L _ FRONT RW ❑
� APPLICANT ��, REAR ❑
� SIDE/SIDE STREET RW ❑
� CONTRACT R SIDE ❑
o CDD SS ZIP EL PROPOSED USE � �
o ARC NG/
� DESIGNER NO.DWEL NO. NO.
ADDRESS UNITS ,� STORIES BEDFi00M5
� CITY TEL
y DESCRIPTtON SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNER-BUILDER pECLARATION SFRJADD/AEM
O
W CENSELAWBFORTMEFOLLONAN6ilEA50N�SEC.7WR6 USWE�ANDDROFE�SS�IONS�DEANVCITYOR Garege/Carport
� COVNTYYMICHREOUIRESA7ERMRTOCONSTRUCT,ALTER,MVROVE,DEMOLISH,ORHEPAIRANYSTAUG �
TURE PRiOR TO fT5 ISSUANCE,ALSO REQUIRES TME MFLIGWi FOR SUCH PERMIT TO FIIE A SIGNED w P8ti0/DeGk
� STATEMEM THAT XE OR SME IS IICENSED PUHSUANT 70 THE PROVISIONS OF T11E CONTMGTOflS LF
$ CENSE I.AW(CHAPTER 9�COMMENCw�WITH SECTiON 7000)OF DIVi510N 70F THE BUSiNESS AND PRO- � POOUSp2
FESSIONS COOE)OR TMA717E OR SME IS E%E4P7 TMEREFpOM ANO iF1E BASIS FOR TMEAILEGED E%EMP•
� TqN.ANYVKKATIONOFSEC110N70�1.6BY1WYAPPLICANTFDRAPERMITSUBJECTSTHEAPPLICANTTO Z Ra-Root
A CML PENALTY OF NOT AAOHE iHAN FIVE NUNORED DOLURS(l5001.):
� 04�30WNEROFTIEPFbPER7Y.ORMYEMPLOVEESNnTHWAGESASTHEIR50LECOMPENS�7qN, 0 COrtIrtlOfClel , -�
NALL 00 TME WOFiK,Ml�T/1E STRUCiURE IS NO7INTENDED OR OFFEREO FOR SALE(SEC.7WI.BU51- J
NE55 AND PilOFE55�ON9 CO�E:THE CONTMCTORS LICENSE LAW OOES NOTAPPLY TO AN OWNEROF
� OROVERTYW/108UILOSORMOROVESTMEFEON.ANDWHOD�ESSULFiWORKHINSELFORHERSELFOR �
Q THROUpH HISOR NER OVM EM7LOYEES,VROVIDE�7HAiSUp11MPROVEM[MS ARE NOT INTfNOEDOR m
QOFFEREDWRSALEIF,lqWFVERTMEBULdNGORMPROVEAIENTLSSOLDWITMNONEYEAROFCO�.IPLE�
Z TION,THE OwNER�BUILDER WiLL HAVE THE BURDEN OF PpOVINO THAT Nf OR SHE DID NOT BULLD OR .
� MVROVEFOR7MEPURPOSEOFSALE).
W OI.ASOWNEROFTHEPROPEP7Y,M1E%CLUSIVELYCOMMCTWOYATHIICENSEDCONTMCTOR3
[L 70 CONSTRUCT THE VROUECT�SEG�04.BUSINESS M10 iROiESSIONS LODE:THE CONTMCTORS Lb Vd�l18�i0R ADJ.AREA
W GENSEUIWOOESNOTAPPIYTOANOWNEROFAYHOPERTYWHOBVItDSORIMPROYES7HEREDN,AND
� NSqCONTMCfS�OR3UdiVRO.IECTSWIT/ACONiMCTOR(S)L�CENSED7URSUu�fTT07NECONTiUG pUMtfITY DESCRIPTION FEE
� TOfiSUGEN9ELAW.}
� O IAM E%EYPTUNOER SEG B.d P.G FOR T1715 REASON U
u" D�TE OWNER r
Z W
F LICENSED CONTRACTORS DECLAAATION w
� IMEREB�AFFIRMUNOERPENALTYOFDEiLA/RYTMATIAMLICEN5E0UNDfRPR�V15�ONSOFGMMTEH Vr
� O�COMMENqNON'ITMSECTiON7oDo)OFDMSKKJ�OFTHEBUSINESSANDVROFESSIONSCODE,AND Z
��� MY LICENSE IS N FULL FOFCE AND EFFECT.
