HomeMy WebLinkAbout11432 � �='�--• CITY OF DIAMOND BAR �r Fi�
COMMUNITY DEVELOPMENT'DEPARTMENT % �
zi66o E.copioy o��e s��ce�90 PRESS
(909)860-3195 Fax(909)861•3117
'�""� BUILDING PERMIT APPLICATION FI R M LY
o� JOBSITE �-- p' / APPLICATION PERMIT �j /C
ADDRESS Z-�73���j`T L/.�T, �l2 DATE� NUMBER ✓ #
� ISSUE TYPE OCC
-- APN LOT TRACT DATE CONST. GROUP
S OWNER
o ADDRESS ZONING SETBACKS
Z CITY ZIP TEL. FRONT ' RW ❑
g APPLICANT TEL. REAR ❑
Z SIDE/SIDE STREET RW �
� CONTRACTOR �1.4w,•�F Z`L�c � SIDE �
ADDRESS //_ ��j_�,l/.�11?t -T
PROPOSED USE
o CITY �����io ZIP 5�a�►o� TEL. - �
�+ ARCH/ENG! O�gI g�O ,.1
z DESIGNER ��
� ADpRESS 1 � NO.DWEL. NO. NO.
� CITY ZIP EL. UNITS STORIES BE�ROOMS
c�i� — DESCRIPTION SQ.F7: FACTOR PSF ADJ.AREANALUATION
p� OWNER•6l;ILDER DECLARATION SFR/AQD/REM �
O
I HEREBY AFFIRM UNDER PENILLTY OF PERJURV TWtT I MA E%EMPT FFqM THE CONTRACTORS LI- G815g8/G81�701'I
W CENSEUWFORTHEFOLLOWINGREASON(SEC.7071.6BUSINESSAN�PROFESSIONSCADEANYCITYOR (n
U COUNNWHIGHREIXIIRESAPERMI7TOCONSTRUCT,ALTER,IM7ROYE,DEMOl1SH,ORREPr�IRANY5AiUC- W P8I10/DBCk
w TURE,PRIOR TO ITS ISSUANCE,AL50 REQUIRES TNE APPLICANT FOR SUCH PERMIT TO flLE�SIGNED W
STA7EMEN7 hIA7 HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF TH TRACTORS LI-
� CENSE UW lCNA77ER Y(COMMENCWG WI7H SECTION 7000]OF OIVISpN 3 11SINE55 AND VRO- � Pool/Spa
FESSIONSCADE)ORTHATNEORSHEISEXEMPTTMEREFROMAND fORTMEAILEGEOEXEMP• (�
TION.ANV VIOLATION OF SECTION 7u31.5 BYANY APPLICANT ERMIT SUBJECTS THE APPLICANT TO � Re-Rooi
ACIVILGENALTYOFNOTMOqETHANFIVEHUNDRE � RS(fSao�J:
❑I,A501NNEROFTHEPROPEfliY,ORM LOYEESWITHWAOESASTiEIR50LECOMPENSATION,
Z wILL DO THE WORK,�ND THE STRUCi NOT MITENDEO OR OPFEREO FOR SALE(6EC.704a,BUSI- � CMIIRIBfCl81
� NE55 AND PROFESSIONS CA�E: ONTRACTORS LICENSE LAW DOES NOT 0.VPLY TO AN OWNEF OF ?
PFOPERTYWHOBUIlD50R OVESTHEflEON,AN�W11000E55UCHYYpRKHIMSELFORNEFlSELROp
Q iHROUGHHISORHEN EMPLDYEES,PNOVIOED7HA75UCHIMPROVEMENTSARENOTNTENpEDOq m
� OFFERE�FORSAL WEVE0.iHE8U1LDINGORIMPROVE►IENTISSOLDWITHINONEYEMOFCOMPL6•
Z TION.7HE OW •BUILDER WILL HAVE THE BUROEN OF vqOVING 7NAi HE OR SHE DID NOT BUILD OR
� IMPROVE F HE PURPOSE OF SKE�.
W SOWNEROFTHEPROPERT',AME%CLUSIVEIYCONTMCTINOWITHLICEN9EDDONTRACiOqS
Q TO STRUCT 7HE PR0.IECT(9EG 7014,BUSINE33 ANO PROFESSIONS GODE:TME OONTMCTORS U• V81U8IIIX1 ADJ.AREA
W CENSEUWDOESNOTAPPLYTOANOWNEFOFAPROPEFYTYWHOBL11lD50RIMPROHESTHEREON.ANO
� WHOCAN7RAGTSFORSUCHPR0.IECBWITHACONTRACTOR�S�UCENSEOPURSUNJT70THECON7W4C� QUANTITV DESCRIPTION FEE
� TORSLICENSELAW.). I
Q ❑I RM EYEMVT LINDER SEC. B.8 PC.FOR THIS NE145dV Q
� � '�'� 0
DATE OWNER U
Z � G_ -^
QQ LICENSED CONTRACTORS DECLARATION � G �-� r -
2 I HEREBV AFFIq1A UNDER PENALTY OF PERJURY THAT 1 AM LICENSED IINDEA PHOVISIONS OF CHAViER
d B�COMMENCING K7TH SECTION 7000)OF OMSION 30F R1E 91151NESS AND PROFESSIONS CODE,AND '�
X MV IICENSE IS N FULL FORCEAND EFFECT. '
LLJ Z L
� LICENSE}CU�SS G�p/�__ LIC.NO. `�.J�'Z�v
V DATE T�"�""�6 CONTRACTOR
„ W
� WORKERS'COMPENSATION DECLARATION 1�?11 .
