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HomeMy WebLinkAbout12158 (11)\M/.. BUILDING PERMIT APPLI0 CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY joBsrrE 277 21660 E. Copley Drive Suite 190 ADDRESS e'wlPij (909)860-3195 Fax(909)961.3117 \M/.. BUILDING PERMIT APPLI0 PERMIT joBsrrE 277 l DATE l ADDRESS e'wlPij # ISSUE TYPE APN LOT TRACT30-S23? ©S23? DATE OWNER GROUP ADORE S - t CITY a r ZIP TEL. FRONT. APPLICANT TEL as CONTRACMF�5.41A, ADDRE Sr SIDE/SIDE STREET CITY ZIP TEL. ++ ARCH/E G/�( A. C DESIGNER L& ---- PROPOSED USE ADDRESS CITY ZIP TEL. n NO. UNITS STORIES BEDROOMS OWNER -BUILDER DECLARATION FACTOR PSF ADJ. AREAtVALUATION PENALTY THAT EXEMPT FROM THE CONTRACTORS 'AM SFR/ADO/REM (PERJURY THEE FOLLOWING S CENSE LAW FORTHE FOLLOW WG REASON (BEC. 7037.5 BUSINESSAND PROFESSIONS CODE: ANY CITYOR R COUNTYWISCH REOWIESA PERMrTTO OONSTRUCLALTER IMPROVE, DEMOLISH, OR REPAIR ANYSTRUIC. Gamgs/Carporl TORE. PRIOR TO GTS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT TWIT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LP CENSE LAW (CHAPTER S (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS E%EMPTTHEREFROM AND THE BASIS FDR THE ALLEGED 0 EMP• TION. ANY VIOLATION OF SECTION 731.6 BYANY APPLICANT FOR A PERMITSUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE TNN FIVE HUNDRED DOLLARS PooySpa O L AS OWNEROFTHE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILLCO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI- -Rod NESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PRDPERRY WHD BUILDS OR IMPROVES THEREON. AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR =RR THROUGH HISOR HER EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR Commercial OFFFREDFOR SALE IF,HOWEVER, THE BUILDING OR SAPROVEMENT IB SOLD WITHIN ONE YEAR OFCOMPLE- - TION. THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE Db NOT BUILD OR IMPROVE FOR THE PURPOSE OF BALE} .. . O LAS OWNEROFTHE PROPERTY, AM F%CLUSNELYCONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LF CENSE LAW WE NOT APPLY TO AN COINER OF A PROPERTY WILD BUL05OR WIPROVE9 THEREON, AND WHOOOMRACTBFOR SUCH PROJECTS NTHACONTRACTOR(S) LICENSED PURSUANT to THE COHTRAO- TORS LICENSE LAWJ• Valuation O I AM EXEMPT UNDER BEC. B. i P.C. FOR THIS REASON W DATE OWNER QUANTITY DESCRIPTION LICENSED CONTRACTORS DECLARATION f[ S I HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER iC 0(COMMENCNG WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PROFESSIONS CODE. AND ACE e MY LICENSE IS IN FULL AND EFFECT. LICENSE C�LASSS�y_.R LIC. NO. _ • . DATE fzM"q c- CONTRACTOR el WORKERS' COMPENSATION DECLARATION � ,N' N _ v rn I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO 5ELF4NSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. Vk—IHAVEAND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE, AS REQUIRED BY SECTION 0 57000E THE LABOR CODE, THE PE ANCECA THE WORK FOR WHICH THIS PE S 'COVPENSATKON ISSUED. MY KE PE : URANCE CARRIER AND POLICY NUMBER ARE: CARRIER POLICY NUMBER 0 (IHBSECTICNNEEDNDTBEDOLilFTWOFTFE PER INTIS FORONE HIFDREDDOUAFS ISIN CRLESS) Lu Z 1 CERTIFY THAT THE PERFORMANCE THE WORK FOR WHICH THIS PERMIT IS I TISSUED. L W ANY MANNER SOMA TO BECOME SUBJECT THE ANY PERSON Y rp cfj WORKER ' COMPEY WS SATION LAWS B CALIFORNIA MIO AGREE THAT IF I SHOULD BECOME SUSUSERS' THE W E PROVISIONS OF SECTION 97000E THE LABOR THE THWT COMPLY -THTNPRONSOI CCOE.1 SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. CODE.16 DATE: APPLICANT: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL OF r= SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100.000), IN ADDITION TOTHE COST OF COMPENSATION. DAMAOES AS PROVIDED FOR IN SECTION 8706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. CONSTRUCTION CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCY PLAN REVIEW FOR THE PERFORMANCE OF THE WORK FDR WHICH THIS PERMIT IS ISSUED (SEC. 7097. CIV. C.). LENDERS NAME LENDERS ADDRESS ow 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATETHAT THE ABOVE INFORMATION 15 CORRECT. PLUMBING (AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTICK AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVIEMENTIONED PROPERTY FOR INSPECTION PURPOSES. MECHANICAL tv INSPECTION FEE PERMITT m _ [AO Or) SIGNATURE OF PERMNTE D9rE SMTP & DEVELOPMENT 70 TION PRESS FIRMLY APPLICATION Z� PERMIT PIC l DATE l NUMBER # ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT. RW ❑ REAR - ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAtVALUATION SFR/ADO/REM Gamgs/Carporl WPatio/Deck U- PooySpa ZRe -Rod 0 Commercial - 5 m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE U e W .. C9 Z m U Z 4 U CONSTRUCTION PLAN REVIEW ow PLUMBING MECHANICAL INSPECTION FEE ISSUANCE ` SMTP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: ML — TOTAL FEES COMMENTS RECPT. N0. 11�PAID BY VALIDATION WHITE—Ospamment Cow YELLOW--Flnenos Copy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN— Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD SET BACK 77 FLOORJOIST+ FTGSlFORMS/STEEL FHA REQMTS - ELECTRIC GROUND UNDER FLOOR DUCT " GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM -' WATER SERVICE J MID HT. BOND:BEAM ROOF SHEATHING 8 FT. BONA BEAM - - FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC _ ROUGH GRADING ROUGH PLUMBING FINISH GRADING . SHOWERITUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG, SEEP PIT/L.L. ON SITE IMPS. GAS AIR FEST FINAL ZONING FINAL CONST, FIRE DEPT. FINAL FINAL HEATING j HEALTH DEPT. FINAL j FINAL ELECTRIC Ti d DEV. FEES PAID i _ FINAL PLUMBING j ENERGY COMMENTS SEPTIC TANK SIZE SEEP PIT/Ll SIZE -