HomeMy WebLinkAbout11212 �
— CITY OF DIAMOND BAR �
COMMUNITY DEVELOPMENT DEPARTMENT
.,,•C 21660 E.Copley Drive Suite 190 PRESS
(909)860-3195 Fax(909)861-3117
'""", BUILDING PERMITAPPLICATION FIRMLY
o� JOBSITE S ;' S APPLICA ION PERMIT P/C
ADDRESS pATE �2"�'3-' 9B NUMBER I!
� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GAOUP
p OWNER
LL ADDR SS �hQ y 20NING SETBACKS
� CITY�ra�Gior_� BtLr ZIP TEL. REART RW p
APPLICANT T�L. SIDE/SIOE STREET RW ❑
Q
a� CONTRACTOR i� SIDE G
� ADDR PROPOSED USE
� CITY C' S ZIP TEL S
o ARCH/ENG/
z DESIGNER �
w NO.DWEL. NO. " ' : •' 1 , NO. .
n. AD�RESS UNITS ` �' STORIES '� : ' •BEDROOMS
� CITY ZIP TEL.
�
u� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER•BL'ILDER DECLAFiATION SFRlADDlREM
O
1 HEREBY AFFIRA/UN�ER PENhLT'OF PERJURV TFUT I AM EXEMPT fROM THE CONTRACTORS LI- GefEQBJC9IPOR
W CENSELAWFOqT11EFOLI.OWINGREA50N(SEC.7031.5B1151NES5ANDPpOFES510N5GO�E:ANYCITYOR (J�
U COUN7VWHIGiREOUIpESAPERIAITTOCONSTHUCT,ALTER,IMPROVE,OEMOLISH,ORREPAIRA1Jy6TRUC- W P211o/OBCk
TUNE.PRIOfl TO ITS ISSUANCE.1LL50 REQUIFES THE APPLICANT FOR SUCH PERMIT TO FILE 0.SIGNEO
� S7ATEMENT 7HAT HE OR SHE IS 110ENSED PURSUANT 70 THE PpOVISIIXJS OF THE CON7RACTORS ll- W
� CENSEU�NfCHAVTERY�COMMENCINGWRHSECTION7000)OFOIYISIONJOFTFIEBU61NE55111IDPA0- � POOUSpB '
FESSIONSOOOE�ORTHAiNEOHSME�SEXEMP77HEREGfiOMANDTHE8A51SFORTHEALLE0E0IXEMP- (�
V TION.ANYVIOLATIONOFSECTION7D3I.SBYANYAPPLICANTFORAPERMiTSUBJEGTSTNEAPPLICANTTO Z Re-Roof
ACIVIL PENALTV OF NOT MORE TNAN FNE NUN�RED DOLURS(5600).�:
p ❑I.ASOWNEROFTFIEPHOVERTY.ORMYEMPIAYEESWITHWAGE5MSTHEIp50lECOMPENSATpN. 0 COr111170fC181
Z WILL DO THE WORK,AN�THE STRUCTUHE IS NOT IMENDE�OR OFFERED FOR SALE�SEC.70aC,BUSI- J
y NESS M1O PHOFESSIONS CODE:7}IE CONTRAGTOR5 LICENSE UW DOES NpT APPLY TO�N OVMNER OF �
PROPER7Y NMO BUIIDS OR IMPqOVES iHEHEON,AND NMOOOES 9UCN WORKNIMSEIFpRHERSELFOH
� THROVGHHISORNEROWNEM7lOY6ES,PROVIDEDTHATSUCHIMPROVEMENTSAPENOTINTENOEDOR m
QOFFEflEOFORSALEIF,HOWEVER,THEBUILDINGORIMPROVEMEMIS50lDWIiMINONEYEAROFCOMRE
Z TION,THE OWNER-BUILDER WILL MAVE THE BUHOEN OF PROYING THAT HE OR$HE 0�0 NOT BUILD pR
= IMPROVEFORTXEPURPOSEOF$l�LE�.
