HomeMy WebLinkAbout11950 (5) CTTY OF DIAMOND BAR �' � � �
CaMMUNITY DEVELOPIv1ENT DEPARTMENT �
-;,.� . 2166�E.Copley Dnve Suite 190 PRES•S
(909)860-3195 Fax(909)861-3117
�'"""J BUILDINGPERMITAPPLICATION FIRMLY
o� JaBSITE } -� -- APPUCATiON .�1�.- PERMIT P!C
ADDRESS��/� ���`�' �'���O�'�..� DATE � NUMBER a
� APN LOT 7RACT ��'3S�a �SSUE TYPE OCC
DATE CONST. GROUP
p OWNER L�'�l Z��� �ff�I�
ADDRESS�4-✓�.'S� �...1 I�=G�1G,<. ZONING SETBACKS
� CITY P1��/�-��l� ZIP�II�S�TEL ` FRONT RW ❑
g APPLICANT TEL. REAR ❑
� SIDE/SIDE STREET RW ❑
� CONTRACTOR �"�L�-C,%�.�G/�_ SIDE ❑
p� ADDRESS PROPOSED USE /`�- �
O -
p ARCI-UENfi/ 71P TEL. ��72�R,r o� P/G sG,�_j`�r7-^�
w DESIGNER N0.DWEL. NO. NO.
Q. ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
�
cn DESCRIPTION SQ.FT. FACTQR PSF ADJ.AREANALUATION
� OWNER•64'ILDER pECLAFiATION SFRlADDIREM
WO 1 HEREBV AFFIRM UNDER PENAIiV OF PER�URY THA71 AM E%EMPT FROM THE CONTRACTORS�I- G8fflg9/C81'POfI
CENSELAWFORTNEFOLLOWINGFEASON(SEC.703t.58L151NES5ANDPRDFE5510NSCODE:ANVCITVOR (/)
U COUNTYWFIICHRE�UIRE50.PEFMI7TOCONSiRUCT,AI,TER,IMPROVE.DEMOLISH,ORR6PN�RANYSTRUC- W Pa�io/OeCk
w 7URE,PRIOR TO I7S ISSVANCE,ALSO qEOUIRES THE APPLICANT FOq SUCH PEFMIT TO FILE A SIGNED W
S7ATEMENT 7HAY NE OR SHE IS LICENSE�PURSUANT TO THE PROVISIONS OF THE CONTRACTOH6 L6
� CENSE LAW{CHAPTER 9(COMMENCING WITH SECTION l000�OF DIVISION 3 OF TNE BUS�NESS AND PRO• � PoOUSpe
� FESSIONSCO�E)ORTHAiHEOR5HEI5E7(EMPT7HEREFROMANDTHEBASISFORTHEALLEGEDEXEMp• (�
V TION.ANVVIOLATIONOF3ECTION?097.SBYANVAPPLICANTFORAPEflMITSV&IECTSTHEAPPLICANTTO Z RB-POOf
A CIVII PENALTY OF NOT MORE THAN FNE Hl1NDRE0 DOLUHS(S6o0�.):
❑I,AS OWNER OF THE PROPERTV,OR MV EMPLOVEES WITH WAGFS AS THEIR SOI,E COM7ENSATION,
Z 0 Commercia�
WILL DO THE WOFiK,AND THE STRUCTURE IS NOT INTENDED OR OFFEFED FOR SAIK(SEC.]044.BU56 J
N NESS AND PROFE9SION5 COOE:THE CONTRACTORS�ICENSE LAW DOES NOT APPLV TO AN OWNEN pF �
PROPERTV WHO 9U0.DS OR IMPROVES THEREON.AND WHO DOES SUCH WORK NIMSELF OR HERSELF OR
� THROUQH HIS Oq HER OWN EMPLOVEES,PRONDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED Oq m
QOFFEREDFORSALE.IF,HOWEVER,iF7E9UILDINGORIMPqOVEMENTISSOIDWITHINONEVEl1ROFCOMPLE•
z T�ON,TME OVlNER�BUILDER WI��HAVE THE BUHDEN OF P0.WINa THqT HE OR SHE DI�NOT 6UIL0 OR
= IMPROVEfORTHEPURpOSEOfSALE).
w ❑I,ASOWNEROFTNEPR07ERTV,AIAEXCWSIVELVCONTFAC7INGWITHLICENSEDCDNTRACT4RS
� TO CON57RUCT THE PqOJECT(SEC,70aI.BUSINE55 AND PROFESSIONS COOE:THE CONTH0.CTORS LI� V81U8I1Of1 ADJ.AREA
W CENSEUWDOESNOTAPPLYTOANOWNEROFAPHOPERTVWHOBUILDSOHIMPROV�STHEREON,ANO
� WHOCONTRACTSFORSUCHPRWECTSWI7HACONTRACTOR(S�LICENSEDPURSUANTTOTHECONiRqG QUANTITY �E CRIPTION FEE
Y TORSLICENSELAW.�.
