HomeMy WebLinkAbout12-1110 ,_�_��`_ CITY OF DIAMOND BAR
� " ''� ^-� - DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
..=---=--'..�,,
� E� . 21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
`�'°^', BUILDING PERNIIT APPLICATION FIRMLY
� JOBSITE APPLICATIj�N PERMITI7,� � p/C
a ADDFiESS �66 R� �LD�4� OR DATE � �v L /1 NUMBEFi " I l� # (a^ ���O
� A N LOT� TRACT �SI�� DA EE � 1 � � I Z TMPE �1.�/ �C
p OWNER AA. TAK(F�ALABI CONST. GROUP
RFD C6 DR. ZONING SEfBACKS
o ADDRESS �
z CITY NO ZIP�fL S TEL9 FRONT q�/y p
p APPLICANT 'g�y� E TEL.634�(�Sl_9�I S DE/SIDE STREET RW p
� CONTRACTOR �'1AS7PR REAtOOECC�Rs SIDE p
ADDRESS O
� CITY SA�I �I�hAS ZIPqj7�3 TEL PROPOSEDUSE�a0bA1 . BA�'}�. AA/d C�.qStf ADOl7'ItaM
o ARCWENG/
z DESIGNER M L
w NO.DWEL NO. NO.
a ADDRESS 6l0 . f+�o�ff� Y�Sfl►
cn UNITS I STORIES �_ BEDROOMS
� cinr3M1 fl+a►nsT_ zie� TEL.b�•�O�I,�I
� . DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
. p� OWNER-BUILDER DECLARATION � SFR/ADD/REM
O
p I HEAEBY AFFlRM UNDER PENAL7Y OF PER0.IRY THA7 I AM EXEMFT FROM THE CON7{UCTORS l4 Gerage/CarpoR
W (�lISEUWFORTiEFOLLOWWOREASON(SEC.7m1.6BU5WE5SANDPROFE5510N5CO0E:ANYCI7YOR (n
C� COUNTYWHICHREOUIRESAPE{UIITTOCONS7AUCf,ALTER�d7ROVE.DEMOLISH.ORREPNRANYSTilUG W P81i0/DBCI! � ..
��� 7URE,VRqR TO RS LSSUANCE.ALSO REOUIRE3 THE MPLICMff FOR SUCH PERMIT TO FlLE A StONED w
� STATEMENT THA7 HE OR SNE IS IJCENSED FURSUANT TO 7NE PROVISIONS�OF THE CONTMCTOR9 U- .
� CEN9E LAW(CHAFTER D(COMMENCWO WITH SECTION�000)OF DIVISION 3 OF THE BUSINESS AND PH6 u' POOUSpB
_ � FESSIONSCOOE)ORTHATHEORSHE�ISEXEMPTTHEREFROMANDTHEBASISFOR7HEALLEOEDEXEMP• (�
TION.ANVVIOLATqNOFSECT10N7o31.6BVANYAPPLICANTFORAPERMIT5U6)ECT37HEAPPLICMITTO Z qg.Rool
AGVIL PENALTV OF NOT MORE�THAN.FIVE HUNDRED DOLURS({SOD).j:
� O4�SOVINEROF7HEPHOPERTY,ORMYENPLOVEESINTHYJAGESASTHEIRSOIECOMPENSATION, � 0 COrt1rtIBfC181 '
Z N7LL DO THE WOW(AND THE S7RUCNRE IS NOT IN7ENDED OR OFFERED FON SALE(SEC.7oN,BUSF �J �
� NESS AND PROFESSIONS CODE THE CONTRACiOR3 LICENSE LAw�OES NO7 APPLY 70 AN OWNEH OF � �
PROPEHfY W110 BUILDS OR IMPROVES THEREON,M1D WHO DOES SUCH VqRK HIAISELF OR HEHSELF OR �
wiHROU0HW50RHEROWNEMPLOVEE3,PPOVIOEDTHAT5Up11A/PROVEAIENTSARENOTpJTENDEDOR m ,
Q OFFERmWRSALEIF,HOWEVERTNEBURDINOORWPROVEMENTI35pDWfTMNONEVEAROFCOM7LE
Z TION.THE�ONTJER�BUILDER WILL HAVE hiE BURDEN OF PROVp10 THAT�HE Ofi SHE DID NOT BUILD OR . . .
� IMPROVE FOR THE WRPOSE OF SALE} . .
