HomeMy WebLinkAbout17981 (32) CTI'1'OF DIAMOND BAR
^----��` — DEPARTIvIENT OF COMMUNTI'1'&DEVELOPMENT SERVICES �' �
21825 E.Copley Drive !
(909)860-3195 Faac(909)861-3117 PRESS I
�'-�" BUILDING PERNIIT APPLICATION FIRMLY �
o� JOBSITE \G.]��1, C E APPLICATION 5�9�02 PERMIT �798� P/C
ADDRESS I�fCJ✓ V DATE NUMBER ti
� ISSUE TYPE OCC
APN L TRA T DATE CONST. GROUP
p OWNER
p ADDRESS ZONING SETBACKS
z CITY ZIP L.
FRONT qyy p
� APPLICAN TEL. REAR p
� SIDE/SIDE STREET RW ❑
� CONTRACTOR 4PPLIANCE IN " SIDE ❑
ADDRESS ' �-
� CITY Z�p�ke PROPOSED USE
o ARCH/ENG/ (562)986=551�—
�z DESIGNER C36#5942�2 NO.DWEL. NO. NO.
� ADDRESS
� CITY ZIP TEL. UNITS STORIES BEDROOMS
cr�
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
�
I HEREBV AFFlRM UNDER PENALTV OF PEqJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G9f8ge/C8fP011
W CENSELAWFORTHEFOLLOWINOREASON(SEC.7031.5BUSINE55ANDPROFESSIONSCODE:ANVCITVOF (n
U �pUNTyWH�CF{qEOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLI$H2ORREPAIRANYSTRUG W
w NRE.PRIOR TO ITS ISSUANCE,AL50 RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FlLE A SI(3NED w P8�I0/DBCK
� STATEMENT THAT HE OR SHE IS LICENSED W RSUANT TO THE VROVISIONS OF iHE CONTMCTORS Ll�
� CENSE LAW(p1MTER B(CAMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSPB
Q FESSIONS CA�E)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALLEOED E%EMP� (�
V TKKJ.ANV VIOlAT10N OF SECTION 7031.6 BV ANY APPLICANT FOR A PERMIT SU&lECTS hIE APPLICANT T0 Z Re-Roaf
A CIVIL PENAITY OF NOT MORE THAN FNE HUNDRED DOLURS(f500�J:
� ❑I,ASOWNEROFTHEPROPERTV,ORMVEM7LOVEESWITHWAGESASTHEIRSOLECOMPENSATqN, 0 COrt1rtIBfC18I
Z WILL DO THE WORK,AND THE STRUCTUHE IS NOT INTENDED OR OFFERED FOR SALE(SEC.704t,BUSI- J
� NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF �
PROPERTY HRiO BUILDS OR IMPHOVES THEREON,!W D WHO DOES SUCN WORK HIMSELF OR HERSELF OR
wTHROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPqOVEMEMS ARE NOT INTENDED OR m
� OFFEREDFORSPLEIF,HOWEVER71iEBUILDINGORIMPROVEMENTI550LDWfTNINONEVEAROFCOMPLE-
Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR
� IMPROVE FOR THE PURP0.SE OF 5/�LE).
w ❑I.AS OWNER OF THE PROPEHTY,AM E%CLUSIVELV CONTRACTINQ WITH LICENSED CONTRACTOqS
[= TO CONSTRUCT THE PR0.IECT(SEC.7Ma,BUSMESS AND PROFESSIONS CODE:THE COMRACTORS LI- VBIUetlOfl ADJ.AREA
W CENSELAWDOESNOTAPPLVTOANpWNEROFAPROPERTVWFpBUILD50RIMPROVESTHEREON,AND '
� N41000NTRACTSFORSUCHPRQIECTSWI7HACONTqACTOR(S)LICENSEDPURSUANTTOTHECONTqAG QUANTITY DESCRIPTION
Y 70RS LICENSE LAW.). FEE
0 ❑I AM E%EMPT UNDER SEC. B.d P.C.FOR THIS REASON Q
� U
LL DATE OWNER �
Z U
� LICENSED CONTRACTORS DECLARATION w
� I HEREBV AFFIRM UNDER PENALTV OF P L{rytl�yy{ 1� �q�'IqpyyAF CHAPTER
X MV�CE SE IS N F�'ULL FOFCENAND EFFE��n��Fj(J�$�•"OFESSKKJS CODE,AND �
Z
� LICENSE CLASS L.��e ood,CA. 90712 • ?
