HomeMy WebLinkAbout17381 (25) �� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNfI'Y&DEVELOPMENT SERVICES EXP I RED ��w 21825 E.Copley Drivo _ (909)860-3195Fax(909)861-3117 �UN 19 2002 PRESS `'-��� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATIO PERMIT P!C o ADDRESS 23620 Monument Canyon QATE a� NUMBER L7 3�/ # � APN LOT TRACT DATE ONST. GROUP p OWNEfl Cimarron Oaks I HOA Q ADDRESS___675 _W. FooY_hill �1V�C1.� #lO4 ZONING SETBACKS z aTv Claremont ziP 1711 T��,��=31-63 FRONT Rw ❑ g APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW p a� CONTRACTOR RO al Roof Co. SIDE ❑ Q ADDRESS rice t. Remove existing wood shakes. � C� Pomana ZIP�],ZE1Z TEL,�RO(1� 4(�O- PROPOSEDUSE o ARCH/ENG/ 769 CORIpOSl lOII S lIIQ 2S z� DESIGNEfl NO.DWEL NO. NO. � ADDAESS UNITS STORIES rwn BEDROOMS � CITY ZIP TEL � v� OESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� �WNER-BUILDER DECLARATION SFR/ADDiAEM O W GENSEUWFORTFIE�OlOW1NOREASON(SEC.TJ�I6BUSN�MIDPPflOFE5510N5W0�EANVCITYON GaragelCarport � U �7yµT11pIRE0UIqESAPEAMRTDCQNSTRUCiA:TER.IIAPROVE.DEUDLISH.ORREPAIql.NYSTAUC• W patlo/Deck W TURE,FRIDR TO ITS ISSUMICE.ALSO REOUIqE3 THE MPLICANi FOR SUCH PERMITTO FIIE A SIGNED STATEMEN7 hIAT HE OR SNE IS LICENSED GURSUANT TO TNE VpONSIONS OF 7HE CANTMCTORS U• � CENSEUri(p/MTERi(OOMMENCINOWITHSECT�IX/7D00)OFDIVISqN70FTHE8USINESSANDPRO� �- PooVSpa FESSIONS[DDE)OR THAT HE OR SHE IS E%EYPT TNEREFROu AND THE B�SIS FOR TME ALLEGED E%EMP• � TqN.ANYYlOUTIONOF5ECT10NT031.68�ANYMPLIGWTFORAPERMITSUBJECTSTHEAPPLIGWTTO Z Re-Fioof A CML VEN.LLTY OF NOT MORE iIUN FNE HUNDFED DOLLARS p500).�: OI.AS OYVNEROFTHE PROPERTY,OF MY EMROYEES WITH WACES AS THEIR SOLE COMPENSATION, � Q Commercial - YNLL DO THE WORKµD THE STRl1CNHE IS NOT INTENDEO OR OFFEFED FOfl SALE(SEC.70U.B1151� J � NESS M!D GROFESSIONS COOE:TME CONTMCTORS L�CENSE LAW DOES NOT APFLV TO AN OWNER OF = PROPERiY YVMO Bl1RD5 OR IMVflOYES THEREON.ANO WMO DOES SUQ1 WORK HIMSELF OR HERSELF OR � TIROUCFIHISORHER0IN�EMPLOYEES,PROV10[01HATSUCMIMPROVEMENTSARENOi7fTENDE00fl m � OFFEREDf-0fl5ALE1F.HON�EVERiHEBULDINQONIMVROVEMEMI55IXDWITMNONEYEAROFCAMRE• Z T10N,7ME OWNER�BURDEfI WILL HAVE THE BUROEN OF FROVINO THAT HE OH SHE DIO NOt BUILD OR � MPFIOVE FOR TME