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HomeMy WebLinkAbout12771 (14) _. i . .. �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNTTY dt DEVELOPMENT SERVICES 216b0 E.Copley Drive Suite 190 (909)660-3195 Fax(909)861-3117 PRESS ��� BUII.DING PERMIT APPLICATION FIRMLY � JOBSITE ��� �y— - � APPLfCATION PERMIT "Z�} P/C o ADDRE55 ��C.J ��PA��� DATE NUMBER � �i P � issue rrPe occ APN LOT TRAC Z DATE CONST. GROUP p OWNER � ADD SS ZONING SETBACKS � gCITY � � ZI � TEL. " - FRpNT RW ❑ g APP CANT � TEL. S DAFJSIDE STREET RW q a� CONTAACTOR SIDE ❑ � ADDRES � PROPOSED USE CI7Y ZIP �TEL. S'� � ARCHlENG/ DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFWADDlREM O I IIEREBY AFFlRM 1M1DER PENALTV OF PERIUAY TFUR I AM E%EMPT iROM TME CONTRACTORS LI- G8f8g8/G91p�ft CEHSEL�WPoRTHEFq10WINORF.A.,ON(SEC.7037.BBUSINESSANDPROFESSIONSCODE:ANYCITVOR (n OOUNiYMhiKNRE0UWE51lYEW91TTOCONSTRUCLµTER,IMPROVE,DFlAOL19H.ORREPAIRANYSTRUG, w P21i0/DBCk . TIAiE,PRIOR i0 R613fiUANCE,AL90 11EOUIREB 7/1E APPLICANT PoR BUCH PERMIT 70 flLE�SIaNED ' BTATEMENT THAT HE OR SHE IS LICENSED PURSVANT TO TME VROVISIONS OF TXE CONTFil1CTOR9 U- C�ISE lAW(CHAVTER i(CqAMENGINO Y117H 6ECTION 7000)OF DIVISION 7 OF TiE BUSINESS AN�PRO• � P��Pe FE85qNS OODE)OR TIAT HE OR SNE IS EXEYPT 7HEREFHOM ANO7HE 9A515 FOR 1HE ALLEOED EXEMP- TpN.ANV VIOIhTqN OF BECTIpJ 7011.6 BVANV APPLICANT FOR A PERMIT 6UBJECTS THE APPIICAl/T TO Z qe•qpp{ � �CIVIL rENALT'OF NDT MORE TIIAN FNE MINDRED DOLUi13 It�O).1: _ �L���EROFTHEPPOPEfIMONMYEMPLOYEESWITHWAGESA5TF1E1R30LE�OMPEN5AT10N, � Commerclal MALL 00 TF1E WONC,MID TME STRUGTURE L9 NOT INTEPOED OR OFFEHED FOR BALE(BEC.70s�,BUSI- .J IIE53 AND YROFE5310N5 OOOE iXE CONTMC70R5 LICENSE UW OOE9 NOT APPLY TO AN OwNER OF � � PflOPEH�YWFiOBUIDSORMIPROVE37lIEREON.ANDWNOOOESSUCHMIORKNIMSELFONHERSELFOq � 7MWUGHHISORNEROWNEMPLAYEES.PROVIOED7MAT8UGIIMPROVEMENiSANENOTMTENOEDOR m OFFERED PC+A9ALE-IF.MOWEVER111E BULDINOOit IMPROVEMBR 19 SOID WIiHINIXJE YEAROF COMPLE- TIDN,iHE OMRIER�BUILCEfi NIILL WIVE THE 6URDEN OF PpOVWO THA7 ME Dli SHE OIO NDT BUILO OR IMAiOVE FOt17NE PURP06E OF EALE�. O 4�OMYNEROFTHE PROPEAfY,AM EXCLUBN0.VCDMRACTING WRH LKENSEO CONTMC?OPS � TO CONS7RUCT THE PRO.IECT(6EC.low.BU91NE53 AN�PROFESSIDNS OODE:7HE CONRVACTOFS ll- V6luetlOn ADJ.AREA CENSE UW DOES NDTMPLYTO AN OVMER OF A YROPERTY YYFp BURDS OR IMPROVEB THEREON,AND � WFqCOMTRACf8WP6UCHVROJECTSWIT7AGONTRACMR(5)LICENSEDPURSUANTTOTMEOONTMG (aUAIYTIN DESCRIPTION FEE � lOfb L10EN8E IANL�. . ❑1 K1 E%EMPT UI�OER SEQ B.6 P.C.iOR THIS REASON � U � � DATE OWNER U . .. , . � LICENSED CONTRACTORS DECLAMTION W � I FIEREBYAFFqW 11NDER PENAL7Y OF PERtt1RY TW�T Il1M UCENSEO UNDER PROVISIONS OFCHAP7ER � f�OOYYENCIN�WITN eECT1OM 7000)OF OMSION 9 OF THE BUSINESS ANO PROFESSIONS L'O�E.AND Z X W LI['.ENSE IS H FIRL FORCE AND EFFECT. � m Q �LICE►NSE CUSS C:LC� LIC.NO. vr� � '�j � `�TE � CONTRACTOR � WORKERS'COMPENSATION DECLARATION a � �- y IHEREBYIIFFIRMUNDERPEWLLTYOFVERIUAYONEOFTHEFOLLONANODECIARATIONS: V � ¢ ��� � _I NAVE AND MALL MAINTAN A CER'fIFICATE OF CONSEN7 TO SEIF�INSURE FON 1VORKERS' _ .��' .