HomeMy WebLinkAbout17460 (25) �
-----�',� -- CITY OF DIAMOND BAR EXP9 F�ED
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
�. � 21825 E.Copley Drive
(909)860-3195Fax(909)861-3117 JUN 19 Z� PRESS
�`%��'� BUILDING PERMIT APPLICATION FIRMLY
� JOBSITE APPLICATION ' PERMIT J L/ P/C
o ADDRESS_23660 MOIIllIIl@IIt Canyon DATE L S O NUMBER / �7 �� #
m ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER C:;marron Oaks I HOA
"' ADDRESS_ Fi75 W F�nthi 11 R1 vr�_ #1 n4 ZONING SETBACKS
Z CITY ZIP�7� TEL.�nT��e� FRONT RW ❑
o APPLICAN TEL. S DE/SIDE STREET RW ❑
z
¢ CONTRACTOR Royal Roof Co. SIDE ❑
� ADDRESS q_(�� ��_��Ee ��� PROPOSEDUSE Tea.r eff wood shakes. Install
o CITYp�n,mnna ZIP�� TEL.�R(1(1�7(7 2
w ARCH/ENG/
z DESIGNER
w NO.DWEL. N . NO.
a ADDRESS
� CITY ZIP TEL. UNITS STORIES ��1A BEDROOMS
v�
v� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM EXEMPT FROM 7HE CANTRACTORS LI- G8f896/CBfpOff
W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITVOR (n
U COUNNWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYS7RUC-
w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIfiES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck
STATEMENT THAT HE OH SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CON7RAC70RS LI�
� CENSE LAW(CHAPTER 9(CAMMENCING WI7H SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSPe
FESSIONSCODE)ORTHATHEORSFIEISE%EMP7THEREFROMANOTHEBASISFORTHEALLEGEDEXEMP� (�
� 710N.ANYVIOLATIONOFSECTION7031.SBVANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICAN7T0 Z Re-Raot �OOO
A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5500)J:
� ❑I,ASONRJEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIFSOLECOMPENSATION, � COmmefCi81 -
Z WILL DO THE WORK,AND 7HE STRUCTURE IS NO7 IN7ENDED OR OFFERED FOR SALE(SEC.7oI4,BU51- J
� NESS AND PROFESSIONS CODE:THE CONTFACTORS LICENSE LAW DOES NOT APPLY 70 AN OWNER OF �
PROPER7Y WHO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
CL THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m
� OFFEREDFORSALEIF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOtDWITHINONEVEAROFCOMPLE-
Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING TFIAT HE OR SHE�ID NOT Bl11LD OR
� IMPROVE FOR 7HE PURPOSE OF SALE).
w ❑I,ASONMEROFTHEPROPERTV,AMEXCLUSIVELVCONTRACTINGWITHLICENSEDCONTRACTORS
� TO CONSTRUCT THE PR0.IECT(SEC.704�,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V2IU8IlOf1 ADJ.AREA
W CENSELAWDOESNOTAPPLYTOANONTJEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND
� WHOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECANTRAC� QUANTITY DESCRIPTION FEE
Y TORS LICENSE UW.).
� O I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q
� U
� �
DATE OWNER U
Z w
� LICENSED CONTRACTORS DECLARATION w
� I HEREBV AFFIRM UNDER PENAL7Y OF PERIURY 7HA71 AM LICENSED UNDER PROVISIONS OF CHAPTER �
d 9(COMMENCING WITH SECTION 7000)Of DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z
`X MV LICENSE IS IN FULL FORCE AND EFFECT. m
� LICENSECLASS r-�A �,T�'. LIC.NO. Li��n�17 . j
wDATE�-����(�� CONTRACTORP.�Taa� ��nf�T d
� WORKERS'COMPENSATION DECLARATION -� '
Q
� I HEREBV AFFIRM UNDER PENALN OF PERJURY ONE OF 7HE FOLLOWING DECURATIONS: Z
Z _IHAVEANDWILLMAIN7AINACER7IFICATEOFCONSENTTOSELF-INSUREFORWORKERS' 2
a CAMPENSATION,AS PROVIDED BV SEC710N 370o OF7HE LABOP CODE.FOR THE PERFORMANCE W
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �
�
� �_I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIHED BY SECTION
Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEHMIT IS G� 2 0
ISSUED.MV WORNERS'CAMPENSATION INSURANCE CARRIER AND POLICY NUMBEFiARE: CONSTRUCTION (l
� CARRIER A.M.S. PLAN REVIEW �
Z POLICY NUMBER 7 �Q Q
WG�F,� ELECTRIC
¢
� (fHISSE(.'fli'INNE�NOTBEOCfv1PLEfEDOFiHEPEfUMISFORONEHUI�DREDDOLLPRS(5100)ORLESS} PLUMBING
Z 1 CERTIFV THAT IN THE PERFOqMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL • � - - � ' —
(.�} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE ' " ' � ' � I ��
Uj WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE �
= SUBJECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000f THE LABOR / ^ n G�
CODE.I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE 1 1 G� /I C. 7 L1 n i{.7
O `��V V tY (.��U I _
p DATE: APPLICANT. SMIP / .S�
J WARNING:FAILURE TO SECURE WORKEHS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C -. e l
� SU&IECT AN EMPLOYER 70 CRIMINAL PENALTIES AND CIVIL FINES UP 70 ONE HUN�HED THOUSAND ENERGY PERMIT �
DOLURS(S1a0,0oo),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. - ' - ��
RETENTION FEE: �.
d CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� I HEREBV AFFIRM UNDER PENALTV OF PERJUi1V THAT THERE IS A CANSTRUCTION LENDWG AGENCY
� FOR THE PERFORMANCE OF iHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.CJ.
Z
W
� LENDER'S NAME
1- LENDER'SADDRESS
� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES �I 3. ��
w I AGREE TO COMPLV WITH ALL pTV AND CAUNTV ORDINANCES AND STATE IAWS REIATING TO BUILD WG
� CONSTRUCTION,AND HEREBV AUTHOFIZE REPRESENTATNES OF THIS COUNTV TO ENTER UPON THE
ZABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS
� T' m Imbru�lia
�
m P (PRINT) � _� � . , � .
� \ i �
� SIGNATURE F PERMITT DATE
_ , RECPT.NO. � PAID BY C VALIDATION
~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy
.. . . . . - .. .., ,. . . . .
C��l�,�° �l� ��Q�l��'i[� [���3
�s�9����`3 0�� ���C�s��
OG�J�[°�`� t a D' �: �'ti'.�.� _t� � O��G�� �?sa'� �. G�t o a
� ��g�� � �. �, ��.
SET BACK � � I � ��_� ���� FL R OIST j
- --- ----
FTGS/FORMS/STEEL � � FHA RE�MTS —��
---_ �_.._...--- --- ----
---�----- ------..._.- ---
ELECTRIC GROUND _ j.';_UNDE€� FLOOR DJCT �
--- ---- __.._...._.._ _ � __...........---
GR�UND PLIlMBWG � � UNDER FLOOR CUMDUIT � � '
SLAB GRADE j ._ _ � FIREPLACE FOUtJDATION _�_ I _ _,_
TEMP POWER __ ___ _ ;_ _FIREPLAGE Bd�!�? BEAM '
WATER SERVICE - � MID HT. BOND BEAM ____ __� _
._.- -
�-�. ....,._.........I.� .8 FT. BOND BEAM ;
ROOF SHEATHING �l 7,;,�- __.. _
FRAMWGNENTILIAI'ION � � �`'� _- ----,-_FINAL�QND.BEAM --._.._._...-----.._._.__�!_.
_._.....__.._._...
ROOF COVER PRE-GRADING �
ROUGH HEF+TING BENCHING
- --- —
ROUGH ELECTRIC ROUGN GRADING
- -- ---._ ---� _ _.- -------- ---- _�_..___
ROUGH PLUMBING ! FINISH uRADING
SHOWERlTUB TEST ' POOL ELECTRIC
EXT. LATH/SIDING i I POOL FENCING - -- ----
---._._ _._....._ -_-_--__-----....--
WALL i(VSULATION � POOL FINAL �
CEILING INSULATIOIV � OFF SITE IMPS.
�._ �
pRYWALL N�ILING � DEDICATIONS �
- ------- ----- ---- ._...__-----------
SEWER ' FINAL ENG.
SEPTIC TAMK LANDSCAPE/IRF�IG.
SEEP PIT/LL. ON S�T��NIFS•
GAS AIR TEST FINAL ZONING
FIIJAI.CONST. i �IRE QEPT. FINA!
FINAL HEATING � HEALTH DEPT. FINAL
F1NAL ELECTRIC j�T DEV. FEES PAID
FINAL PLUNIBIt�G j ENERGY _ __ i _
------ _....._._._
C�C�G t�Q(��o _
CUfVliViEi�1'S __ — -
SEPTIC TANK SIZE
SEEP PIT/U SIZE ---� ��
� -
�� � - - -___ _____._...----_---
� i � � . '
g .� ______.._______
: -�,