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HomeMy WebLinkAbout10163 - CTCY OF DIAMOND BAR COMMUNTfY DEVELOPMBNT DEPARTMENT � 21660 E.Coplcy Drive Suite 190 PRESS (909)860-3195 Fex(909)661-3117 ^�"'� BUILDING PERMIT APPLICATION FIRMLY o ADDRESS � -s N '� DATEICATION �_�_L?� NUMBER NrC ��-/ / � ISSUE � TYPE OCC APN LOT_� TRACT �? �T_ DATE CONST. GFOUP SOWNER �/!�) '1'�A-('I 8 ADDRESS �����'�""J �NYOa 20N1NG SETBACKS CITV �. /L_ ZIP 9I745 TEL. FRONT RW ❑ APPUCANT �, REAR ❑ SIDE/SIDE STREET RW O CONTRACTOR Q�E�iYIA�,L�_I�..J/ �Ir SIDE ❑ ADDRESS PROPOSED USE � � � CITY 21P��yEL �' . aPi ARCWENG/ � DESICaNER NO.�WEL. NO. O. ADDRESS -� UNITS STORIES BEDROOMS � CRy ZIP TEL. N DESCRIPTION S�.Fl: FACTOR PSF A�J.AREANALUATION � � ONMER•Bl:ILOER DECIARATION SFFVADWREM O p 1 MEREBV AFFlM1 VNDER PENlLLTY Of PERAIRV TiMT 1 AM E%EMPT FROM THE CONTPACTOit4 U- deI��9/CBI�011 LI,I CENSEUWFOHTMEFOLLOW�NGREAuON(8EC.70i�.6BUSME95ANDPROfES510N5CO0ENJYp7YOR (J) �7 OOUNfYWNICHRE0U1RE5AVEHMITTOCONSTRUCf.ALTER,WPROVE,DEMOLISH.ORREVAIRANY8TFl1C• W P9�IO/DBCIf LL� TURE.MqR TO RS ISSUANCE,AL90 IIE�UIRE9 THE 11PVUCANT FOR SUf.l1 YERM�T TO FlLE A BIONEO � STA7EYENT TMAY ME OR BHE IS LICENSED PUNSUANT TO THE PROVISION9 OF TlIE CONTHACTOHS W � CEN6E UW(CMAPTEIi Y(COYMENCINO N7lM BECTION 7000)OF DIVISION 7 OF 7HE NSINESS ANp PRO- � P��� FESSIONS CODE)OR THAT ME ON SHE 19 IXE40T TMEREfROM AND THE BASIS FOR TME ALLEOED EXEMP- TION.ANVVIOlAT10NOF8ECT10N7o91.iBYANYMPLM.IW7FONA0ERMITEUBJECTS7/1EAPPLK'JJJTTO Z Re•ROOI � A CML VENKTY OF NO7 NORE hWd FNE HUNDRE�DOLLARS�i6a0).1: O P4�4�'1EROFTME►FIOPERN.ORMYEMPIOYEEBMl17NMUliESA5THE1Fl90LE00�APENSATqN, Q COIIR11BfC191 Z WILL�O�NE WORK NiD TNE STRUCTURE 18 NOT IMEPOED Oti OFFEFED FOR SJiLE pEC.7oN,BU61• J NESS AND PROFESSIONS CODE:iHE CONTRACfORS LICENSE U1W�DES NOT MPLY TO AN ON�NER OF j ./� � PROGERTYWHOBUILDSORIMPFi0VE87HEREON.ANOYIHODOESSUpIWORNNNASEIFORFIERSELFOR ��� Q iMROUGII WSOR HER OWN EYPIAYEES,VXONDED THAT 6UCH IMPROVEMENTSAAE NOT INTENDCD OR m � OFFEREDFORSl4I..EF,YIOWEVERTNEBUL�ING011YPROVENENTISSOLDWITIIINdJEYEAROFCOMPLE- Z TqN,111E OWNER-BUILDER WILL MAVE THE 9URDEN OF P0.0VIN0 THAT ME OR 3XE D�D I�T BUILD OR � IMPROVE iORT1E PURP09E OF BALEL � OI.A60MINEROFTMEPi10PEHTY,AME%CLUSiVELYCONTRACTINOWITHLICENSEDCONTRACTORS 70 CONS7RUCT TXE PRO.IECT(SEG.70N.BUSINESS AND PROFESSIONS CODE:THE CON�RIICTORB L�- VelYi1 ADJ./1FlFA CENSE UW DOES NOT APPLr TO AN OWNER OF�YROPEHT!WFIO BUILDB OR MIPROVEB hIEREON.iWD � WIpCOMRACTSFORSUCHOROJECTSM7TMAO0NTRACTOR(S)LNCENSmPURSUANT70TNEGONiMG dUAN'TITY D SCRIPTION FEE � TORS IJCENSE UW.). O I M1 EXEMPT UNDER SEC. B.