HomeMy WebLinkAbout18194 (19) �� CTfY OF DIAMOND BAR ,� DEPARTMENT OF COMNiUN1TY&DEVELOPMENT SERVICES 21825 E.Copley Ilrive (909)860.3195 Fax(909)861-3117 P $S ��%�� $UILDING PERMIT APPLICATION RM LY � JOBSITE Z�� [} I�Ai�.L n N � APPLICATION � �� ,,, ERMIT Q P/C o ADDRESS �d L r� /�� DATE MBER u # $ ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER o ADDRESS '�+r.. G ev� ZONING SETBACKS g CITY ' ZIP TEL �- - FRONT RW ❑ APPLICANT TEL. REAR O SIDE/SIDE STREET RW O � CONTRACTOR ' o SI�E O p� ADDRESS PROPOSED USE �ZP_h�oflP_ .S���e �L s-r/9aV�b•S�D o CITY IP TEL � - wo ARC NG/ , - , S� z� DESIGNER NO.DWEL NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CIN ZIP TEL. N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � p� ! OWNER-BUILDER DECLARATION SFR/ADDIREM O p 1 HEREBY AFFIRM UNDER PENALTY OF PE0.NHY TH�T I AM EXEMPT iR01A THE CONTMCiORS LI• G913g0/C81pOR W CENSEUWFORTHEFOLLOWIN�FEASON(SEC.70.71.66USWESSANOVROFE5510NSGOOE:ANYCI7YOR (n V COVNiYWHICHRE�UIRESAiERMITTOCONSTFUCT.ALTERIMVROVE,DEMOLISH,ORREPAIRANYS7RUC• W P0110/D¢Ck W7URE.GRIOR TO RS ISSUMlLE./�LSO REOUIRES THE AP7LICANT FOR SUCH PERMIT TO FllE A SIGNED W � STA7E�EM THAT HE OR SHE IS UCENSED GURSUANT TO TME FHOVISIONS OF THE CONTMCTORS ll• � CENSE UW(pUDTER i(COAIMENCINO VATN SECTION 70D0)OF DIVISION�OF TNE BUSMESS A4D VR0- � PooUSpa FESSIONS CODE)ON Tl1�T HE OR SHE IS EXE�APT T1IEREFROM►ND THE BA515 FOR THE 1LLLEGED f%EA1P- � TqN.ANVV10lATqNOFSECTKKJ70]1.60YANYA7PLICANTiOflAVERMITSUBJECTSTHEAPPLICANTTO Z Re•Roof �Z � ACMLVENALTYOFNOTMORETHANiNEXUN�REDDOLUR5lf5o0).Y � 04��WNEROFTHEPHOPERTY,ORMYEMVLOYEESWITHWAGESASTNEIRSOLECOMDENSATqN, O Commercia� - Z WILL DO THE WORK AND THE STRUCTUFE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70u,BU51• J N NESS 1WD PROFESSIONS CAOE:THE CONTMCTORS LICENSE UW DOES NOT APVLY TO AN OWNER OF = PpODEHTY HIF1D B111L�S OR 0.1FRWE5 THEREON.AND MMO DOES SUCH WORK HIMSEIF OR MERSELF OR � THROUGHHSORHEROVMEAICLOVEES,CROVIDEDT1UTSt1CHIAAPROVEUEMSANENOTMENDEDOR m w OFFEHEDFORSALEIF,FiON�EVERTME8U0.DIN00RIMPROVEI�IEMI550lDWRHINONEYEAROFCOMPLE• � TION,THE OWNER�BUILDER WILL NAVE THE BURDEN OF GROVINO THAT HE OR SNE DID NOT BUIL�OR Z IMPROVE FORTME PUHPOSE OF SALE). �= OI,ASOWNEROFiMEVROPERTY,AME%CLUS�VEIYCONTRACTPIGWRHUCENSEDCONTMCTORS