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HomeMy WebLinkAbout11632 - .+�. �'• CITY OF D[AMOND BAR ��-' '� ' COMMUNTTY DEVELOPMENT DEPARTMENT �"� :..;w 2t660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS �'""' BUILDING PERMIT APPLICATION FIRMLY � JOBSITE +� �� �-r� o ADDRES�����J �� �� /���DO DATEICATION� 1� PERMIT ��/C � _. NUMBER $ APN LOT TRACT �SSUE TYPE OCC p OWNER ���j ��- -- DATE CONST. GROUP p ADDRESS � �C ZONING SETBACKS FRONT gCITY �;xi ,LI.�.�'i ZIP TEL. REAR RW ❑ APPLICANT TEL. ❑ SIDE/SIDE STREET RW ❑ � CONTRACTORC:�'��L^G,� SIDE � O ADDRESS CITY ZIP TEL. PROPOSED USE e��l�c-�"�^V/L't w ARCH/ENGI �jG f a/� C rerr/Y rrrr..- z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BI;IIDER DECLARATION SFR/ADDlREM � p 1 HEREBV AfFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FRpM THE CONiRACTORS U- G8f8 0/C8 Of[ W CENSELAWFORTFIEFOLLOWINGREASON(SEC.7031.68USMESSANDPROFESSIONSCODE:ANYCITYOR (n 9 � U COUNTYYMICHREOUIRESAPERMITTOCANSTRUC7,A�TER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- W w TURE,PRIOR TO ITS ISSUANCE,AL50 qE�UIRES THE APPLICANT FOR SUCM PERMIT TO FILE A SIGNED W Patio/Dack � STATEMENT THAT HE OR SHE IS LICENSED PURSUAN7 70 THE PROVISIONS OF THE CONTRACTORS LI- � CENSE LAW(CHAPTER e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOUSpB FESS�ONSCODE�OHTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEOEDEXEMP� (� TION.ANVVIOLATIONOFSECTION7031.SBYANYAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENQTY OF NOT MORE THAN FNE Hl1NORE0 OOLURS(f5oo).): O ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPIOVEESWITHWAGE5A57HEIRSOLECOMPENSATION, O COITfI1B�C18I Z NALL 00 THE WORK,AND TNE STFUCTURE IS NOT INTENDED OF OFFERED FOR SALE(SEC.701I,BUSI� J N NESS AND PROFESSIONS COOE:THE CANTRACTORS LICENSE UW DOES NOTAPPLV TO AN OWNER OF = PROVERTY WF10 BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WOHK HIMSELF Oq HERSELF OR L� THROUGHHISORHERONRJEMPLOYEES,PpOVIDEDTHAiSUCHMAPROVEMENiSARENOTINTENDE00R m Q OFFEREDFORSALEIF,HOWEVER,TNEBUILDINGORIMPROVEMENTi550lDWITHINONEYEAROFCOMPLE- � TION,TME ONMER�BUILDER WILL HAVE THE BUHDEN OF PROVINa THAT ME OR SHE Ot�NOT BULLD OR = IMPROVEFORTHEPURPOSEOFSAIE�. w ❑I,ASDWNEROFTHEVROPERTV.AMEXCLUSIVEIVCONTRACTINQWITHLICENSEDCONTRACTORS � TO CONSTRUCT THE VROJECT(SEC.7014,BUSINESS ANO PROFESSIONS CO�E:THE CONTMCMRS LI- V81u8tiOn AW.AREA W CENSE lAW DOES NOTAPPLV TOAN OWNER OF APROPERN WHO BUILDS OR IMVROVES THEREON,AND � WHOCANTRACTSFORSUCHPqOJECTSWITNACONTRACTOR�S�UCENSEDPURSUANTTOTHECONTRAF QUANTITY DESCRIPT�ON FEE TORSUCENSELAW.). O ❑I AM EXEMPT UNOER SEC. B.8 P,G FOR TNIS REASON Q � -U �'�" OAT OWNER f {- . O U � UCENSE�CONTRACTORS DECLARA ION W � 1 HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OFCHAPTER � d e(COMMENCING WI7H SECTiON 7000)OF DIVISION 30F 7ME BUSINESS AND PROFESSIONS CODE,AND Z � MY UCENSE IS IN NLL FORCE AND