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HomeMy WebLinkAbout14421 � ��� . . - CITY OF DIAMOND BAR �� '4 � ' � � COMMUNITY DEVELOPMENT DEPARTMENT 21660 E.Copley Drive Suite l90 PR ESS � (909)860-3195 Fax(909)861•31I7 '""' BUILDING PERMIT APPLICATIO FIRMLY o� J08SITE f �� ', /�t,�i/ h PPLICATION 'Z-!���� PERMIT I P/C ADDRESS 1 � "�" DATE ( NUMBER k � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER p ADDRESS ZONING SETBACKS � CITY ZIP TEL. REART RW j APPLICANT TEL. SI�E/SIDE STREET RW Cl � CONTRACTOR SI�E C � A�DR - � PROPOSED USE � CITY �Tils'�ZIP ^ TEL. oARCWENG! � DESIGNER ADDRESS NO.DWEL. NO. NO. UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BI:ILDER DECLARATION SFFVAD�/REM O I NEREBY AFFIRM UNDER PENFLTY OF PERJUHY 7HAT I AM EXEMPT FROM THE GONTR0.CTOR5 41- Gef89BJC8�0A �W CENSELAWFORTHEFOLLOWINGREASON�SEC.7031.6BUSINESSANDPROFESSIONSCOOE:ANVCITVpR (f� U COUryryWHICHREQV�RESAPERMITTOCONSTRUCT,RITER,IMPROYE.OEMDUSH,ORREPAIRANYSTRUC- W {�ailOIDOCit � lURE,PRIOR TO RS ISSUANCE,ALSO REQUIFES THE APPLICAM FOR SUCH PERMIT TO FILE R SIGNED w STIITEMENT TMAT ME OR 6HE IS LICENSEO PURSUANT TO THE VNOVISIONS OF THE CONTflAC70RS ll- W � CENSE LAW(CHAPTER B�COMMENqNa WITH SEGTION Tooa)Of�IVISION!OF THE BUSINE55 AND PRO� LL' POOUSpfl FESSIDNSCODE�DRTHATHEORSHEISEXEMP7iNEREFflOMAN0THE6A515FOflTHEALLEOE'JEXEMP- (J TION.MIYVqLATIONOFSECTION7071.5BYANYA�PLICAMFOHAPERMITSUBJECTSTHEAOPI,ICANTib Z Re-Roof r A CIVIL PEN�LTV OF NOT MORE 7HAN fIVE HUNDRED DOLLARS�l500).�: _ � ❑I,ASOWNEROFTNEPHOPERTY.OHMVEMPLOYEE5YVITHWAGESASTHEIFSOLECOMVENSATION, � COrtImBlCIaI WILL DO THE WORK,AND THE STqUCTURE IS NOT INTENDED OR OFFEHEO FOH SALE(SEC.70M,BUSI- J � NESS AND PROFESSIONS CO�E.TME COMiRACTOR3 LICENSE ll.W DOES NOT APPLY TO AN OWN[R OF j iROPER7Y YAfO BUIL0.S OR IMPROVES THEHEON.AND WI10 OOES SUCH WORK HIIASELF OR HEHSELF OR � THRWGHHISORHEFlOWNEMPLOYEES,PROVIOEDTHATSUCHIMPROVEMENTSARENOTMTENDE[)OR m QOFFEREOFORSALEIF,NOWEYEF,7NE6UlDINGORIMPROVEMENTIS30LD'MTHINONEVEAqOFCOMPLE- y TpN,TNE OWNER-BUILDER WILL NAVE THE BURDEN OF PROVING THAT HE OH SME OIU NOT BUIID OR � IMPROVEFORTHEPURPOSEOFSlLLE�. w ❑I,ASOWNEROFTFIEPROPEHTY�AAIEX0.USIVELYCONTMCTWOWITHLICENSEOCONTMCTORS � TO CONSTRUCT THE OROJECT(SEC.7010.BUSINESS AN�PFOfESSIONS CODE:TME CONTRACTORS ll• V91U8�IDr1 � ADJ.AREA � CENSEUWDOESNOTAPPLYTOANOWNEROFAPHOPERTYWFIOBIlILD50RMIPROVESTHEREON,ANO NM1IOCANTMCTSPoRSUCHPROJECTSWITHACONTRNCTOR(S)LICENSFDPURSl1AN7iOTHEOONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � O 1 AM E%EMPT UNDER SEC. B.6 P.G FOR TNIS REASON q � U LL � DATE OWNER U Z W � IICENSED CANTRACTORS DECLARA710N W � 1 HEHEBY AFFIRM UNDEH PENALTV OF PERIURV TH�T I AM LICENSE�UNDEF PROVISIONS OF CHAPTER � � Y(COMMENCING WITH SECTION 7000)OF DINSION 9 0F THE BUSINESS AND VROFESSIONS CO�E,AND Z . �� MY UCENSE IS IN FUL�FOR AND E T. m LICENSE CLA , LIC.NO. ��9 a� � �,_ J v oare � 7 corrraaclo = W ��� WORKERS'CAMPENSATION DECLARATION I� a � I MEREBYAFFlIIM UNOER PENALTY OF PERJURY ONE OFTNE FOLLAWINQ DECURATqNS: Z � _IHAVEANDWILLMAINTAINACERi1FICATEOFCON9ENTTOSELF-INSUFEFORWORKERS' _ Q COMPENSATqN.AS PPOVIDED BV SECTION 