TO CONSTRUCT THE PROJECT�SEG.70N,9USINE55 ANO PROFESSIONS COOE:THE CONTRACTORS l4 V3Wdti011 � ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOVMENOFAPROPERTYWHOBUILDSORqAVROVESTHEREON,NJD � WFqCONiMCTSFORSUp1VROJECTSWITHACONTMCTOR(S)LICENSEDPURSUANTTOTHECON'MG QUANTITY �ESCRIPTION FEE � TORS LICENSE UW} �� � O I AM EXEMPT UNDER SEC. B.1 P.G FOR THiS REASON U � Q DATE OwNER V �¢ UCENSED CONTRACTORS DECLARATION W LL IHEREBYAFFIHAIVNDERiEWLLTYOFGERIURYTMA7I.UAUCENSE�UNDERPROVISiONSOFCHAOTER Vr � Y(COMMENCRIO WITTi SECTION 7oa0)OF DMSiON J OFTHf BUSINESS AND GpOFES5lON5 OOOE,AND Z �� MY LICENSE IS N FULL FORCE AND EFFECT. m � UCENSE CLASS � UC.NO. U '� � � � J VDATE CONTRACTOR ' � a . . . . .. W � .. .. . __ .... r� �WORKERS'COMPENSATIONDECLARATION Q � ' V � IHEREBYAFFIRMUNDEFPENALTYOFVERNRYONEOFTHEfOILOYNNGDECLARATIONS: N Z Q � �I HAVE AND WILL MAINTNN A CERiIFICA7E OF fANSENT TO SElFaNSURE FOR WOPICERS' S � COMPENSA710N,ASPFOV�DEDBYSECTION7looOFTHEUBORCOOE,FORTHEVERFORIAANCE W OF TNE VYOfiK FOR WMICH THIS VERMIT IS ISSUEO. � � w _IHAVEANDWILLIAAINTAINWOIiKERS'COMPENSATIONINSURANCE.ASREOUIFEDBYSECTION � Q ]1000FTHEUIBORCODE,FONh1EDERFORMANCEOFTNEWORKWRWHICHTNISVERMITIS . � O ISSUED.MYWORKERS'COMPEN ATKKIINSURANCECAMiE�R/ANDPOL�CYNUMBEHME: CONSTRUCTION � j GRRIEF ' ����_ ��'nfl PLANREVIEW � POLICI'NUMBER_,���2�+ ___.. ELECTRIC � (�f15sECTqNNEmt+oTBEttX.e3E7mOFl1E7ERMTBPoRd�E�+1lLHEDD�l1Ai5R+a7��1 PLUMBING w MECHANICAL Z ICERTIFYTMATPlTFIEVERFOftMANCEOFTNEN'ORKiORWHILF/TMISPERMITI515SUE0.l (J SHALLNOLEMPLOYANYVERSONNANVMANNERSOASTOBECAMESU&IECT70TNE � VIORKERS'W�d7EN5ATIONIAWSOFGLIFORNIAAN0l1GREETNATIF1511OUlDBECOME INSPECTIONFEE S SU6IECTTOTMEWORKERS'COMPENSATIONPROYISIONSOFSECTION]7000FTHELIBOR ISSUANCE - COOE,I SHALL FORT11NnTH COUPLV WIT11 TNOSE VROVISIONS. � __��/ ."/ AVPLICnNT: �,��(ne. SMIP -- p OATE: w ENERGY P/C WARNIN6:FNLURETOSECUREWOHKERS'C0IAPENSATpNCOVEMGEISUNUWFULAN� BE � SUBJECTANE�APIOYERTOCRiA11NALPENALilESAN�CNILFINESUPTOONEMUNDRE0TM0USAND ENEFiGYPERMIT DOLURS(f100.000�.IN 11DDITION TOTNE COST OFCdAGEN5AT10N.DAMAGESAS PROVIDED fOR IN � SECTqN970eOFTHELABORCODE,INTERESLAND�770iWEY'SGEES. RETENTIONFEE: a �, CONSTRUCTION LENDING AGENCY pRE-ALT FEE: � IHEREBVAFFIRMUFAERDENALTYOFFE0.IURVTIUTTHEREISACONSTRUCTIONLENDWGAGENCY n- fORTHEFEqFORMANCEOFTHEWORKFORWMiCNMISGERMITI5155UE0(SEC.foG7.CN.C.