HomeMy WebLinkAbout17056 (23) � CTTY OF DIAMOND BAR EXP I RED DEPARTMENT OF COIvIIvtUMTY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195Fax(909)861•3117 JUN 18100Z pRESS `%:� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE APPLICATION PERMIT i�����j�/� P/C ADDRESS � �� DATE_�� � NUMBERI�.�L� M � ISSUE TYPE OCC APN LOT TRACT DATE b� CONST. GROUP p OWNER s C:�! �.'� " ADDRESS ' ' � / ZONING SETBACKS 0 gCITY � ZIP TEL. - �� � FRONT RW O APPLICANT TEL. REAR � � SIDFJSIDE STREET RW D � CONTRACTOR SIDE O � ADDRESS PROPOSED USE h.rs-e1' � CITY ZIP TEL. o ARCWENG/ � � � DESIGNER NO.DWEL. N0. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � DESCRIPTION SQ.Ff: FACTOR PSF ADJ.AREANALUATION � ONMER-BUILDER DECLARATION SFR/ADDlREM O 1 XEREBV AFFIHM UNDER PENALT'OF PERRIRY TMAT I AM EXEMPT FflOM THE CONTMCTORS L4 Garage/Carport W CENSEUWFORTHEFOILOWClORE1150N(SEG70]1.6BUSINESSANDVIiOFE5510N5CWE:/iNYGI7YOR (n U CpUNttWHICHRE4UIRESAPEFMITTOCONSTRUCT.AITEH,0.�PROVE,DE40t15�i3OFREPNRANYSTRUG W P01i0/DBCk Z TURE 7RqR TO RS ISSUANCE.ALSO REOUIRES THE A7PLIGWT FOR Sl1CH VERMIT TO FILE A SIGNEO W STATfMENT THAT HE OR SHE IS UCENSED WRSUANT TO TNE PROVISIONS OF 7FIE CONTMCTORS L4 W � CENSEUW(CNAPTERO(COMMENCINQWITHSECTqN7000�OFDMSIONlOFTHEBUSINESSANDORO. LL' POOUSpfl FESSIONSCOOE)ORT/A7HEORSHEISEXEMPTMEFEFROMANDiHE8ASI5fORTHEALLE0E0E%EMP� (� TpN.ANYVKKA710NOF5ECT10NT0�7.58VANYADPLICANTFORAOEFMIT5U0JECT5THEAVPIICANTTO Z Re-Root ACML PENALTY OF NOT MORE TMM!FIVE FIUNORE�DOLLARS�5500).): Z ❑4��NEROFTMEVRDPERTY,ORAIYEMPLOYEESWITMWAGESASTNEIRSOLECOMPEN5�T10N, � COr11TBft121 . �� VALL DD THE WORK,AND THE STRUCTURE IS N0T INTENOEU OR OFFEREO FOR SALE(SEG 7011,BU51• J N NESS/WD PROFESSIONS CODE TME CONTMCTORS IICENSE UW DOES NOT MPLY 70 AN OWNER OF = PHOPEHTYMA/O BUILDS OR IMPROVES THEREON.AND YAIO DOES SUpI WORN HiMSELFOR HERSELF OR � THROUGHHISORHEROWNEYPLOVEES,VROVIDEOT1UTSlKMtlAPROYEMEMSARENOTMENDEDOR m OOFFEAEOFORS�LEIF,{qWEVERN�BUIDINQORIA/VROVEMENTISSOLDWITNINONEYEAROFCOMPLE• z TION,T/E OWNERBUILDER WILL HAVE THE BURDEN OF VROVINQ TNAT HE OR SHE DIO NOT BUttD OR = MPROVE FOR iHE PURPOSE OF SALEJ. W OI.ASOWNEROFTHEPfiOPERTY.AMEXCLU5IVELVCONipACTINOVrtTHIICENSEDCONTMCTORS (t TO CONSTRUCT