EFFECT. � � IICENSE CU155 �IQ NQ � V DATE CONTRACTOR d W � WORKERS'COMPENSATION�ECLARATION Q � IHEREBYAFFIRMUNOERPENALTVOFPERJURYONEOFTHEWLIOWINGDECLARAT10N5: Z � IHAVEANDWILLMAIN7AINACERTIFICATEOFCONSENTTOSELF-INSl1REFORNIORKERS' _ a COMPENSATION,ASPROVIDEDBVSECTION37o00FTHEl,ABORCODE,FORT4/EiERFORMANCE (.) Q OFTHE WORK FOR WHICH THIS PEFMIT IS ISSIIED. � Qw _I HAVE ANO WILL MAINTAIN WORKEqS'COMPENSATION INSURANCE,AS REOUIRE�BV SECTION R��\ 37000f THE LABOR CODE,FOR THE PEflFOHMANCE OFTHE WOHK FOR WMCH THIS PERMIT I5 (�U ISSUED.MV WORKERS'COMPENSATION INSUMNCE CARRIER AND POLICY NUMBERARE� CONSTRUCTION ���Y./ J +�Q. CAqRIER PLAN REVIEW Z POLICY NU�ABER E�ECTRIC Q � (fiQSSEC110NPE�NO7BE00MREf�OF7FEPERMRISfORONEViIN�DRWDOLLARS(StOD�ORIESS}. PLUMBING Z I CEflTIFY THAT IN THE PERFORAIANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUE0,1 MECHANICAL �� . C �k' ti° C�} SNALL NOT EMPLOV ANV PEHSON IN ANY MANNER SOAS TO BECOME SU&IECT TO THE ..i.: _.- (p WORKERS'CAMPENSATION LAWS OF CAUFORNIA,AND AGHEE THAT IF I SHOULD BECOME INSPECTION FEE � = SUBJECTTOTHEWORKERS'CAMFENSATIONPROVISIONSOFSECTIONS7000fTHELABOR CO[lE,I SHALL FORTHWITM COMPLY WITFI TFiOSE PROVISpNS. ISSUANCE / Q p OATE: APPIICANT: SMIP � W J WARNING:FNLURE70SECUREWORKERS'COMPENSATIONCOVERAGEISUNLAWFUL,ANDSHALLBE ENERGYPlC � SU&IEC7ANEMPLOYEPTOCRIMINALPENALTIESANDCIVIIfINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT JDOLIARS�5/00,000).IN ADDITION TO T11E COST OF COMPENSATION,DAMAGES AS PROVIDE�FOR IN SECTION 3708 OF THE LABOF CO�E,INTEREST,ANO AITOFNEI"5 FEE5. a� FiETENTION FEE: l ,, OCONSTRUC710N LENOING AGENCY PRE-A�T FEE: � IHEREBVAFFIRMUNDEFPENPLTYOFPERJURYTHATTHEREISACONSTRUGTIONIENDINGAGENCY FOR THE PERWRMANCE OF THE WORK FOR WHICH TMIS PERMIT IS ISSUED�SEG.3087,CIY.C.). Z W � LENDER'S NAME F- LENDERSADDRE55 � w I CERTIFY THAT I NAVE flEAD THIS APPLICA710N AND STA7ETHATTNE ABOVE INFORMATION IS CANRECT. TOTAL FE ES ' � � I A6REE 70 COMPL�WITii ALL CRY AN�CAUNTYORDINANCES AND ST�TE LAWS RELAi1NG TO BUILOING � CONSTRUCTION,ANDHEflEBYAUTHORIZEREPRESENTATIVE50FTHISCOUNTYTOEMERUPONTHE , Z ABOVE•MENTIONEO PROFERTY FOR INSPECTION PUHPOSES. COMMENTS � ' ��R4 �" J � m PERMIT7EENAME(PRINn � � . � � .: . ., .. � � J-�_ � - N NATUREOFPERMIT7EE OATE � RECPT.NO. ___PA�D BY VIU..YDATION WHITE—Depertment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN—AppllcanPs Coqy'' � '- '��-' � '"� �� ' ��,� �A� �^;":�'� �W,'t��,�,.:��av,��v �.,. }.�r a�v��y:v�� 'e �r�;;v?.'r�`s�` �,.����a ,.;.:.r.��,�+�ti�r ���y.�:�+�u,.,���;.�,d'c.,������ y;�a�'r-,;:r'���s�"�'�»�s�!�'���r�'�''�;�",'�� ,.., .,�.�++`���&,,.. . '�,�k , �,',`` •'�a�'.�'., `,�<' CI�"Y' OF �1ANIUND �AR . � .,u �,._ ,� ., �. . . _,, » , . ,f . dNS�ECY6�!'�i Fi�C4R[9 �<,,, ;.�,'; � .�, ,��`�: ... _ f . . � � , , • _ � � o , • � • . ��,�,� � _ .. , ..,.,. �. - ............E._. . .. '._. '. .._ . '.... . . _ ' -:__ ___.. . FLOOR JOIST.