HomeMy WebLinkAbout17556 (40) _ _----------- -_.._ _ . -- - -- ---__- ----- --_----- - ---
- ----- . . .__ .-- -
� C�
OF DIAMOND BAR . `-- �� .
,� DEPARTMENT OF COAMi1UNtCY&DEVELOP SERVICES
21825 E.Copley Drive
{ '"` (909)860.3195 Fax(909)861-3117 PRESS
`%.� BUILDING PERMTT APPLICATION FIRMLY
� JOBSITE f�?�.� APPLICATION ' PERMIT P/C
o ADDRESS �N " ✓� DATE �'Z�• O( NUMBER�� 8�_
� APN LOT TRACT DATE �' I " ` 1�O� ONST. V-(K� GROUP �
p OWNER �
" ADDRESS ZONING SEfBACKS
g CIN ZI TEL.�1 • FRONT RW ❑
APPLICAN TEL. REAR ❑
SIDE/SIDE STREET RW ❑
� CONTRACTOR SIDE O
Q ADDRESS PROPOSED USE �
� CITY T�L�i?J� ZIP�_ TEL.
o ARCHlENG/ � , r
� DESIGNER NO.DWEL. NO. �„ NO.
ADDRE 5 UNITS �� STORIES BEOROOMS �
� CIN U ZIP TEL7��[���
N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER•BUILDERDECLARATION ' SFWADD/REM
O
p I HEREBY AFFlRU UNDER PENALT/OF PEfWRY THAT I AM EXEMPT FROM THE CONTMCTORS L4 Garage/Carport
W CENSEUWFOR7HEFOlLON/1N6PE1150N(SEG7a]1.68USINESSANDVNOFESSIONSCODE:ANVCITYOR (/)
U COUNT/WH�CHqEOUIRESAVERMRTOCDNSTRUC?AITERMPROVE,0EA10L1511,ORREVAIRANY4TItUP W P0110/DBCk
Z TURE.PRqR TO rtS ISSUMlCf,ALSO REWtRES TME APPLiCANT FOR SUp/PERIAIT TO FILE A SiCNEO w
STATEMENT THAT HE OR SHE IS UCENSEU FURSUANT TO TME PROVISIONS OF THE CONTMCTORS LI�
� CENSELAW(CHAPTERY(COMMENCINOWITHSECTION7000�OFDiNSION70FiHE8USINESSANDPRO- � PooVSpa
'F��. FESSIDNSCOOE)ORTHATHEORSMEISE%EMPTTNEREFROMAN�TNEBASISFORTHEALlE0E0EXEMP• (�
V TION.ANYVIOU17qNOF5ECTION70]1.SBYANYA�PLICAMFORAPERMITSU&IELTSTHE�7iLIGANTTO Z Re-Roo1
ACML VENAL7Y OF NOT MORE THAN FIVE HUNDRED DOLURS(f500).�:
� O�ASOWNEROFTHEPRDPERTY.OR►IYEM7LOYEESWITHWACESASTHEIRSOLECOMPENSATqN, 0 COmmBrClal �
MALL DO THE WORK AND THE 51RUCTURE IS NOT IMENOED OR OFFEREO FOR SALE(SEG 70N.BU56 J
� NESS M1D 7ROFESSIONS CO�E:TME CONTqACT00.S UCENSE UW DOES NOT IPPLY i0 AN OWNER OG ?
CRODfRTY V1H0 BUILDS OR IAIPROVES THEREON,AND WHO DOES SUp/WORK H�4SELFOR HERSELF OR
� THROUGHHISORHEROWNEAIPLOYEfS,CROVIDEDTW�TSUCMIMPqOVEA1ENTSARENOTINTEA'DEOOR m
QOFFEREOFORSKEIF,FiOWEVER7TIEBULDiNGORIIAPROVEMENTIS50LDNrtTHINONEVEAROfCAMRE-
Z TION,THE OWNER�BUILDER IMLL HAVE THE BUPOEN OF PROVIN6 THAT HE OR SNE�ID NOT BUR.D Ofi
� MCRDVEFORTMENRPOSEOFSALE}
w OI.ASOWNEROFTHEVROPEHT7,AA1ExClUSNELYLOMMCTINOWRMLICEN5E000NTMCTORS e�
� TO CONSTRUCT THE PRQIECT(SEC.701�,BUSINE55 M7�PROFESSIONS CODE:1HE CONTRACTORS LI• V2IU8IIOf1 C.t l] ADJ.AREA
CENSE UW OOES NOTAPPLY TO AN OWNER OF A PROPERTY WMO BUILDS OR IMPROVES THEREON,AND
� NTIOCONTRACTSiOR5Uq1GR0.JECT5WITHACONTHACiOR(S)IICENSEDPURSUAHTTOTHECONTMG QUANTITY DESCRIPTION FEE
Y TORSLICENSELAW). +�
� ❑IM1f%EIAPTUNDERSEC. B.iP.C.FORTH15REASON U G�
� � �c E D.s�
LL" DATE OWNEH
Z W
� UCENSEO CONTRACTORS DECLAFiATION W ,
1 HEREBY AFFIRI.1 UNDER VENALTV OF iER1URY TMAT IAM IICENSED UNOER PROVISIONS OF CHAPTER Vr
p„ 0(COMMENCINCWITMSECTION7000)OFDIVISION70FTHEBUSINESSANDDROFESSIONSOODE,AN� Z
X MY LICENSE IS IN NLL F AND EFFECT.
