HomeMy WebLinkAbout16862 (23) CITY OF DIAMOND BAR - ,.i
�� � - DEPARTMENT OF CaMMUNTfY&DEVELOPMENT SERVICES EX P I R ED
_ 21825 E.Copley Drive
(909)860-3195Fax(909)861-311� JUN 171002 PRESS
"'%�'� BUILDING PERM[T APPLiCATION FIRMLY
N JOBSITE � l,.� J � APPLICATION �PERMIT � a P/C
o ADORESS �� ��•••- �
� DATE NUMBER #
c� ISSUE TYPE OCC
-- APN��OT TRACT DATE CONST. GROUP
¢ OWNER f�_> '`��� �
p ADDRESS—� � �+�5 c tJ'r-sL Z , ZONING SETBACKS
Z CITY � ZIP TEL. FRONT RW ❑
S APPUCA E � REAR O
SIDEISIDE STREET RW ❑
� CONTRACTO — � SIDE O
ADDRESS `� ` '� �
0 CIN, ..,n� �.tin. ZIP°��(-�TELG?f, ��� 3�� PROPOSEDUSE <<
o ARCH/ENG/
� DESIGNER NO.DWEL. NO. NO.
� ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�
OOWNER-BUILDER DECLARATION SFR/ADDlREM
p I HEREBV AFFIRAI UNDER VENALTY OF GEfWRY THAT I M1 E7(EMPT FROM THE CONTMCTORS Lb Garage/Cerport •
W CENSEUWFONTHEFOILOWINGREASON(SEC.7071.6BUSINESSrfJOPROFES5IDNSLODE:ANVLITYOR (n
U CWMYWHItl/REOUIRESAPEHMITTOCONSTRUCT.111TE0.1MPROYE.DEMOLISH,ORREVAIRANYSTRUG W PdtIO/DOCk
LL� TUR�FRIOR TO RS ISSUANCE,A150 REOUIHES THE APPLICANi FON Sl1CH PERMIT TO illE A SIONED W
� STATFMENT THAT HE OR SME IS LICENSED OURSUANT TO TME PROVISIONS OF TIE CONTiLICTORS LI-
.� CENSE UW(CMAPTER Y(COMMfNdN6 WIiH SECTiON 7000�OF DIVISqN�Oi 7NE BVSINESSAND VRP LL- PooUSpa
FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTMEALLEGFDE%EMP- (�
� TION.ANYVIOLATIONOFSECTION7W1.68YAN'/�PPLICANTFORAVEFMITSUBJECTSTHEMPUC/�MTO Z Re•Root ��
� ACIVR VENALTT OF NOT MORE THAN FNE HUNDREO DOlURS(f500�.�:
0 O�ASGWNEROFTHEPH07ERTY,OHMYEMVIOVEESVnTHWAGE5A5ME1HSOLELOMPENSATION, 0 '(,�mmB�Cf81
Z WILL DO TME WORK.MIO THE STRUC7URE IS NOT IMENOED OR OFFERED FOR SALE(SEC.70N,9USI• J
NESS AND PROFESSIONS CODE:THE CONiMCTORS LICENSE UW DOES NOT MPLY TO AN OWNEH OF
� VROPERTVWMOBUMSORIAIVROVESTHEREON.ANDMAIODOESSUq1WORNHiMSELFORHERSELFOF m
� THROUGNHISORHERONMEUPLOYEES,FFOViDEOTNATSUOIIMPROVEMENTSARENOTlRENDEDOR
w OFFEREOFORSALEtF,HOWEVERTMEBVILDWCORMPROVEMENTI550lDN1THiNONEVEAROFCOM7LE�
� TON.TME OWNER-BUILDEl1 WILL HAVE h7E BURDEN OF PROVIN4 THAT HE OR SHE DID NOT BUILD OF
Z MPROVEFORTHEWRPOSEOFSALE�
_ ❑4��'�'NEROF7MEPROPERTY,AME%ClUSIVELYtOMMCTWGWITHLICENSEDCONTRACTOHS
� TO CONSTi1UCT TME iR0.1EC7(SEG 70��.Bu51NESS ANO PROFESSIONS GOOE:THE COMMGTORS ll• V81UeSI0f1 ADJ.AREA
W CENSEUWOOESNOTAPPLYTOANOWNEROFAVROPERiYWMOBUILD50RIMPROVESTMEREON.AN�
� W/IOCONTMCTSFORSUCHPRQIECTSWITHACONTMCTOR(S�LICENSEOPURSUIINTTOTHECONTMG OUANTITY DESCRIPTION FEE
� TORS LICENSE LAW.).
Q OIAAIIXEMP7UNDEHSEC B.67.C.iORTNLSREASON �
� U
�
LL' DATE OWNER V
W
F UCENSED CONTFiACTORS DECLARATION W
� 1 HEREBY AFFIRM UNDER PENAITYOF GE0.IURV iHAT I AM LICENSEO UNDER CROVi5i0NS OF CMMTER V.
