HomeMy WebLinkAbout16061 CITY OF DIAMOND BAR - -- DEPARTMENT OF COMMUN7TY&DEVELOPMENT SERVICES l � 21660 E.Coplcy Ihive Suite 190 � . (9p9}860-3193 Fax(909)861-3117 PRESS `'�A�� � BUII.DING PERMIT APPLICATION ' MLY o� JOBSITE C'� APPUCATION 1 ..� PERMIT ��O J�� �/C ADDRESS � � O �� pATE NUMBER �E' $ ISSUE r7 y b� TYPE OCC -- APN LOT TRACT pATE �- CONST. GROUP � OWNER o ADDRES ZONING SEfBACKS C1TY ' IP TEL O FiiONT RW ❑ APPLICANT TEL. REAR ❑ SIDE/SIDE STREET RW ❑ CONTRACT - O SIDE ❑ qF ADD. PROPOSED U 'r � N �� CITY ZIP - � ARCH/ENG/ . DE NO.DWEL. NO. NO. ADDRESS UNITS STORIES �_BEOROOMS � `�`� CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION v� Q OWNER-BUILDER DECLARATION SFFVAOD/REM O 1 MEREBV AFFlRY IN�DER PENlLLTY OF PERAIRY TM�T I M1 EXEMPT FROM THE OONTqACTOH3 LI• G8/BgBJC81pD11 CENSELAWiOR7HEFOLLOWMONEA3ON1�C.7W1.6B��NESSANOPROFEbb10N9CO0EANYCITvaq (n OOUMVYNIICHREOUIHESAPERMRTOOON57AUCT,AL7ERtldPRWE,DEMOIISH,ONFiEPAIaANYS7RUC� w pa��p�peck NRE,PRqN 70 R9 ISSUIWCE.ALsO REQI�NES TNE MPLIGWf FOR SUpI PERMIT N FILE A SKiNEO STATEIdENT TNAT NE OR 97iE�LICENSE�PINiSUANT TO iHE PHOVISIONS OF THE WNTILtCTOR9 U� CENu[UW(QLWTER Y(CdAMENCING VATM 8EG7�ON 7000�OF�IVISIDN 3 OF TNE BUSINESS KNU Pq0• � PaoVSpe FESSIONSCOOqORTMATMEORSHEIBE%FJAPTTHEREFROM�NO7NEBItRISFaRTMEALLEOEDFJfEMP• (� TION.ANYYIOIAiIONOFbECTIONTo9/.6BYANYMPLICANTfORAVENMI73UBJECT9THE�PP4�CANTTO Z Re-Roof � A CML PENAL7Y OF NO7 MOAE TFMN FNE HUNDRED DOILARS(tGoOJ.): 6 01ASOWN6ROFhIEVROVERTY.ORMYEMPLOYEE9WITMWAGE5AS7HE1R50LECOMVENBATION, � C0�7�fI19fCi81 ' Z YYILL DO THE WOHIC,M1D THE STRUGTURE IS NOT IMENDED OR OFFERED WR SALE BEC.7oAs,8U51� J NESS INO PROFESSIONfi OODE:THE CONTflACTORS LICENSE LAW DOES HpT MPIY TO AN CWNER OF � PibPERfYVM10BUlDSORYPROVE6TMEREON.lWDNMODOE98l1CHNtlRNHIAISELFORNERSEtFOR = (� TllppllliN NIS OR NEH OWN EY%AYEES.VPOVIOED TNAT iUCN IMPNOVEMENT9 RNE NOT IMEN�ED Ofl m �1� OfFEREDPORSALE1F.110WEYE1LiNEBUILD�N60XM1PROYEMENT1890lDWRHINONFYFJ1FiOFCOMPLE ZTqN,iHE pNMER-BUILGEH YYILL HlNE THE BURDEN OF PqOYM1O 7FUi NE OR SNE OID I�pT BURD Oil � MGROVE FOR AiE PUNPOSE OF 8ALE1 W ❑LIl40WNEHOFTIEPROPERiY,AME7(CLWNELYCOHTMCfIHOWRNLICENSEDCOi`RMCTORS � TO CONSTNUCT THE VRO.IECT(BEC.70at,BUdiNE85lJ/D PROFE581ONS CODE:7HE CONTRACTORS U- V9W6�iOFl