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HomeMy WebLinkAbout11946 �. _ _. _ . _____�_.____ ____________._.._____.___.___ _ . CTl'Y OF DIAMOND BAR C„� � COMMUNITY DEVELOPMENT DEPARTMENT -,.w 21660 E.Copley Drive Suite 190 (909)560.3195 Fax(909)861-3117 PRESS 4"'"' BUILDING PERMITAPPLICATION FIRMLY '� DDRIESS��� ��/L�p APPLICATION PERMIT C !C �a �-�s��,r.a-� �rL `��-- �"7..'C� o DATE_ NUMBER # � APN LOT _ TRACT S•3 �SSUE TYPE OCC DATE CONST. GROUP p OWNEF i9h-lT�l'`tn-fC-s es .. p ADDRESS L2>- f^O�'T/'�!L C ZONING SETBACKS �W CITY �-A�N� ZIP l � TEL. •L��LG�vY REOART RW ❑ APPLICANT TEL. SIDE/SIDE STREET RW p � CONTRACTOR L�GC.71tfC/L SIDE ❑ ADDRESS O PROPOSED USE ��'� ��`Z✓��v� C. oCITY ZIP TEL. 3,y,����;,y1 y��'i��l T—'� ARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � � DESCRIPTION SQ,FT. FRCTOR PSF ADJ.AREANALUATIQN p� OWNER-BI:ILDER DECLARATION SFR/ADD/REM O p I HERFBV AFFIRM 1/NOER PENALTY OF PERJURY iHAT I AM IXEM7T FROM THE CONTRACTORS LI� G8�7 BJCB O W CENSEIAWFORTHEFIX.LOWINGREASON�SEC.7077,5BUSINESSAN�PROFESSIONSCODE:ANYCITVOR (f� 9 � rt z COUNTYWHICHREOUIRESAPERMITTOCONSTqUCT,ALiER,IMPROVE,DEMOUSH,ORREPAIRANVSTRUC� W Patio(Deck w TURE,PRIOR TO ITS ISSUANCE,ALSO RC-0UIRES THE APPLICANT FOR SUCH PERMIT TO FlLE A SIGNED w � STATEMEM THAY HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTORS LI� � � GENSE LAW(CHAGTER B(COMMENCING WITH SECTIqV 7ooD)OF�IVISION 3 OF THE BUSINE55 ANO PRO- POOUS(78 Q FESSIONS CODE)OR 7HAT HE OR SHE IS EXEMPTTHEFEFFOM AN�iHE BASIS FOR iHEALLEOED EXEMP• (} V 7qN.ANYVIOLATIONOFSECTION7031.5BYANVAPPUCANTFORAPERMITSUBJECTSTHEAPPUCANTTO Z R0-RODf � A CIViI PENAL7V OF NOT MORE iHAN FIVE HUNDRED DOLlAR5155aD).): 0 OI,ASOWNEROFTHEPROPERTY.ORMYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, C� CofflrtlBfCi81 Z WILL DO THE WORK,AND THE STRl1CTl1RE IS NOT IMENDED OR OFFERED FOR SALE(SEC.70{a,BUSI- �J � NESS ANO PROFESSIONS CODE:THE CONTRACTORS UCENSE LAW OOES NOTAPPLV TO AN OWNER OF � PROPERTV WHO BUILDS OR IM PROVES THEREON,AND WHO DOES SUCH WOflN HIMSELF OR HERSELf OH WTHROUGHHISORHEROWNEAIPLOVEES,PflOVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m Q OFFEREDFORSALE.IF,HOWEVERTMEBUILOMGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TIDN,TFiE OWNEH•BUILOER WILL HAVE THE BURDEN OF PFOVINCt THAT HE OR SHE DID NOT BUIlO OR � IMPROVE FOP THE PURPOSE OF SALE). W ❑I,ASOWNEfiOF7HEPROPER7Y,AlAE%CLUSIVELYCONTRACTINGWRHLICENSEDCONTRACTORS � 70 CONSTRUCT THE PROJECT(SEC.700a,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI� VdlUBtiOn ADJ.AREA W CENSE UW DOES NOT APPLY TO AN OWNER OFA PROPERTV WHO BUILDS OR IMPROVES THEREON,AN� � WHOCONTRACTSFORSUCHPqOJECTSWITHACONTRACTOR(S�LICENSE�PL1RSl1ANTTOTHECONTPAC- QUANTITY DESCRIPTION FEE Y TORSLICENSELAW.j. 0 ❑1 AM EIfEMP7 UNDER SEC. B.&PC.FOR 7HI5 REASON Q � V LL � Z DATE �7 _ OWNER� Z' U � UCENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PENALTV OF PERJURY THAT I AM LICENSE�UNOER PpOVISION50F CHAP7ER � d 9(COMMENCINGWITHSECTION7000)OfDIVISION30FTHEBUSINESSANDPROFESS10N5CODE,AN� Z w AAV LICENSE IS IN FULL f-0RCEAND EFFEC7. � � � LICENSE CLASS I.IC.NO._ � V �A7E CONTRACTOR a w � WORKERS'COMPENSATION DECLARATION a � U � IHEREBVAFFIRMUNDERPENALNOFPERJURVONEOfTHEFOLLOWINODECLARATION3', z Z _IHAYEpNOWILLMAINTAINACERTIFICATEOFCONSENT705ELF-INSUREFORWORKERS' _ ¢ COMPENSATION,AS PROVIDED BY SECTION 37Do OFTHE LABOR CODE,FOR THE PERFORMANCE U Q OFTHE WORK FOF