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HomeMy WebLinkAbout11951 � .. _ __.. CPI'Y OF DIAMOND BAR /' _ � C�� COMMUNITY DEVELOPMENT dEPARTMENT �j ` 21660 E.Copley Drive Suite 190 ` PRESS• � (909)860.3195 Fax(909)861-3117 �'""' BiJILDING PERMIT APPLICATION FIRMLY < ADDRIESS I�-I J jv���O CS�+�/y0'� APPLICATION �---�'-'I � PERMIT � P/C p DATE � 1 NUMBER # � APN LOT TRACT �^ ° '5�•�•��G ISSUE TYPE OCC — DATE CONST. GROUP p OWNER ,' s�IW'j'�C /«!�,B G%i4 � ADDRES��� ( «-L- ZONING SETBACKS z CITY M� ZIP�,j 79� TEL. .� "�^/'� �-- FRONT RW ❑ p APPLICANT TEL._ 5 DE/SIDE STREET RW O � CONTRACTOR ' �% SIDE ❑ Q ADDRESS � CITY ZIP TEL. PROPOSED USE � . oARCH/ENG/ �'r-/`tt n�o� C/� C r�7`/L°'9-""" �z DESIGNER NO.DWEL. NO. NO. a AD�RESS UNIT5 STORIES BEDROOMS � CITY ZIP TEL. N <n �ESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BI;ILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNOER PENALTV OF PERJURV THAT 1 AM EXEMPT FROM THE CONTRACTORS ll- GBf890/CfllP011 W CENSEIAWFORTHEFOILOWINGREASON(SEC.�031.5BUSINESSANDPROFESSIONSCO�E:ANYGTVOR (n U �qJNTYWHICNRE�UIRESAFERMITTOCONSTRUCT,ALTER,IMPROVE,DBAOLISH,ORREPAIRANYSTRUG W Petio/DBCk NRE,PRIOR 70 ITS ISSVANCE,0.LS0 qEOl11RES THE APPUCANf FOR SUCH PERMIT TO FllE A SIGNED � STA7EMENT THA7 HE OF SME IS LICENSED PURSUANT TO THE PROVISIONS OF TNE CONTRACTORS LI� W � CENSE UW(CHApTER 9(COMMENCING WITH SECTION 7ma�OF DIVISION 3 OF THE BUSINESSANO PRO- u' POOVSpB � FESSIONSCODE)OR7HATHEORSHEISExEMPTTHEREFNOMAN�THE8A51SFORiHEALLEOEDEXEMP- (� V TION.ANYVIOLAiIONOFSECTION7o31.6BYANVAPPLICANTFORAPERMITSUBJECiSTHEAPPLICANTTO Z RB•ROOf � ACIV�L PENALTV OF NOT MORE TNN�1 FIVE HUNDRED D04URS(5500J.): Z ❑I,ASOWNEROFh1EPROPERN.ORMYEMPLOYEESWi7HWA0ESAS7HEIRSOLECOMPENSATION, � CommefCiHl WILL DO THE WORK,ANO THE STRl1CTURE IS NOT INTENDED OR OFFERED FOR SALE ISEC.70H,BUSI- J N NE55 ANO PROFESSIONS CODE:THE CON7FACiORS UCENSE UW DOES NOT APPLY TO AN OWNER OF = PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WNO DOES SUCH NbiiK HIMSELFOR HERSELF OR � THROUGHNISORMEROWNEMPLOYEES,PROVIDEDTHA75UCHIMPROVEMENTSARENOTINTEN�EDOR m OOFFEREDFORSPLE.IF,HOWEVER,TNEBLALDINGORIMPROVEMENTISSOIDWRHINONEVEAROFCOA1pLE- Z TION,THE OWNER�BUILDER WILI HAVE 7HE BURDEN OF PROVMG 7HAT HE OR SHE�ID NOT BUILD OR � IMPPOVEFOHTHEPURPOSEOFSALE). W ❑I,ASOWNEFOFTHEPROPERN,AME%CLIJSIVEIYCANTRACiINGWITHLICFNSE�CONTRACTORS _� � TO CONSTRUCT THE PROJECT(SEC.7o4a.BUSMESS AND PROFESSIONS CODE:THE CONTPACTORS L6 VelUation ADJ.AREA W CENSElAW00ESNOTAPPLYTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTHEREWJ,AlA � WHOCONTRACTSFORSUCHPflOJECTSWITHACONTRACTOR�S)LICENSEDPUPSUANTTOTMECONTRAC- QUANTITV