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HomeMy WebLinkAbout18370 (19) , J� CITY OF DIAMOND BAR ��F,' � �_ � D�PARTMENT OF COMMUNiTY&�DEVELOPMENT SERVICES l/ 21625 E.Coplcy Drive (909)864-3I95 Fax(909)861-3117 PRESS `'��� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE /��� Q L j�� APPLICATION �J G� PERMR � P!C o ADDRESS �� DATE ��/ NUMBER # � ISSUE TYPE OCC APN LOT TRACT DATE ��CONST. GROUP p OWNER " ADDRESS �,�, ' cV� ZONING SETBACKS 0 gCITY„�=�.1 ,(�g._ ZIP TEL. a – �' FRONT RW ❑ APPLICANT TEL. REAR ❑ � SIDE/SIDESTREET RW ❑ � CONTRACTOFi _ SIDE ❑ p� ADDRESS eV� G(�• � CITY �rJ 7/ �TEL. d'�f'P3`�ll� PROPOSED USE (�i � S � S o —�1J��� -�—�—� w ARCH/ENG/ �z DESIGNER NO.DWEL. NO. ' NO. n. ADDRESS UNITS STORIES BEDROOMS � CITY 21P TEL. � cn DESCRIPTION S0.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFFi/ADO/REM O I HERE9Y AFFlRM UN�ER PENALTY OF PEfWRY THAT 1 MI E%EMPT FROA1 THE CONTMCTORS L6 G2f8Q6�C8�pOR W CENSEUWFORTHEFOLLOWINOREASON(SEC.7071.6BUSINESS.WJ>ROFESSi0N5CO0E:ANvdTYOR (n U COUNTyWHICHqEWIRESAPERM�TTOCONSTRUCT,ALTERIIAPROVE.OEUOLISH,OHREPAiRANVSTRUC- w w TURE,PRqR TO RS ISSUANCE,AL50 REOUIRES THE ACPLICJWT FOR SUpi OERMIT TO FILE�SifiNED W Patio/Deck STAIEMENT TMAT F1E OR SNE IS UCENSED iURSUAtlT TO TME GROYISIONS OF THE CONTMCTORS lF � CENSE UW(puPTER 9(COMMENCING WiTM SECTON)000)OF DIVt510N 7 OF THE BUSiNESS IWD PRO• � FooVSpa FESSIONSCOOE)OfliHATHEON5HEI5E%EMPTiNEREFpOMANOTMEBi4515FORTHEAILECEDE%EMP• (r] V TION.ANYVId.ATqNOFSECTION7001.SBYANYAPPLiCAYi FOR�GERUIT5U8JECT5TNEAPFUCIJITTO Z Re-Raaf � A CML VENALTY OF NOT MORE TMAN FNE HUNORED DOLUFS(f5a0I.1: • Z04��N�NENOFTMEPRODERTV.ORIAVE�PLOVEESWI7HWAGESAS7NEIRSOLECOYPENSATAN, 0 COmmOrCial VnLL 00 THE WORK ANO THE STFUCTUAE IS NOT INTENOED OR OFFERED FOH SALE(SEC.70��,BU51� ,.J N NE54 ANO OROFESSIONS COOE:THE CONTMCTORS LICENSE UW DO'c5 NO'APPIY TO fN OWNER OF j FROPERTY YA10 BUILDS OR IMPROVES iHEREON,AND VM1fO OOES SUCH N'ORK NIMSELF OR HERSELF OH Q TMROUCHMISORMEROwNEMPLOYEES,PROV10E0MAiSUCM0.1PROVEMENTSARENOTIHTENDE00R m W OfFEREDFORSILLEIF,/10WEVERTMEBUILDINGORMPROVEMENT650LDW1TMNONEYEAqOFCOM�IE• � TION,TME OVlNER�BUILDER WILL HAVE TME BURDEN OF VROVWG'HA7 ME OR SHE 01�NOT BUILD OR Z WPROVEFOqTMEPURPOSEOFSALE� w