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HomeMy WebLinkAbout10-1196 ��� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702'7 PRESS �'9�'� BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE �( ' APPLICATI PERMIT � p/C ADDRESSX I`I DATE �I a /i o NUMBER��� #�'Z(p-- (1q(p ISSUE TYPE J OCC � APN LOT TRACT DATE 3 CONSL i` p OWNER C i�Vl r �" � GROUP p ADDRESS ZONING SETBACKS Q CITY Z{P TEL. REART RW ❑ � APPLICANT �I TEL. y�-+ '"-( ❑ SIDEJSIDE STREET RW O � CONTRACTO PX' pv�cA/' SIDE p Q CDDR SS � PROPOSED USE �C7 l� ��Sf" CQ�,'� ZIP TEL.�/��?Ss.a1 w ARC ENG/ ,1 �_ � ,, �z DESIGNERX VG��� i>� NO.DWEL. } Lp. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS' ' � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HER�V AFFlRM UNDER PENALTY OF PERNRV THAT I AM EXEMPT FROM THE CANTRACTORS lb Gaffl B/C8 R W CENSE UW FORTHE FOLIOWINO REASON(SEC.7031.5 BUSINESSAND PROFESSIONS CADE:ANV CITV OR (n 9 � U �p(JpJn'WHICHRC-0UIRESAPEFMITTOCONSTRUCT,ALTER.IM7HOVE.DEMOLISH,ORREPAIRANVSTRUC- w w TURE.PRIOR TO RS ISSUANCE,AL50 RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W P8�10/DBCk . � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � POOUSPB FESSIONS CODE)OR T}IN7 HE OR SHE IS EXEMPT 7HEREFROM AND T1iE BASIS FOR 7ME ALLEOED E%EMP- (� TION.ANY VqLAT10N OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE AVPLICANT TO Z Re-Roof A CML PENALTV OF NOT AqRE THAN FIVE HUNDFED DOLLARS(5500)J: � OI.ASOWNEROF7HEPROPERTV,ORMVEM7LOVEESWITMWAGESASTHEIRSOLECOMPENSA710N, � CommBrCl81 Z VIILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7061,BU51� �J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERiY 1N10 BUILDS OH IMPROVES THERE-0N,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROU(iH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m 0 OFFEREDFORSALEIF,VqWEVER71'1EBUILDINGORIMPROVEMENTISSOLDWfTHINONEVEAROFCOMPLE� Z TION,THE OWNER-BUILDER WILL HAVE TME BUROEN OF PROVWO THAT HE OR SHE DID NOT BUIID OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERTV,AMEXQUSIVELVCANTRACTINOWITHLICENSEDCONTRACTOR3 Q 70 CONSTRUC77HE PRQIEC7(SEC.7oU,BUSINESS AND PROFESSIONS CODE:THE CONTMCTOqs U- VBIUBtlOf1 ADJ.qREA W CENSE LAW DOES NOT APPIV TO AN ONMER OF A PROPERTV WHO BUILOS OR IMPROVES THEREON,AND � � NTIOCONTRACTSf-0RSUCHPROJECTSWITHACONTMCTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION roasucENseuw.�. FEE - � ❑I AM EXEMPT UNDER SEC. B,8 G.C.FOR THIS REASON � r Q ` � � � S u � DA7E OWNER ¢ .7 � LICENSED CONTFACTORS DECLARATION W � 0� ¢ J�C� 2 I HEREBY AFFI{iM UNDER PENALTY Of PERJURV TNAT I AM LICENSED UNDEF PFOVISIONS OF CHAPTER � u � G(COMMENCING N7TH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z ' LLJ uY�ICENSE IS W FULL FORCE AND EFFECT. m � LICENSE CLASS LIC.NO. � V DATE CONTRACTOR d �' W � WORKERS'COMPENSATION DECLARATION � . � U � I HEREBY AFFIRAI UNDER PENALTV OF PERIURY ONE OF THE FOLLOWING DECLARATIONS: Z . � _IHAVEANDWI�LMAWTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' a 2 � C0IAPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CADE.FOR THE PERFORMMICE U OF THE WORK FOF WHICH THIS PERMIT IS ISSUED. W � � w ,//-.��TM,��AVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BV SECTqN Q V 3700 OF THE I.�BOF CODE,FOR hIE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS . ISSUED.MV WORKERS'COM E ATION IN C RRIER AND P LICV NU ER ARE: CONSTRUCTION jCAARIER PLAN REVIEVJ _I�"7. 3� 0 POLICVNUMBER ��TIS✓ Zd ELEC RIC 0 (rrnssecrqrir�E�rio7BEooewtrEooFnfrpEw,vrsroqoriEr+ix�oDauas�stm)oqLEss} PLUMBING . w Z I CERTIFY THAT W THE PERFOFiMANCE OF THE WOH7(FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL CS SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO B ME SU CT TO THE � (J� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND A R HAT IF I ULD BECOME INSPECTION FEE � SU&IECTTOTHEWORKERS'COMPENSATI PROVI510 F ECTIO OFTHELABOR � O CODE.I SHALL FORTHWITH COMPIV Wl HOSE PRO IS ANC � p DATE:__��1� APPLICANT: SMIP w ENERGY P/C J WAANINO:FAIL qE TO SECUFE WORKERS'COMP SATION CAVERAGE IS 11NLAWFUL,ANO SHALL BE � SU&IECTAN EMPIOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED T/iOUSAND ENERGY PERMIT ' DOILARS(5100,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAOES AS PROVIDED WR IN J SECTION 37oB OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. .; �7'\ w RETENTION FEE: pc U O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 NEREBV AFFI{U/UNDEF PENALTY OF PERJURY THATTHERE IS ACONSTRUCTION LENDINO AOENCY � FOR THE PERFOFMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDEF'S NAME � LENDER'SADDRE55 1 w I CERTIFV THAT I HAVE READ THIS MPLICATION AND STATE THAT 7HE ABOVE INFORMATIOfJ IS CARRECL TOTAL FE ES I��• J� � I AaREE TO COMPLV WITH ALL CRV AND CAUNTV ORDINMlCES AND STATE UWS REUTINO TO BUILDINO C.�(,��dl CONSTRUCTION,AND HEREBV AUTHORRE REPRESENTATNES OFTHIS CWNTV TO EN7ER UPON THE � � � ABOVE EMIONED PROPERTV FOR INSPECTION URPOSES. Z 0 COMMENTS � J � � � m PERMI E AME(PRINn ' � Q "-' PIc - a 3�i-11 � SI�NAN OF DAT � RECPT.NO. PAID BY � VALIDATION WHITE-0epaAment Copy,YELLOW—Finence Copy,PINK—Assessar Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITV O� DI�,Ni06�D �AR I(�S��CY80�1 R�COIRD �= '�a�p�c�400a �c��A:�,. ,�a�Q�c��a . oa��c��ooa ,_= o �4r�� :t Dt����c�'ar �. SET BACK ' FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC L DEV. FEES PAID FINAL PLUMBING ENERGY �,�� COMMEiVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � n � � ,