Loading...
HomeMy WebLinkAbout12-538 �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 I (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ��'°^°+ BULLDINGPERMITAPPLICATION FIRMLY I � JOBSITE ^ O�c �A Or„;� APPLICATION L'� PERMIT � p/C o ADDRESS_41 •� I��� �i ��`'�VJ 1� DATE �/ � I� �� NUMBER�Z���� � � APN LOT TRACT �SSUE i � TypE I p OWNER S�+O ES��it DATE � I CONST. GROUP � � ADDRESS o1C�iZ S Morh�N �,q.. ZONING SEBACKS � � `1-�Lc FRONT Z CITY� �d � ZIPr�-� TEL. ZT) 1�1'�'1pC/S RW ❑ o APPUCANT o acA3n{�.�,A TEL. 21 7 � REAR � � SIDE/SIDE STREET RW p i � CONTRACTOR •C.wr- SIDE p ADDRESS � CIN a r ZIP A 1�63 TEL PROPOSED USE o ARCWENG/ �z DESIGNER NO.DWEL. NO. NO: a ADDRESS � CfJY ZIF TEL. UNITS STORIES BEDROOMS � � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� �OWNER-BUILDER DECLARATION � SFR/ADD/REM O p I HEA�V AfFlRM UPIDER'PENALT'OF PERAIRV TNAT I AM E%EMPT FROM 7}�E CONTAAC70R3 LI- G8f8 B/C8 W CENSEUWFOR7HEFOLLOWIN(3REilSON(SEC.7o31.6BU5ME5SANDPROFE551pNSCOOEANYGTYOR (� 9 �rt � CIXJNTYWHICHqE0U1qESAPERMR7000NSTRUC7.ALTER,IldPROVE.DEMOLISH,ORREPNRANY3TRUC- W P0ti0/DBCK � NRE,PWOR 70 RS ISSUANCE,ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FlLE A SI�NED w STA7EYQfT 7HA1 HE OR SNE IS LICENSED PUHSUANT TO THE FROVISIONS OF THE CONiRACTOqS L4 � CENSE LAW(CVUYTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE59 AND PR6 �'1' POOI/Sp9 � ^ FESSIONSCODE)ORTHATHEORSHEISEXEMPT7HEREFROAIANOTHEBASISFORTHEALLEOEDE%EMP� (ry � TION.ANVVIOLATIONOFSECTION7031.6BVANYADPLICJWTFORAPERMITSU&lECT37HEAVPLICANTTO Z� Re-Rool � A GVIL VENALiV OF NOT MORE�THAN FIVE HUNDRED DOLURS(i600).): 0 ❑4ASOWNEROFTHEVROPERTY,ORMYEMPLOVEESWITHWA6ESASTHEIRSOLECOMPENSATION, 0 CpmmgfC�l Z WILL DO 7HE WORK AND 7HE STRUCTURE IS NOT INTENDED OR OFFERED FOH 9ALE(SEC.7o'i,BUSI- J � ' � NESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW�OES NOT A7VLY TO AN OWNEp OF j � PROPERtY N?i0 0UM1D3 OR IMPROVES THEREON,AND WHO DOES SUq1 VqRK HIMSELF OR HERSELF OR WiHROUGHHISORHERONNEMPLOVEE3.VHOVIDEDTHAT5Uq11MPROVEAIEMSARENOTVffENDEDOR m . Q OFFERIDFORSALEIF,HOWEVER7HEBUIIDINOORIMPROVEMENT1550LDWITHINONEYEAROFWMPLE- Z T�ON..T1E OWNER�BNLDER WILL HAVE TiE BURDEN OF.PROVMO THAT HE OR SHE DID NOT BURD OR . � IMPROVE FOR THE PURP0.SE OF SALE): � W ❑I,ASONRiEROF�THEPROPEHTV,AMEXCLUSNELYCAMRACTINOWfTTILICENSEDCONTRACTORS Q TO CONSTRUCT TF1E FRQIECT(SEC.7W1,BUSINE59 ANO PROFESSIONS CODE:TME-CONTRACTOR9 ll- V8lueti0fl� q�q(j� � ' W CENSE LAW DOES NOT APVLY TOAN OWNER OFA PROPER7Y WHO BULDS OR W GROVES TMEREON,AND ' � WNOCOMAAC75FORSUCHPR0.IECTSWI7HACONTRACTOH(S)LICENSEDPURSUANTTOTHECONTRAF p�q�17Y � DESCRIPT1pN roas ucENse uw.�. FEE . Q ❑I AM EXEMP7 UNDER 6EC. �B.d P.4 GOR iH15 LIEASON � � U � DATE OWNER � Z U � UCENSED CONTRACTORS DECLARATION � � I HEREBV AFFlRAI UNOER PENALTV OF PER0.IRV THAT I AM�LICENSED UNDEH PROVISION9 OF.Cl1APTER � � � 9(COMAIENCINO WITH SECTIOM 7000)OF DIVISION 7 OF THE&151NESS NtD PROFESSIONS CODE,AND Z J� ��� M'LICENSE IS PI FULL FORCE AND EFFECT. ., � UCENSE CLASS L�� LIC.NO. 6 W��)� � . v on� Ma�i � . 2d�2 corrrrwcroR.