DESCRIPTION FEE x TORSLICENSEUW.). � ❑I AM EXEMPT UNDEfi SEC. 8.8 P.0.FOR THIS REASON J O � � OATE _r OWNER � U O W �.Q UCENSED CONTRACTOAS OEC TION W ¢ �HEREBY AFFIRM UNDER PENAL7Y OF PERJUFY THA71 AM LICENSED UNOER PHOVISIONS OF CHAPTER � d 9(COMMENCING WITH SEC710N 7000)OF�IVISION 3 OF THE BUSMESS AND PROFESSIONS CODE,AND Z X MV LICENSE IS IN FUII FORCE AN�EFFECT. m tll � � LICENSE CLASS LIC.N0. � � J V DATE CONTRACTOIi d W -,.. ,�,...._: . �-.._ ..�.... � WOFKERS'COMPENSATIDN�DECLARATION ��� � � —� Q � I NEREBY AFFIRM 11N�ER PENALT'OF PERJURV ONE OFTHE FOLLOWMG DECLARAT�ONS: z z �I HAVEAND�N1Ll MAINTAIN A CERTIFICATE OF CONSENTTO SELF-INSURE FOR WORKERS' _ COMVENSA710N,AS PROVIDED BY SECTION 37o00F THE IABOR CODE.FOR THE GERFORMANCE U a OF THE WORK FOR WHICH THIS PERMIT IS ISSUEO. � � W IMAVEANDWILLMAINTAINWORKERS'COMPENSAiIONINSURANCE.F5RE0UIRE08V5EGTION Q 370o OF TNE LABOR CODE.FOR THE PERFORMANGE Of THE WORK FOF WHICH THIS PERMIT IS �R � ISSUEO.MV WORKERS'COMPENSATION INSURANCE CAIiRIER AND POLICV NUMBER ARE: CONSTRUCTION Vd��1` J � CAHRIER PLAN REVIEW z POLICY NUMBER ELECTRIC d 0 fI}iISSECTIONNE�NOTBEOJMREfE0OF1}EPEMYTIS:ORIXJEHUADqmOCUAHS(S70DI�NLF55). PLUMBING Z I CEPTIFY THAT IN THE PERFOR�IANCE OF THE WOAK FOR WHICH?HIS PFRlAIT IS ISSUE�,1 MECHANICAI. ('3 SHALLNOTEMPLOYANYPERSONINANYMANNERSOASTOBECAMESUBJECTTOTHE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOUL�BECOME INSPECTION FEE � SUBJECT TO THE WORNERS'COMPENSAT;ON PROVISIONS OF SECTION 3700 OF THE 1.A00R � CO�E,I SHALL FORTFMlITH COMPLV WITH THOSE PHOVISIONS. ISSUANCE � � SMIP � p DATE: APPLICANT: � WARNING:FAILURE TO SECURE WORNERS'COMPENSATION COVERAGE�S UNL4WFUL,ANO SNALL 8E ENERGY P/C LL SU&IECT AN EMPLOYER TO CRIMINPL PENALTIES AND CIVIL FMES UP TO ONE HUNDREDTHOUSAMO ENERGY PERMIT DOLLARS(ft W.o00).�N AODITION TOTHE COST OF COMPENSATION,OAMAGES AS 7ROVI�E�FOq IN � SECTION 3708 Of THE LABOH CODE,INTEREST.ANC1 ATTOflNEV'S FEES. {3ETENTION FEE: _„_ � OCONSTRUCTION LENDING AGENCY ppE-ALT FEE: Q I HEREBV AFFIRM UNDER PENALTYOF PEFJUPV TNAT THEflE IS A CANSTRUCTION LENDING AGENCY .� '� d FOR TNE PERFORAIANCE OF 1HE�NORK FOR WHICH THIS PEfiMIT IS ISSUED(SEC.30PJ.CIV,C.). � _ W � LENDEA'S NAME F_ LENDER'SADDRESS � /7�p w I CEPTIFYTHAT I HAVE REAO THIS APPLICATION AND STATE TMAT THE A80VE INFORMATION IS CORHECT. � IACREETOCOMPLVWI7HALLCITYANDCOUNTVORDINANCESANDSTATELAWSREUTINGTOBUIL�ING TOTAL FEES $ � '� (J � CANSiRUCT10N,ANDHEREBYAUTHORI2EREPRESENTAiIVE50FTHI5COUNTVTOENTERUPONTHE Z ABOVE-MENTIONE�PROPERT'FORINSPECTpNPURPOSES. COMMENTS � iLG7'J G-q%�`� �i < ,�,j�',R?