TNE PR0.JEC7(SEC.1oN,BUSiNE55 M70 PROFE55qN5 GODE:h1E CONTMCTORS lt� ValUfltlOfl ADJ.AREA W CENSEUWDOESNOTAVVLYTOANO'M�EROFI1PqOPERTYWNOBULLD50RIMPROVESTMEREON.AND � N'HOCONTMCTSiOH5Up7GRO.lECT5WI7MACONiMCTOR(5)LICENSEDPURSUANTTOTHEGON7MG �UANTITY DESCRIPTIDN FEE Y 70RSUCENSEUW.). � ❑IAME%E40TUNDERSEC. B.IP.GFOR7HISREASON Q � � y� � R r ' DA7E OwNER V W �¢ IICENSED CONTRACTORS DECLARATION W 2 IHEREBYAFFIiWUNDERiENALTYOFPEfWRY7NATIAMLICENSEDUNDERPROVI5pN5OFCMAPTER � � Y(COMMENCIN(i1MTISECTION7000)OFONISION70FiMEBUSiNE55ANDGHOFE5510N5CODE,ANO Z W UCENSE IS N ML FORCE AND EFFECL m llJ � UCENSE CU55 11C.NO. J V OATE COMMCTOR d W � WORKERS'COMPENSATION DECLAFlATION 4 N IHEREBVAFFIHI.IUNDERVENALTYOFGE0.IURYONEOFTHEfOLLOWINODECLARAT10N5: U N a � _I//�VEANDNALLMAMiAINAGERTFICATEOFCONSENTTOSELFdNSUREFORWORHERS' _ � COMPENSATqN,AS VROV�DED BY SECTION 77000F THE UBOR CODE,FORTME PERFORMANCE U Q OFTNEWORKFORN711CHMIS7ERMITIS�SSUEO. � � W �IHAYEANDWILLMNNTAINWON(ERS'COMPENSATIONINSURANCE.ASREWIREOBVSECTION Q �7ooOFTNELA80RC00E.fORTME7ERFORMANCEOFTHEWORKFORwHICHiH15PERMRIS ISSUED.MYWORKEHS'COMPENSATIONINSURANCECARRIERANDPOLICYNUMBERARE: CONSTRUCTION J j CARRIER PLAN REVIEW � roucrriuMeEa ELECTRIC � . � �nass[ct�ecmr+oreEeanermoFn�rsroRrsrona+erarn�noatu�sRiaqon�Fss7 PLUMBING Z I CERTIFY THAT INTHE iEFFORMANCE OF TME WORK FOR WMIq1THi5 PERMIT IS ISSUED,1 MECHANICAL C7 SHALL NOT EMPLOYANY PERSON N/�NY MANNER SOAS TO BECOME SU&lEC7 TOlHE � WORKERS'COMPENSATIONUWSOFCALIFORNIAANDAGREETHATIF15110ULDBECOME INSPECTIONFEE S SUBJECTT07HEWORKERS'COUPENSATiONVROVISIONSOF5ECT10N]7000FTHEUBOR �/� CO�E,I 6w1LL FOR7M4I7H COMPLY WIM hqSE PROVISiONS. ISSUANCE � �/ � SMIP 0 onr�: nrrucnNr: � ENERGY P1C WARNIN6:iA0.l1RE TO SECUFE WOHKERS'GOMPENSATqN LOVERAGE IS UNUWFUL.AND SHALL BE �y SUBJECTANEMPIOVERTOCRIA/WALOENAL71ESAN�CMLFWESUPTOONEMUNOREDTHOUSAN� ENERGYPERMIT OOlURS(S�OO.00D),IN ADOITON TO THE CQST OF COMPENSATION.DIIMAGES AS PROVIOED FOR IN J SECT10N770eOFTF1ELABORCODEWTEREST,ANOATTORNEV5FEE5. RETENTIONFEE: Q a CONSTRUCTION LENDING AGENCY PRE•AlT FEE: Q IHEREeV�FFlRMUNDERPENALTYOFFE0.NRV7MATTHEREISACONSTRUCiIONIENDIN6AGENCY d FOH TME CERFOR4ANCE OF iHE WORN FOR WHICH 7MIS CEPMIT IS ISSl1E0(SEG 