HomeMy WebLinkAbout17198 (25) a
CITY OF DIAMOND BAR
`�----��` ---- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES E����E D
21825 E.Copley Drive
�" (909)860-3195 Fax(909)861-3117 ,1 U N 191002 PRESS
''"-����� BUYY.IDING�ER1iqIT APPI.ICA'�'ION FIRMLY
� JOBSITE ,3�� �re sado dt i a Mond bu r APPLICATION '�Qti��l NUMBER_1'� �/C
i o ADDRESS / DATE 1
� ISSUE TYPE OCC
APNag��. LOT TRACT DATE CONST. GROUP
°C OWNER O
O
o ADDRE�SS O O ZONING SETBACKS
Z CITY ZIP_ TEL �O FRONT RW ❑
o APPLICANT TEL. S DE/SIDE STREET RW ❑
a CONTAACT ��C O S C d SIDE ❑
� ADDRESS D O �.
� CITY � ZIP�a TE . O � PROPOSED USE
oARCH/ENG/
�z DESIGNER NO.DWEL. NO. O.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
N
cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
I HEREBV AFFIRM UNDER PENALTV OF PERJURV THA7 1 AM EXEMPT FROM THE CONTRACTORS LI- Gef89B/COfPOf[
W CENSELAWFORTHEFOLLOWINGREASON(SEC.7031.58USINESSANDPROFESSIONSCODE:ANYCITYOR (n
U COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANVSTRUC-
w TURE,PRIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT 70 THE PROVISIONS OF THE CONTRAC70RS LI�
� CENSE LAW(CHAPTER B(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB
FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� (�
� TION.ANYVIOUTIONOFSECTION7031.5BYANYAPPLICANTFORAPERMITSU&lECTSTHEAPPLICANTTO Z Re-Roof
A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(f5oo).):
H
�I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, Q
Z WILL DO THE WORK,AND THE STRUCTUHE IS NOT INTEN�ED OR OFFERED FOR SALE(SEC.7041,BUSI- J CORIm0fCl81 -
� NE55 AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF �
PROPERTV NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF Oq
� THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m
� OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPHOVEMEN7ISSOLDWI7HINONEVEAROFCOMPLE-
Z TION,THE OWNER-BUILDEH WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
� IMPROVE FOR THE PURPOSE OF SALE).
w ❑I,ASOWNEROFTHEPROPEH7V,AME%CLUSIVELVCON7RACTINGWITHLICENSEDCANTRAC70RS
� TO CANSTRUCT THE Pfi0.1ECT(SEC.70I1,BUSINESS AND PROFESSIONS CODE:THE CONTHACTORS LI- V0IU0IlOf1 ADJ.AREA
W CENSEIAWDOESNOTAPPLYTOANOMMEROFAPROPERTYWHOBUILDSORIMPHOVESTHEREON,AND
� WHOCANTRACTSFORSUCHPR0.IECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECON7RAC� QUANTITY DESCRIPTION FEE
Y 70R5 LICENSE LAW.). .
� ❑I AM EXEMPT UNDER SFC. B.6 P.C.FOR 7HIS REASON J
O a
� U
� ¢
DATE OWNER �
Z w
� LICENSED CONTRACTORS DECLARATION W
¢
� I HEREBY AFFIHM UNDER PENALTV OF PEfL1UfiY THAT I AM LICENSED UNDER PFOVISIONS OF CHAPTER �
� B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE.AND Z �
X MY LICENSE IS IN FULL FOHCE AND EFFECT. h
� UCENSE CLASS P,"��v� 1 N�V LIC.NO._ V O� v� � � �
yy� 0
V DATE�n��n�_ CONTRACTOR A 1� � �
�W ��
WORKEFiS'COMPENSATION DECLARATION Q
� I HEREBY AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWING DECLARATIONS: Z
� I HAVE AND WILL MAIN7AIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _
� COMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE 'U
Q OF THE WOFK FOR WHICH THIS PERMIT IS ISSUED. �
w I HAVE AND WILL MAINTAIN WORKE(i5'COMPENSATION INSURANCE,AS FiE�UIREO BY SECTION
Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED.MV WORK(€�qs/J PENSr yyION INSUR NCE CARFiIEF AND POLICV NUMBEfiARE: CONSTRUCTION
j cnq iq ER �+ 1'1�� 1 V�� PLAN REVIEW
Z POLICVNUMBER_i�1,I f��r�� ELECTRIC
Q
� (fHISSECTIONNE�NOTBENAAPLEfEDOFiTiEPERMffISFORONEFNI�DREDWLLA0.5(5100)OfiLESS} PLUMBING
W —+.�..---�----
Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS IT IS ISSUED.I MECHANICAL �- ..-. �-�- r.-
(,�} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECO BJ T TO THE I -� ����`� I ; � I ' J
�` � �
� WORKERS'COMPENSATION LA NIA,AND AGREE T I 1 SHO LD BECOME INS?ECTION FEE �+ �" ' o�O
= SU&lECT70THEWORKERS'COMPEN`y`y`y���TION OVISIOISOF ECTI 3700 FTHEIABOR
CODE,I SHALL FORTHWITH COMPLV W�fH THOS RO SION . ISSUANCE �
O • SMIP , •
p DATE:�Q��T APPLICANT:
J � ENERGY P/C I�.; I
J WARNING:FAILURE TO SECURE WORKERS'C PENSATION COVERAGE IS NLAWFUL. SHALLBE .
