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HomeMy WebLinkAbout12-914 —_--- —_ CITY OF DIAMOND BAR � X ��� � --��� DEPAR'I'MENT OF COMMUNITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 PRESS � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 �<��^���W BUILDING PERNIIT APPLICATION FIRMLY � JOBSITE APPUCATIO �J 2j PERMIT /1 �/C � ADDRESS� � �I�/�P/� �� SST E , �. � 1 �u,EBER �Jr�I �It OCC � APN LOT TRACT DATE �� CONST. V� GROUP � p OWNER � i/ �I�G�l U� ADD ESS '� �- ZONING SETBACKS a � FRONT RW ❑ ' Z C� ZIP T . - REAR ❑ o APPLICANT � � 7E SIDE/SIDE STREET R1N � I � CON7RACTOR � � SIDE � I oADDR SS _ Z�P TE B PROPOSED USE ciTv w AFlC NG! z DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STOFtIES BEDROOMS � CITY ZIF TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BUILDER DECLARATION SFR/ADD/REM � O ��q�Y kFiIqAI IAID£R VENKTY OF P£R1URY TiUT 1 AM EXEMFT FROM THE CONTRACTORS L4 Garage/Carport W CENSE UW FON THE FOLLOW W[i REASON(SEC.7031.6 BUSfNESSAND PROFESSIONS COOE MiY pT/OR (n . . U COUNTYWHIp1RE0UWE3APERIAITTOCON3TAUCT.ALTER,IM7ROVE.DE/AOLISH,ORREPAIRANYSTRUG W Pg���� Z TURE,VRIOR TO RS�SSUM7CE.�L50 NEWIAE9 THE APPLICANT FpR SUCH PEAMIT TO FILE A SIONED W W STATEMENT TMAT NE OR 5HE IS LICENSED PURSUANT 70 THE PROYISIONS�OF THE�CONiRACTORS 11- � CEN4E LAW(GUPTER Y{COMMENpNO WITH SECT�ON 7000)OF DMSION 7 OF 7HE 9USW E55 AND PR6 � PooUSpe � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTIEREFROMANDTHEBASISFOfiTHEALLEOEDE%FI.IP- ' '� - V 71pM./�J1VVqLAT10NOF5ECTION7Wt.5BVANVMPLICANiFORAPERMI75U&IECTSTNEAPPLICANT70 Z R9-qppl � 11Gy�LPEJJALT'OFNOTMORETHAN�FNElA1NDREODOILAFtS(f500).): Q ❑I,ASON?JEROFTHEPROP£RTY.opMYF1dPLOVEESWITH)VA(iESASTHEIRSOLECOMPENSAiION, 0 COrtt(fIBfC181 Z WILL DO THE WORK.AND THE 9TRUCTURE 19 NOT IMFNDED OR OFFEREO FOR 9ALE(SEC.7ou,9U51- J � NESS M!D VROFESS�ONS CODE TNE CONTfUC70R3 LiCENSE LAW DOES NOT A7CLY 70 AN OWNER OF j � PROPE{TTYW/qBUILDSOAI�IPROVE9THEREON,ANDVJ11000E55UCHWORKHIMSELFORHERSELFOR m . Q THRDIKW HIS OR HER ONM EM7lOVEES,CiIOVIDED THA7 SUp71MPROVEMENTS ARE NOT INTENDED OR W pFFEqEDFORSALEIF.11aNEVERTMEBNLDWOOPDaPROVEMFNTISSOtDW�TMNONEVEAROFCOMPLE- � T10N,THE OWNER-9UILDER WILL HAVE TME BURDEN OF.PROVIN4 TFUT HE OR SHE DID NOT BUIID OR ' - - � Z IMPROVE FOR THE PURPOSE Of SALE}. � � � _ ❑I,ASOMMEROFTNEPROPERN./WE%CIUSNEIYCANTFiACT1NOW1T11�ICENSEDCONTiUG70R5 � ' ' � ' ' w TO GONSTRUCT THE VROJECT(SEC.7014.B�ISINESS AND PHOFESSIONS CODE THE CONTiUCTOR4 L1- V8IU9IIOf1 A0.1.AREA � � CENSEL�WDOESNOTAPVLVTOANO`NNEROFAPROPERTYNMOBU0.DSORIMGR6VE9THEREON,AND , � -- WHOCOHTMCTSFORSUCi1PRO.lECfSWIT1ACONTMCTOR�S)LICENSEDPURSUAIfTTOTHECONiMC• p�q�7Y DESCRIPT70N FEE � � TOq5110EN5E lAW.1. - O ❑1 AM E7(EMPT UNDER SEC. B.8 P.C.FOR THIS REASON � U �i 2 � OATE OWNER ~ U ZW . . . . . . . � � UCENSED CONTRACTOflS DECLARATION -�� � � w � 1 HEREBV AFFlRIA UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDEH PROv1510NS OF GHAPTER Ur a/ � 9(COMMENCOKi VATH SECTION 7W0)OF OMSION 1 OF THE BUSINE54 AND PROFESSroNS COOE,MA Z _ X MV LICENSE IS IN NLL FORCE AND EFFECT. m . lll � � LICENSE C SS LIC.NO. J � V DATE ' CONTRACTO