� OIASONMEROFhiEPROPEHlV,AMEXq.USNELYCONTfUCTWOWfTHIICENSmCONTRACTOHS VelUe110n� � �,�5, -�y qpJ,qREq�- '
TO CONSTRUCT THE M10.1ECT(SEG 70N,�BUSINE55 AND PROFESSIONS CODE:hIE CONTMCTORS U- � � �
CENSE UW DOES NOTAPVLV TOAN OWNER OFA VROPERTY WV10 BURDS OR IMPROVES 7HEREON,AND
� WIiOCOtRMCTSFORSUCMPRO.IECTSWfTHACONTAACTOR�S)LICENSEOPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION
Toas ucErose uw.�. FEE �
I � ❑1 AY EXEMPT UNDER SEC. �B.8 P.C.FOR THIS REASON Q �+VS SW�Lf1GJ � I
U
. LL DA7E OWNER F¢- � �G � '�•
o � ; ::� -r. _.�y., � —!0 3
F. LICENSED CONTRACTORS DECLARATION W _. �,,
' � I HEREBY AFGIRM UNDEH PENNSV OF PERJURV TMAT I MA�LICENSED UNDER PROWSION9 OF CHAPTER � '' �
d 9(COMMENClN(i WfTH SECTION 700D)OF DNISION 7 OF THE BUSINESS AND PROFESSIONS CODE,AND Z O'
X MY LICENSE IS Pl FULL FORCE AND EFFECT. �" m � .
11J Q I�
� LICENSE CLASS i! � �`'•LlC.NO., ��SO��� y ^' � 1 --� �
~ DATE � � �Z CONTRACTOR . '.�a� a '' .
� �M//�.�Iai 1'�S�d✓ , /
� WORKERS'COMPENSATION DECLARAT � � - A �N � --
' � a
� 1 HER�V AFFIRAI UNDER PENALTV OF PERNHY ONE OF THE FOLLOWING DECIARAT10N5: ,Ow���S �� .'�
� �� _INAVEANDWILLMAINTAPIACERTIFlCATEOFCOMSEH(TOSELF-INSUREFORWORI(ERS' � � "_ __ - :.��. " '-"" �
Q CONPENSATION,AS PROV�ED 8Y 6ECTION 37uo OF THE LABOR CODE,FOR THE PERFORMANCE W' . .
Q OF T/iE WORK FOR WHICH THI9 PERA/1T IS ISSUED. � �I� . ./t.Ii�%..'
� _I HAVE AND NnLL AWNTAW�WORKEfIS'ODMPENSATION INSURANCE;AS REQUIRED BY SECTION � �
Q a7o0 OF-h1E LABOR CODE,FOR THE PERFOFWANCE�OF THE WOPoc FOR WHICH THIS PERMR IS A ,, Q
�SSUm.MY WORNERS COMPENSATION INSURANCE CAARIER�AND V0.1CY MIAABER ARE: �CONSTRUCTION Cp�}+"P_� I
jCMRIER PLAN REVIEW S �. ",
Z� ��c�r�n�eER . ELECTRIC `j
Q �
0 (nassEcrtaarEIDr+oreEooAFl.Er�oFir+EaEfwrrswaor�FR��DiiEDoalAfsK�roloaLEss} PLUMBING � . 3
W �� I CER7IFV THAi IN THE PERFOHMANCE OF THE.WORK FOH WHlpi THIS PERAIR IS ISSUED,I MECHANICAI
�} SNALL NOT EAIPLOY M1V PERSON IN ANV IdANNER SOAS TO BECOME�SU&IECT TO THE � �
� WORKEFS'CAMPENSATION lAWS Oi GLLIFORNIA,AND A(iREE THAT IF I SHOULD BECAME INSPECTION FEE
SU9IECT TO THE WOAKERS'�COM�ENSATqN PROVISIONS OF SECTION J700 pF THE UBOR �
-~j cooE,i s�uu wqr�m coua�v wm�n�ose rao iswNs. ISSUANCE .... . . . �•D / ..
O --
p DATE: � �� APPLICANT:: .SMIP __ ��
W ENERGY P/C S�'. ,�
J WARNIN0.FA0.URETOSECUREWORI(ERS'COMPENSATION MGEISUNLAWFUL,ANOSHNIBE
J
� SU&IECTANEMPLOYERTOCRIAIW�LPENALTIESi1NDqVIL ESUPTOONEHUNDflEDTHOU3MID ENERGYPERMIT .'`�t'�`
DOLUfls(itro,oDo),W ADDITION 707HE COST OF COMPENSATION,DAAU(iE5 AS PROVIDED FOR ttl
J 6ECTION 370E OF 7HE LABOR CODE,INTEREST,AND ATfORNEY3 FEES.
W RETENTION FEEc Q�
O , CONSTRUCTION LENDING AGENCV p ALT FE .