ADJ.AREA CENSE lAW OOES NOTMPLV TOAN OWNER OF A PROYERT'I1NF10 91JM3 Ofl IMPqOVEs hIEREON.AHD WFqOONfMCfSFORSUCHPROJECieWI7H�CONfW1cTOR(S)LICENSEDPURSUANfMTMECOMRAG pUANTITY DESCRIPTION FEE � iOAe 110ENSE UNV.). ^ ❑1 AN pCEYPT UNOEN BEC. B.i�P,C.FON THIS R[ASON U ` 5 ¢ LL' OATE OWNER V 1-� J LICENSED CONTRpCTORS DECIARATION W � 1 HEREBYAFFIMI UNOER PENALTY OF PEiUURY TFMT I AM LICFNSED UNDER PROVISIONS OF CHAP7EN Ur s �(COI.WENdNO WliM SECiION 7000)OF qViSqN 9 0F THE BUS�N S ANO PROFESSIONS COOE,ANO z LL; W LICENSE IS H FlIL1 lGE D EFFECT. � 0 LK:ENSE C�SS ��� IIC.NO. � 7 � p�7E L�� ` CONTRACT'OP a WORKERS'COMPENSATION DECIAMTION a y IHEREBVKFlqMUNDERpENALTYOFPERIURYONEOfTHEFOLIOWINOOECLAMYIdJB: U y 4 _�INAVEANDWILLWVNTAINACERfIFICATEOFCONSENTTOSELF�INSUAEFOHWORKERS' _ COA17EN9ATpN,�lR VROVIDEO BYBECTION]7a00F THE LABOR OODE,FOfl iME PERFpflMANLE tU OF TiE 1VORK FON WMICN TNIS iENMIT IS ISSUE�. � �_I H1NE MID VYILL I.WMMN WORKER3'C041PENSA710N IN&URANCE,AS REW�RED BY SEG7�ON (}• /� �� � 0700 0F THE OR COOE,FOR THE PERW RM/NCE OF THE WONK FOR V/HICH iHIS PERMIT 15 Q 6 •'/]/� 1 ISSUFO.W 001AOENSATI�N NSURANCEc�/p��RIER�AN�ppf LI Y NIAABENAR@ CONSTRUCTION � ((� } �pqiEq � 1�1�11 Y� � PLANREVIEW � ro��NuuaEa - � ' ELECTRIC 4 �� � (R166ECfIpINE�1a7BEOd.�IETEUOFT�FaFRAa�BFORONENUIOREDOqinRsfflOoIORLE5s4 PLUMBING 1 CERTIFV TViAT N TXE PERFOPMMICE OF TME YNDRN iON NTIICH iHIS PERMIT IS ISSUEO,I MECHANICAL SFINl NOT EMPLOY ANY PENSON MI ANY MANNER SO A3 TO BECOME SUBJEC770 iHE N WORKERS'COMPENS�TIONLAW&OFCMlFORMI/�AN�AONEE�TIRISFIOULOBECl�ME WSPECTIONFEE S BUeJECTTO7NEWORKERS'COMPENSATIONPROVISIONSaFSECTioNa�uoaiTHELABOR ISSUANCE FEg �—�p1 CODE.1 6M�4 FOf1T�IWIT/C0IAPLV WITM iHOSE PROVISIONS. 0 SMIP • p DATE: APPLICANT: � 1 ND BAR - WARfJINO:FAILURE TO SECUHE WORKERS'f.UMPENSATION COVERAOE IS UNIAWFUL,ANO BHALL 6E ENERGY �y BUBIECTANEAIPLOYENTaCfL'MINALVENALTIESMI�CIVILFINESUPNONEMUNUREDTXOUSAND ENERGYP�� G AND SAFETV DOILAFISIf��.�1.N 110DITION TO THE COST OF COMPENSATION.DMIAGE3 AS PROVIDED FOR IN � BECTION9)0lOFTHELABORCODE.INTEREST,ANDATTOPNEMSFEES. RETENTIONFEE: CONSTRUCTION LENDING AGENCV PRE-ALT FEE: O � INEflEBVAFF�RMUNDENPENALTYOFPERJURYTHATTiERE18ACON3TRUCTIONLENDINOAGENCY 2 FORTHE PERFORMANCE OF iHE WORK FORNM1IICH TMIS PENMIT IS ISSUEO(SEG 3077.CIV.C.