WHICHTHIS PERMR IS ISSUED. � Qw _I HAVE AND WILL MAINTAIN WORKER3'COMPENSATION INSURANCE,AS qEQUIRED BV SECTION r 3�0o OF THE LABOR CODE,FOR THE PERFOFiMANCE OF THE WORK FOR WHICH THIS PERMIT IS {n ISSUE�.MY WORKERS'CAMPENSATION INSURANCE CARRIER ANO POLICY NUMBERARE: CONS7RUCTION W����O J j CARRIER PLAN REVIEW Z POLICYNIIMBER ELECTRIC Q � (n�ssEcraniNEmrioTeEoonu�reDOFn+�aeaµr�sr�or�E�Doatnas�atar�on�ss4 PWMBING w Z I CER7IFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL C7 SHALL NOT EMPLOY ANY PERSON N ANY MANNER SOAS TO BECAME SUBJECT TO THE (/� WORKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOUL�BECAME INSPECTIONFEE � SU6IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F TNE LA60R 'o = CODE,I SHALL FORTHWITH CAMPLY WITH THOSE PROVISIONS. ISSUANCE 0 /� p DATE: APPLICANP. SMIP �r�y W � WARNINGFAILUqETOSECUfiEWORKERS'CDMPENSA710NCOVERAGEISUNLAWFIA,ANDSHALLBE ENERGYPIC �y SU&IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES U7 TO ONE HUNDNED THOUSAND ENEHGY PEHMiT OOLLAHS(f100,000�,IN ADOITION TO THE COST OF COMPENSATION,DAMAGES AS PROV@ED FOR IN � SECTION 37oe OF THE IABOR CODE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE: I OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRAI UNDER PENA�TV OF PERJURV THATTHERE IS A CONSTRUCTION LENDIN6 AGENCV FOP THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED�SEC.90D7,CIV.C.�. � Z W � LENDEWSNAME - F— LENDER'3ADDPESS � w ICERiIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES l � � I qGREE T0 COMPLY WITN ALL CITY AND COUNTV ORDINANCESANO STATE IAWS RELATING TO BUILOINO � CANSTRUCTION,ANOHEREBYAUTHORREtiEPRESENTATIYE50FTHISCOUNTYTOENTERUPONTHE ABOVE-MENTIONED PHOPERN FOFl INSPECTION PVRPOSES. COMMENTS � �c�� �rq,�`� �-E���. �' � PERM�E NAME(PRINT)��J��— ! �!J `! � -- .�... . � . . %'� � SIONATURE OF PERMITTEE OATE ��_./p�� � � RECPT.NO. _ � � PAID BY VALIDATION ` WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—ApplicanPs Copy � . ... ..-�,yri ' SI . � ..., ..� � , � . . tiw� �,.. , .. . � ��..... .. . .�k.��'.;�.',�y.�1Y u� .m�.. �;y�` , '.r . ` . ,� , '^� . . :.�� . ., <,.� . „ :...: i �.�:','r: ....; �.p'S�t:"S'if3%°. ',N .w.'7i? �:i p..- .. . , . , . . . . . , " 'ry, � CITY OF DIAMOND BAR . , . INSP'ECl'It�N RE�URt� • � � . • � � ° i � � � . �.�. SET BACK „ "..,•; : _ F�OOR J015T _ FTGS/FORMS/STEEL "" FHA REQMTS ELECTRIC GROUND ' '-s•- UNDER FIOOR DUCT � � GROUND PLUMBING ' UNdER FLOOR CURIDUIT =_ SLAB GRADE � ' A'''�`' FIREPLACE Ft�UNDATION _ --- TEMP POWER FIREPLACE BOND BEAM � " WATER SERVICE; - , : ' ' ° Mlp HT. BCJND BEAM ROOF SHEATHING . � 8 Ff.,84ND BEAM - ' FRAMlNGNENTILIATION - �INAL BOND BEAM � ! '� - PRE-GRADING ROOF COVER '�' . , . �_� _ _ _. ROUGH HEATING ``� ' '' -'"' BENCHING _�_ _ ROUGH ELECTRiC _ ___..._. , =" ROUGH GRADING , ., _ ,:. , R011GH PLUMBING - .____ _ __..... __ ... FINlSH GRADING , `; , . ,.. -. SHOWER/TUB TEST POOL ELECTRIC. ! EXT. LATH/SIDING ` POOL FENCING _ VVALL INSULATION _ _ , PO(?L FINAL -, ; CEILING INSULATIC)N i OFF SITE IMPS- ' _ '; ;,,„ '.;:' - DRYWALL NAtLING � DEDICATI�NS � "' "' ' __ SEWER < , ' FINAL ENG. ; ' ..I _ . ....._ :: SEPTIC TANK "� i IANDSCAPE/IRRIG. SEEP PIT/LL. ___ __ ' C)N SlTE IMPS. � �= � FIIVAL ZONING ' �' = ': GAS AIR TEST - , FINAL CONST. - -- -- FlRE DEPT. FINAt � . _ _ . , _ . _ FINAL HEATING - HEALTH DEPT. FINAL ' FINAL EIECTRIC ._ __ .. _ _ . __ DEV. 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