HomeMy WebLinkAbout18126 (25) , --- - — -------1.
CITY OF DIAMOND BAR �_�
--��` --- DEPARTMENT OF COMIvfUNITY&DEVELOPMENT SERVICES
I I
21825 E.Copley Drive �
'� (909)860-3195 Fax(909)861-3117 PRESS
��'%�»��� BUILDING PERMIT APPLICATION FIRMLY
� JOBSITE /17 � � APPLICATION 7 /,� PERMIT %� P/C
' o ADDRESS�'�' Ls DATE �l NUMBER #
� ISSUE TYPE OCC
APN LO TRACT DATE CONST. GROUP
p OWNER
p ADDRESS 'J ZONING SETBACKS
Z CITY TEL. FRONT RW ❑
� APPLICANT T REAR ❑
� SIDE/SIDE STREET RW ❑
z -
Q CONTRACTOFi SIDE ❑
� ADDRESS � PROPOSED USE
oARCFi/ENG/ ewood,�� 071�2 TEL.
�z DESIGNER NO.DWEL. NO.
NO.
a ADDRESS
� CITY ZIP TEL. UNITS STORIES BEDROOMS
�
cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
I HEREBV AFFIRM UNDER PENALTY OF PEFiJURV THA7 I AM EXEMPT FROM THE CON7RACTORS LI� G8f89B/C2fp01t
W �CENSELAWFORTHEFOLLOWINGREASON(SEC.7o31.58U51NES5ANDPqOFE5510NSCODE:ANYCINOR (n
U COUN7YNMICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMFROVE.�EMOLISH,ORREPAIRANVSTRUG � �
w TURE,PRIOR TO ITS ISSUANCE,AL50 RE�UIRES 7HE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck
� STA7EMENT THAT HE OA SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CONTRACTORS LI� �
� CENSE UW(CHAPTER Y(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� POOVSPB
� FESSIONSCADE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- �
V TION.ANYVIOLATIONOFSECTION7031.5BVANYAPPLICANTFORAPERMITSU&1ECTSTHEAPPLICANTTO Z Re•Roof
� A CIVIL PENALTV OF NOT MOFiE THAN FIVE HUNDRED DOLLARS(f500).):
Z ❑I,ASONRJEROFTHEPFOPERTY,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECAMPENSATION, � COrtIfilBfCifll - ��
WILL DO THE WORK,ANO THE STflUCTURE IS NOT IN7ENDED OR OFFEFED FOR SALE(SEC.7o4I,BU51� J
� NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NO7 APPLV 70 AN OWNEH OF �
PROPERTV WHO BUILDS OR IM PROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
� 7HROUGHHISORHEROWNEMPLOVEES,FROVIDEDTHATSUCHIMPROVEMENTSARENO7INTENDEDOR m
w OFFEREDFORSALE.IF,HOWEVERTMEBUILDINGORIMPROVEMEMISSOLDWI7HINONEVEAROFCAMPLE-
� TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
Z IMPROVE FORTHE PURPOSE OF SALE).
= OI,ASOWNEROFTHEPROPERTV,AMEXCLUSIVELYCON7RACTINGWITHLICENSEDCANTRACTORS
W
� TO CONSTRUCT THE PRQIECT(SEC.7014,BUSINESS AND PROFESSIONS CODE:THE CONTRACTOPS LI- V2IU2ilOf1 ADJ.AREA
W CENSELAWDOESNOTAPPLVTOANONTJEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND
� WHOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAC- OUANTITY DESCRIPTION FEE
Y 70R5 LICENSE LAW.).
� ❑I AM E%EMPT UNOER SEC. B.8 P.C.FOR THIS REASON Q
� U
� �
DATE OWNER �
Z W
� UCENSED CONTRACTORS DECLARATION w
� I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT 1 AM UCENSED UNDER PROVISIONS OF CHAPTER � •
d e(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PROFESSIONS CODE,AND Z
X MV UCENSE IS IN � CE AND EFFECT. r ���111
W ����� �
� LICENSE CLAS IIC.NO.C_�Il �
U DATE�� .I I� CONTRACTOR t d ,
'`/ /'
� — ' WORKERS'COMPENSATION DECLARATION �(�1�i]�c1�� U
..�'�/ %b (•
� I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DEClARA710N5: Z
. Z _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSEN7TOSELF-INSUREFORWORKERS' _
¢ CAMPENSATION,AS PROVIDED BY SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE w
OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. �
0
w HAVE AND WIL MAMTAIN WORKERS'COMPENSATION INSURANCE,AS RE�UIRED BV SECTION
Q 3700 OF 7HE B R CODE,FOR T E PERFOR NANCE OF THE WORK FOR WHICH THIS PERMI7 IS
ISSUED.MY 5� E S�iANCE CARRIER AND POUCV NUMBERARE: CONSTRUCTION
� CARRIER �O� PLAN REVIEW
Z POUCVNUMBER ELECTRIC
Q
� (iHISSECiIONNEmNOTBE00MREfE�OFTFIEPERMfTISFORONEHUI�DRED00LLARS(f100)ORLESS). PLUMBING
Z I CERTIFV THAT M THE PERFORMANCE OF THE M/0RN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
(,�} SHAIL NOT EMPIOY ANY PERSON IN ANY MANNER SO AS TO BECAME SUBJECT TO THE
� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOUID BECOME INSPECTION FEE
= SUBJECTTO THE WORKERS'COMPENSATI N P OVIS NS OF SECTION 37000F THE LABOR
DE��QQ��lf.L pq�TH H COMPLV WITH H E PRO I 10 5J� /^�� n ISSUANCE
p DATE:�r'�j��PLICANT: ` (..C�,(�.�/` SMIP
•
J WARNING:FAILURETO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C
LL SUBJECTANEMPLOVEHTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT
DOLURS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE:
� CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� I HEREBV AFFIPM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.).