� SUBJECTANEMPLOYERTOCRIMINALPENAL7IESANDCIVILFINESUPTOONEHUNDRE T OUSAND ENERGYPERMIT �� � �
DOLLARS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PilOVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE,IN7EREST,AND ATTORNEY'S FEES. RETENTION FEE: Y �^
� CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV
� FOR 7HE PERFORMANCE OF THE WORK FOR WHICH TMIS PERMI7151SSUED(SEC.3a97,CIV.C.).
Z
W
� LENDER'S NAME
� LENDER'SADDRESS �
� TOTAL FEES
� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE W FORMATION IS CORRECT.
w I AGREE TO CAMPLY WITH ALL CITY AND CAUNTV ORDINANCES AND STATE UWS FELATING TO BUILDING
� CONSTRUCTION,AND HEREBV AUTHORRE R NTATIVES OF THIS COUNTY TO ENTER UPON THE
� ABOVE-MENTIONED PROPERTV FOR INSPE ION P POSES.
Z COMMENTS
� � I
�
a� PERM TTEE NAM (PRINT
�, • ( Q -3- DI
Uj SIGN UREOF E DA7E
= RECPT.NO. PAID BY VALIDATION
~ WHITE—D rtment Co YELLOW—Finance Co PINK—Assessor Co GOLDENFiO�File Co GREEN—A IicanYs Co
PY, PY. PY, PY, PP PY
. . . . � -. ... . .. . . . ... .. . . ... R .... .i ' 'i'�V�� .. .�� . .. . , . � ' a. .. ... .... .. . . .
`V��� �II ��fN��UV� lJ4'�lll V
o��pr�c��o�� �r�c����
oUVCJIT L'�LJ U 17�.:JU V . p , i,`�'��' 0�„�� � . "...LRIV.JU l�\:✓U i-f�::h.7?.� �:°`.. _ � � j�re"" ,° � "��"-^' +c-�_.�dL.i,�,O a.__
SET BACK _ ; FLOOR JOIST ' � �
FTGSlFORMS/STEEL ; I FHA REQMTS �
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING � UNQEI�FLOOR CUI�!QUIT __ ' � � ' � . � _ ___
��..__ �,_�, , � ' `� _' :
. � : .
SLAB GRAQE __ � _ _, ,FIREP�AC� FC7UNI�AT10l�! i' ' '' ' '
�..,_�______ � __._.__
TEMP POWER FIREPLACE BQN.C1 BEAfvi ____
WATER SERVICE __{_ IVIID HT. BOND'B'EAM ' j . .� . , . .
ROOF SHEATHING 'b(_ 0�1 8 FT. BON.D�BEAl�/l • ' ' i
/- �— �-- --
FRAMINGNENTILIATION � FINAL BOP�D BEAM
ROOF COVER PRE-GRADING
�ROUGH HEATING BENCHING _ � � • _�_ �
ROUGH E�ECTRIC ROUGN GRADING
ROUGH PLUiVIBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDIfVG POOL FENCING
WALL IfVSULATION POOL FINAL �
CEILING IN�ULATION OFF SITE IMPS. �
DRYWAL�NAILING I DEDICATIOIVS
SEWER FINA�ENG. ------
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FIiVAL PLUMBIMG ENERGY , �
" --
��� ' , . • � � .
_....._.._...__._..___. —�_`_ ___ - � ° °`: ._ ,.�-----= ----.__.
� _�� ..- � - - - - ---- ----
CUMNiENTS
. ______ r _..___.
SEPTIC TANK SIZE
SEEP PIT/U SIZE
�
l�i � _
� I ��
.� �