. � IICENSE CUSS ' LIC.NO.� ' �/� I � �s.�� �
.. V DATE �Z� S I � ��ZOO�L.r COMRACTOR�S �QA�D� a . .
W
� WORKERS'COMPENSATION DECLARATION I� a
� IHEREBYAFFIRMUNDEROENALTYOFPERJURVONEOfTHEFOUOWINGDE4ARATIONS: U
f� Q
� �IHAVEANDWILIMAINTAINACER7IFICA7EOFCONSENTTOSELFaNSUREFORY.OHNERS' _ �
COIAPENSATION.ASPROVIDEDBYSECTIONJ7000fTNEU1BORCODE.FORTHEifRFORMANCE W
OF THE WORK FOR WNICH TMIS DERAIIT IS ISSUEO. � •
0
_INAVEANO WILLMNNfA1N WORKERS'CAAIPENSATiON INSURANCE,AS REOUIRE�BYSEC7ION .�q r
Q �700 OF iHE UBOR COOE,iORTHE VEHFORAIANCE OFTME WOPo(FOR WMCM THiS PERMIT�S � ��[1
� LSSUED.MVWORKERS'COMPENS�TIONINSURANCECAARIERANDPOLICYNUMBERARE: CONSTRUCTION � �
Q ��., c
] CAHRIER � -!AT rC r LS 1J PIAN REVIEW
� POLCY NUAI6ER.2,.��A 1 IJ L�I T OO�J _ ELECTRIC �•'
0 (rm55Eciv+nEmnoieEm.s�FtmOFn�eewnrisra�on��ooalnns�S�mlOr+tFsst PLUMBING �--- , ---
Z ICERiIFVTHATWTHECERFOFUAANLEOFTHEWORKFORWHICHTHI5PEM11T15155UED,1 MECHANICAL '}`"`, �-�� � ` 1'����-
C7 SHALLNOT fA1PLOY ANV VERSON IN ANV MANNER SOAS TO BECOME SUBJECT TO THE -_ .-
� WORKERS'COMifNSATIONU�M50FCALIF NIA,ANO�GREETMATIFISFIOUI INSPECTIONFEE ;�
S SUBJECTTOTHEWORKERS'CCr.�PfNSAT PROVISIONSO SECTION7700 f ' � � ',
cooe,i snut roarnvnn�caaa�v wi ose pyov�s ISSUANCE
� j SMIP � �
'p DATE: I' O�O APPLICAM: .
11 ENERGY P/C �T��r
J WARMNO:FNLURETOSEWREWORKERS' PENSATIONCOVERACEISUNLAWFULAND . BE ,�1
� SUOJECTANEMPLOYEATOCRIMWALPENAI.IESANDCNILFWE3UPTOONEMlNDREOTMOUSANO ENERGYPERMIT —`'��-_�—�--
DOLLARS�f100,000),IN AODITION TO 7NE COST OF C01.IPENSATqN,DAMACES AS PHOVIDED FOF IN
J SEC�IDN770BOFTHEUBORCOOE,INTEREST,AN�ATTORNEYSFEE3. RETENTIONFEE: ' �
�
d CONSTRUCTION LENDING AGENCY pRE-ALT FEE:
O
� IHEREBV11iFIRMUNDERPENALTVOFDEiWHYTWITTMEREISACONSTRUCTIONLENOINQIGENCY
FOR iNE PERFORMANCE Of THE WORK WR WF7iCM 1MiS PEiWIT15ISSVEO(SEC.JOY7,CIV.C.).