V DATE CO� p p d ,
w R�OYGUL
� WORKERS'COMPENSATION DECLARATION �
� I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWINO DECLARATIONS: V
� Z
� I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSUqE FOR WORKERS' a '
� COMPENSATION,AS PROVIDED BY SECTION��00 OF THE LABOR CODE,FOR 7HE PERFORMANCE U
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W
� �
Qw I HAVE AND WILL MAMTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTKKJ
3700 OF 7HE R CODE,FO THE PERF RMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED.MY S' AT I URANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION
J
j CARRIER PLAN REVIEW
Z POLICY NUMBER ELECTRIC
Q
� (nissEcitaar��r�o78Eeor.�E7moFn�rEanai�sFoaorrEix�ror�Eooalntis�siro�oa�ss�. PLUMBING
w
Z I CERTIFV THAT IN THE PERFORIAANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL �
�}' SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO OECAME SU&IECT TO THE
(/� WORKERS'COMPENSATIONUWSOFCALIFORNIqANDAOREETHATIFISHWLOBECAME INSPECTIONFEE
= SUBJECTTO THE WORKERS'COMPENSATION PROVI IONS OF ECTION 3700 F THE LABOR
��COMPLVWI�rHps; vis P �_W�� ISSUANCE
p DATE: PLICANT. wi� \.� SMtP
w
J WARNINO:FPJLURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C
J
�y SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT
DOIURS(f 1 a0,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
J SECTION 3]oe OF 7HE UBOR CODE,INTEREST,AND ATTORNEI"5 FEES.
OC RETENTION FEE:
w
� CONSTRUCTION LENDING AGENCY PRE•ALT FEE:
� I HEREBV AFFIRM UN�ER PENALTV OF PERIURV TiATTHERE IS ACONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED(SEC.�oe7,CIV.C.�.
Z
W
� IENDER'S NAME
F— LENDER'SADDFESS
w ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFOFMATIONISCARRECT. TOTAL FEES ��{\�
d I AGREE TO COMPLV WITH ALL CITV AND CAUNTV ORDINANCES AND STATE UWS REIATINO TO BUILDING ��(��,�'V
� CONST�,tUCTION,AND HEFEBY AUTHORIZE REPR SENTATIVES OF h115 CWN7V TO ENTER UPON THE
Z VE�MENT NED P ERTV F S TI�PURPoSES. COMMENTS
�
J
�
m �ER AME R T)
� ��
� 5 NATUREOFPER ITTEE A7E
� RECPT.NO. PAIDBY 944R VALIDATION CC
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy
tCO�'�( �� �6��lil�il9� I��f�
9��L�[�C��'��R�l ����P��
° `O�C� DD GJ�i � � � a 4 . ° �.C�� a . . o ��` " f�� o = �
SET BACK FLOC)R JOISl" I
FTGS/FORMS/STEEL FHA REQMTS T—
ELECTRIC GROUND UND�R FLOOR DUCT
GROVND PLUMBWG UNDER FLOOR CU�IDUIT
SLAB GRADE FIREPLACE FOUNDATION
TE.MP POWER _^ FIREPLACE.�[JN��SEAM
WATER SERVICE ___ MiD HT. BOND:'E�EAM'-� �
ROOF SHEATHING 8 Ff. BOND BEAM ' � • •��.•,.�.
FRAMIfVGNENTILIATION FINAL BOND BEANI ��-� �
ROOF COVER PRE-GRADING ��
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING4
ROtJGH PLUNIBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDIIVG POOL FENCING
WALL INSULATIO�J POOL FINAL ��
CEILING IIVSU�ATION � QFF SITE IMPS.
DRYWALL NAIUNG DEDICATIONS
SEWER FfNAL ENG.
SEPTIC TANK tANDSCAPE/IRRIC,.
SEEP PIT/LL ON SlTE IMPS. )
C,AS AIR TEST FlNAL ZONING
FINAL CONST. , FIRE DEPT. FINAL
FItVAL HEATING HEAL H DEPT. F{NAL
FINAL ELECTRIC / � ' EES PAID
FINAL PLUMBING , I'71 b�. c �` v,_, 'u',: .i,: ,;r,:_ � . ---
c �' ,,�, ., ,
���o��_� ���a�'. � -• �
CQ���N�S
. ,
SEPTIC TANK SIZE
SEEP PIT/U SIZE - --
� � � � �
. , " � �
I � ° . . �
� �i � --