HomeMy WebLinkAbout14431 I �� � � : : -� -
/ ...�,,,,,� . . .
_� CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY 8t DEVELOPMENT SERVICES .
_ a 21660 E.Copley Drive Suite 190
• (909)860-3195 Fax(909)861-3117 PRESS
����'�� BUII.DING PERMIT APPLICATION FIRMLY
� JOBSITE I U r APPLICATION �� �� q q PERMIT P/C
� ADDRESS DATE NUMBE� # �
I � ISSUE TYPE OCC
APN LOT TRACT� DATE � CONST. GROUP
p OWNER I� .
o ADDF{�SS C ZONING SETBACKS
"' cirr v ZIP T L. FRONT RW ❑
� APPUCANT C� TEL. , � REAR ❑
� SIDE/SIDE STREEf RW p
CONTRAC OR SIDE ❑
Q ADDRE S PROPOSED USE � /
� CITY ZIP�_TEL.
� ARCH/ENG/
� DESIGNER' NO.DWEL. NO. NO.
ADDRESS- '" ' �� � UNITS STORIES BEDROOMS
� CITY ZIP TEL.
�
u� DESCRIPTION SQ.FT. FACTOR BSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION
� SFR/ADDIREM
I HER�Y/iFFIFOA UlOER PENAL7Y OF PERAINV THA7 I MI E%EMPT FROM THE QDNTfUCTORS LI- GBfH B/C9 rt
W CEHSELAWFORTMEFOLLONMIUREA90N(SEC:7031.68USMESSnNDPROFE5510NSCO0E:ANYq7VOR (n 9 �
s7 CpLMJ}yWHIG1pEpUy�EgAPERMffTOCONSTHUCT,ALTER�PROVE.DEMOLI$H2ORREPAIRANVSTRUC- W PefIOJDBCI(
Z NRE,PRIOR TO ITS ISSUANCE,ALSO REWIRES THE AVPLIGWT FOR SUCH PERMIT TO FlLE A 516NED
�� STATEMENT THA7 ME OR SHE IS LICENSEO WRSUANT 70 7HE PROV4SION5 OF THE CON7RACTOHS LI� �
� CENSE UW(QiAPTER G(COIdMENC1N0 WIiN SECTqN 7000)OF DIVISpN 3 OF THE BUSINESS AND PRO- PooUSpa
FESSIDNSG�DDE)OR7TIATHEORSHEI9E%EMPTTHEREFROMANDTHEBASI9FORTHEALLEOEDEXEA/P• �
TION.ANY VIOLATION OF SECTION 7W7.6 BV ANV MPLICANT FOR A PERMIT SU&1EC75 THE MPLICMfT 70 Z qg-ROOf
� AqVIL PENALTV OF NOT MORE THAN FNE HUNDREO DOLLARS(i600).): .
Q ❑LtiSOWNEROF7HEPROPERiV.ORMYEMPLOYEESWITHWA(iESASTHEIR50LECOMPEN5A710N, 0 (`,pmm0fCl31 . -
� WILL DO THE WORI(AND 7HE STRUC7URE IS HO71N7ENDED OR OFFERED FOH SALE(SEC.7WI,BUSF J
� NESS MD PiqFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT A7PLY TO AN OWNER OF ?
PROPEH�1'WHO BUI�pS OR�1PROVES 7HEREON,AND M/MO OOES SUpI W'ORK HIMSELF OR NERSELF OR -
LL 7HROUGH WS OR MER OWN EMPLOYEES,PROVIDED THAT SUCFI BAPROVEMENTS ARE NOT IMENDED OR m
W OFFEAWFORSALEIF,NOWEVERINE9U0.DINOORIMVROVEMBfrIS50lDWfTHINONEVEAROFCOMPLE•
� �•TION,T}(E OWNER-BUILDER YHLL NAVE 7HE BURDEN OF PROVINO THAT HE OR 6NE DID NOT BUILD OR
� IMPROVE FOR 7HE PURPQ4E OF SALE}
(y,� ❑4�SOWNEROFTHEPROPEHfV,AMIXCLU3NELVCONTMCTPlOWITHLICENSFAQONTMCTORS'
� 70 CONSTAUCT THE PROJECT(SEC.70N,BUSINESS AND PROFESSqNS CODE 7HE CONTRACTORs U- VBIU8110f1 . ADJ.AREA
Z M710ECONTMCTSPOfi5Up1PROJE��ETMO�APH�pp�ry�(S�iLOICENBDEDPURSUANTTOTFIERCONTRAG
� rais ucENSE uw.�. OUANTITY E IPT10 �E
� 0 I AM D(EMPf UNDER SEC. B.i V.C.FOR THIS REASON � � y
3 � .