p. !(CqI/dENCIN(3 WRH SECTIDN 7000)OF�INSION 70F THE BUSINESS AND PFiOFE55i0N5 CODE.AND Z
X ►IYLICENSEISINFULLFONCEANOEFFECL m
LL1 //� � �
� LICENSE C LIC. O.�(,��. J
H
V DATE �C CTO d
W
� `Q yJ(7RKERS'COMPENSATfON DECLARATION 4
� -�u'3/ U
� IHE �AFFI UNDERPENALTYOFPERIURVONEOFTHELOUOWINODECLAMT S: �� a
� �IIUVEANDWILLMAMTNNACENTIFICATEOFCONSENTTOSELFdNSUREFORWORNERS' 2
� COMPENSATION,ASPROVIDEOBVSECTION71000FTHELABOHCODE.FORTHEFERFORAIANCE w
E WOpK FOR WHICH TIIS PERMIT IS iSSUED. �
G
1 EANDYALLMAI TAINWORKERS'CAMFENSAT�CE.ASREWIREDBVSECTION ` � ��'� /�
O OOOFT U�HOR 4FOR71iEPERWRMANCEOFTHEWORKFORWNIp1TM13iERMITIS I I
� ISSUED. RNER C�AlAENSATIONINSU ANDPOLICYNUMOERME: CONSTRUCTION �,�
7 �qq�Eq \ PLAN REVIEW
� POLICYNUMBER ELECTRIC
� (iM55ECI1d�NEmNOTBECd.RETEDOFTIEPETY.tT6FOR0�'EMlDf1EDDQ1AiLlSt00)OqIE 1 PLUMBING
W MECHANICAL
z I CERTIFY THAT INT/IE FERFORAAANCE OF THE WORK FOR WHICHTHIS PERMIT IS ISSUED,1 __ ___
(} SHALLNOTEAIPLOYANViERSONINANYMANNER50 .SUOJECTTOTHE
' N MIO ERS'COA1 ENSATIONUN50FCALIFORNIA �GREETHAT 5/10ULOBECAME INSPECTIONF �'� �
S ECTTOT WORKER5 NSATIONVROVIS OFSECT ]TOOOFTHEU80 - - - �;
� I�
E,ISH FOR71MlITMCOM vnn+na vaoh ar+s. ISSUANCE �
� SMIP ����4�gn� � ���� -.
0 on�: � aav� rrr:
LLw WARNIN(i:FiuLU TO 5 AE V�qRKERS'COuiENSATION CO �GE IS UNLAWF D SHAII BE ENERGY P!C y
6U13JECTANEMPLOYERTOCRIUWALPENAL1tE5ANOCNILfwE t1PTOONE REDTHDUSMID ENEIiGYPERMI '
DOIURS(f10o,0001,IN ADDITION i0 ME COST DF COMPENSATq OA6u AS CROVi0E0 FOR IN � — I
� SECTIDN77080FTHELABORCODE,INTEREST.ANDATTORNEYSF RETENT�ONFE --
a CONSTRUCTION LENDING AGE - PRE-ALT FEE:
Q IH[REBVIIFFIRIAUNDfRPENALTVOFOFRJURVTHA7THEREISACONSTFUCTIONLENDWOAGENCV
d FOH iHL PERFOWAANCE OF TNE WOFN FOR WHICN iMIS VERMIT IS ISSUED(SEC.]097,CIV.C.).
�
� LENDER'S WWE
� LENDER'SADDRESS � �� • ��
WICERTIFYTNATIMAVEREWTHISAPVlIGt10NANO5TAlETlUTTiEABOVEWFORIAATIONISCARRECT. TOTAL FEES
� IACREETOCOMPLVWITHALICIT`/ANDLOUNT/ORDINANCESANDSUTEUWSREUTINGTOBUILDIN6
ODHSTRUCTION.ANO NEREBY AUT110RRE FEPRESEN7ATIVES OF THIS Cd/N7Y TO ENTER UDON iHE
Z #IENTIONEOOR PERTYLORINSPECTIONPURPOc5E5. COMMENTS
� '`.►� , `
�
¢ RMITTEE NAM FRINTj
N
� SIGN�TUREOFPERMITiEE O�TE
� � RECPT.NO. PAID BY VALIDATION
WHITE—Departmen opY. ELLOW—Finance Copy,PINK—Assessa Capy,GOLDENROD--File Capy,GREEN—ApplicanYs opy
� - - Cii o_'f C�F�L'1�f��:(�€�'?� �'3�'�f;
If�Sf�EC�"fOI+] �i�=C;C7�E7
� .___�..—. _____.._� .._
_�______.
_ _ __..._..
_ _ . _
1►�F-'���=ic`�[lo��`i �}�tC=. �I►��`1.�=�c "'c���t I�`F-�F7 c`'�lc')��E c�;,�:r'_ �w►�E. CI�Ef dcj.�
..�_.._..__. ..___.__.._ ______.._ . ___ _ _._--- --____..,,
� .
_ ..... _____------- --- ..._.._._____ _.___.__�___.._�_._�.J._.___�___��.��
SET BACK � _ : ' I FLOOR JOIST �
FTGS/FORP�IS;STEEL � FHA REQMTS I
ELECTRIC GROUND UND�R FLOOR DUCT 1{
GROUND PLU��IBING I UND�R FLOOR CUMDUIT I '
SLAB GRADE I � FIREPLACE FOUNDATION
TEMP POWER I I FIREPLACE BOND BEAM
V�JATER SERVICE � � , MID HT. BOND BEAF1� �
ROOF SHEATHING �'2C � � 8 FL BOND QEAti1 �
FRAMINGNENTILIATION i FINAL BOND BEAM
FlOOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC � ROUGH GRADING �
ROUGH PLUMBIfJG � FINISH GRADING
SHOWER/TU8 TEST � � POOL ELECTRIC
EXT. LATH/SIDING j I POOL FENCING
WALL INSUTATiON POOL FINAL j'
CEILING INSULATION OrF SITE Ih4PS.
DRYWALL P�AILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS. �
GAS AIR TEST FINAL ZONING �
FINAL CONST. � GIRE DEPT. FINAL �
FiNAL HEATING � HEA�TH DEPT. FINAL
FINAL ELECTRIC � � DEV. FEES PAID
FINAL PLUMBING � ENERGY
i
N€�.,� � r.t� .,tr:�'_--------------,.1-
COMMEP�TS � � i� -
SEPTIC TANK SIZE
SEEP PIT/U SIZE
��� �
'�I�r�
I
�j i , ` •