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HomeMy WebLinkAbout16701 (33) EXPIRED _f�� CITY OF DIAMOND BAR DEPARTN�NT OF COMMUNITY&DEVELOPMENT SERVICES �UN 19 ZDD1 ZTy ,� 21825 E.Copley Drive (949)860-3195 Fax(909)861-3117 PR ESS `<�� BUILDING PERMITAPPLICATION FIRMLY r JOBSITE C / C APPLICATION PERMIT P/C o ADDRESS��� J C�`���L ���e �' DATE O NUMBER # � APN LOT TRACT ISSUE � TYPE OCC o OWNER Uf: . /�]Z�'/ f/ . DATE CONST. GROUP o ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT RW ❑ g APPLICANT TEL. REAR ❑ SIDElSIDE STREET RW ❑ � CONTRACTOR � . �f�7, SIDE ❑ o ADDRESS PROPOSED USE �7�K ���E�C. S ��SL°S o CITY ZIP TEL. o ARCWENG/ iz DESIGNER NO.DWEL. NO. NO_ a. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � � DESCRIPTION SO.Fi. FACTOR PSF AW.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBY AFFIRM UN�ER iENALTY OF PERIURY THAT 1 AM E%[M7T FROM TNE CONTMCTONS U• G0(2gB/C31POfl W CENSEIAWFORTHEiOILOWINOHEA50N(SEC.7031.SBUSINESSANOPROFESSIONSCOOE:ANYCITYOR (n U �JHryWHId/qEOUIRESAPERMRTOCONSTRUCT,pLTEH.IMPHOVE,OEAIOIJSH.ORREPA1R/INYSTRUC- W patiolpeck W TURE,PRIOR TO RS ISSUMlCE,A150 REWIFES THE APPLICANT FOR SULTI PERMI7 TO FILE A SIGI:[D w � STATEA/ENT THAT HE OR SHE IS 4CENSEO DURSUANT TO TNE PROVISIONS OF THE OONTRACTORS Lb � CENSE UW(GUP7ER Y(COMMENqNO YATH SECTqN 7000)OF DIV1510N�OF THE&14iNE55 M1D GRO� u- PaoUSpa iE5510N5 CODE)OR TMAT XE Ofi SHE IS EXEMPT 7HEHEFROM AND THE BA515 iOR 7HE ALLEGED E%EMP• � TION.ANVVIOLA710NOFSECilONT0�I.SBYANVAPPLICANTLORAPERMITSU&lECiSTHEAPPLICNlTTO Z Ro-Root ACML VENALTY OF NOT MOfiE 7HAN FIVE HUN�RED DOlURS�SSOD).g Z ❑I.ASOWNEROFTHEPROVERTV,ORAIVEMCLOYEESWITHwACES/SiHEIR50lECO/ACEN5A710N, � COfi1f11BfClal - YAII W TME WORK,AND TNE STRUCTURE IS NOT NTENDED OR OFFERED FOR SALE(SEC.7w1,BU51� J N NE55 AI:O 7ROFESSIONS COOE:THE CON7MCTOR$LICENSE UW DOES NOT APPLY TO AN OWNER CF = PROVERTY Yll-q BUILOS OR IM7ROVE5 THEREON,AND WNO DOES SUCM WORN HiMSEIF OR MERSELF Oq Q THROUGNHISOHHEROWNEMV�OYEES.PROVIDEDTHATSUd11A1PROVEM[MSMENOTINTENDEDOR m w OFFEREDFORSALEIF,MOVJEI/EiLhiEBU0.DINGORMPROVEMENTISSOIDWITHINONEYEAROFCOMPLE- 0 TqN.THE OWNER�BUILDER NALL MAVE TME BUROEN OF VROVINO TMAT ME OR SME DIO NOT BUILD OR 'Z IAIGROVEFORTHEVURPOSEOFShLE). w ❑4ti40MMEROFTHEPROPERTY,AMEXCLUSN&LYfANiRACTPIOWITHUCENSEDCONTMCTORS � TO CONSTiiUCT THE VRQIECT(SEC.70a1.Bl1SINE55 AND PROFESSI�NS CODE:THE CCNTMCTORS L4 V2IUelIOff A0.1.AREA W CENSEUWDOESNOTMPLYTOANOWNEROFAPROPERTYWHOBUI�DSORIMPqOYEShIEREON.AND � MM1IOCONTMCTSFOFSUCH7R0.1ECi5WITHACONfMCTOR(5)LIGENSEDPURSUANTTpiMELONTMG QUANTITY DESCRIPTION FEE Y TOqS UCENSE UW j. � ❑IAAIE1fEMPTUNDERSF_C. B.lO.C.FOqTHISREA50N Q � U � � OAiE OWNER � Z W �q' UCENSED CONTRACTORS OECLARATION W 2 1 HERfBYAFFIRA!UNDER PEW�LTY OF PERJURY iHAT 111M LICENSED UNOEH PROVISIONS OF�HMTER � •/ L S �• � Y(COMMENCWaW17M5ELT10N70oo)OFDNISION70FTHE8USINESSANDiROFES5qN5CODE,AND Z W UCENSE LS N FL1LL iORCE ANO EFFECT. � UCENSECUISS���Q ��L/ LIC.NO._� ��� / � � V DATE ��7� O J CONTRACTOR�U.V�n�. a W � WORKERS'COMPENSATION DECLAFATION a � IHEREBVAFFIFIAUNOEROEWLLTYOFDE0.IUHYONEOFTHEiOLLAWINCOECI.AMTIDNS: Z a � �IHAVEANDWILLNAINTAINACERiIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' _ COMPENSATION,�SPROVI�EDBVSECTIONJ�o00FTHEU80RCODE,FORTHEVEflFOiiM�HCE U � OF THE WORK FOR WHiC/l TMIS VERMIT IS ISSUED. � G _I NAVE AND WI��I.UINTAIN WORNERS'COI.�CENSATqN INSURANCE,�S RE WiRED BY SECTION ¢ J7000F JXE UBOR CODE.FOR iME VERFORMJWCE OFTHE WORK FOfl WHip1 TI45 PERMIT IS ISSUED.MY WORKERS'COMPENS TION INSUAA E CARP ANO POl NUI.IOERARE: CONSTRUCTION � CARRIER i,� �� U� PLAN REVIEW Z> � �7 � PouGY duMBER---------.,-�� � _ ELECTRIC ¢ ,i � (ila55EGTIC7VNEmNOTBEWMiiEiEDOF7IEPEFa.f��Sf�fiONEHU�OPFJD4AAR51Ei0�IX1LE55� PLUMBING Z 1 CERTIFy THAT IN THE VERFOFMANCE OF iHE N'ORK FOR WHICH THIS PERMIT tS ISSUED.1 MECHANICAL ('} SNALLNOT EMPLOY M!Y VERSON IN ANV 1AAflNER 50�5 TO BECOAIE SVBJECT TO TNE (J� WOW(ERS'CW.�PENSATqNUW50FCALIFORNII�MID�GREETNATIFISFIOVLO6ECOME INSPECTIONFEE S SUBJECTTOTHEVlORKEFS'COIAFENSA710NCROv1510NSOFSECIKKJ7)00OFTHEIABOR CODE,I SHALL FOflTHWITH COMPLY WITH THOSE PROVISqNS. ISSUANCE O SMIP p DATE: APPLICANT: J WARNINC:FAILURE TO SECUFE WORKERS'COMPENSATpN CAVERAGE IS UNLAWFUL,Ml0 SHALL BE ENERGY P!C �y SUOJECTANEAIPLOYERTOCRIIAIN.LLVENALTIESANDCNILFWESl1PTOONEMINDRE�TNOl15AN0 ENERGYPERMIT DOlUR3(f 700.000).IN AODITION TO THE COST OF COMPENSATION,DAMAG[5 AS GROY:DED FOR IN � SECTION370BOFTHEUBORCOOE,NTEREST,JWDATTORNEY'SFEES. RETENTIONFEE: d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O Q I MEREBV�iLIR1A UNDER DENAITY OF VERIURV TH�T THERE IS ACONSTRl1CTION LENDINC ACENCY n- FORTHEPERFORMANCEOFiHEWOFiKFORWHiCHTHISPERMITISISSVED(SEC.]ou],CN.CJ. Z W � LE1�EN'S NA1AE F_ LENDERSADORE55 � w I CERTIFY TMAT I HAVE READ TMIS MPLICATIONAND STATE T1UT TNE ABOVE WFpRA1ATlpr IS CARRFCT. TOTAL FEES � d IAGREETOCOIAPLVV/ITHFLLGRYANDCOVNTYORD!NANCESIWUSTATEUwSREUTINGTOBUILDING � CONSTRUCTION,ANONEREBVAUfNOP2ER'ePRESENTATNE50FTHISCOUNTYTOENTERUPONTNE 2 J180YE�MENTIONEOPROP 1TYFOHINSPECTiONVURPO5E5. COMMENTS � J � ¢ VEiWi T) � .i�,r. - -� S O' N .N HI: �ITT ' D�T. � RECPT.NO. T PAID BY . � VALIDATION _ WHITE--Deparlment Copy.YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—Applicant's Copy , ..�, :,ti ..�:...,,;.. .., _. , . ,.f•.tr..�.. �7�!•'l��:v�rJ+'�C..,r;,ru,..tia��:�qa>:'-, i,r.•'- ) .. . . � ` t" 1 . M{:��i�. ur:,...;tx�.�•,(.�.`li:�,...-. ::r:f,r� �,i:.l^%...,:7;:iH.�'�i•.+ H..-t�� . .�..�+r a. , .��� .r _ ... ...,.. :i� V:, �.�:i.h.uAi.41.`"J. �t4:. �ITI' C?F DIAf��JafkD Bp.f� ii�S't�'�C�i I�dP�! ��CGF�D I�F-'����c;i�l�l►'R c��"���'� I��f-`iC�1=��;'�`n�:� il►h�.'t�?-t�',�CCo;y►�f, e�i�wG�= 1►�'�:�=;c�i�e��� _ _ . _. - _� . . � . —__�_.__._______. __...__.__...-------- � 1 __._«.."_.."..___ '� _ ...�.. . ._.._..'__...'�....__�w..♦ ��_._��_�_,._.__..�_.�_.��.___�_.�.....�._�...__`_��._..._...... �� . _. SET BACK ; � FLOOR JOIST�'� , � � .____ FTGS/FORMSlSTEEL ; FHA REQMTS I ELECTRIC GROUND UN�ER FLOQR,DUCT GROUND PLUMBING � UNDER FLOOR CU�dDUIT SLAB GRADE I FIREPLACE FOUNDATIO�d TEMP POWER I FIREPLACE BOPJD BEAM WATER SERVICE MID HT. BDND BEAP�A � ROOF SHEATHING ' £3 FT. BOND BEAM FRADAINGNENTILIATIDN FINAL BOND BEAM ROOF COVER PRE-GRADING � ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEVYER FINAL ENG. • SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. OiJ SITE IMPS. GAS AIR TEST FINAL ZON(tJG FINAL CONST. � FIRE DEPT. FINAL FIN�,L HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING . \ ENERGY � c;_a:fs �:1: k'le;�� � _�. ..._ _r...,�.t:i.._ �__...�. ;._ CUMMENTS •(��;\ ���� . SEPTIC TANK SIZE SEEP PITIU SIZE --� ,�� � � i � ,�lif I�li _ i � , �� � � �