OI.ASONMEROFTNEOROPEHTY.AAIE%CLUSIYELYCONiRACTWGWITHIICENSE�CONTRACTORS Q i0 fANSTRUCT TNE PROJEM�SEC.70��.BUSI�E55 AND PROFESSIONS CODE:TMF.COMRACTORS U- VelU3tiqf � ADJ.AREA L11 CENSEUWDOESNOTAPPLYTOANOVMEROFAPROPfRTVW�+02U�.D50RIMPppVESMEREON,AND F WFIOCONTMCTSFORSUp1VRO.lECTSWITMACONTRACTOR�S)I�LEA5CD0UR5UANTTOMECONTMG QUANTITY OESCRIPTION FEE � TORSLICENSEUW). � 0 O I AAI EXEYPT UNDER SEG B-1 V.C.fORTHIS REA50N U LL 2 DATE OWNER V Z w � LICENSED CONTFiACTORS DECLARATION W � IMEREBY11iFIRMUNOERPENAITYOFFENURYTNATIAMUCENSEDUNDERPROVSION50fCMAPTEF � p. i�COMMENCWOWITHSECTqN7D00)OFDNISION]OFTHEBUSMESSANOPP.OFESS�ONSCO�E,AND Z X UY IICENSE IS IN NlL FORCE AND EFFECT. m � UCENSECUSS � LIC.NO. O Z � V DATE �'�"rI v�- CONTMCTOR a W � WORKEHS'COMPENSATION DECLARATION a N U � IHEREBVAiFIRA1UNDERDfNALTVOF0ER1URVdJEOFTHEFOLIOW:NGDECLARATIONS: Z Q � _INAVEANDWiLL1MINTluNAGERiIfICATEOFCONSENTTOSELF�NSUHEFORWORKERS' S { COMPENSATpN,ASPR�NDEDBVSECT10N77000FTNEl/E00.CO0E,FORTHEPERFORMANCE U Q OFTHEWORKiORNMICHTHISVERMITI5155UED. � � w _I NAVE AND W4L MAMTAIN WORKER5 COM7ENSATIpN IHSUMNCE.AS REOVIRED BY SECTION � ^� � y� Q 7700 OF THE UBOR CODE,FOR ME PERFORMMiGE OF TME WORK FOR WHlpl iHIS PERMIT IS / 1 / 1 LSSUED.MY WORKERCSC'�gIAP.jF-NSATqN INSUHANCE C/ARRiER AND POIICV NUMBER ARE: CONSTRUCTION l l . V jCARRIER '�+e '�Y-11/K PLAN REVIEW ' Z PoIICYNUMBER ��� ELECTRIC 4 � (IICSSECiqNNEmNOTBEOGdPLE7EDOFTEPERMT6PoRONEFI�DRED00l1ARiIf�001�LE55} PLUMBING Z ICENTIFVTHATNTHEPERFOH/AANCEOFTHEWORNFORNMiCNT1115PERAliT1565UE0.1 MECHANICAL (�} SMALL NOT EA�VIOY ANV OERSON IN�M'IAANNER SO AS TO BECAME Sl1BJECT 70iNE vj WORKERS'GOMPENSATIONLAWSOFGILIFORNV�ANOACREETHATIFISHOLADBECOME INS?ECTIONFEE '`- SUBJECTTO TNE WORKERS'COMPENSATION PROVISIONS OF SECTKKJ 77000F THE IABOR . � S eoo¢.�sn�ucoarHvnrneorao�rv,�n�tw sevno�sar+s. ISSUANCE � � � � SMIP ` ��� 0 onrE: �aa��Nr: � ENERGY P/C J WARNIN(i:FNLUHETOSEWflEWORKERS'COAIVENSATIDNCOVERAGEISUNUWFUL,ANDSMILLLBE � SUBJEGTANEMPIOYERTOCRIMINKiENALilESM10CMLFINE5Up700NEHUNDREDTNOUSAND ENERGYPERMIT DOlURS U 7aa.0oo).w IWOiT10N TO TNE CAST Of COMPENSA710N,DMIAGES AS PROYICED FOR IN J SECTION�70lOFTHEUBORCODE.P77EREST.