� U 1 AM IXEMPT UNDER SEC. ._B.8 P.C,FOR7HI5 REASON Q
� i U
�'1" DI1TE_/'l�'�� � OWNER� � V
z �„
� LICENSED CONTRACTOFS D LARAT N W
� I HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
p. 9(COMMENCINGWITHSECTION7000)OFDIVISIdJ30FTHE8USMESSANOPROFESSIONSCODE,MA Z
>C MV LICENSE IS IN KULI FpRCE ANO EFFECT. m
LLI
� LIGENSE CLASS UC.NO. j
� J
V DATE GONTRACTOR O.
W . .. , .:�: :�.� . . � :�. .� . ..
� WORKERS'COMPENSATION DECLARATION a
� I NEREBYAFFIRM l/N�ER PENALTV OF OERJURY ONE OF THE FOUAWING DECLAflATIONS: Z
� _I HAVE AND WILI MAINTqIN A CERT�FICATE OF CqNSEMTO SELFINSURE FOR WORKER5 =
Q C04PENSATION,AS PROVIDED BV SECTIDN 970o OF THE LABOR CODE,FOR THE PERFORAIANCE W
OF THE WORN FOR WHICH THIS PERMIT IS ISSUEO. �
O
�I HAVE RN�W IlL MAINTAIN WORKERS'CqMPEN5AT10N INSURANCE,AS REOUIpEO BY SECTION T
d ��o00F THE IABOR COOE.FOF TNE PERFORMANCE OF THE WORK FOR WHICH THIS PEPMff IS ��
� ISSUEO.MY WOpKERS'COMPENSATION INSURANCE CARNER AND POLICV NUMBEH ARE: CONSTRUCTION �(��
j cnaaiEa PLAN REVIEW
Z POLICYNUMBER ELECTRIG
Q
0 (rHl6seciaNUEmworsEWf.+alE'rEooFP-EPEw.uTsroPorvEHuwRmDalu�s(3�oaloR�E�c,ry. PLUMBING
Z I CEHTIFY 7HA7 M THE PEpFORMqNCE OF THE WpRK FOP WHldl THIS PEAN�T IS ISSUE�,I MECHANICAL
L'7 SHALL NOT EMPLOY ANV PERSON IN ANV MANNEF 50 AS TO BECOME Sl1BJECT 70 iME
[,/) WORKERS'GOMPENSATIONLAWSOFCALIFORNIA.ANOAGRE�THATIFISHOU�pBECOME INSPECTIONFEE
= SU&IECTTOTHEWORNERS'CqMPENSATIONPROVI510NSOFSEC710N77000FTHELABOR *
CO�E,I SHALL LORTHWITH COMPIV WITH THOSE FROVISIONS, ISSUANCE (
�
p OATE: APPLICANT: SMIP �
� WRRNINO:FAILURE TO SECURE WORNERS'COMPENSATION CAVERAGE IS UNLAWFIIL,AND SHAL4 BE ENERGY P/C
� SUB.�ECTANEMPIOYEqTOCHIMINALPENALTIESANDCIVILFINESUPTOONEHUNOREDTIi0U9AND ENEFiGYPERMIT
OOLURS(31oa,000�.IN ADDIT�ON TO THE COST OF COMPENSATION,DAMAGES AS PROVIOED FOR IN
J SECTbN370BOFTHELA90RCODE.MTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: e
�
� CONSTRUCTIONLENDINGAGENCY PRE-ALTFEE: �7
O
� 1 MERE9Y AFFIRM UNDER PENAITY OF PERJURV TNAT THERE IS r1CAN5TFUCTION LENOING AGENCV
fOR THE PERFORVAANCE OF THE WOPoC FOH WHICH THIS PERMIT IS ISSUEO(SEC.3087,qV C.�.
Z
W
� LENDER'SNAME
F— LENDER'SA�ORE55
� TOTAL FEES ,�
� I CERTIFY TW1T I HAVE READ iN15 APPLICATION AND STATE n-IAT THE ABOVE INFORMATION IS CORFECT.
� IAGREETOCOMPIYWITHALLCITYANOCOUNTYORDINANCE5AND5TATElAMSRELATINGTOBUILDING -'
� CONSTqUCT10N,ANDHEREBYAUTHORREFEPftESENTATNESOFTHISCOUNTYTOENTEf7UPONTHE �
Z ABOVElAENTIONED 7ROPEHTV FOF INSPECTION PURPOSES.