Z
W
� LENDER'S NAME
� LENDER'SADDRE55
� TOTAL FEES
� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. f�
w I AGREE TO COMPLV WITH ALL pTY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING
� CONSTRUCTION,ANO HEREBV AUTHORI2E REPRESENTATIVES OF THIS COUNTV TO ENTEF UPON THE
� AB E-M TIONED PROPERTV FOR INSPECTION PURPOSES.
Z COMMENTS
� ! C� �^ �
J �
� V �..►I '�!�
m PE I E NA E P T
Q
�
� SIGNA REOFPERMITTEE DATE
= RECPT.N0. PAID BY VALIDATION
~ WHITE—De artment Copy,YELLOW—Finance Co PINK—Assessor Co GOLDENRO�File Co GREEN—A IicanYs Co
P PY. PY. PY. PP PY
�6`�� ��� �������� i��(� .,
�f�l�u���`���� !�[����36�
OG��LC�00[� D�� . OG',�`�G� �, �G� ���G�C�OG��� � '�� ��:� � � � .
_._ __ � _ .
SET BACK � FLOOR JOIST•, � � �
._� �__-- •--- ----------�-- --- -_- -------_
FTGS/FORMS/STEEL ,, 1 FHA REQft�ITS �
-- - _,_.-- ----- - •----
_.._...--
ELECTRIC GROUND � � ; UNDER FLOOR DUCT �
- --- --- ---_-_— ----- -----------r— _._______
GROUND PLUMBING __ � UNdER FLOOR CU�I[��117__� '
� __.._...._...__
SLAB GRADE i __ _ _I FIREPLACE FOUNDATION___�______ -
_..._
TEMP POWER i � FIREPLAGE B0�1D B�AM ,:' ��
--- _. _. _ -- --._
WATER SERVICE _ _ _ � ___I . MID HT. BOND BEAM ��� �
__
-- ---..___.__ , .;.. -------
ROOF SNEATHING _ _ � ' 8 F-f. BdND BEAM _____ I
FRAMINGNENTILIATION i FINAL BOND BEAM ',
- -- __ _ ----._,_..___ _...___.. __ _...-- ---; ---._ ......_
ROOF COVER i ` PRE-GRA[�ING ___j_
ROUGH HEATING - ---- BENCHING ___.__._ � __._._-.__�
ROUGH ELECTRIC R�UGH GFtADING
--- -- --
ROUGH PLUMBING � ! FINiSH GRADING
----____ _-_.__ ____ __._._� ___- -----_ �----.._...---.----
----- ......_....
SHOWERrfUB TEST � ; POOL ELECTRIC
EXT. LATH/SIDING ; POOL FENCING
-- -- -� ---... _____....____._ ___._-- -�-------.._. _�
WALL IiVSULATION � POOL FINAL j
---
CEILING IN�ULATION I � OFF SITE IMPS.
_ _ --- -----, -.....__ __.- --_..__.__._____ _________ ___
DRYWALL NAILING ' � DEDICATIONS
, ----
SEWER FIPlAL ENG.
----- ---- -�--�__.____._.__.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP �IULL. ! � QtV SITE lht1PS.
GAS AIR TEST FINAL ZONING
FINAI.C�NST. ; � F!RE DEPT. FINR!..
FINAL HEATING , I� HEAI.TH DEPT. FINAL
FINAL ELECTRIC �' � ' I � DEV. FEE� PAID
FINAL PLUMBIMG ;��f�yi ' i ENERGY-- -------- _ '-----._.._
�
//- - � ;
' — � ___ ' 1 C�Of� o �o ' -----
CONi�iiEf�TS - - _
SEPTIC TANK SIZE
SEEF PIT/U SIZE -- --�--
� _ �_ __. �_...___ -----
l�It (� __ __. � --------_-------.
� � � � �