� ¢
DATE OWNER V-
� U
LICENSED CONTRACTORS DECLARATION w
� I HEREBY AFFtRM UNDER PENALTv OF FER.IURV 7T1A7 I AM LICENSED UNDER PROVISIONS OF CHAPTEH � .
� 9(COA/MENC@N3 N7TH SEC710N 7000)OF DNISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND Z
��� MY LICEHSE IS W FUIL FORCE AND EF T. m
� UCENSE SS LIC.NO. �
V DATE � � CONTRACTO d `
`v Zb
� WORKERS'COMPENSATION DECLAAATION -� .
� .¢ , �*',+ . . ��,.�. ._ ,
N 1 HEH�V AFFIpM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWINQ DECI.AMTpNS: � � y /� �,
' N a � - 'W,..
� _INAVEANDWILLAIAINTNNACERfIFICATEOFCONSENTTOSELF�INSUREFORY/ORKEFiS , ' ' ' i
COMPENBATION,AS PROVIDED BV SECTION 37oa OF 7NE UBOR COOE,FOR 7HE PERFORMANCE U
Q qFTl1E WORN FOR WHICH hIIS PEqM1T IS ISSUED. �.
/
��I HAVE A!�WILL MAR(TAPI WORKERS'COMPENSATION INSUqANCE,AS flEWIRED BY SECTION
Q ]70o OF T1E LABOR IXq FOR THE CERFORMANCE OF THE WOfiK FOR WHlpi THIS PERMR IS
ISSUED.MY WOR MPEN TION I � MNCE CAARIER AND OLICY NUMBER ME: CONSTRUCTION ��l� �
jc�wER � PLAN REVIEW
� ao�rorr�eea ELECTRIC
� (n-rssECrqr�r��NoreEmr.r�iIDOFn-��rswaar�ru�na�ooulasKiro�oa�ss� PLUMBING Zt
w �7 �
Z +I CERTIFV 7HAT W h1E PERFORIAMICE OF 7ME MIORK FOH WHICH THIS PERMIT IS ISSUED,I MECHANICAL
U' SW1LL NOT EMPLOY ANV PERSON IN ANV AIANNER SO AS TO BECAME SUBJEC7 TO7HE
(n WOPo(ERS COMPENSATqN UWS OF CALIFORNI/�fWD AOPEE THAT IF 1 SFKKILD BECOME INSPECTION FEE (�
S SUBJECT TO THE WOR)(ERS'CAMPENSA OVISIONS OF SECTION 3700 OF THE IABOR D�C fj
cooe,i sw�u w coMv�r wini E/P1ROVISION 'JJ ISSUANCE v
p � " �.�f/� P ,(J/� SMIP d�.,..,__ �, c�U
DATE: APPLICANT: y��,,� �►.la r VN ll1q1VI0 p�'y
� WARNINO:FAILURE TO SECURE WOR!(ERS'COMPENSATqN COVERAOE IS UNUWFUL,AND SHALL BE ENERGY P/C �7��� ���B±Iy(�
LL SUBJECTMI EMPLOVER TO CRIMINAL PENPLTIES NJD CM�FINES UP TOONE HUNDRED THOUSANO ENERGY PERMIT �'11.V L SAL'I,'�
DOLURS(f100.000),W ADDITION TO THE C0.5T OF COMPENSATION,DAMAOES AS PflOVIDED FOR IN
J SECTION 37oe OF THE LABOR CODE.INTEREST,AND ATTORNEY u FEES.
w � RETENTION FEE: j
O CONSTRUCTION LENDING AGENCY PRE-AL�_T E: �
� I HEHEBV AFFIRM UNDER PENALTV OF PER1UqY THAT THERE IS A CONSTRUCTION LENDM(i AGENCV �
Z FOR THE PERFORMANCE OF h1E WORK WR WHICH hIIS PERAl1T IS ISSUED(SEC.3007,CIV.C.).