�. W � LENOEfl5 NMIE C LENDER'SAOORE89 ]� � ICERTIFlTIMTIHAVEREADh11SAPPUCAT10NM1DSTATETHATTIIEABOVEINFORMATqNISCORRECT. TOTAL FEES � �� V � IMREETOGOYVLYWI7NALLGTYANOCAUNTYOROINANCESANUSTATElwWSREIATIN(iTOBt1RDINO f � CONSiRUCiION.ANDMEREBV�UTHORREFEPRESENTATNESOi7HI5COUNTYTOEMEFUiONTHE � IONEDPROPERiYFOHINSPECTIONWRP06E5. COMMENTS o l m 4 PE ME�flINT) /� � � �•v y SIONATUR F TTEE DATE � RECPT.NO. _PAID BY YIWpAT10N NMITE—DepaAment Copy,YELLOW—Finance C,q�y,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—Applicanfs Copy . , . . .. � r• . . .., . .. a.r'- . .. . . . . . . . . ..... . . . .. . . . . .. . .. . .. .. .. . ... . . . CITY OF Dl�tttJ�Qh4D E�Aaf� .. �` IF��P'ECTIC)�� R�GC3f�G . ,,. _ �.�, � �. .. ..�;,�-�,»�, ...� ��-�� ::, �-� "�`"� ,��� �� �'' � `.... � � �� � � �,� � � ...� ��1 � .` ' �'����,�yl� , �„ SFT BACk: ` I `� ? ' FLOOR JOIST . , � � -- -.-._._----_ ._ _!___ _ ___.. n _ _ .�.�_ � _;.----- •-� �T(;SIFORMS�STEE L t ! FHA R �PATS � --_—_.__.._ ..__ __� -- --- ---_ _ ____ �._ ..___. -�— -�-�, ---------- �ELECTRlC(�ROUPJt3 ; ' - UNQE�FLC30R�iJCT I .__ __�_ ' � -�-.-�-y _ _��___. ---:--------- _--_ .L_.__. -l.��l���NC�PE �PAF�3��; I � UNDER FLfJOR CCJi I�UtT � ... �_ ____ __ __... -�--�-- -�--- �----- ------------__---._ I_ ___.�_.. . __ _---�---�-�- ----- -_ -- S�.A�G�A�F �_.�.—___._. FIREP'�A.CF_F�lll�ll�AT(C�h1 i r----------. _______-' --- ---- _ _----__ �_____,____ �_._.------- ---___ ; TFtti�1P F'O'vv�-P F3RFP�AGE BE}Nd BEAtiR ; 1 , _ -- -. __ __ -- ^ ---� ___—. _ -- — ' VL'ATFR SEFVIC� , . � MID HT. BOND BE.A4A ' � � _ __�,__� ._. __-- -- - ------•- ----�--�---- -----._ ;._ � t ___ __ �___...._ ._ FiOC7F SHE��"�-alPd�� IGZ-�._o I _ . , . .�FT �ON�7 BE�tM : � i � � • •- ---__.__ _ ...�__�-.._._ �__ _ _ FFiAP11Nt""'t°VTILIATIC7N� � ` I �It+lAL BC3ND BEAM — t --- i .,--- _ ._.,_ _____.____ _.._.._ ._ _._ _ ._. }� -�. _ ___ ___ ,. _.._ ____._�;---- �''JOF�C�L'r-R ;�V'�Z`� --!"� : PRE GRR[�ING _ _._ ---�__ __ u� _ _--` ���— � --- - --_.—_.� — _ __ _ _ : ROUCaf�N"'4TiNG � i �_S NCHiPaG ___ _ ._._----___�_ __________—.� -- -------+-----__ -- -.__ _ i ROUG°I �LEC rRIC { i RJUG�i GRADING "---..__..__----.----- � _.___. . .. ., _---'.—'._._.___._.__�A.-"_--'-..--_.-'.�'-.