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HomeMy WebLinkAbout18202 _�\ CITY OF DIAMOND BAR , � � DEPARTMENT OF COIvIIvIUNITY&DEVELOPMENT SERVICES Y� 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS ��'%�»� BUILDING PERMIT APPLICATION FIRMLY JOBSITE / 1 APPUCATION PERMIT �P/C o ADDRESS�Sr �7Cl�I r DATE I �NUMBER � p c� ISSUE /�-� � TYPE OCC APN LO TRACT DATE �1 v CONST. GROUP p OWNER � ADORESS t/A ZONING SETBACKS z CITY �D ZIP • TEL. FRONT RW ❑ � APPLICANT TEL. REAR p � SIDE/SIDE STREEi RW ❑ � CONTRACTOR C � il C_ SIDE p � CODRESS Z�P TEL. -fl(QC� PROPOSED USE ✓ •� (,� �✓ S�s►t.� o ARCH/ENG 2_'_'_T� �f�+-�t �Ts z� DESIGNER NO.DWEL. NO, NO. n. ADDRESS UNRS STOAIES BEDROOMS � CITY 21P TEL. cNi� DESCRIPTION SQ.Ff. FACTOfI PSF ADJ.AREANALUATION p� ' OWNER•BUILDER DECLARATION SFWADD/REM O p 1 HEREBY AFFIRM UNDER PEN/�LTY OF PEKRlRY TNAT I AM EXEUPT FROM THE CONTMCTORS LI• GaregB/Cg1�OK W CENSEUWFOHTHEFOLIOWIN6REA50N(SEC.70.71.68USINESSMIOPROFESSIONSCOOE:ANYCITYOR (n U COVNT7YMICHqE�U1RESAPERAIITTOCONSTRUCT,ALTER0.IPROVEOEMOlISH,OFIREPA�RANVSTRUC- W PStiO/DBdt Z TURE,�FIOH i0 RS ISSUANCE.ALSO REOUIRES THE APPLICANT FOH SUCH PERMIT TO flLE A SICNED W STATE4EHT THAT HE OR SHE IS LICENSEO GURSUM7T TO TNE PROVISIONS OF THE CON7MC70R5 lb W gCENSE UW(CHAVTER Y(COMIAENCINQ VATM SECTqN 7Doo)OF DIVISqN]OF THE BUSINESS�NO DRO- V" POOVSp3 FESSIONS WD�OR Tw�T HE OR SHE IS EXEMPT THEREFPOAI MJ�THE BA515 FOR TNElLLLEGED EXEMP- � TqN.ANYVIOLATIONOF5EC110N7071.SBYANYAPPLICANTiOR�PERMITSUBIECTSTNEAPPLICANiTO Z qe-Roof I A CMl VENALiY OF NOT MORE TN/�N FNE MUNDREO DOLURS(f500).1: Z04ASQARiEHOFTMEVROPERTY,ORMYEMPLOYEESWITMWAGESASTHEIR50LECOMPEN5AT10N, O COTR18fC12I � WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEG 70��,BU51• J � NESS ANO PROFESSIONS CODE:THE CANTRALTORS LICENSE UW DOES NOT AVPIY TO AN ONrtJER OF = iHOPENTY WFfO BUILDS OR MGROVES THEREON.Ml�NMO DOES SUGH WORKHIMSELF OR HERSELF OR Q THROUGHHISORHEROVMEMttOVEES.VROVIOEUTHATSUCNI1AvpOVE/1ENTSARENOTwTENDEDOR m � OFFEFEDFORSFLEIF,HOWEVER711EBUILDINCORMPROVF/AFMISSOLDWITNINONEVEAROFCOMP�E- Z TqN,THE OWNER�BUIIDER NALL IUVE TME BUHDEN OF FROYWO THAT NE OR SHE D�D NOT BUILD OR � MPpOVE FOR THE PURPOSE OF SALE} w ❑�ASONMEROFiMEPR07ER11',AME%GLU5IVELYCON7MCTWOWfTMUCENSEDCONTRACTORS � TO CONS7RUCT THE iRQIECT(SEC.70N,BUSINE55 M1D GROFESSIONS CODE:TXE CONTMCiOR5l1• V8IUBIIOf1 � ADJ.AREA CENSE UW DOES NOT MPLY TO IW OYINER OF A iRODERTY WHO BUQ�S OR IMPROVES THEFEON,AND � MIFqCONTMCTSFORSUCHPROIECTSWITHACONTMCTOR(SILICENSEDWRSUAMTOiHECONfMG �UANTITY DESCRIPTION FEE Y TORSUCENSEUW). � � O I AM IXEMPT UNOER SEC. B.t P.C.FOR THIS REASON a � U tL ¢ DATE OWNER V Z W �¢ LICENSED COtJTRACTORS DECLARATION W K IHEREBYAFFIRMUNOEROENA�ttOFDERJURVTHAT1AlALKENSEDUNDERDROVISIONSOFCHAPTER � d 9(CO�MENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 ANO PROFESSiONS COOE.AND Z X MYULENSEISINFULLFORCEANDEFFEC7. � IICENSE SS �� � LIC.NO. �"�'��� � � V DATE O Z CONTMCTOR� ✓ W � n- W �� � WORKERS'COMPENSATION DECLARATION a � IHEREBYAFFIRMUNOERVENAL7YOFPERNitYONEOFTHEFOt10WiNODECURAT10N5: Z a C� �IMAVEANDIMLLEWNTAMACERTIFICATEOFCONSEMTOSEIF.IN5l1REFDRWORKERS' _ { COMPENSATIDN,ASPROVIOEDBYSECTIONi7ooOFiHELAeORCOOE,FORTHEPER�ORMANCE U Q OF T11E WORK FORNTUp1 THIS iERM1T IS ISSUED. � � �IHAVEAN0IMLLI.WNTAINWORKERS'COMPENSMIONINSURANCE.ASREOUiREDBVSECTqN /'� �., 4� �700 OF THE UBOR CODE,FOR hIE VERFOPAIANCE OF THE WORN FOR WNiCN THIS FERMIT IS � S�. YL/1 � ISSUE�.MYWORKERS'CprA7EN5AT!bNIN-SU CECARHIERANDPOIICVNUMBERME: CONSTRUCTION lJL/ � CARRIER tS�TC �✓N� PLAN f1EVIEW � pOLICYNUMBER L�� _ ELECTRIC � (11dS5ECIqNNEmNOTBE�EfEDOF'1}EFERMTISFaiONEMf�Oi7E�0011Ai5R10�)ORLESS? PLUMBING Z 1 GERiIFY 1HAT N TME VERFORMANCE OF TME WOHK FOR WNlqi THIS PERMIT IS ISSUED,1 MECHANICAL (J SHALLNOTEMPLOVANYPERSONINANY MANNERSOASTOBECOMESUBJECTiOTNE � WORKERS'COMPENSATIONUN�SOFCALIFOHNIqANDAGREETMATIFISHWIDBECOME tNSPECTIONFEE SU9IECT TD THE WORKERS'COMPENSATION FROVISIONS OF SECTqN]7000F THE LABOR OE sN ooan�win�ca�a�r win�tHosE vaowsioras. l/� ISSUANCE p DATE:� I O APPLICAM: `V �� 'RK,� SMIP I 1 � ENERGY P/C WARNIN4:FAIIURE TO SECURE WORKERS'COIAPENSATION COVEMCE ISUNUWFUL.AND SWLLLBE LL SUBJEC7ANEAIPLOYERNCRIIA�NALPENALTIESANDCMLFINESUPTOONEHUNDREDTHOUSANO ENERGYPERMIT pOLURS(f 10a.000�.IN ADDITqN TO TME CAST OF COIA7ENSATqN,OAIAAGES AS PR WIDED FOR N � SECTION31000FTHEVBORCODE.INTERES�FNDATTORNEYSiEES. AE'TENTIONFEE: � CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � IHERfBYAFFIRMUNDERDENALTYOFPE0.NRYTHATTMERE15ACDN5TRUCTIONLENDWOAGENCY FOR THE PERFORMANCE OFTNE WORK GOR VMICH THIS VERUIT IS ISSUE�(SEG 9097.CIV.C.