W ❑I.ASOWNEflOFTHEDROPEflTY,AME%GLUSIYELVCANTMCTINGWITHLICENSE�OONTRACTORS
� TO CONSTRUCT THE PROJECi(SEC.701�,BUSINESS AND PROFESSKKJS COOE:7ME CONTMCTpRS U- Y81118�1 -�- ADJ.AREA
W CENSEUWOOESNOTAPPLVTOANOWNEROfAPROPERIYWHOBUILOSORIMPHOVESTHEHEON.MN
� WNOCON7RRCTSFORSUCHDR0.IECTSWITHACONTMCTOR�S�UCENSE�PURSUANTTOTNECONTMG QUAfJTITY DE5CRIPTION FEE
Y TORS UGENSE LAWJ. �
� ❑I AM EXEMPT UNOER SEC. B.8 P.G FOF THIS HEASON Q
� U[[
u' D11TE OWNER F •
Z W
� LICENSED CONTRACTOFS pECLARqTION W
� I HERE9Yl4FFIRM IIfJ�ER PENALIV OF PERJUNY TFUT 1 AM LICENSEO UNDER PROVISIONS OF CMAPTER �
p_ i(COMMENCINGWIlHSECTION7000�OFDIVI510N30FTHEBUSME55lWDPHOFESSiONSCODE,ANO z
X MV LICENSE IS W FULL FORCEANO EFFECT. �
LLI p�
� LICENSE CLASS � LIC.NO. V j
�j DATE O Z�C��a'�9�_ CqP7TqpC70R '- �
W
� WORKERS'COMPENSATION DECUlRA710N �'j��'� �
./�
I NEREBYAFFIRM IINDER VENALTV OF PERJURY ONE OFTHE FOLLOWINO DEGLAR�T S:
� _IHAVEANOW�LLMAINTAINACEHTIFICATEOFCONSENTTOSELF-INSUREFORWORKEAS' _
Q COMPENSATION,�S PROYIDEO BY SECTION 57000FTHE LI�BOR CODH,FOR7HE PEHFORMANCE �U
O OFTHE WOfiH FOR WHIGiTHIS PERMIT 151SSUED. �
W _I HAYE AND WILL MAINTAIN WOFtKERS'WMPENSATpN INSURANCE.AS REOVIRED BY SECTION A /�
Q 87000F7HEUBORCOOE,FOHIHEPERFORMANCEOFTHEWORKfORWHICNTHI3VERMITIS �(,J�`
ISSUE�.MY WO/ryc/r�q5'WIUP SAT N INSl11UNG AFRIERANO PDLICYNl1MB flARE' CONSTRUCTION 6RlJ
� CARRIER �+ t' C �K C-• PLAN REVIEW _
Z vouCYNUMeER ELECTRIC
¢
� (IHISSECiIONNE�NDTBE00MPl.ET�CFiHEPERMfISPoNONEF0.R�URmOp.IARS im�oa PLUMBING
W
Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
C7 SMALLNOTEMPLOYMIYPERSONINANYMANNE SOA5T09ECOMES �JEfp TDTFIE
� IM�Po(ERS'COMPENSATIONLAWSOFCALIFOR ANOAGREETXATI H R7LDBECONE INSPECTIONFEE
SUBJEGTTOTHEWOflKERS'COMPENSATION YI&IONSOFSECT 3� OFTHEU160R �
OC�E.I SHAl1 FORTHWIIH COMPLV WITH :PROVISIONS. �SSUANCE
p DATE: e��3�SSAPPLICANT: � SMIP ��� ���
� WARNIN(1:FAILUflE TO SECURE YVORKEFS' SATION CAYERAOE I&UNUWFt1L.AND SXALL BE ENERGY P/C
�y SU&IECTAN EMPLOYER 70 CRIMINAL PENA PND CIVIL FINES UP TOONE NUNDREO TFi0U9AN0 ENERGY PERMIT
�OLLARS(f100.000�.INAD�ITIONTOTHEC FCOMVENSATION.DAMAGE5ASPROVIDEOFORIN
¢ SECTIONJ70BOF7HELABOHCODE.IN7E r,uao�rrow+ersFees. RETENTIONFEE: ��C� �
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� IHEREBYAFFl{iAIUNDERGENAITYOFPERJURVTHATTHENEISACONSTRUCTIONLENOWQAGENCV
FOq iHE PERFORMANCE OF THE WORN FOF WHICH THIS PERMIT IS ISSVED�SEC.�o9i,CIV.CJ.
Z
W
� LEN'JERSNAME
H' LENOERSAODRE55
w ICERTIFVTHA7IHAYEREADTNISAPPLICATIONANDSTATETH�TTHEABOVEINFORMATIONISCARflECi TOTAL FEES � ��
� IAGFEETOCOMPLYWITHALLCI7YANDCOUNTYOROINANCESAN�STATELAWSRELATINGTOBUILDING ,
� CONSTRUCiION,AND HEREBY AUTHONIZE REPflESENTATIVES OF THIS COUNTY 70 ENTER UPON THE
Z RBOVE�MENTIOIVEOPROPE FOHINSPECiIONPURPOSES. COMMENTS
0 � •
_
QPE EE NMIE ,INT� �y�� /� p
� �/' � �(�.t+f �"�V ._�CJ_='��ar/�� Y
N�TVFEO MITiEE ^ DATE �
� HECPT.NO. � 6�PAID BY VALIDATON
WHITE--0epartment Copy.YELLOW--Flnance Copy,PINK--Assesea Copy,GOLDENROD—File Copy,GREEN—ApplicenYs Copy
, ... .�. .��- . , • .. .. .- ., . ... . �. . .. . , „ ' �r '': ' � . . . .. .., '� , .. -, �i ., - - , , . � ' � �y � �
� CITY OF DfAMOND BAR '
INSPECTION RECORD
o � . • • - E � � . a .
SET BACK FLOOR J�IST �
FTGS/i=ORMS/STEEL FHA REQMTS
ELECTRiC GROUND UNDER FLOdR�UCT
GROUND PLUMBtNG , UNQER FLOOR CO�IDUIT t
SLAB GRRDE � FIREPLACE FOUNDATION '
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE ` ' - MID HT.BOND�BEAM ' '.
ROOF SHEATHING � 8 FT.BOND BEAM
FRAMING _ _ � � FINAL BOND BEAM
ROOF COVER PRE-GRA�ING
ROUGH HEATING BENCHING
RQUGH ELECTRIC � ROUGH GRADING
ROUGH PUiMB11�tG` ' FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
E?CT.LATN/SIDING PO�L FENCING
WALL INSULATIQN I POOL FINAL
CEILING INSULATION � � OFF SITE IMPS.
DRYWALL NAILING ' DEDICATIONS
SEWER ' � , FINAL ENG.
SEPTIC TANK , � I LANDSCAPEJIRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZOiVING
FINAL CONST. � I � FtRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINA�
FINRL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY �
� ..� , � +
• s s . .
COMMENTS �
. � ��'� ,. �,� • , ,.. .�
• , �, . . ; ,
Y� ,
SEPTIC TANK SIZE
SEEP PIT/U SIZE
i
I �
. �`
t