- .. ---"-'......�._�__.,___.._.,'�'_-•.'--"--.._--. . � R:)�. Fr �'t tJP✓IEiI�lG j I ' riNISH GRADING j � __ .__—__._•-.— -�--------------------{--- ___ _�._�_---------_._.—� .��,_--- �--_,T.—_.._.__..-- -----; f SyG�'Y�`�1,'TiJB TEST I, ' , C POQL Ei_ECTRlC ! _.._ _� .--- -- --a�_..� __ _ . �_ --- ----- — - --- ---— - - --- ._---- - .� �X1 � A�u ��DI�!G I 1 �P�lt3L FENCIRG ; : 1 t ____ . ._._� �_____._�____^_.._._.,�— ------_,.-.--_.`�-----------_ r���--- VVALL �Pl�:.�LATiQN � 1 , ' ; POC3L FiNAI_ i r �_�._�__. _.._ , _------<--_--_—__--_----t------ : � ,.�, - ,_.._—_---�• — _._.. _ � .,,��LINC; i'v�J�ATi��! . � OFF S�YE lt�1F'S. � _ � I R - ------ _.._--- _--��-----�--- - ��___.� i_:_.. _.__ __--------- f _ i��f?`l�,':�i.,_Nfi.1'ik'd i j � ' '�E"}IC;ASI`�.�tvs _ . ---------- -- ------ — i i -- _ _ � E 5�§tr�r ; � � _ -- : ; F�3NAL �'hIG. i -- - ---._____ __ f � ^ __ _----.-_----.�--- ---; ----f-�--.._�_---_.__— -�---, ------..--•- ---�--._�____._ ------.__,_._...... ? � ` t=r'"°'i 4`' T�P•d1G � ' ' . , � ! LAfVI�SCf'��"E.`l�iRla. ' ---------___ _ __� _. . _ _--------._�,__.....----- , ���_� . .,,��.� ���sir��ii��s �f�i � , ; . , _. .._..--�-+=- --_---__._.__`.__._.._�__..._^�._____---------_---�}------ ------�----- - ---------- ---------�----._.____ _ ' �lr�.�1 ri.�l !i..J� � �'�:�`��s.`.�".J����a� � t "' 't._'_"T�...__._.,....__._'_' '_�' —. .._,._ '_[ f'�c [ (�_.i q._ .... . . .. .. . .. .. ._._._.._ .. .... 1 P 1 J JRVe`s`I. ���� ��— � i I-' d.�C.}�9 f 11Y✓i� .. �. . .. . �'.___'_"�"'_".__r--�.��__..�..'_ '__.,_...�.__'__�.._ (.�,. ....._ _ ....... ... �__...._'_'_" ".. � ...._ . ........._. ,. �I,......I.�.r"aT7iV� 3 k''F..��..ni'� L��� (. :.! Ida�.. - ..... -- .,._---- � ------- --•------. .__ . ...__. . ..... -----� «_._.__..-----.______..____...------- � : ...,,:. . _ , _ _.,,._..._ .-- -- _.._. -- --_.___..----._... ,..�.,:�.i. i,i_F:.C=fa1:; •. � ; t".}��J. i'=r�< w.hiC ,.. _. __�� .---._._ __.._.__�---_._ __ . . . � :i,. �ss.i'3t �rt.��P C; i , �G � t"�! Y -. ..._'___.___,__.. .._...""'._.._..._.._._..__...._."_'___". .......I..._.......... ...._... ....._.... ""............ ... ........._...."""� �._. .. . ___ ... _ . . . _..� _. _"—.. L"'__—___. _`' __"'___ 'y�. . ,Te q 'W tii9k6 "... ,� ..,.. . . . } ... . . _.. __. . . _. . . N ..'i . . . . .. .. f � W i�- ,..A.f..'