�. Z W � IENDER'S NAIJE F= LENDER'SAO�RESS wICERTIFYTHATINAVEREADTH�SADPLICATIONANDSTATETII�TTNEA90VEINFORAIATIONISCORRECT. TOTAL FEES � �� U � IAGREE TO COMPLV YAMKLCT/AND COVNTV ORDiNANCES AND STATE UWS FELITINO TO BUILDIN� CONSTRUCTION,AND HEREOY AUTpR12E PEPRESENTATNES OF THIS COUNTV TO ENTER UPON THE ZABOVE•MEMIONEDVROPERTYFORINSPECTIONVURPOSES. COMMENTS � � f�l � � �.S�J�f m ¢ PERMITTEE NA1AE(PRI ) �„ / d � S�GNATURE D E OATE � RECPT.NO. _PAID BY VALIOATION WHITE—Depanmenl Copy.YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—FIIe Copy,GREEN—ApplicanCs Gopy -.,...._. . . .... ... . . . . . . ..,.. _ ..... ., � .Ir� . � ,-c-r7+" .. -� � --.sa..-.. .... . ,�.n, w. .. -�'+' . �. . • .. . .. ... .- CE i�' C�F [�l�PJi��rfE3 ��F? li�!�Pa u'�'d0�r'�1 �CCG�;� ►��- r�! _' _)�._�.M' .r.l+� �...... �_ _....r.._..... ��,`�;��c .C�li" �7��.�'= Id�.':i� �c�=� ' .I '�' �'.���Cf� �k �l �0�' ►k- ��"�'c ci �I�_ `.��d _„ � ��e�o'.� � __.__...___�_________ _____-- - . . . _ .__ _.�___.. .. ... ,_..__-<_..__ ___�__.. ._._____� _.____. �.__._:�_.. .____ .____.�__:_..___.__�.__._ SET BACK i ! � FLOOR JOIST � FTGS/FORMS/STEEL � _ I __�_ FHA REa"r1T5 _ ELECTRIC GROUNQ j . UNDER FLOOR DUCT � GROUND PLUMBING I UfJDER FLOOR CU�IDUIT I SLAB GRADE � � FIREPLACE FOUf�1DATlO�d TEMP POWER L � F(REPLACE BO"JD 6�AP�1 WATER SERVICE i MID HT. BOND BEAP�1 ROOF SHEATHING ���I '' _ II FT. BONb BEAPA FRAMINGNENTILIATION I FINAL BOtJD 8EAh4 j— ROOF COVER I ��Q1' � ��T FAE-GRADING ROUGH HEATING BENCHING I ROUGH ELECTRIC � ROUGH GRADING ROUGH PLUPJ!BING j � FI�JISH uRF,DING SHOV✓ER/TUB TEST � POOL ELECTRIC EXT. LATH/SIDING j POOL FENCING � 4'UALL INSULATION • —�-� POOL FINAL ; CEILING IN�UL.ATION j OFF SITE ID.4PS. QRYWALL NAILING DEDICATIOPJS SEWER FIMAL ENG. SEPTIC TANK � LANDSCAPE/IRRIG. SEEP PIT/LL. � ' ON SITE IMPS. GAS AIR TEST F►iJAL ZONIfJG FINAL CONST. FIRE DEPT. FINA! FINAL HEATiNG __ � NEALTH DEPT. FINAL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUME3IPJG �— � ENERGY uC�:���.T'.;_��':�E�:T_r._Y_____... I CUMMENTS , SEPTIC TANK SIZE SEEP PIT/U SIZE i'q� ^. ���� �` � , . _., i •