` m PERMITTEENAME(PFINn � � c¢_n Ct! ��i3` N iGNKNREOFPERMi OATE = RECPT.NO. �BY VALIDATION � ~ WHITE—De artment C YELLOW—Finance Co PINK—Assessor Co GOLDENROo--File Co GREEN— � � , � ��� � � P oPY� PR PY� pY, plicant's Copy . . .,�.:.s �, �� . ,�:i;.. r,, .�a; T eY.�,:r� y ..�:,F.-, .. »:ars�.. .. , ,. .. . _ +�, �Y;t. �;aik .r:*., �,xt.,a,.�;; yt� .. , , . �y'^','" `n;�yy ,. . . `:kfM i5��,9't,. '�+'`w�R r r1•.r.;�^5c1`a-`u�'q'.' �•PU.�Yrv"!?�.;...,y� .,':', & CITY OF DIAM4ND BAR _ INSPECTION RECClRD • � � , � o - • e � • • � . . _.. _ . . .. _ SET BACK . ; _ `. FLOOR JOIST _.... __�. - _ - .__ FT6SIFOqM�/STEEL ` - � FHA REQMTS ; ' ELECTRIC GROUND ' ' UNDER FLODR DUCT � . , , � - GROUND PLUMBfNG ` ' - UNDEfl FLOOR CC��IDUIT • - '` - "' --— -- -- — SLAB GRADE ' FIREPLACE FC}UNDATION TEMP POWER FIf�EPLACE BOND BEAM --" - � WATER SEflVlCE - MiD HT. BQND BEAM ROOF SHEATHiNG ' � . , ` 8 FT. BOND BEAM ' ' FRAMkNG/VENTI{_IATION ;.,' '''" FINAI BOND BEAM ,,, i� RC10F COVER __ PI�E-GRADING _ � ; ROUGH HEAT(i�fG " ` ._ __. ' � . BENGHING _ � _ �._ _� .._._ ROUGH ELECTRIG _ ' _ y, RbUGH GRADING . , , . , ROUGH PtUM81NG _._ . __ ` FINISH GRADING ,. ,;. � SHOWER(CU6 TEST " _ POOL��ECTRIC ; EXT.IATH/SIDING _ _- POOL FENCING , . ,. . ; WALL iNSULATION -- ,, ... POOL FINAL - . �CEILING WSUl.AT10N OFF S17'EIMPS. ' DRYWALL NA1LiNG DEDICA710NS ` y __ _ SEWER _ . _ .___ , '. , FINAL ENG_ & SEPTIC 7'ANK �'' '`''' ' ' LANDSCAPEIIRRIG. ' SEEP PIT/L.L. '::' .__ ON SIT�1MPS. GAS AIR TEST _ FINAL ZONING � ' � , '� F4NAL GONSI'. _ _ FIRE DEPT.FII�lAL� �� :, p > . . , y F#NAt NEAT►NG _ -__.. HEALTH DEPT. FW L . 1 � . �'fNA�.ELECTREC _ ____ _ � DEV. FEES PA4D .: :.... :.:.:._ : FtNAL PLUMBING � _ _ ENERGY � ,: _._ _ , __ a ' i • _ ,,.�.. _ ..,._. ....... .__ ___.. _. COMMENTS >.:_ , ., �.� . ;:;;.: -- . .,,� . - � �.. . . -.,, � . > . _:,:.... ; : . � i.i v t;l�,l>:. .� �,-Ma::., �: ': '-r �tt :;,ar v' '.•'H3C=; � __• -� .. �. ���. . -. .: � . . . . �. '--... ..Y .. .. _. .. ,: ; , . ' . --- --- -- ��� ; '�" �;,i9:4��' i .. 3:?'- .. .\S . . .-'., . . .. . . . .. ___. _ . . . . .. ....... ...... ' . n., ,'ryflN".'< .)ie.:,:..i .'.. . -�� ...�.,. � _,. �. . . .. .'........ . . .... .. ..."_._ . . . , .. .. .. : � .0 7 , ...... -r.,..,., _. �._ �� . " . �(i�f � .�M. .�,� . � ...... . ,._ . . .' ..�_'. .�.',:' " �...y- °F�. -�". . �'`w� . �.. . . . .. SEPTlC TANK SIZE -�.:t �:... �,.�.., ..�. _ _ SEEP PIT/U SIZE � ',. '` , � _. _. . ___ _ .:. ,. ,�, ' .,. ..�-•.._..,.,e.�.�..;.�.�.,m. ::<�. � . ;.'::',, `,,.,,` , ;�:: , .:;: r. ,�. � _. _. ._ _ , - ! �, .r ,- .. .. _ . _ . . � . --_"�—'� ` , . . .. .. ,. � ���