.,����-. . , � ( �?. , �, 1,J4...�G''i��t+✓��i�d �c`S . t �'._.�.."___.._..__.._._._._._'_..__'_'.._..__...___._.._.._._'..�._�.,'_'._._.....'_'_'_..._'—._'_._�__._.."'__._....._—.,..._.__�._._.._........_"_""___"__".'—____...___.._....._._—.._...�.._...................._..._................_� + �.. _ �_..�_,..__...'.'_"__�''....._.."'....._'_'_.__""'" . _.._ ........._.._ ' ......... ......... ._....._....... ....._.�........ .... ._...; ! + ' r" _,_ ' .�'_"__�....._�._......,_.._'_'__...._._.._..�_...,.._..._..__..'"'__."__'_.._._.�_._..."_"""""'..�...____.._._.�__..............__"._... _ i _ ..... '� i """___.._._.. ._..._"' "'�..._ .... " ' _""_. �_._L.._ ...._�..._..___.. ._" . ,. , . .. .. _ .. __ . .. .,...'_"_._'_ . . ...., . -j( �_.._._._.__._. . _._—. .___.-__.— ______ _._�..._.__ ..�_. _. _ .. . ...... ....'"'._.. . . . _ _...._.._. .�_ ._. ._..... . S � ___ �—_—__._'__._—'__—'.—.......____... ___'�'_--' � � "_._ _ . . . . . . _. . t.�"""'_.._.�_"'__""""""_'__""'_"'_._.._._'_"._._..._._._._.�..___�..""'_'_"'_"'__"'_""'"_'._ ..... ....... ... ......................_..... ._._._........._._ r . . .....'"'..._._. ..__. . ,.... .�. � t . ...,."_'�'�_'".�'___�..__.._.._.__...___..._..__.�_.__.... . .._._,._...__—__...'_'"...."_....... .._....'_"'_'"_""""_ ' ' ._.�_�._..__._.._..-�.._..,__ . ......"_'___'__.._...__._.._.�. � ��?�������� �EL.'._ --__..-_.. , � �.I �� �<_� , � ._ _, . , -- ---- _ ., 1 �, M1 _.. r_.._.__._. _... . �._,., ; � �-� I '� I . ...---._.___. _...--. . __-_.___.�_ _._... ..--�-�---_ ...,m__---- ___..__._._._..__.._ . ! � � " . .., . _.._ .._ ...__.__, ._..__...____,_.. _._....,.j � __....._.___.�..---- __ ..._ . _�_.._._.. _.-------_._ ...-�-------�--�---- -- I� _...._.........------...� �----.�__._-------- -------- --__ .,__�__._._..______._.__. ----------__—. __.__ . ! .. � �� -----_ _.__ _...__ __— - __�_ -----___ . . ._ .. _ __ _ _.__. _._� � • � _._----.,.,._.__._------------ ---- .__._. _--___ _—._.___..____..- --_ __ _ ___._.._ _ .__ _..—..__ _--� . � 1 � _._._._._..�.___----�_.___—__�.,...----� --..�._..�_...._------- - -...__---- --_.. _ .._....- --_.. . .. _ _ _{ � � , , _....�_.......�__-----..�.__w�_�.,,. .__�,..____.___� . - ' i