970o OF THE LABOR CODE.FOR THE PERFORMANCE 1U O OFTHE WORK FOR WHICH TMIS PERMIT IS ISSUED. � � _I HAYE AND WILLMAINTRIN WORKERS'COIAPENSATION INSURANCE,AS REOUIREO BY SECTpN � 97000F THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS VERMIT IS J ISSUED.MY WORKERS'CqM�P N�SA[TION IN 1R9NCE CAPRIER AND POUCV NUMBERARE CONSTRUCTION � CARRIER V - / PLAN REVIEW z POIICV NUMBER ELECTRIC Q w (MISSECTqNNEmNOTBEWMREiEDOFhEPERhYfI3FORONEHU�ORED0011IA5�i1aDlpRlE55� PLUMBING � Z I CERTIFVTHNT W hiE FERFORMANCE Of iNE NY1RK FOH WH�CH THIS PERMIT IS ISSl1EU,I MECHANICAL (7 SHN.LNOTEMPLOYANYPERSONINANYMANNEHSOA5T08ECOMES�bJECTTOTHE � V/ORKERS'COMPENSA710N LAWS OF CAI.IFORNIA,ANDAGREE THAT I SHOV�D BECOME INSPECTION FEE '��' _ �- SU&1ECT TO THE WORKERS'COMPENSATqN PROVI510 F SEC�TION Oi THE IA90R ;O/pE�,JJ�HAJLL FOR7HWITH WMPLY WIhITHOSE PRO �IONS. ISSUANCE 1p DATE:(� APPLICANT: I SMIP � WARNINQ:FAIWRETOSECUHENlORKERS'COMPENSATIONCOVERAQEISUNIAWFUI.ANDSH�LLBE ENERGYP/C � LL SUBJECTANEMPLOYERTOCRIIAINALPENALTIESANDCIVILFINESU7TOONENUNOREDiHOU3ANU ENERGYPERMIT D� DOLURS�5100.000),IN/V�DITION TO THE C0.ST OF COMPENSATION,DAMAGES AS PROVIDE�FOR IN � SECTION370lOFTHELABORCODE,IMEREST,ANOATTOHNEI"SFEES. RETENTION�� , O CONSTRIICTION LENDING AGENCY pRE-ALT FE�U�Tn R L7iir�J�ETY � 1 NEflEBYAFFIqM UNDEFl PENAL7Y OF PERIUFY THAT TMERE IS A GONSTRUCTION LENOING AGENCY FOR iHE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSIJED�SEC.3097.CIY CJ Z W � LENDER'S NAME 1— �ENDEWSADORESS � TOTAL FEES ¢ I CERTIFY THAT I HRVE READ THIS APPLICRTION AN�STATE THAT T17E ABOVE INFORMATqN IS CONREGT W I A6R C041PLV WITNALL C�TY AND COUNTY OROIYANCESllNO STATE UWS REUTINC TO 9UILDING � CON RU TION,ANO HEREBV AUTHORIZE REFH ENTATIVES OF THIS COUNTY TO EN7ER UPON THE ZABOV�ME;TpNEOPpOPEflTYFORINSPECTION POSES. �� S � CAMMEfYTS � J � � m P All �E E(ORINT � � � � SIGNATUR VFRMITfEE ATE � RECPT.NO._ PAID BY _VALI�ATION �� WHITE—Department Copy,YEk.LOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy . . . ��� �� . .. . . . . . . � CITY O� DIAMOND Br4R „ , _ �_ It�tSPECTION RECORD • � � + • � ' ' E E 4 �`�;�,� � . .,..� � SET BACK � � �LOOR JOIST � FTGS/FORMS/STEEL �� FHA REQMTS i ~ ^ ELECTRIC GROUND UNDER F1.00R DUCTi Y GROUND PLUMSING UNQER FLOOR CU�IDUIT � ,� SLAB GRADE � _ FIREPLACE FOUNDATI�N � _`��_ TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ^ ROaF SNEATHING 8 FT. BOND BEAM FRAMING/VENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING � ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING � ROUGN PLUM8ING ; FIN15H GRAOING � SHOWERlfUB TEST POOL ELECTRIC � EXT. LATH/SIDING ! POOL FENCING � � WALL INSULATION ' POUL FINAL ` CEILING INSULATION OFF SITE IMPS. ! DRYWALL NAILING � , � �EDICATIONS � ^ SEWER � ; FINAL ENG. i i� SEPTIC TANK LANDSCAPEIIRRIG. J SEEP PIT/L.L. � ON SITE IMPS. , � ^' GAS AIR TEST ' � FINAL ZONING ` FINA�COfVST. • FIRE DEPT. FINAL ^ � FINAL HEATING I � NEALTH DEPT. FINAL m FINAL ELECTRIG � DEV. FEES PAID � � FINAL PLUMBING ENERGY II --------..�------�- � M � ---- --•-- COMMENTS SEPTIC TANK SIZE T SEEP PIT/U SIZE ---- i---- -T----- ----- �;��'i g 'l � ----- --- -- __._._ , ,