Z
W
� LENDER'S NAA1f
� LENOEfTSADDRE55 �
� TOTAL FEES �QU� —'�S �3�Z•2�
w ICERTIFYTHATIHMEREADTNISAPPUCATIONANDSTATETHAT7NEABOVEINFORIAATqNISCARRECT.
1 AOREE TO COMFLY N7TH ALL CIiY AND LOUNTV ORDINNJCES AHD STATE LAWS REtA71NG TO BV0.DIN0 �
CONSTRUCTION,ANDHEREBYAUT110RIZEFEPRESENTATNESOFTHISWVMY70ENTERUPONTHE r--�� r
Z ABOV MEMIONEOiROPERttFORINSGECTIONPURPO5E5. COMMENTS ��
� �. � D�-E
QP MIiTEE NAGE(PRI 1 I r IO�O�
Cn •
y SIGNATUREO PERMITfEE DATE
RECPL N0. PAID BY U �G b VALI�ATION
WHIT —0epertment Copy.YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy
, _ , ._.., .. _. . . . - -- .
, , . .:: ,,, . .. ,., , , : >,;.•,.;.;.•.:.-.-�,:�. . , ..,. , _ . � .. . -�, . ,��. , ,
�� ���:', G�E= Liil��!����tr� �:�t�
. ii'v�i-'���i��! RF�CE3f�F�
(1��`�s�J:�S�[(f!��1� ....�...,_ ��.�_�'^ .._..l.1��,-�v 1 '� �'�',�a� �_... �1!�.7r� °Ci 9��'�'��"!i...._�___.. E�'���: '����i..�.�,eaC�1��-��
.
_....�__._....._. . ..,.___.___... _ ._ . . . .. ... .--• — _.._ ._ �
_ ._ _ � __.._� ._ __-�___.�..._ _
SET E3ACf: ; I I FLOOR JOIST '.�, ' ��"
FiGS/FOR!�1S/STEEL �, �I __ __ �_^ � FHA REQP�1TS __ •
ELECTR(C GROUN�_ � _,_ � _i � UIJ��R FLOOR DUCT�
� GROUND PLUMBING 1_� Uh�DER FLOOR CUP�?vUIT. � � �
SLAB GRADE �—� _ � FIR�PLF�CE�FOU{JbATION '
TEMP POWER � ; . T--- � �
FIREPLA�E BOUD BEAM
WATER SERVICE � I • � �J�ID HT..�OND BEF,�l1 ' •' �� • '
ROOF SHEATHIPdG ' �`'�� � Q S FT. BOND aEA��.1 .
. .` . FRAMINGNENTILIATION ,��/Cl�-"��-� � F���AL E30(JD BEAh�t � . - � �
ROOF COVER • -- - PRE-GRADING � �-^,., .• . .
R.OUGH hiEATING BENCHINu � - ` .I - � • • '
ROUGH ELECTRIC `�r-OZ`_ ` ROUGH GRADING ' _
ROLlGH PLUMBING ; � FIMSH GRADING �
' SHOVJER,�Tl38 TEST � - _� PdOL ELECTRIC
EXT. LATH/SIDING � � I POOL FENCINu (
WP,LL INSULATION I POQL FINAL �
� CEILING IN�ULA710N OFF SITE IMPS.
DRYWALL N�ILING:• >� �J�C�Z,,,_ IO ' � ,,= I DEDICATIONS
SEWER � � �_____�� FINAL ENG. -
•�'. SEPTIC TANK ' • r � LANDSCAPE/IRRIG. • '
�� SEEP PIT/L.L. � ��' '`•� ' ON SITE It�9PS. I
� C,AS AIR TEST FWAL ZONI�JG •
' FINALCONST. , -- 1 �IRE �EPT.Flh,4L ---
��. .—__�.
F�I�L H�F.TfPdG � � �HEALTH DEPT. FINAL
�= — —�-- — —_- —i
F1��:f.L ELECTRIC - � DEV.FEES PAID
r ' FINAL PLUMBIPJG � _ � _ E�JEPGY I
� -iu� I
� . v �
r - . ..� � � __ ----1 `��� ;;,�� ��, _._�_ _`_,_ � -._` _
� � --
CU«I��IENTS
�:
SEPTIC TANK SIZE
SEEP PIT/U SIZE
���
�i'�� I
�
r��� ;� �
,�
-.,
�_... . � ..._-._ ..__ _..�_-----��: , ;