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HomeMy WebLinkAbout13070PE�RAffr AJTLICA CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES JOBSTE �B/UUR1DING DDR( SS 21660 E. Copley Drive Suite 190 ZONING SETBACKS (909) 860-3195 Fax (909) 661-3117 PE�RAffr AJTLICA I -: DATE NUMBER � ` 1-t 46 JOBSTE �B/UUR1DING DDR( SS DATE 1 CONSTT, GROUP ZONING SETBACKS �'- Z SIDE/SIDE STREET RW ❑ APN LOT T CT - j OWNER j ADDRESS << DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION CITYTEL. SFR/ADDIREM En APPLICANT TEL. Garape/GBIpeTI CONTRACTOR 3 ADDRESS CITY ZIP TEL. ARCH/ENG/ POOVSPS DESIGNER 5 ADDRESS Re -Roof CITY ZIP TEL. Commercial - - � N OWNER -BUILDER DECLARATION 1 HERESY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS U - CENSE LAW FORTHE FOLLOWING REASON (SEC. 7031.8 SUSINESSMND PROFESSIONS (ADE:ANY CITY OR Valuation � ADSAREA COUNTY WHICH REOUWESAPERM TTO CONSTRUCT,ALTER IMPROVE, DEMOLISH, OR REPAIR ANYSTRUC- QUANTITY DESCRIPTION FEE TURE, PRIOR TO ITS ISSUANCE. ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE ASIGNED STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS U- C CENSE (ATV (CHAPTER S (COMMENCING WITH SECTION TODD) OF DIVISION 3 OF THE BUSINESS AND PRO - SESSIONS CODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEKEMP- TON. ANY VIOLATION OF SECTION 7031.8 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO ACRAL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (85mI.): ❑ L ASOWNEROFTHE PROPERTY.OR MY EMPLOYEES WITH WAGES AS THEIRSOLE COMPENSATION, WILL DD THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, SLI NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES HOT APPLY TO AN OWNER OF PROPERTY WHO SUILDB OR IMPROVES THEREON, AD WHODOES SUCH WORK HIMSELF OR HERSELFOR = THHOUGHNSOR HER=EMPLOYEES, PROVIOEDTHAT SUCH IMPROVEMENTS ARE NOT INTENDED OR LA OFFEiEDFORSNE SC HOWEVER THE BUILDING OR IMPROVEMENT ISSOLDWRNNONEYEAR OFOCMPLE- TION, THE OWNER'BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). V I7 L AS OWNER OF THE PROPERTY AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TD CONSTRICT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS COD@ THE CONTRACTORS U- 1�.1 = DENSE LAWDOES NOTAPPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHDCOMgACTB FOR SUCH PROJECTS WITHACOMfRACTOR(S)LICENSED PURSUANTTOTHEODNTRAC- TCRSUCENSELAW.). ❑ IAM EXEMPT UNDER SEC. B. S PG FOR THIS REASON L DATE OWNER PLAN REVIEW 169-7 1 ELECTRIC 1 0" 1iz> t � LICENSED CONTRACTORS DECLARATION C_ i 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER MECHANICAL �, 17 0 k ou 9(COMMENCWO WITH SECTION 7000) OF DIVISION 3 O THE BUSINESS AND PROFESSIONS CODE, AND K W LX:ENSE 0i N RAL CE AID EFFECT. ISSUANCE Lou- � CA � { Or SHIPIZ I LICENSE CLASS UC. NO. V L DATE _ CONTRACTOR _ ENERGY PERMIT WORKEROMPENSATION DECLARATION Q A I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING 0ECIARATIONS: n D I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE QL W OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 HAVE AND WILL MINYAN WORKERS' COMPENSATION INSURANCE, A9 REWIRED BY SECTION 0 