�P.C.FOR TN16 REASON U �� �S � , / 3 � T /!a a�('Y-tT LL' DATE OWNER � F LICENSED CONTRACTORS DECLARATION W , � IHEREBYAFFIHAIUNDERPENALT'OFPERIUIiY7MATIANIICENSE�UNDERPROVISIONSOFGiAPTER Vr � �(COLIMENCINGWITHBECTION7000)OFDMSION]OF7HEBUfiINESSANOVFiOFESS10NS000E,AND Z ��� W IICENSE IS N iULL FORCE MI�EFFFCT. m 0 IICENSE CIASS� LIC.NO.� � H J � DATE CONTMC'TOR a = WORKEHS'COMPENSATION�ECLARATION � � INEREBYAFFlRMUNDENVEWLTYOFPEfWRYONEOfTNEFOLLOWR7aGEClARATION3: U �j Z Q � _I N1NE AND WILL WIMAN A CERTIFIGTE OF CONSENT TO SELFINSIIRE FON WORKERS' 2 OOMPENSATqN,A8 PRONDED BY 9ECTION 970u OF TNE IABOR CODE.FOR 7HE PERFORMANCE �U O OF T/1E WORK FOR NR11d1 TNIS PERMIT b 199UED. � _IMAVEM1�NfILL1AMN�AP1WOfIKERS'COMPENSATIONINSURANCE,ASREWIREDBYBECTION �� � QQ f7000FTHELABORCODE,FORfl1EPERFORMMICEOFTNEWORKFOHYYFi1CH7WSPERYRIB � ISSUED.W MADRKERS'CONPENSATqN INSURANCE CARRIER AIA POIICY NUMOERME: CONSTRUCTION GIHRIER P �' crRi � I POLICYNUMBER � � �ss[�cnoN�raraeox�FrfnasnfvErarrsanor�N.ranmoouiasR�mlae� PLUMBIN(i W IGERTIFY7NATNTNEPERFORFAANCEOFTIEWWIKFORN�NICMTNISPERMR18155UED,1 MECHANICAL 6HALl NOT EMPLOY AN'!YERSON N ANY MANNEH SOAS TO SECOME BUBJECT TO THE � WONKE 'COMPENSATqNUW50FCILLIFORNIA,ANDl1ONEETMl1iIFIS/qUIDeECOME iNSPECTIONFEE SUBJE TOTHE RKEHS'COMPENSATIONP OVISIONSOF S}IELABOR �j , SHALL qTMM7HCOMPLYWI7NTNi EP I 5. '�" �SSUANCE • 0 SMIP p pATE: APPLICANT: � WARNING: URETOSECUREMR�RKEpS' ATION RAOEISUNIAWFUL,MlD6HALLBE EN�EROYP�'.' � BUBJECT EYPLOYERTOCF11YN1ALPE TIES OCMLFINESUPTOONENUN�REDTiqUSAPID �ER(jYPERMIT ��V A E� � �7 �i r DOlLM51f1oD.oao),N AODI710N TO TME 001APENSIRION.OAMAl3E5 A6 PROVIDEO FOR IN � �EGTION77osOF7HELABORCO�E,MTERE9T.AND�iTWiNEMSFEE6. RETENjTIONFEE: � • �� � � CONSTRUCTION LENDING AGENCY pRE-ALT FEE � 1 lIEHEBV AFFWAI UI�ER PENALIY OF PfeRJUiW TUT iHERE IS A CONSTRUCTION LENDMIa AOENCY 2 Poq T1E PERiO W.IANCE OF THE YNDRK WR NM1IICN 7M�IS VERAIIT IS 185UED(6EC.3oA.CIV.G} W � IBJ�EN'SWWE � lB1UERSlIWRESS � 1 CEpTIFY iWR I W WE REA�THIB MIwICATqN AND ETATE TUT T1E MOVE INFOFMATqN IS CORRECT. TOTAL FE ES r t K.IiEE TO OOGPLY WITH ALL CIIY AND COUNTY ORDPIANCES AND STATE LAW6 NEUTWO TO BUM.DINO OONSTRUCTION,AND NEREBY AUiT10Fi2E REPRESEMI171VE5 OF T1118 GOKINTY TO EHTEfi UPON 7ME S�. ABWE#IEMqNWPROPEHTYFORINSPEC7qNiURPOSES. 