COMMENTS
m �G� G$�`-��c'i3c/��
¢ P/E�qM177E�EN]AME�ORINT)
fn /�"t/� . +-.-s. ��
� SIOW�NREOFPERM EE DATE �
� RECPT.NO. PAID BY VAlIDA710N
WHITE—�epartment Copy,YELLOW—Fhance Copy,PINK—Assessor Copy,GOLDENHOD—Rle Copy,GREEN—AppllcanYs opy ' - .
� i�d..ti':f�.i . de��;i�'Z;'}\�71i�.;:�".f'+n1}M`,•.'4Fvi^'_tir^c:t..-,�WNR.:.,,..nyuq^.urn.'-.'-r'- ;i . ri;C" ".'(v��Y�5R4\'ai`.�N`Kf"�H"� '+�`''!�v"S�p/ �aa'4 '^i�.MF �`}ar'e� 4}P ? '�
� . . , , .. . ':'�!'2., .:,# . ,i .�.3;s�;�,�+ X}��U9 �tg:',4s�;u�n ::f,�-}:r�:�e;�..a�',�h,.
crrv oF DrAnnoN� eaR=� �
IiVSPECTION RECLIRD -
' • ! i • • - • • ii • • •
SET BACK - F�bOR J015T
FTGSIFORMSlSTEEL - FHA REQM7S � �
ELECTRiC GROUND UND�R FLUOR dUCT 4
GROUND PLUMBING UNDER FLOOR CUMDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WA7ER SERVICE ' - -' `' ' 'r M!D HT. BOND BEAM
ROOF SHEATHING " � 8 FT. BOND BEAM
FRAMING/VENTI�IATION '' ` ��` FINAL 80ND BEAM ' ,
ROO�COVER ... _ _ F'RE-GRADING `' �',,, ',
ROUGH HEATfNG - BEiVCHING '
�
_.�.�_.�
FiOUGH ELECTRIC _� ROUGH GRADING �.::�, ;.-.
__.__ ____— _. — �. _ ,.�_
FiOl3GN PLUMBfNG _ FINfSH GRADING
SHOWER/TU8 TEST _ . .. POOL ELECTRIC, ,_
E7CT.LATH/SIE7ING . POOL.FENCING — . ,� ,. ' '`
WAL�lNSULATION POOL FINA� - �' -
� �r �,
CEILING INSULATIQN OFF S1TE IMPS.
, . ,.
DRYWALL NAILING D�QICATtONS ',° >... ':
_ _ . __
SE'rNER_ . _ . , ,�. � FINAL ENG. ���
SEPTIC TANK ,'' _ ._��.:. -1 LANDSCAPE/IRRiG. — — n , `
:,n :,.._
SEEP F'lTIL.L. `' ' , '� ON SITE IMPS_ �
�,,+, �
GAS AIR TEST - - � FlNAL ZONiNG "°�,� '
FINAI CONST. � , FIRE DEPT. FINAL -
;
.._ : ,
FtNAL HEATING - j HEALTH DEPT. FINAL �
. , ,..,.
FINAL ELECTRIC _ . _ ; DEV. FEES PAID _ ,. .-�_., ,
��_...� �,. ;
�lNAL PLUMBIfVG � . .__ __ . ENERGY ° : , ,
� —� - -- �
_ ... . __ .._. _ . (
. ,,: ,,t �
_ _ _ ,
.
, . • s ,
� � _ . . ,� .... �=3�,.._.., _
. .. . .. . .. ... ... . . .__.. ._ _ . .._ . .. . . _ .. .
COMMENTS , . , ,-, ,. ,. ,
- ,. , ; . ;a,��F:,:,,_. -- ,
� ,. ,, , ,, . � �:,�:.�, .; _
_ __ _ _ � ,,,.,., .
_
. �
_ _
� .
_
,. ,. ,.. , ,
_-- __ ._. :� , � �., . , ,; .; �,,..:
,. _. .
� _ _ __ . „ , . ., .
...... ._.. .... __. .... _ . ..__ .. . .. ., � ,. . ... :.M1.-,;,.. ; :';��� .�f'.,
; . ., ... . .. ..�i. .
.� � �� .� . �- �-.,. ��..: .
.� .i
� .. � .�� :,... .� . ' ...
,,__ _...._..._.. __.. ..._ .... ._"_
,-...� . ��i.�. ',S'H` M .. ':'. ':/.-...:
li
. �... . nn , . .. � �
i
. .. .� ... ... . ,
. ,. '. �.:.... . , - . .'��.i.-. '. �."I , .... �
.'..i. .;� . .. . . . .
SEPTIC TANK SIZE -`' `' ' ` ."
�, � � �;� , <.
SEEP P1T/U SIZE W .._ _ . � — --- ---- ---
----�.�—.,—sz_ _ . ,.._ .
_ �. . ; :