�NDA7TOfiNEY5FEE5. FiETEMIONFEE: Q a CONSTRUC710N LEND�NG AGENCY PRE-ALT FEE: ' � INEREBYAFFIR�IUNOERVENALTVOFPERIURVTNATTMEREISACONSTRUCTIONLENDWCAGENCY �- FOfl THE PERFORMANCE OF TME WORK FONN'„ICM 7MI5 iERMiT IS ISSUED(SEL.70a�,CIY.C.). Z W � LEN�EftS NAME � � LENOER'SADDRESS ' I � ' �� w ICERTIFYlH11TIMAVEREADTM15AVVLICATqNANDSTAtETHATTNEABOVENFORMAT�ONISCORRECT. TOTAL FEES � IAGREETOCOM�LYWITHALGRYANDCOUNTYORDiHANCE5ANO5iA7EUw5PEU7iHGTOBU0.D�NG CANSTRUCTION,AND HEREBYAUT110N�ZE PEVPESEN7ATiVE50F TNIS COUNTI TO ENTER UPON THE � ABOVE�MENiIONEDGROPERTYfORINSVECTiW/DURPO5E5. COMMENTS = 3'L.�/ �/O f��/C VERMiTTEE NAME(vql ) � , � �� a � � � y S�GN � EOFPERI. � � DATF � = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy.YELI.OW—F�nance Copy,PINK—Assessor Copy,GOLOENROD—File Copy,GREEN—ApplicanPs Copy C�T" �i� �I�'�i��1Jf'z� F3Wfi • 1P���E�z'Bflr� ��GD�'1D � �,----._ --�,�►,i�.��.1��I�1,��,r:�,�o �b C�, �'�I� ,.�.�._.������ -I��',F ;���l.�a�.�_..__.".___��E!"!F�',��#,r�i;1.�� �`e�a @;� �- k��.� � .� l�.�`,�� �� �'. 5ET BACK ` ; +_ ...Y.,�. u ��.'FLGdR JOIST ��� ' ' — --- — ----- FTGS/F�RMS/STEEL � ' __�_ FHA RE(7^,1TS J ' ---- —�-�- -- — -- ---- - .— ELECTRIC GROUND ; _ j Uv�ER PLdOR DUCT � GF�C�UiJD PLUD.481�J—G -�— I U!'d0E_R FLOOR CU�!DUIT 1 i SLAB GRADE � � � FfREPLP,CE FOUNDATION __ I I � ----1--- -�'- - - - TEMP POWER __ _ I ___ . __�_l_FIREPLACE B�ND BEAM _ WATER SERVICE I _____ _"___. � PA1D HT. �OND E3EAP�1 ' ROOF SHEATHI�dG �'_/8' G'� __._� _ �� Q�. 6aPda BEAP11 _ � __ FRAMING�`VENTILIATION / � � FIP.AL E30tJD BEAM ROOF CaVER &�� iZ -- --- - -� PRF_-GR.ADIfJG -- - — ROUGH HEATING � � . , BENCHIPJG ROUGH ELECTRIC __ __,� RC�UGH UR.AD�NG _ ROUGH PLUD,�BING —�- FINISF�GRADIP�G SHOWER.�TUB TEST j F'OOL ELEGTRIC ' EXT. LATH/SIDING F'OOL FENCIhlG � WALL INSULATION j POOL FINAL j � CEILING IfJ�ULF,TIOIJ _ _ I OFF SITE Iti1PS. _ DRY�NALL NAILING DEDICRTIO�JS SEl'VER FIPdAL ENG SEPTIC TANK � LANDSCAPE/Ir�RiG. SEEP PiT/L.L. _�_.��_�.ON SfTE IDAPS. GAS AIR TEST � ; FI�JAI.ZONING FINAL CONST. � �c/s2. � _ � i �!RE DEPT. FWAL FINAL HEATING � '_ 1 ( HEALTH DEP'f. FINAL _ FiNAL ELECTRIC � � � DEV. FEES PAID FI'JAL PLUMBING ( ENERGY i -- - - - -- �y; . y . .:�L��..���:.o.gx.�:.._.._.__ CUMMENTS ��PTIC TAF�K SIZE SEEP PIT/U SIZE — `-- ---- -' _' . -'y�T.-_._._.__.�.'I ---- , ��. i .VfY�( " �,I�I�I --- — --- .Faw�rr � , � ! — -- , ; „i, ___._._..._:.�'.___�.'_°��_:..:� , - . _--