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H(�ND REAM �� ' - ------...._---._.._ ..--��� - -, _.. .- --------- - �-- --- ---- -- , - - FRAMINGNENTILIATION � ' '� FI�JR!, F3QNI7 RF.AM �. ��� � � -------- ---------a------ - - T_ __" _ '_'_"' '"'_ ' _"' ________"____"' __...___"__._._Y........"_ . ROOF COVER ; F'RE•GRADING --------------_---- ------------ �------- .. .__.._..-- - � -•- - ----- - - - --- --- ------ - - -. . .---.._..._..--:. -. -----�---...._ �- ---- - ---------�;.BENCHIh�C� � . ..- - - ---------------•- ------, - -�------.. . ,. ._ ... .... --- - - - -.._._ __.:_�.--- -- --.._._.._.__ _--- . ._.. ....- _, ROUGH ELECTRIC � , I � f30UC.�H GRADING �, „ -- - � ---•-• ---�--�_ . ---._.._.. ._......----...- -- , --- - ROUGH PLUM6ING ; ' � F'INISH GRADING• � ' y .. . .. -------..�.- - -------- --- ---�---- -- ---- ._.._.._........--�-- - -- - �-• --_-_-- -----•--.�_.___.___ ____.�___ --._..;..._.... SNOWERIfUE3 TEST _ ! I .� PDOL ELEGTFiIC i -- - �--------- EXT.LATH/SIDING � . 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SEPTIC TANK ; y ------ 1 - � '-- -------------------- ----- ---------...---- ----------- --� � �' ' l_ANDSCAPtlIRRIG. ,�----- ' ------ - -----------------�------- -� ----------- --------... ------- SEEP PIT/L.L. i � UN SITF: IMFG_ �--------i --- -�--- --; - --- --- _ __..__.._._.__.._..... - ---- ---- -- ----�- -- -- -- - -- -- --- GAS AIR TEST .- �. . . F1l�:AL 7_OfyiNG j � -- ------. _. ... -- ---- _._. . ..---�-- --._.,..----�--- - --- -- ------...---�--------.�._. .---- - -- ---- ....... ----- - s F1NAL CONST. �1f' - ' FIFtE UEFT. FIP.IAL � � , '- --�----------- - - -------..............�-- ---- ---..._._..-------....�- --= ------= -- --- ----- ------_-, s FINAL E ECTR C — -- -� ��. - ----- - -- ----.-_DEVLFE SEPAID LNAL.. ..•__.__ I. . - - .. ....- -' - - -- -- ----... _I �— --------�--�•-- --•----_._�__.�.-•-•---... . 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