HomeMy WebLinkAbout12-1707 , ��_ CITY OF DIAMOND BAR � ✓
� DEPARTMENT OF COMMU1vITY&DEVELOPMENT SERVICES
21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Notline(909)839-7027 PRESS
��''^', BUILDING PERMIT APPLICATLON FIRMLY
y JOBSITE ¢ APPLICATION PERMIT �J I J�
o ADDRESS��I'a'�6 cl�LV�N G�N �� _ DATE ( Z I Z NUMBERIv�4'��/�#/C
T° APN LOT TRACT DA EE �� TMPE�Y�� �C
CONST.� GROUP
p OWNER
p ADDRESS ZONING SETBACKS
Z CITY ZIP TEL. FRONT Ri/y �
� APPLICANT TEL. REAR p
QSIDE/SIDE STREET qVy p
� CONTRACTOR 7� I � SIDE p
ADDRESS
� CITY ZIP � TEL tt'L� PROPOSED USE
w ARC NG/ �� q G P
z DESIGNER
w NO.DWEL. NO. NO.
a ADDRESS
� CITY ZIP TEL UNITS STORIES BEDROOMS
�
N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNEA-BUILDER DECLARATION SFR/ADD/REM
O
0
i tieaeev nc�ciroa w+o�ver+Kn oc a�war Twv i u,��c�aaT Faou rne cor�rtw�croas u• Garage/Carport
W CENSEUWFORTHEFOILOWWOREASON(SEC.7W1.59USPIESSANDPROFESSIONSCODEANVCITVOR (n
U COUNTYNRI1Ci1RE0UIRE5APERM777000N3TRUCT,ALTERDAPROVE.DEMOLISH,ORREPAIRANY97RUG W P8t10/DBCk
�� NRE,Pq10R TO RS iSSUANGE,ALSO REWIqES THE APPLICANT FOR SUCH PERMIT TO FlLE A 516NED W
� STATEMFM 7HAT HE OR SHE IS LICENSED PURSUANT TO hIE PROVISIONS OF THE CONTAACTORS lF
CENSE UW(CHAPTER Y(COMMENCWO WfTH SECTION 7000)OF DMSION�OF TME qU5WE55 M1D PRO� � POOUSPe
Q fESSlONS COOE�OR 7T1A7 HE OR SHE IS EXEMPT TTIERFFROM AND THE BA515 FOR THE ALLE6ED EXEAIP- C7
V TION.ANYVIOLATIONOFSECTION7031.68YANVAPPLICANTfppAPERMITSU&IECTSTHEAPPLICANTTO . Z RB-ROOI
� A CML PENALTY OF NOT MOFE THNI FIVE NUNDRED OOILAHS(fSooJ.J: .
❑�,A40WNEROFTHEPROPERT/,ORMVEIAPLOYEESWfTHf4AGE5A$THEIRSOLECOMPENSATION, � Commeroial
Z N7LL 00 THE WORI(AND THE STRUC7URE IS NOT IMENDED Oq OFFEAED FOR SPLE(SEC.�ou,BUSL _1 '
� NE55 AND GROFESSIONS CODE:il1E CON7RAC70R5 LICENSE LAw DOES NO7 A7PLY TO Ml OWNER OF �
PqOPEHTY NhiO W IL0.4 OR IMPROVE9 THEREON.ANO WHO DOES SUq11MORK HIMSELF OH HERSELF OR
w THROU6HHISORHEROWNEMPLOYEES.PROVIDED7HATSUCi11MPROVEMENTSARENOTW(ENDEDOR m
Q OFFEAmPDRSALEIF,HOWEVERTNEBULDPlOORYAPROVEMENT1950lDWfTT9Np11EVEAROFCONV�E-
TION.7HE OWNER-BULLDER N1LL HAVE TiE BURDEN OF PROVPJ�THAT HE OR SHE DID NOT BUILD OR
� IMPROVE FOR THE PURPOSE OF S�LE}
W �4��MINEROFhiEPROPEHTV,AME%CLU6NELYCANTMCTIN�WRHIICENSEDCONTRACTORS
� TD CONSfRUCT THE PRQIECT(SEC.70L1,BUSiNE55 AND PROFESSIONS CODE:7TIE CONTMC70R3 LI- V81UatI0I1 - /{�,J.qq�
W CENSE UW DOE9 NO7MPLY 70AN OWNEA OFA PROPERTV NM11D&10.DS OR IMPROVES THEREON,AND � ,
� M�iOCONTRACT5FOR5UCJ/%1WECf5WfTHACONTMCTOR(SJLICENSEDWqSUAHiTOTHECONTMG Q�J/UfT�r( DESCRIPTION ��
x Toris uc�sE uw.�. , FEE
� ❑I AY D(EMPT UNpER SEC. 6.8 7.C.FOR THIS REASON Q .
