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HomeMy WebLinkAbout17478 (33) � �� CITY OF DIAMOND BAR � i DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES .�. y 21825 E.Copley Drive {409)860-3195 Fax(909)861-3117 PRESS �''%�� BUILDING PERMIT APPLICATION 'FIRMLY � JOBSITE � APPLICATION PERMIT PIC o ADORESS 3 Q , ►ti �� � DATE, [� NUMBER,�7y7�y r • � tssue TVPe occ APN LOT RA�T DATE CONST. GROUP p OWNER "" ADDRESS '� r ZONING SETBACKS gCITY 21P TEL. C • O'��KrI FRONT RW � APPUCANT . 1�� TEL �b . 1 REAR p � SIDEJSIDE STREET RW ❑ � CONTRACTOR SIDE p � ADDRESS PROPOSED USE - ' Lt � CITY ZIP TEL o ARCHIENG/ � z� DESIGNER NO.DWEL. NO. NO. n. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNC-R-BUILDER DECLARATION SFWADD,'REM O 1 HEREBY AFFIPoA UNpER GENALTY OF FERNRV TMAT 1 AM E%EMPT FROM THE CONTMLTORS LF Garege/Ca�port W CENSEUWFOR1HEiOLLOWINOREA50N(SEC.70]1.68USINESSANDVROFESSIONSCOOE:ANYCITYOR (n U �qJq7YWHICHREGVIRESAGERMITTOCONSTRUCT,ALTER��ROVE.DEMOLISH,ORREP/UHANVSTHUC � TURE,PRIOF TO RS ISSUANCE.AL50 REOUIRES THE APDLICANT FOR SUp1 DERMIT TO FIIE A SIGNED w P82ip/�eCIC '. STAT£MENf TUT HE OR SHE IS LICENSED PUPSUANT TO 7HE PROVISIONS OF TNE CONTMCTORS U� � CENSE UW IC?1APTER Y(CAMMENCWO MATN SECTION TOoa)OF DIVISpN 70F TME 6USINE55 ANO VRO• LL' P�VSpB '� FESSIONS COD�OR THAT HE OR SNE IS E%EMPT TME REFPAAIµp TNE BASiS fOR TNEALLEGED E%EA1P- � TION.ANYVIOLATIONOFSECTION70]1.6BYANYAPPLICANTfORAPERMIT$VBJECTSTHEMPL�CANTTO Z Re-Roof '� 11C ENAITYOFNOTA�ORETHANFNEHUNONE�OOLURS(f5no�.)� ZI,ASOMMEROFiHEPROPfRTY,ORMYEAIPLOYEESWITHWACCSASTNEIRSpLECOMPENSATpN, � Commercial - '� WI THE WORK AND TNE STRUC7URE IS NO7INTENDED OF OFiEREO FOR SALE(SEC.IOtt.BU51- _! N NESS AND PROFESSIONS CODE:TIE CANTPACTORS UCENSE LAW DOES NOT ADP�y TO AN ONMFH OF j . OROPERTY MA10 BUIlDS OR M VROVES TMEREON,AND YA70 DOES SUCH WORK NIMSELF DR MERSELF OR CL TXqOUGHHISORMEqOWNEMPLOVEES,ORONOEOTHATSUCMWPROVElAEMSAqENOTMTENDEOOR C� QOFFEREDiOR5AlE1F,HOWEYER7HEBNLDINOORIMPROVEMENTI550lDWRMNONEYEAROFCOMPLE- Z TION.THE OWNER-BUILDER WILL MAVE THE BURDEN OF PROVIN6 iH�T HE OR SHE OID NOi BUIID Oq WPROVE fORTHE PUHPOSE OF SALE). O 4�OYMEH OF T11E GROPERTY,M1 EXCLUSNEIV CONTMG7IN0 WRH UCENSEO WN7MGTORS Q TO fANSTRUCT TME PRQIECT(SEC.��l�,BUSINESS ANO VROFESSIpNS COOE:THE CONTHACTORS U• V81U0GOf1 ��U ADJ.AREA 111 CEHSEUWDOESNOTAPPLYTOANONT�EROFAPtiOPERTYNRIOBURD50FIMPROVESiMEREON.AND F YY1qCANTMCT5FpR5UpICROJECTSWITHACONTMCTOR(5)LILENSEDVURSUANTTOTMECONTMG QUANTITY DESCRIPTION FEE Y TORS L10ENSE Uw.). 0 ❑11W E%EYPT UNDER SE4 B.t PfS FOR THIS PEASON Q ' � U LL DATE �' •y OWNER ' V Z W �Q UCENSED CONTRACTORS DECIARATION W 2 IHEREBVAFFIRUUNDERVENAIT'OFVE0.tt1RVT1ATIAAIUCENSEDUNOERVROVISION50FCNAVTER �r . p. •(COMMENqNOWITHSECTION700a1OFDrv14lON70FTHEBUSiNESSMlDFHOFESSqN3OOOE,AND Z ' � MYIICENSEISNFULLFORCEANDEFfECL m � UCENSE CUSS LIC.NO. � � V DATE CONTfiACTOR a W � WORKERS'COMPENSATION�ECLARATION a � IHEREBYAFFIRMUNDERPENALTYOFPERNRYONEOFTMEFOLLAWINGDECLAMTqNS: Z � _IXAVEAN�WILLMAINTAINACEqTIFlCATEOFCONSENiTOSELF�INSUREFORYARNERS' _ COIdPENSATION,ASPROVIDEDBVSECTION77o00FT/EUBdiCODE,FORTHEPERFORMANCE W OF THE WORK FOR MR/lpl THIS VERMIT IS ISSUE�. � G _I HAVE ANO WILL IAAINTIUN WOFiKERS COMPENSATqN INSUMNCE./15 REOU�RED BY SECTqN 0 0700 OF THELABOR CODE.FOfl TNE 7ERFOAAtANCE Of THE WORK FOfl WHICH THIS PERMITI$ G�J�' � � LSSUED.MYWORNERS'COMPENS�TIONINSURANLECAHRIERIWOPOLICYNUMBERARE: CONSTRUCTION D t � c�awea PLAN REVIEW � va�crriuuaEa ELECTRIC o �ssEenonw[me+oTeE��oFnEa�w.