PURPOSE OF SALE} w OI,ASOWNEROFiHEPROPERTtl,M1EXCLUSNELYCONTRACTINfiWrtHL10EN5EDCONTMCTORS � TO CONSTRUCf THE PRO.IECT(SEC.7olt.BUSINESS M1D FROFESSiONS CODE:TME CONiMCTORS LI• V01U9ti0n SnOO AQI.AREA W CENSEUWDOESNOTAPPLYTOMIOWNEROFAPHODERTYWNOBURD50RIlAPROVESTHEpEON.ANO � Y.9IOCONTMCi5FOA5UCM7R0.1ECT5W17HACONTMCTOR�S)LICENSEDRJRSUANTTOTHECOMMG OUANTITY DESCRIPTION FEE � MRSLICENSEUW). � ❑IAMEXEIAPTUNDERSEC. B.iD.C.FORTH�SREI.SON a � U � DA7E OWNER r Z W F LICENSED CONTRAGTORS DECLARATION W � IHEREBYAFi1qAlUNOERPENALNOFPEFWiiYTHA711UALICENSEDUN�ERVROVI510N50FCNMTER � d •(COA�MENCWOWITHSECTION700D)OFOMSION�OFTHEBUSINESSANOPflOFESSIONSCODE.AND Z X YY LICENSE IS N F1AL FO{3CE ANO EFiECT. m LL � LtCEN5ECU55 C-39 HT(: uc.No.L�],3067 _. � � w pATE7�i��_ COMfUCTOA�tvt.���'�Q.f�()r � .� � WORKERS'COMPENSATION DECLARATION a N I NEREBYAFFIRM UNDER PEN�LTY OF FEH.RJH'IONE OFTHE FOLLON7NG DECUiU710NS: V "' a � _IMAVEANDW�L�MAMTNNACEflT�FIGTEOFCONSENTtOSELF•INSUREFOfiWORKERS' _ COMPENSATiON,ASPqOVIDEOBYSECTION77ooOFTHEUBORLODEFORTHEPERFOPMANCE `U OF iHE WORK FOR WHlpl THIS DERMIT IS ISSUEO. � G � ���IHAVEANDWILLMAINT�INWORNEpS'COIAPENSATIONINSURANCE,ASREOUIREDBYSECTION /f.�. � �7000FTHE LABOR COOE,FOR THE PERFOFMANCE Of TME WORK FOR WMCH7MIS VERMiT IS 7 ���� ISSUED.MYWORKERS'COr.�PENSATqNINSURANCECMRIERANDPOUCYNUMBERME: CONSTRUCTION /i � CARPoER A.ri.`S. PLANHEVIEW � POLICYNUMBER WC2—L��.IS 9� 77 ELECTRIC � (IHSSEC110NNEmNOTBEOp.a;E7FDOFhEPEPMT6Fqi0NEW�DRE00d.UiLSIS�00)ORlE55} PLUMBING Z I CERTIFY THAT M THE FERFORMANCE OF THE VlORK fOR WHlpl THIS FERMR LS ISSUED,I MECHANICAL (� SHAILNOTEMPLOY�NVPER50NM�NYMANNEF50A5TO8ECO�.�ESUBJECTTO7ME WOPo(ERS'COMPENSATIONUWSOFCALIFORNIqANOAGREETHATIFIS�KKILDBECOME INSPECTIONFEE t"""'"--"""-'- � Sll&IECTTOTHEWORKEfiS'COMPENSATqNPfiOV1510N90FSECTKKi77000iTHELABOR - + S CODE,ISMAILFORTMW17NCpMPLYWRHTHOSEPROV�SIDNS. ISSUNNCE �•� � � � � O DATE: APPLICANT. SMIP � 1 ^ - O WWARNMC:FMURE TO SECUFE WORKERS'COMPENSATION COYER�GE IS UNLAWFUL,AND SHALL BE ENERGY P/C � �f -� ` I LL SUBJECTANEIAPLOVEFTOCRIMWALPENALTIESANDCMLFWESUPTOONEMUNOREDTIIOUSAND ENERGYPEHMIT I r DOLUiLS(S10D.000),INIDDITIONTOTHEGOSTOFCOMPENSATION.DAMAOEShSPPOV10E0FORIN � �, �-- � SECTIDN�t000FTHELABORCODE,NTEREST,ANDATfORNEYSFEES. qE7ENTIONFEE: a CONSTRUCTIONLENOINGAGENGY PRE•ALTFEE: � � � � � - � � Q IHEREBVAFFIFMUNDERGENAITYOFPEfWRYTMATTNEREISALONSTPUCiIONLENDINOAGENCY 0- fORTHEPEHFORAIANCEOFiNEWORKFORWHIpITHi5DER1AITISISSUEO(SEC.]091,CIV.C). � � 4ENOER'SNAYE � �ENDEflSADDRE55 W ICERTIFY7HATIIUVEAEPDTMSMPLICATqNMJDSTATETHATMEABOYEWFONMATqNISCORRECT. TOTALFEES /I�� " O � IAGREE TO COIAVLV VATHALLCfTY ANO C9UNTV ORDINMICES�NO STATE UN5 RELATWO TO BUIl��N6 � CONSTRUGTION,ANDMEREBYAUTNORIZENEPRESENTATIVESOFTHISCOUNTYTOENTERUPONTIE Z ABOVE�IAEMqNEDCROPERTYFORINSPECT�DNPUAPOSES. COMMENTS � Tom brugl' s m DEiUAi77EENUA (n � �'� �J Uj SIONATUREOFFERMI E , DATE � HECPT.N0. P/UD BY � VALIDATION WHITE-0epartment Copy,YELLOW—Finenee Copy,PINK—Assessw Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy -•- • , , ,; .,. , . . . .. - - - . . .. .. _ . . .. . . ._ .., , , , . , . . .. .,���.. . ... . . . �t���� �� �ri�,r,na��� �r�� ir,fi.�-���ic�r� �ec�ro Ivh_Js�=��i�/�,11r0 � �.y..�E' _ `li�+`��.j=dQ, rC,�:1;._____._ �1'�+`���..�C'.�i{�:�1!�� Wy`°i.E':.i (►r��r�'_'{t�i��� I .._...___---...- ---__.._w..�_.._ .. . .. .. _.. ,_____, . . _ _ _. .. ._____.. _. ��. .._.:..,..-- - __._.._ . . _._�.__---.___�� _.._.__....___`..,____ SET BACK 1 _ `_ I�FLaOR JOIST FfGS/FORMS.�STEEL �_ ! � FHA REQ"�1TS ELECTRIC GROUfJD � '� UN��F� FLOOR DUCT � GROUND PLUP�IBING ~ Ut�lDER FLOOR CUMDUIT SLAB GRADE FIREPLACE FOUtJDATION I TEMP POWER � FIREPLACE E30ND BEAM I WATER SERVICE I __( _MID HT. BOND BEAP�1 ROOF SIiEATNING ���=c/ ,��� i I II Fr. E30�1D B�AM I FRAMING,NENTILIATION� FI�dAL 60ND E3EAM ROOF COVER � PRE-GRADING � AOUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUM8ING 1 � FINISH GRADING SHOWER/TUB TEST __�_ POOL ELECTAIC EXT. LATH/SIDING I POQL FENCING V'JALL INSULATION POOL FIfJAL � CEILING INBULATION QFF SITE IMPS. � DRYWALL NAIUNG DEDICATI�NS � SEWER FINAL ENG. SEPTIC TANK LANDSCAPElIRRIG. SEEP PIT/L.L. ON SITE ItJ!PS. GAS AIR TEST FINAL ZONING FINAL CONST. �IRE DEPT.FINAL FINAL HEATING � HEALTH DEPT. FINAL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUMBING � ENERGY • • - � r,:''�f"' <!)' C�flf.: �' � COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE ►�I ` ,���� - � ,� . , , ,,,