�. Z W ' � LENDERSN.WE � LENOERSIWORE55 �� ^/ � I CERTIFV THAT 1 HAVE AEAD TNIS MPLIGITION AND STATE T/UT TME ABOVE MIFORMATION IS CORRECT. TOTAL FE ES � f/� •�,,.O � IA6REETOCOMPLYN1T11�LLCRYANDCOVNTVORDINANCf5AND5TATEUwSRELATWOTOBVILD:N� � CONSTRUCTICN.AND HEHEBY AUTHOfi�ZE REPRESENTATNES OF THIS COVNTV TO ENTER UPON THE ZA00YE�MENTqNED VPOVERTY fORINSPECf�ON PURPO5E5. COMMENTS � �"�N 'l�� H� � PERMfTTEE�� �„ /J I//�� '�/ f) �� � SIC�IATUREOFVERMI E � DATE � ,_.� RECPT.NO. PAID BY VALIDATION , WHITE—Depanmenl Copy.YELLOW—Finance Copy,PINK—Assessor CaDY.GOLDENROD—File Copy,GREEN—ApplicanYs Gopy ... , ., . _, , � ,,, - . - . . :. . .,�..-.,; , _ .. ,. .,-.... w . , .� . , ,.,. . . -�- . � . -� �-.-, _,., . . �i��:� �� ❑��1,�1��=�i� k��'�� !C�!����:i iGf�± ��CG:oEf' _ .�...____........ �..�.�..�....___.�_ �.. , �_-- __ _ _ . I° �� '��? f�� � � = I►�E-� ?"��`, �C��.: �►a�:� ��5,-S'(��1i1 ,.�t'=: �li►�E. :d�c' I��'�:� � �k-'� � CC �A �'`C��_ �) � _...� �___.___ ___._._ _. .._._ . - -. SET BACK ---_. _._ � _ .___I-I FLOOR JOIST __ ..___.._..._ _.I-------____._.._._��.....____..�_____._._ . FTGS/FORP�IS/STEEL _ ; FHA RE0�.1T5 ��J. ELECTRIC GROUND j j ; U�•dDER FLOOR DUCT j GROUND PLU�ABlNG � i UNDER FLOOR CU�!DUIT ; SLAB GRADE � FIREPLACE FOUNDATION TEPAP POWER � I FIREPLACE BOND BEAM WATER SERVICE � �_ MID NT. BOND BEAP�7 ROOFSHEATHING ����jl6�i��— I a FT. BOtJD 6EAM • ( _ FRAMINGNENTILIATION`, �I __ J� I FII`JAL F30ND E3EAM ROOF COVER �1J/C�. ��,� PRE-GRADING ROUGH HEATING �' � BENCHING I ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB 7EST ' � POOL ELECTRIC EXT. LATH/SIDING I I POOL FE��CING WALL INSULATION �� PaOL FINAI I CEILL'VG IN�ULATION i OFF SITE(MPS. DRYV'JALL NAILING � DEDICATIOPdS SEWER FINAL ENG. SEPTICTANK - � LAPJDSCAPE/IRRIG. SEEP PITlL.L. ON 51TE IP�IPS. GAS AIR TEST � FINAL ZOP�IPJG FINAL CONST. � GIRE D�PT. FIPJA! FIPJAL HEATIhJG � f HEALTH DEPT. FIhJAL FINAL ELECTRIC � ^ DEV. FEES PAID FINAL PLUMElING � � � ENERGY � i —.—s—.-„---.-- . .,.; �_ . �� I t?' ��r R i . � . . . . -----. .�.:. . . _..._:,_.� _._c`....____..____._.__; COMMENTS SEPTIC T�NK SIZE SEEP PIT/U SIZE --- �----, !1�� '� ,��,,� - � ' sp ,