� _ SET BACK ,., _ . FT'GS/FORI+AS%STEEL _ _ h�-iA REQMTS _ . , ,,.. _ " �y. --- ELECTRIC GROUND ; ; "'"' ::'. UI�ID�R FLOOR dUCT ... . ` . , , - _-=_,_ _ . � N.. ,- ,, GROUND PLUMBIN� ' _ ___. ., , UNDER FLOOR Cf3ti4DUIT ''-• '•` _` r y .. _ _ _ ; _ , SLAB GRADE '`:s '�'� "�'.=�� � FIREPLACE F(?UNDATIiC�N TEMP POWER -... _.. __. ,:, ; FIREPLACE BOND BEAM ' RaOF SHEATHING .. �� j� t�C �` � � " " 8 I�HT. BOND BEAM _ ; ;�,, Y�. t , , � � BOND BEAM � `�' � — _ —� . . , � FRAMINGNENT1�lATION � ` FINAL BOND BEAM ±� -- _.. ROOF COVER _ _.._ . __... ._-- "PRE-GRADING _ �a;�. ,.,. , _ _ ROUGH HEATING '_ _ � -�.. .' "''' BENCNING ., _ . . ,,. --- --- ---.__ .._______._._ ROUGH ELECTRlC __.__... _.. , ,-" ., FIO.UUH GRADING _ ,,,, , ,,,„. , ROUGH PLUMBING . ._ _ _! .._ _ ,, FtN1SH GRA[}IN� ,,. " , , , ., " SHOWER(fUB TEST _ __. ._ _ ,;, : P��bL ELEGTRjC ,': . , ' ;.:., ' ,„ � _. EXT.LATH/SIDING - --_.__ __._. _ __ : Pbt�L FENGING ., .` ` '; " z�: _ ..r .��;?',iz ,L:-, �ti, - _ WALL INSUl1�TION —_ _ . .._ _ _ _ __- . , POOL�INAL . , :in; . , - -- c��z,��,!:w _r , - . .. . .. . .,. __ ._._,_..._... � � . . � CEILING INSUL,4TION OF�51T�iMPS. ,_ , " ` ;: ''' �„ �;�:. ..._. �- �... �. . .�. '." . }". , r'.t �PsN _,.'_ DRYWALL NAIUNG _ . _ DEDiCATI(7NS � � r �., , .. �:;:, 5EWER _ _____ . _ ;__.._._.. __..:�...--.._.._ .. FWAL ENG. ,: .;. ., , , , :..I, r,�y ; SE.PTIC TANK_ '.:_:.:.:' _' ::.a . �,. . .:�.. �i,.ANDSGAPE%II�RI.G. " , ' ', .: . i`i ,�,,.i ` ,...,cti , .' o,:�� . � .-�'., - . � ,.., ___.. —_ ... ..�. .�. 5EEP PITlL:L. "'"'�, __ ` �`"' ' ON SlTE IMPS. ����—� !iJR.I i.l�!t.: ,.. .. _� ."_ __� �� GAS AIFi TEST . , � FIh1AL�t7N9NG �_ �� ,: _ !_,,!� J .._ ;, `� t.�.`�ar�e�.,..�- I i IFIRE DEPT. FINAL _., � . FINAL CONST. � �'I�,�t w.,_�- "" E, -� _----- ' _ � > -.. ; ,:, fINAL HEATING � � ' _ � � HEALTH DE�'1. F1NAL,' . .. = FINAL ELEGTRIC . _ �_"I 0� E1/• FEES PAID i �;_•. ' ---_. _------------- � ,:... . ,. `:_ — -� '.. , . -- FINAL PCOM6ING ,_ -----� , �NEFiGY A��: ,�. �� ...,._ ;:�x ' - ..... _ ___. _. ._ —;— . --- - .i .. . -. � �,� ".. . � ,. . . . _. .'�./J . ,. v.., .. .. .... ._ _..{ ..." _......_.._.._. ..... tia J_:..}.,.: : .. .._._......__... ...._.... _ . ( � � ...�. � ..__...._. ._____._.._.__....___. .__._.'�_I ........_... .... .. . . . .. ,. .._ ._.... . ... : . ' '. I , i � o • . ..- ._ i .. ... . .. .�.. � . ,. � 3 3t .:: ..,e. . t ......_ ..... .... ...... _ ...._.__.. __._.,... __.._'__'_ ' _..�__.. ._...... ' .. COMMENTS . '�' ,.: . , , , �„� �fa,. � _�_.. - _ . � _,:� �. F � , �.. �� � t,n i ;'� 'N �F { ._._.. . . ..�... _ _.._.__ .. _�.� . ._.. ...._..._. ._ ._. . :i. .. .. � . , . y i, :n a .. . ... - . ....._. ' ' i Y ... ,, . ,... ..__.._.. ..... ...._. . .____ ._.... . ...... . _... . .. � � � , . t° .]-- ._:. Y?," . .. '. J 1:'.lA4M iN'r-�:x.'V�L- :..' ..___._. 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