�
� I HEREBY AFFIRM UNDER PENAL7Y OF PEHJURY qJE OF 7HE FOLIAWINO DECLARATIONS:� �
�
� _IHAVEAN�WILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKEFS'
COMPENSATION,AS PPOVIDED BV SECTIIXJ 37oD OF 7ME UBOR CODE,FOR THE PERFORMANCE
OF TME WOFK FOR WHICH TH19 PEiBAIT 19155UE0.
C
� _IHAVEANOWILLMAIMAINWORKERS'COMPENSA710NINSURANCE,ASREOUIREOHYSECTION
QQ 9700OF THE LABOfI CADE,FOR THE PERFORIAANCE OF T/E WOPo(FOR WNICH THIS PERA/IT IS
� ISSUED.MY WORKER5 COMPENSATION INSURANCE CARRIEIi ANO POIICY NUM9ERME: CONSTRUCTION
� CARRIER PLAN REVIEW
, Z aouCYNUMBEn - ELECTRIC
a � v
� (iFLS3ECf10NNEmNOTBE00MPLE7WOF7HEPERAYfISFORO�EHIHX�ED0�1.tA0.S�f7m�ba�ssF PLUMBING
Z I CERTIFY TMAT IN THE PERFORM/WCE OF THE WOFK FOR WHICH THIS PEP411T IS ISSUED,I MECHANICAL ~
'C�7' SHALL NOT EMPLOYANY FERSON IN pNY MANNER SOAS TO BECAME SUBJECT TO THE
(n MIOWCERS'COMPENSATION LAWS DF CALIFORNIA,ANO AGREE TH0.T IF I SFKKILD BECOME INSPECTION FEE
� SU&IECTTOTHEWORNERS'COMPENSATIDNPqOVj$I(�o1B�OF3`ECTION87o00FTHELABOR / �jy
� COOE.I SHALL FORiHWIiH COMPLV WI eSE'GRovISIDNs. ISSUANCE {�/V p
�
p OATE: CANT: SMIP
� ENERGY P/C _ _
WARNING:FAILUR ECURE WORKERS'COMPENSATION COYERAGE IS UNUWFUI,Ml�SHALL BE
� SU&IECTAN OYER TO LRIAIINAL PENALTIES AN�CIVIL FINES UP TO ONE MUNDRED THOUSMIO ENERGY PEFiM1T
DOI.IARS(f1 OOD).IN AODITION TO THE COST OF COMPENSATION,�MIAOES AS PNOVI�ED FOR IN
; ;� 6ECTION 370!OF TiE IABOR WOE,INTEF7EST,AND ATTORNEY'S FEES. RETENTION FEE:
� O CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� INEAEBYAFFIRMUNDEAPENALTYOFDE0.IURYTHATTHEREISACONSTRUCTIONLEN�INGAGENCY
FOA TNE VERFORMANCE OF TNE WORK FOR WHICH SHIS PERIAfT IS ISSUEO(SEC.9o9�,CIVI C.).
W kl,� �
� IENDER'SNAIAE � . i
F— LENOER'SADDRESS
� ICERTIFYTHATINAVEREPDTHISAPPIICATIOHANDSTATE?HATTHEABOVEINFORMATIpNISCORRECT. TOTAL FEES
� 1 AGREE TO CqMPLY WITH ALL CITV pND COUNN ORDINANCES AND STATE UWS RELATING TO BUILDING �
� CONSTRUCTIDN,AND FIEREBY AU7HORIZE REPRESENTATIYES OF THIS COUNTYTO ENTER UPON TME
ABOVE-MENTIONED iRDPERTY FOR INSPECTpN VURPO5E5. COMMENTS
� Gf �`'�
m PERMfTTEE JAE(P �
� .� 6 �Z�
SIGNATURE flMITfEE . DATE
� �� HECPT.NO. PAID BY VALIDATIO '
� WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Capy,GOLDENROD—Fiie Copy,GREEN—Applicant's Copy
. . ' . . � .il� i �� . � .�. . , . .
. . .. - . , :� . . .
� CITY OF DIAM�ND BAR
INSPECTICIN RECORD
- � � A � e - - e e � . i .
SET BACK + FLOOR JOIST
FTGSlF�RMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UN�ER FLOOR CO�IDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM��� - .• �' a ' •` �
WATER SERVI�E� � - � MiD 7.BOND,BEAM, ' - �' '- , ,, '
ROOF SHEATHING 8 FT.BOND BEAM
FRAMINGNENTiLIATION FINAL BOND BEAM� . ' ' `� � " ' `
ROOF COVER PRE-GI�ADIGJG - r •� ;'- . -
ROUGH HEA'fING BENCHING � � '
ROUGH ELECTRIC z3� �8 R�UGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWERlfUB TEST POO�ELECTRIG ..
EXT.LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL •
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICRTIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCRPEJIRRIG.
SEEP PITlL.L_ �Ir1 SITE IMPS.
GA5�11R]'EST ) � ' • �-�� FINAL ZONING
�OVAL��NST. '� ' ' ' - FIRE DEPT.FINAL
FINAL HEATING � HE�LTH DEPT.FINAL
FINAL ELECTRtC P'f � � � DEV. FEES PAID
FINAL PLUMBING ' ENERGY
, . .. . _ ti�, _c �-- _
• • • � • . � ,
; ' _ " _ _ , ----� .
. ,
COMMENTS
, ' - �:' ��
. , � �'r _ `� - • � � .
«
L,.r, • .
.. � � 9/ �
SEPTIC TANK SIZE � dS ��
SEEP PIT/U SIZE / I � ,/ J 1/ I/ c�� b
�- /`l�Ss���� �
�.'����`'2
� ?� � �.��.cd �
�
-�°'' �.�/��ti
, , ; g� �� ,