�/� CONPENSATION.A9 PHONDE�BY SEC7'ION 97uoOF TNE IABOR COOE.FOH THE VERFORMANCE W OF THE WOqN FOR WHIGI TNIS PERM�T IS ISSUED. � �� � - I IMVE MO 1MLL hWNTIUN WOR�(ERS'COMPENSATION INSUHMICE.A9 REOUIFED BY SECTION � 9700 OF THE IABOR OODE.FOR TNE PERRDRM+WCE OF TiE WORK FOR WHICH THIS PERMIT IS IS4UEO.AIV ERS'OO�IPENSAT NINSURANC`EC,ARRIER DPOLICYNU oeaaaE: CONSTAUCTION � CMPoER � � M �� PIAN REVIEW � POLICYNUM� �� �" '�jL�'`�L� 2�� •^� ELECTRIC 0 lrnssEcnoNr�np78Eod+aFiEuaFn�aeaMrswr+anEruroamoou�wsR�mlaa�ss} PLUM NG Z1 CEATIFY THAT IN T/E PERFORMlJJCE OF THE YYORK FOR WHICH TFqS PENWIT LS ISSUED.I EC AL ��T� ' L � SHALLNOTEMVLOVANYPERSONINMlYMANNER60ASTOBECOMESUBJECiTOTHE � VNDRKERS'GOIdPEH3ATqNUW50FCALIFORNI0.NNDAOREETHATIFISHOUTABECOME SPECTIONFEE S SV&IECTTOTIEIMORKERS'COMPE PflOV�S F, N OfTHE R ` cope.isH,ulFoqn�rnn� r s v s.� ISSUANCE ��+� q � �� p OAT@� AP ICAM� � SMIP _,lyr��y�AQ LLI vr•" V V IN � riAFWINO:FAILURETOSECUREWORKER3' S COVERAOEISUNLAWFUL,NID9HNIBE ENERGYP/C t�� BUBJECTANEMPLOYEXTOCWMINALPENALTI SNJU IIFINESUPTOONENUNOREDTMqJSAND ENERGVPERMiC.1TY OF DIAMnTTT)RAR � DOLLAHS IIt0o,700).N AD�ITIONTO THE C0.5TOF CO IPENSATION,DAMAOES AS PROVIUED FOR IN Tm � BECTION97oeOFTHEtABORLODE.INiEREST,ANDATTORNEI"9FEE5. RETENTIONFE�IJ��.�INCi ANT�yS�Y CANSTRUCTION LENDIN6 AGENCY PRE-ALT FEE: � IFIEREBVAFFlRMINDEflPENALTYOFPERJURYTMATTMEREISACONSTRUCTIONLEN�W��6ENCY Z FOR 7HE PERFORMANCE OF THE WORK FOH WHIC)H THIS VERMI715 ISSl1E0(SEC.90Y7.CIY.C.). iL LENDERS NAME w // � . S � LENDEH'S ADDRE55 ICERTIFYTUTIHAVEREADiHISAVPLICATqNAN�STATETUTTHEA60VE1NFOPAIATIONiSWflRECT. TOTAL FEES � c.r('j � I ACiRF'TO OOMiLY WRH ALL CITY AND COUNTY ORDPIANCES AND ST�TE UWS REUTING TO BURDINO �5�,� � CONSTHUCTION,AND MEREeY1LLff1iOHIZE REDRESENTATNESOF THIS COUNTI TO fNTERUPON THE � ABOVEJAEHTqNED VRDVERTY FOR INSPECTION PURVOSES. COMMENTS � EENNA IPRIN7) '� �^ /� N O � DAiE � RECPT.NO. -__PAID BY _. , VALIOATION YVNITE—Oepertment Copy,YELLOYV—Finanoa Copy,PINK—A�aeasor Copy,QOLDENROD�ile Copyr,GFEEN--IVpplicanCs Copy � � CITV OF DI�FJIOND BAR � � ' IFd�PECTION RECC?RD � � e � � � - � a a � � - SET BACK _ � � FLbOR JOIST " FfGS/FORMS/STEEL FHA REQMTS . � ELECTRIC GROUND UNDER FLOUR DUGT - � ' ' - - ------- - --- - - � - : - - — GROUND PLUMBING UNDER FLQpR CGI�Dt.JIT . __: .. : .. . SLAB GRADE FIREPLACE FOUNDATION -----• � � -� • • � - TEMP POWER FIREPLACE BOND BEAM - -- "- --- -- - WATER SERVICE MID HT. BOND BEAM • • -- ROOF SHEATHING 8 RC�OND.BEAM � � � � - � FRAMINGNENTILIATION FINAL BOND BEAM ' ROOF COVER PRE-GRADING ROUGH HEATtNG '< -�l ' BENCHING ROUGH ELECTRiC ROUGH GRADING � ROUGH PLUMBING FINISH GRADING � � SHOWER/7UB TEST POOL ELECTRIC EXT. LATNlSIDING P�QL FENCING WALL lNSULATION POOL F1NAL CElLING INSULATION OFF SITE fMPS. DRYWALL NAILING DEDICA710NS SEWER FINAL ENG. SEPTlC TANK LANDSCAPE/IRRiG. � SEEP PiT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONItVG FINAL CONST. FIi�E DEPT. FINAL � � FINAL HEATINCa HEALTH DEPT. FINAL FINAL:ELECTRIC QEV. FEES PRID FINAL PLUMBING ENERGY � . � --- _ C��4/������ • � ..._ , . , . . . . . . �-,*s� - - il-,r �� ��� _ .. � � • , . ,. �:.... ,. .... : ,. ., .. , .. . .._. SEP71C TANK SIZE . ....,_,�.,'- :;.�;'„i'v1i'..�,':i'' SEEP PIT/U SIZE � - _._.�_._.----. - _.-_ j ;' ��"' . . . � -- , �_�- 7 . .. ...�.. , . _. . . . -•• ., T�� 9 ,I � I '_,_ - � { �-7 ,