9DY7,CIV.CJ. Z w � lENOEH'SNAAIE � LENDER'SADDRESS ^ � I CERT1iV THAT I IUVE NEAD THISAPPLIGTION AND STATE THAT TME 11BOVE NiORMATION IS CDRRECL TOTAL FEES �{/�� (��/ W 1 AGREE TO C04PLY N7TN ALL CRY ANO COUNTV ORDINANCES ANO STATE UWS REUTINO TO BUILDINQ � CdJSTqUCTqN,ANDHEREBVAUTHOPo2EREPRESENTA7NE5OFTHISCOUNTYTOENTERUPONTNE ZABOVE-MfHTIONEDPROPERTVFORINSPECTIONPURGOSES. COMMENTS � �FlZ � S 1 A-L'Lr N c CS m CEFM��E(Pa����L!��" ¢ Cn t�1'!Q�1 � SIGNATU OF�ERMI EE �� C' t'���T� RECPT.NO. PAID BY VALIDATION ~ WHITE—Depanment Copy,YELLOW—Finance Copy,PINK—Assessa Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy �.�V"� [.. ;1,. Yr✓r��. .. � ..�� '.r1� ,.i�'! :lia'.,:.ar�e.�R.!4� .. ^., r._ ..�...- r,. n,. -�'�" . , ^x+., ..:.., nF.��j`. , .. �,L'"Z'.x^ J. �. .. �.t .. r.. i i �•,s-v;v�r C.��'l� Q�' d�/��l.��i�� L�t�c� �r�s��c��iar� ��cu�D T_.�__..� --_ �.____ � ____._�_�. �I►°E'���a=?�''CC�'�►�f �.�`��� ',�i`!-`! !_i.F t"E^a:4 1►�.k-�:a�;Q`.�:t��7►�� c�'�F'_�; !I►���.►�;�'at'e�;� ' _�....___.__._. ...�._________ _. .. ._.. _ ._.... ._..__._.._. ,. _ ..---_ .______._..�_ ._. �_.___._..__..�..__._�_._�_`�._ SET BACK � � ' FLOOR JOIST� �� I FfGS/FORMS,�STEEL � `�_ , FHA REQh1TS � ELECTRIC GROUND � � UNDER FLOQR DUCT - • GROU�dD PLUP�4BING UtJDER FLOOR CUPIDU(T_ " SLAB GRADE ` I FIREPLAC� FOUNDATION TEMP POWER I �FIREPLACE E30ND BEAM ♦I WATER SERVICE __ MID HT. BOND BEAM I ROOF SHEATHING � I , 8 �. BOND BEAP�I � FRAbl11NG/VENTILIATION I FINAL BOND BEAM � ROOF COVER I ~ PRE-GRADIfdG I ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRAOIt•�G ROUGH PLUMBING � I FINISH GRADING SHOWEFi/TUB TEST � j� POOL ELECTRIC EXT. LATHlSIDING � I POOL FENCING WALL INSULATION POOL FINAL 'I CEILING INSULATION OFF SITE IMPS. QRYWALL NAILING OEDICATIONS SEWER FI"JAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. � SEEP PITlLL. � ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FtRE DEPT. FIPdA! FINAL HEATING • _l_ HEALTH DEPT. FIP�.AL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUMBING ENERGY - � i ...,._,.,_�....-,--.�.,�----- C3:f+'!.r' :�'f��i.�t�i.'"� i .,.' _-._-__.-----� ._..___------__...._� i COPJIMENTS SEPTIC TANK SIZE SEEP PIT/U 51ZE ��''�N ' � � � � y��� i i�, i .__� � • - � �