� 1 HEREBY AFFIRM UNDER'PENALTV OF PERIURV THAT THEi7E fS ACONSTRUCTION LENDINO AOENCY �� � ,�
FOR THE PERFORMANCE OF THE WOPo(FOR WHICH THIS VERMR IS ISSUED(SEC.3aY7,pV.C.}
Z
�� LENDERS NAME N/A. . . . . _ . . . �
f- LENDER'S A�DRESS � -
� 'ICERTIFYTHATI�HAVEREADTHISAPPLICATIONMASTATETiATTiEABOVEWFORMATqNISCOR(iECT. TOTAL FEES� �a � S�' '�J 3. ��
� I A(iREE TO COMPLY N7TH ALL CITY AND COUNTY OqDPlANCES AND STATE UWS REUTINO TO BUILDIN6
� CONSTRUCTION,ANU HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON.7HE � 1 ^� /�
Z ABOVEMENTIONED PROPERiY FOR INSPECTION q)R705ES COMMENTS �� P` ,O�� a� C��Q'�1�1\�'1�o t�o�/'�M 1
0
-� �vE�r KyivE
�
QPERMITTEEyp�(PRINf) �/� � ' �
� .Ol[.�l /'�f� 9ll��lL � � 5 er�
0
Uj �510—N�A I1RE OF PERMfITE DA7E �7 �
� RECPT.N0. / PAID BY I VALIDATION
WHITE—Depaitrnent Copy,YELLOW—Flnance Copy,PINK—Assessor Copy,GOLDENROD—File(',opy,GREEI�AppllcanCa Copy
f
CITY OF DIAMOMD'BAR "�.�_:_.�; '
_ ^
lNSPECTIOiV RECOFiD
. . � ,:� . . � � . ..
•� . � e .:��. .. � �.. � _- ' s � e., 'h' ��� �{� ' �. � � � i �'� o .. _� p - �
� . .. �� ".� . ' .. � . ..:.. . . . +i
SET BACK FLOOR JOIST '
FTGS/FORMS/STEEL FHA REQNltTS �
ELECTRIC GROUND q - UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOORLONDUIT • - • • •
SLABGRADE ; FIREPL'ACEFOUNDATION ' ' �
TEMP POWER � FIREPLACE BOND BEAM • ' - ' � �
WATER SERVICE. . r . . MID HT.BOND BEAM ��
ROOF SHEATHING ,p '�'�„ 8 FT.BOND BEAM
FRAMING/VENTILATION FINAL BOND BEAM �
ROOF COVER PRE-GRAQING . •
ROUGH HEATING I BENCHING
ROUGH ELECTRIC ROUGH GRADItVG
ROUGH PLUMBING FINISH GRADING
SHOWEWTUBTEST Z, ( POOLELECTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATIQN POOL FINAL
CEILING INSUlATiON !' " OFF SITE IMPS. .,.
QRYWALL NAILING �d,�j tl L DEDICATIONS _
SEWER FINAL ENG. _ _ _
SEPTIC TANK LANDSCP:PE/I RRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIRTEST • . � FINAL ZONING
FINAL CQNST. '� FIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT.FINAL
FINAL ELECTRIC � DEV.FEES PAID
FINAL PLU ENERGY
INAL PLANING . '
FINAL ENGIfdE RING 7, � � ' • e
COMMENTS
S'
SEPTIC TANK SIZE �
SEEP PIT/U SIZE
; q�, ---- . . -
I Il
� '
"'''' �� CITY OF DIAMOND"BAR .
INSPECTION REC4RD `
° � � � .� � � � B � o � �
SET BACK FLOOR JOIST .
FTGS/FORMS/STEEL FHA REQMTS ' �
ELECTRIC GROUND q. - UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT •
SLABGRADE FIREPLACEFOUrfDATION ' '
TEMP POWER ` � FIREPLACE BOND BEAM � � - � -
WATER SERVICE. � MID HT.BOND BEAM '� ' -
ROOF SHEATHING �.,� a, 8 FT.BOND BEAM
FRAMING/VENTILATION FINAL BOND BEAM `
ROOF COVER PRE-GRADING . . .
ROUGH HEATING I BENCHING
ROUGH ELECTRIC '� ROUGH GRADING '
ROUGH PLUMBING FINISH GRADING
SHOWER/TUBTEST � (. POOLELECTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION POOI FINAL
� CEILING INSULATION � � OFF SITE IMPS.
DRYWALL NAILING �Q�,� tl Z DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ' ON SITE IMPS.
GA5,41RTEST . ' fINALZONING
FINAL CQNST. �V FIRE DEPT.FINAL
FINAL HEATING HEAITH DEPT.FINAL
FINAL ELECTRIC � DEV.FEES PAID
FINAL PLU EIdERGY
INAL PLA ING
. ,
FINAL ENGINEERING �7, ,��� `� . 0 0
•�r
COMMENTS L ' ��
t,
SEPTICTANK SIZE �
SEEP PIT/U SIZE -
i� �
�
� �