�(c ' a � � w � WORKERS'COMPENSATION DECIARATION ��AN I � - � - - � 1 HEREBV AFFIH►1 lR1DER PFNALTV pF pERIUqY ONE OF THE FOLLOWWO DECIARATqN$: V N Z � _IHAVE�AND�WILLMAINTAINACERTIFIGTEOFCONSENT70SEtF-WSUREFOqKORKEqS� ERS CCYdPENSA710N,AS PROVIDED Bv SEC710H 370o OF 7HE LABOR COOE,FOq THE PERFORMANCE U� . OF THE WORK FOR WNICH THI3 PERMIT IS ISSUED. W � � OW _IHAVEANDNR�LMqR(TAWWORKERS'�COMGENSATIONINSURANCE,AgREQUIREDBYSECTION � /� 3700 OF-THE LABpR CODE.FOR THE PERFORM/WCE'OF THE WOPo(FOR WH101 THIS PERAUT IS � .� y� /�// . ISSUED.MY WOR RS'COMPENSATION INSUFiANCE CARqIEH AND POLICY NUMBER ARE CONSTRUCTION � ::T jcnaroEa_�O�o �1 PLAN.REVIEW . . . �Z va.icv miin�sea � Dd�S�Z S�"9D'� ELECTRIC Q 0 (hi6SEClioFlN�NOTBECOAFtET�OF7NEaERAfistbRatEHUrafi�oauastsiro)oalEssl �PLUMBING � W Z I CEH7IFV THAT W hiE PEHFORMANCE OF THE WORK FOR WFIIGH THI$PEWAIT IS ISSUED,1 �MECHANICAL C7 SHALL NOT EMPLOY ANY VERSON M ANV MANNER SOAS TO BECOME SU&IECT 707HE (/� NOflNERS'CAMPENSATION UWS OF CALIFORNIA,AND A4REE THAT IF I SHOULO BECOME �NSPECTION FEE SUBJECT TO THE WORKERS'COMPENSATION PRONSIONS OF�SECTION 97o00F THE LA9pp �' -/ O O ,caAoE,i sw�u warriwin+coua�y Nnn+T�+osE aaov�sioNs. ISSUANCE � `p DATE:�` Zh= APPLICANT: ���r�1A�i��{/� �SMIP � ENERGY P/C WAFNWQ�FA0.URE 70 SECURE WORKERS'COMPENSATqN COVERAGE IS UNLAWFUL,/V1p 5�{N,�BE � SUBJECT AN EMPLOVER TO CRIMINAL PENAL71E5 AND CML FW ES UP TO ONE MUNDRED TVibUSAN� ENERGY PERMIT DOLURS(5100.000).W ADDITION TOTHE COST OF COMPENSATION,DAMAOES AS PROVfDED FOq IN J 6ECTION 370E OF 7HE LA80R CODE,(NTEHEST,AND ATTORIJEYS FEES. ' RETENTION FEE: ' Q O . GONSTRUCTION-LENDING AGENCY �PRE-ALT FEE: � 1 HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS ACONSTRUCTION LENDINO A(iENCY Z �FOR THE PERFORMANCE OF hIE WORK FOR WH1CH h115 VERMR IS ISSUEU(SEC:�3oe7,qV.C.). W �. LENDER'S NMIE . . . . .. � LENDER'S ADDRESS - ' � � � ICEFTIFYTW�TIHAVEREADTHISAPVLICATIONANDSTATE�T1iATiHEABOVEPIFORMATIONISCORRECT. TOI'AL FEES /5 . I 7 1 A6REE T0 COMPLV WITH ALL GiV AND COUNT`/OROWANCE$AND STATE UN5 fiElATWO TO BURDWO � CONS7RUCfION,ANDHEREBYAUiHORREREPRESENTATIVE50FTHISGOUNTYTOE17rERUPONTHE � Z ABOVE�MENTIONED PROPERTY FOR INSPECTION PURPOSES. (�'QMMENTS 0 ��' 1 J /t7�d �AC.G�`/�1'�� � °O veaMirrE ru��vwHr� ¢ � .��!' Ma.� I , 2 0�2 N SIONATU F PEiU1fTTEE p�7 2 � RECPT..NO. PPJD BY VALIDATION � WHITE—De rtment pe Copy.YELLOW—Flnence Copy,PINK—Assessor Copy,GOLpENRQD—File Copy.GREEN--ApplicanCa Copy . CITY OF DIAIVIOND BAR - INSPECTION REC�RQ .� ,. ., i: . ,.. Y: ,f a . �n� ' ' 1 3.,r i;�. . � 1 �..o � _ .. . ., - .' ,y, - ,. � 4 �,. _, � � � �t ° Q �}...� • � y, � � '�`� e �. fy. SETBACK _ FLOURJ�IST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUNO UNDER FLOOR DUCT GR�UND PLUMBING UNDER fL00R CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ROOF SHEATHING 8 FT.BON�BEAM FRAMING/VENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRfC �j � ; ROUGH GRADING ROUGH PLUMBING �j _�"y'� �� � � �r, FINISN GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING IfJSULATION OFF SITE IPAPS. DRYWALL NAILING DEDICATIONS 5EWER FINAL ENG. SEPTICTANK LANDSCAPE/IRRIG. ^ SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST �FINAL ZONING FINAL CONST. j FIRE DEPT.FINAL FINAL HEATING ;HEALTH DEPT.FINAL FINAL ELECTRIC DEV.FEES PAID FINAL PLUMBIlVG �f'" - !ENERGY FINAL PLAtdING �FINAL ENGINEERING . � e � COMMENTS _ SEPTiCTANK SIZE SEEP PIT/U SIZE — �� � .� � �� . + ��, � '� �.� � �'s= ,�r Y � �,._,Z '.- n�� � �� �� �,� fi �ti- �., j ��]�� l����� �'�'3- _ - R � � "