m
� LICENSE USS. � LIC.NO.�� J
V pATE � � CONTPACTOR a / . . -
w
� WORKERS'COMPENSATIONDECLARATION j � -�
� '
� IHEREBY/IFFIRMUNDEFPEWLLTIOFPE0.NfiYONEOFTNEFOLLOWiN�DEQAMTION. �' O`
VJ Q
� _IFu. WiLLAWMAINACERTIFICATEOFCONSENTTOSELF.INSUREFOfIWORNERS' S
� ENSATION.ASPqOVIOEDBYSECTION77ooOFT11EWBORCODE,iORTHEYERFORAIANCE W
O E WONN FOfl WHlpl THIS PERMIT IS ISSUEO. �
�
IF4�VEANDN/ILLMNNTAWWORKER5COMVENSATIONINSURANCE.ASNEWIREOBYSECTION �� � ]
Q l700 OF THE OR OOOE,i0{I THE PERFORAAANCE OF THE WORK FOR WMICN TMIS PERMI715 V
ISSUE0.MY O KERS'COMOENSATqNINSU CARRIEft11NDPOLICY UMBERME: CONSTRUCTION
� CAqqIER � � PLAN REVIEW
� PCIICYNUMBER "� � ELECTRIC
0 (M1ASSECf�Or+NEm1+o78EOd�s�ETEDOF71EVEFMfsFoaOUEHlDpEDOotL�R4(t+ I � PLUMBING
Z ICERiIFYTHATPiTHEPERFOiIMANCEOFTHEWONfiOAMMIpfiNISPERMiTI5155U D.I AAECHANICAL
(J $HA��NOT EIAPLOY ANY PERSON IN ANY MANNER SOAS TO BECAME SU&IELTTO THE '��l
� WORKERS'COMPENSAi1ONLAW50FCALIFORNIA�ND REETHAiIFIBHOVLDBECOME INSPECTIONFEE � ' �--�� �� TT •-`
S Sl1fl1ECTTOTHEWOPo(ENS'COMv �T P 1510 OF ECilON97000FTMELABOR , �_
�ncooe,i �u1 co i+v+in+wre v w� os � s s� ISSUANCE
� �atE:lY� � �C SMIP '� r
W �
WARNINO:FNWRETOSEd1REWORKERS'COMPENSATIONCOVEM(3EISl1NUWFULANUSWLLLBE ENERGVP/C
��—y SU&IECTMlEMPLOYERTOCRiMWALPEN/�LTtE3M10CMLiWE9UPTOONEFri1NDHE0T110U3AND ENERGYPERMIT -
DOLWiS(f 100.000),N ADD�110N TO THE COST Of COMVENSATION.OAMAGES AS iROVIDED FOH W
� SECTION 770!OF THE LABOR COOE.INTEREST,AND ATfORNEY'S FEES. RETENTION FEE: �- _
oW., CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� IHEREB�AFFIRMUNDERPENALTYOFPERNRVT/UTTHERE� CONSTRUCTIONLENOIN6AGENCV
FORTMEVERWRMIWCEOFTNEWORKFORWHICMT/ MITISISSUED(SEGJOV�.CIV.G�.
Z
W
� LENDERS NAME
� LENDER'SADDRE55 �
� ICERTIFI'M�TIHAVEREMTHISAPPIICATpNANDSTATEhV1TTi1EABOVEINFOHAlAT10NI5CONRECL TOTAL FLES ��
� IACREEtOCOMPLYWITN/ILLCITYMIDCOUMYORDINANCESANOSTATEUNiSNEUT OTOBU�
� WNSTRUGTION.NIDMEREBVAUfIqRREREVNESENTAilYE50FTNI3COUNTYTOE�7�UPd�iM
A80 EDVROPEHTYFORINSPECTIONVURPOSES. /►/�N,�y..��
Z �f•µ�y� •. COMMENTS
� �-�..e��� �
_ �.�
m pE i E N E RI
� , (. 1
� SIGNA OATE
� RECPT.NO. PAID BY VALIDATION
WHITE-0epartment Capy.YELLOW—Finance Copy.PINK—AssessorCoDY•GOLDENHOD—File Copy.GRE N—Ap licant's Copy
�40' ;eia:�A��ti:.P�w,�.r.v�y .. e,��--�a1'..r•.- . � . . :�e.:;C' �'�u.:i1 .d.,rr.n�+t� ^"^. . :.rrr....�--�•......i..r--. ..-.._ , _ ,r. «.. , _.,. ....-.�. .. ._ . __. . -_ ,�.
�ITY Qf= DIAf�fOP�lD BAR
It�JSPECTiON�F�ECOI�D
., ____-------�--...�� ���_.�
_ �
. '1����3.�?iC��.� ���d-t �1►�I�-;�=t�^ o ,4 _.. i ���:.y��,Er�l�►�� : ����p� :����������
- - .-- - -�. ___ ._.___.....___ �_ ....�__ __ _ ,_
SET BACK ' y��FLO�R JOI T�' �
FTGS/FORMSlSTEEL , -~� FHA'REQMTS _ �
ELEC7RIC GROUND " � U^JDER FL�OR DUCT , .
GROUND PLUMBING UNDER FLOOR CUPIDUIT • _I . . ,
SLAB GRADE I FIREPLACE FOUNDATION ��I � � - ' ' '� •
TEMP POWER I � FIREPLACE BOND BEAM ' - '
WATER SERVICE �I ,_i__ � MID HT.BOND'BEAPJI " ' '
ROOF SHEATHING ��'2 � 8 FT'. BOND,BEAM. I
FRAMINGNENTILIATIOP. � _ f I FINAL BOND BEAM I �
ROOF COVER ��l.rl � � � PRE-GRADING I I
ROUGH HEATING �� � �� BENCHING I
ROUGH ELEC7RIC I RDUGH GRADING
ROUGH PLUM8ING- j i FINISH GFiADING
SHOWEHfI'UB TEST POOL ELECTRIC
EXT.LATH/SI�ING � I PO�L FENCING
WALL INSULATION i POOL FINAL �
CEILING INSULATION � I OFF SITE IMPS. !
DRYWALL NAIUNG ; DEDICATIONS � �
SEWER � FINAL Ef�G.
SEPTIC TANK ; � LANDSCAPE/IRRIG. j
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST � FINAL ZONING
FINAt.CONST. � I r{RE DEPT. FINA!.
FINAL HEATING ! HEALTH DEPT. FINAL I I
FINAL ELECTRIC ' I DEV. FEES PAID �
FINAL PLUMBWG j � ENERGY �
j i ' ;
� �:e ,;a,r;��,4�.o s��;, � . �
COMMENTS �
SEPTIC TANK SIZE
SEEP PIT/U 51ZE
�_1.��
,I��.�� - - �I
i ,
_ . . , .
_`�. _ � , .. ,
._._ -_.._f