W ,
� LENDERS NAME � �
F- LENDER'SADDRESS (�
w ICEflTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATEhiAThiEABOVEINFOWAATIONISCORRECT. TOTAL FEES �V � g .�
� �AGFEE 70 COMPLY WfTH ALL CfTY AND COUNTV ORDINANCES AHD STATE UN5 RELATINO TO BUILDING
� CONSTRUCTION,M1D HEREBv AUTFIDRIZE FEPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � ` �� ^ ^' �
Z ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES.
� _ COMMENTS�� S �
J 7
�
m E TTEE NAYE(P '
Q �
�
Uj S OF PERMITfEE DA7E RECPT.Np. PAID BV VALIDATION
� WHITE—Depertment Copy,YELLOW�inence Copy,PINK—Asaessw Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy :
�9� O� �U6����[D f��6�
II�tSPEcC1i'��� I�fE���$�
' � � � '�.� .�'��UL�iLn)�" UW�� . � �� � ,�, ' O
� e. _ , .
SET BACK � � FLOOR JOIST � � '
FTGS/FORMS/STEEL - FHA REQMTS ' ' ' � '
ELECTRIC GROUND 2, .3_ UNDER FLUOR DUCT !
— , _ __-
GROUND PLUMBING UNDER FLOOR CUf�;��UIT� '' � - �, ' , -
SLAB C.�sRADE �� FIREPLACE �OU�DATlON ' � �� � , r
TEMP POWER FIREPLACE BOND BEAM � ' ' ` '
WATER SERVICE MID HT. BOND BEAM ' .
� ROOF�HEQ7HING� , ' - +. ti . 8 F7 BOND BEAM �' ' - •
FRAMII�GNENTILIA710N - FINAL B�ND BEAM �
ROOF COVFR � • PRE-GRADING 1_2�� Cb '1�
ROUCH F-lEATI►VG BENCHING ������
ROUuH �LECTRIC ROUGH GRADING
ROU��!-i PLUNIBING FINISH GRADING
SI-iCt+�1�R,'T'UB TE�T • POOL ELECTRIC � -�p -
�FXT. L�;TNfSID1NG POOL FENGING - •,J� �
V1iALL INSULATION POO�FINAL
��______
� GEIL�P�IG !PlSULATION �FF SITE IMPS. �
� DRYVi�kt.�NAl�ING DEDICATIONS �
�ScV'�ER � FINAL ENG. �
; ��P s tC TANK LANDSCAPE/IRRlG. .
�^
Z 5t��� ��iIL.L. . ON 51TE IMPS. � � �
,�-�---
� i�H�A��? '��ST �- _t�..�; . FINAL ZC�NING
��f=?n=:`'._���,�1$T., ' FIRE DEPT. FINAL ,
� !-+i i'.._=-iEATlNG HEALTH DEPT. FINAL
� . �_ CLEC7RIr � DEV. FEES PAID
-''_PLUMBING ENERGY - .
' ' ' �
" ---- � . � ' �.� r � '
o. . . _ ..
; . ., , � .
. � � , �, . .. _
, "r`="�1NiEfVTS _.�C_ m�' ' '[�.. `. ���—?, — a� � -_ - � -----� ------
i J s,..'i
�
i
.�
. � ' .. . ( � , , '
SEPTIG TAI�K S�: �
SFEP PIT/U SIZE '�1`��`'".`���= � �
�� , � �'.�,�_� ��. �,,� � —
�p.
�� , .� F �[� -
. � ��
� � �,�A � . �
� .�: , . � � � ------
z �� � r- � � _� � _._
. �_�� � . � � � _ � J
� �,