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WOi((qI:f1�LIR7S' PENSATKN INSURANCE CARRIER AND POLICY NUMBER ARE: .M CARER .. vY POLICY NUMBER RECPT. NO. PAID BY VALIDATION (THS SECTION NEEDNOT BECOAPLELEDOFTFE PERMIT S TORONE HUNDRED DOULARS WOO) OR LESS} Wp Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 L� SHALL NOT EMPLOY ANY PERSON IN AMY MANNER SO AS TO BECOME SUBJECT TO THE IA WORKERS' COMPENSATKN LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME S SUBJECT TO TH KERS'COMPENSATION PfIOV SKNSOF SECTION 7000F THE LABOR CODE, SHALL RTHWITH COMPLY WITH TMOSEP '.iI O p DATE: APPLICANT: _ USETO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL BE WARNING: FA USE ry SUBJECT AN TO CRIMINAL PENALTIES AND CML FINES LP TO ONE HUNDRED THOUSAND DOLLARS (SIGOMM), N ADDITION TO THE COSTO F CDMPENSATKN, DAMAGES AS PROVIDED FOR IN SECTION37080FTHE LABOR CODE. INTEREST. AND ATTORNEY'S FEES. a CONSTRUCTION LENDING AGENCY EEI HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE RK RNM1IICH THIS PERMIT IS ISSUED (SEC. 3087, CIV. C.). W LENDERS NAME LENDERSADDRESS W 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE TRATTHE ABOVE INFORMATION IS CORRECT. p- (AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE 9= ABOVE-MENTIONED PROPS TY FOR SPECTION PURPOSES. P►�t�� 4 PERMITTEE NAME(PRN-r CD SIGNATURE OF PERIATrTEE ATE TION (9 - PRESS FIRMLY APPLICATION PERMIT q I -: DATE NUMBER � ` 1-t 46 ISSUE TYPE OCC DATE 1 CONSTT, GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE eW NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADDIREM En Garape/GBIpeTI LUP 3 U- POOVSPS Re -Roof OJ Commercial - - � N Valuation � ADSAREA QUANTITY DESCRIPTION FEE U , 2 V cd W L9 Z m 4 U 2 6 S W CONSTRUCTION PLAN REVIEW 169-7 1 ELECTRIC 1 0" 1iz> t � PLUMBING ."g-0 MECHANICAL �, 17 0 k ou INSPECTION FEE ISSUANCE Lou- SHIPIZ I ENERGY P/C I K9 tat A'H99 ENERGY PERMIT Q RETENTION FEE: T�Ti PRE -ALT FEE:rT jC Y ' Z TOTAL FEES —1zve <43 _V v (05 COMMENTS RECPT. NO. PAID BY VALIDATION WHITE—Depanment Copy, YELLOW -Finance COW PINK—Assessor Copy, GOLDENROD—FIIB COpy, GREEN—AppIIGRT'S GOpy CITY OF DIAMOND BAR INSPECTION RECORD SETBACK FLOOR JOIST) 01 r FTGS/FORMS/STEEL FHA REQMTS; ELECTRIC GROUND UNDER FLOgR RUCT - i . • I .. ; T, GROUND PLUMBING UNDER FLOOR �QNDLJJ-`'' s?''' :; t 'I •__ . 1 �. ` <:; .` SLAB GRADE FIREPLAC FgL.YNI ' TION TEMP POWER FIREPLXCt-BOND REAM WATER SERVIC MID HT. BOND BEAM- ' • " " ' ROOF SHEATHING 8 FT. BOND BEAM FRAMING/VENTILIATION leZ- FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING !'k ; < ROUGH ELECTRIC r ROUGH GRADING ROUGH PLUMBING , __. FINISH GRADING SHOWER/TUB TEST i ,, POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION on POOL FINAL _ CEILING INSULATION 7' OFF SITE IMPS. DRYWALL NAILING '7-3f'`I oDEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDS CAPE/IRRIG. _ SEEP PIT/L.L. ON SITE IMPS. _ GAS AIR TEST FINAL ZONING _ FINAL CONST.t•3 �� FIRE DEPT. FINAL FINAL HEATING ' _ HEALTH DEPT. FINAL FINAL ELECTRIC i j DEV. FEES PAID FINAL PLUMBING I ENERGY { COMMENTS �J SEP I TANK SIZE SEEP PIT/U SIZE _ i.