a . . . .. . W � WOftKERS'COMPENSATION DECLARAl10N -� Q � (� � I HEREBY AFFIfiM UNDER PENALTY OF VERIUfiY ONE OF THE FOLLOWINO OECLAMTIONS: � ZQ p �HAyE ANp WILL MAMlTAIN A CERTIFICATE�F CON..ENi TO SELF-INSURE�OR WORKEHS' 'S � PENSATION.As PROVIDED BY SECTtON]7000F tl/E UBOR COOE.FORTME PERFORMANCE W- . . THE WORK FOR WHNki THIS PERMIT IS ISSUED. � . � i HAVE AND WILL M!VMAW�WORKEFi3'COMPENSATION IN3URANCE,AS REOUIRED BV SECTION Q 3700 OF 7HE LABOR CODE.FOiI THE PERFORMM�CE'OF THE WORK FOR WHICN iHIS PERMR IS ISSUEp.hry WORXEAS'COMPFN IItSUr��cy��CMAIER ANU .�['��sEa ME: �CONSTRUCTION� jCARRIER ��]r+- � ,JT PLANREVIEW o POLqVNUMBER � �-���� ELECTRIC � (niS5ECf1�NNE�1�piBEaoAKEf�OF7lfFERMisFORa+EHUM17mDa1Af�lSloqaalf-ss1 'PLUMBING � . . . . ' � - w 1 CER7IFY 7HAT IN hiE PERFORMANCE OF THE.WDRK FOR WNICM THIS PEfU1�T IS ISSUED,1 MECHANICAL Z � SHALLNOTEMVLOVANYVEREOMwANYMMINERSOAS.TOBE TM� INSPECTIONFEE Vj M/ORKERSCOMPENSAT�ONlAM�50FC111FORNl A6RE ATIFISV10VlD ME . . . A1 l � SU&IEC7TOTHEWORKER5COM7ENSA7lONP IONSOF CTION97o00FTN IABOF ISSUANCE � " ' ` OC]O E.�ISHnLLFO�HWiTHC01APLYWITH PHOWSiONS. . . , .. 0 ppTaC�1� APPLICANT:� . . �SMIP _ J ENERGY P/C J WARNINO:FAIWRETOSECUREWORI(ERS' PENSATION GEISUNLAWFUL,ANDSMALLBE � SU&IECTANEMPIOVERTOCRIMINALP ESVPTOONEHUNDREDTHOUSMID ENERGVPERMIT pOLWi3(tloo,000),W ADDITION TOTHE COST OF COM➢ENSA7qN.DAMA�ES AS PROVIDED fOR IN � J SEGTpN 370E OF h1E LABOR CODE.INTEREST,AND ATfORNE�"g FEES. ' RETENTION FEE: � � w CONSTRUCTION LENDING AGENCY ' PFE-ALT FEE � �.. . . . . . . . .. .. O � I HEREBY AFFlRM UNDER PENALTV OF PERIURY THAT THERE IS ACONSTRUCTION LEND�NCi AOENCY nZ-' �FOR THE PERFORMANCE OF 7HE WOR1(FOR NM1i1CN T114 PERMIT IS ISSUFD(SEC.300'7.C�V.CJ. . W . �� LENDERS�NAME , . .. . . F- LENDER'SAODRE55 . � � � �� �/'f� � 'ICERTIFY7MAT�MAVEREADTV119�PP��GTIONANDSTATE7HATh1E�BOYE�NFOiWATIDNI9CORRECT. TOTAL FEES 1 . �� � W 1 A6FEE 70 COMPLV WI7H AL CI7V AN ORDWANCES AND STAT UWS RELAT�NO TO BUILD�NO � COHSTftUCTION,ANOHEflE REREPRESENTAT FTi�S 70ENTERUPONTIE Z ABOyEMEMIONED7ROPE ORINSPECTqN PU � COMMENTS ' 0 J � ' m PERAn7'T W�ME(VPo . . . . � . . Q � � 5 E DATE RECPT.NO. PAID BY VALIDATIO � VYHITE—Oepertment Copy,YELLOW—Flnence Copy.P�NK—Auessor Copy,GOLDENROD--FI�e Copy.GREEN--Appl�anYs Copy . . CITY 4F DIAMOfVD BAR � INSPECTION REC�RD , � . - . : . . ._ _ , �: � � . �� � �r: .� � ti°.' F�-.� �, o ��m�,. .,..�. ��� � aR�"� � � � �� �-,fi' L � � , ' SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR�UCT GROUN�PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATIOtd TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM RO�F SHEATHING I$FT.BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM ROOF COVER PRE-GRAQING __ ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCItdG WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IP/1P5. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.l. OP!SITE IMPS. GAS AIRTEST FINAL ZONING FINAL CONST. FIRE DEPT.FINAL FINAL HEATING HEALTH DEPT.FINAL FINAL ELECTRIC DEV.FEES PAID fINAL PLUMB�NG ENERGY FINAL PLANING FINAL ENGINEER�NG ' • e COMMENTS SEPTICTANKSIZE SEEP PIT/U SIZE � ��. �,