�rrsraaar.�µra��ooivnsa+�)a��css1 GLUMBING Z I CERTIFV THAT plTHE PERFORMANCE OF TNE WOkK FOR WNICH THIS PERMR IS ISSUEO,1 MECHANICAL (�'} SNALLNOiEMPLOY/NYPEHSONINANYMANNERSOASTOBECOMESUBJECiT07ME - . � WORKERS'CqAPENSATqNL11WSOFCALIFOFNIA,ANOAGREEiHATIFISHOULDBE�ME INSPEGTIONFEE �, ��� � � S SU&JECTTOTMEWORKERS'COMPENSATIONPROVISIpN50F5ECTION97000FTHEUDOfl '- ' n�� CODE,I SNALL iORTHWITH COMPLY WITH TMOSE VROVISIONS. ISSUANCE n �� p DATE: APPLICANT: SMIP � ��G� i � %��1'� �5� � ' ENERGY P/C � WARNING:iAILURE TO SECURE Wl7HNER5'CdAPEN5AT10N COVEHAGE IS 11NLAWFl1L,AND SMALL BE I � SUOJECTANEMPLOYERTOCRIMINALPENALTIESMACMIFWLSUPTOONEHUNDREDTHOUSANO ENERGYPERMIT DOLURS(f 100.000I.W/�DD1710N TO THE LOSTOF WMPENSIITION.DAMAGES AS PROVIDED FOR IN ¢ SECTION]'lOEOFTHELABORCODE.W7EREST,ANDATTORNEY5FEE5. RETENTIONFEE: I�-?-� • -- ---- --��-��- - ��d a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � O � IH[REBVAFFIHMUNDERPENILTVOFPERIURVTMATTMEREISACONSTRUCTIONLENDINGAGENCV Za' FORTMEPERFORMANCEOFTMEWORKFOiiWMIpITNI3VEflMRI5155VED�5EC,]OG�,CIV.0.). . . W � LENDER'S NAME F— IENDER'S/�DDRESS �7 � ICERTIFYTMATIMRVEREADiMISAPPUC�TqNANDSTATEiHATT1EABOVEINFpRMATIDNISCORRECL TOTAL FEES ��3- /D � IAGREE TO COIAPLV WRH ALL CITY ANO COt1NTY ORDINANCESAND STATE UWS REUTING TO BU0.�ING � CONSTRUCTION,AND HERCBV I1UfHORRE REPRESENTATNES OF THIS COUMY TO ENTER UPON TNE Z ABOVE�MENTIONEDPR07EHTYFORINSPEGTqNYURVOSES. COMMENTS � J _ � PERMiTTFE E(P INT) ¢ ` Y o/. � � � SIGNATUREOF aMm o ,E � RECPT.NO.�JI V PAID BY G VALIDATION ITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy.GREEN—Applicant's Copy r • . r,�. . • .. .. ... . � :•, �i. . , .. , .. .i�:it„M1 , ., .. , .� � , . . . ... .-. ,. , , .. ;i tw, � . �ii'',' CF �IF�E:+��f�i� f3/"�R Ir�S�=�C"3 QC+f�! �?�CC�RD _ __._._..._._.�... _�.._ _____. _ .__._____��_______ _�_..�__._.�._._ _._ � _ . __ ... . _ �I��.��,.a��ke ntm)it r�:.'�r�.. �I.��`i�;�,.F`�;i.s �(��.E-'i � .�:��¢�ie'�►�i ej� ��!: (►��-7��c'�t'�'�� ���� �.____-------------. .__.`. __..--, , ---..._ ._ .___._.._.___ : _-. _____----___...._.. _. ---:_ ________�_ _-_=�_____.___ 5ET BACK � � � I FLOOR JOIST . � I FiGSlFORMSiSTEEL l 1 ! � FHA REOP�ITS � ELECTRIC GROUND � _�__ _ ' I UNDER FLOOR DUCT � � GROUND PLUMBING ! UNDER FLOOR CU�!DUIT SLAB GRADE FIREPLACE FOUNDATION � TEMP POWER I � FIREPLACE BO�dD BEAh1 WATER SERVICE ! � _� FJ!ID HT. oOPJD BEAr�1 ROOF SHEATHING l�J2�p� /C. �-c.e_.� 8 FL BOND 6EAP�1 _ FRAMINGNENTILIATION �__ � FINAL BOND BEAh4 ROOF COVER ��jOL PRE-GRADING ROUGH HEATING BcNCHING � ROUGH ELECTRIC ROUGH GRADING ROUGH FLUMBING ; �—FItJISH GRADING SHO�NER�TUB TEST l.I POOL ELECTRIC EXT.LATHlSIDING ; POOL FENCING � 4'VALL IfJSULATIOP� POOL FINAL CEILING INSULATION OFF SITE IMPS. QRYWALL NAIUNG DEDICATIONS SEWER FINAL ENG. � SEPTIC TANK J . LANDSCAPE/IRRIG. SEEP PIT/L.L. ' ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. �IRE DEPT. FIP�AL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING EPJERGY .�,...'a-e,......,_�..�......________--__._.•- r l�i,'.{�T r�: ?':�€1( COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE � �R�i � , i ���� i� i , .j I' ___._.,.____.....-----_.__.._.�,i � �