� U
LL DATE _ ONMER ' f-
Z " U
� . LICENSED CONTRACTORS DECLAAATION � ' � � � w �
� 1 HEREBY AFFIRM UNDER VENAL7Y OF PERRIRY THAT IAM LICENSED UNDEA PROVISIONS OF CNAPTER �
d Y(COAMENGNO H7TH SECTION 7000)OF DMSION]OF 7HE BUS�NESS M10 PROFESSIONS CODE,AND Z
X �IY LICENSE IS W FULL FORCE AND EFFECL m
LLI r�/ ,y�p�
� UCENSE C S ✓�+Z TO IIC.NO. ��y� �
v on� � � CONTRACTOR '�"1 InJ �o�l NG a
w . .
� WORKEAS'COMPENSATION DECLARATION � �
� I HER�Y�FFIRid lR1DER PENAL7Y OF VERAIHY ONE OF THE FOIIOWINO DECIAFATIONS: �
� Z
� _I HAVE AHD WILL MAINfAW A CEATIFICATE OF CONSEM TO SELF�INSUqE FOR NOqI(Eq$' a
'� COMPENSATION,AS PROVIDm BY SECTION 3700 OF 7NE UBOR CODE,FOR THE PERPotiMANCE U�
OF THE WORK FOR NM1iIC}i THIS PERMIT 19 ISSUED. W
� �
Qw �i HAVE AND WILL MAWTAIN VlORKEAS'COIAPENSATION fNSURANCE,AS qEOUIpED BV SECTION /.��/�
�7000F 7HE LABOA CODE,FOR 7HE PERFORMANCE oF T1E WORK FOR WHK]i THIS PERAIIT IS �//�-7• GJ�
�SSUFD.MY WOPoCERS'COYPENSATION INSURANCE CAARIER AND POLICV NUMBEA ARE CONSTRLICTION /� /L
> ��� PLAN REVIEW
� POIIGY NUNBER
Zd ELECTFiIC
0 (nassEcr�aur�wreEarftFrIDaFn+eaEw.TrsraAa��oauas�s�mlaa�,ss� PLUMBING
w
Z �CERTIFY THA7 W h1E PERFORMANCE OF THE WORK FOR WHICH THIS 7ERAtlT IS 455VED.1 MECHANICAL • �
C�S SWLLL NOT EAIPLOV M7Y PEHSON IN ANY NMINER SOAS TO BECOME SU&IECT T07HE
(n WORKERS'COMVENSATqNUW30FCALIFORNI/�ANDAGqEETHATIFISHOVLOOECOME INSPECTIONFEE �
SUBJECT TO THE WORICERS'COMVEN9A7qN PROVISIONS OF SECTION]700 OF THE UBOfl
S co�oe.i s wmrMnn�coua�v Nnnr n+osE aaohsar+s. ISSUANCE
� �, pZ�2 —rvc�►� c,�
p DA1E APPIICANE . �SMIP O
� WARNWO:FALURETOSEWREWORKER5COAIPENSATIONCOVEMGEISUNUWFUL,MIDSHAL�BE ENERGYP/C �
� SUBJECTAN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TOONE HUNDRED 7YpU5AND �ERGY PEFiMIT
D�ILAHS(2100,000�W PDDI710N TO THE COST OF COMPENSRTqN,DMIAGES AS PROVIDED FOR IN
J SEC710N 370!OF 7HE�ABOR COOE,IMEREST,AND ATTORNEYS FEES. � �
w RETENTION FEE: .(,
O CONSTRUCTION LENOING AGENCY PRE-ALT FEE
� I HER�Y AFFlRM UNDER PENALTY OF PERh1RY THAT THERE IS A CANSTRUCTION LENDPI6 AGENCY `�� � �
Z FOR THE PERFORMANCE OF 7HE M10FK WR WHICH 7HI5 PEqMR IS ISSUED(SEC.7oW.CIV.G� v✓�. ' , . .
W
� .�ENDEHSNAME .
F— LENDERSAODRE55
� ICERTIFY7HATIHAVEREADTHISMPIICATIONANDSTATETiATTHEA80VEINFOiUfAT10N19CORFIECT. TOTAL FEES � . ��(.,�(,l Z.
� IAGREE TO COMPLV M7TH ALL GTY AND COUNTY ORDWANCES AND STATE LAWS RELATA�O TO BUILDIN(3
� CONSTRUCTION,AND HEREBV AUTHO{i1ZE qEPRESENTATNES OF THIS COUNTY TO ENfER UPON THE ' . . �
Z IBOVE-MEMIONED PROFERTY FOR INSPECTION 7URP0.5E5. COMMENTS �
0 r
J � �
�
� Q PFAMI7T lP �� ^'Z /� �
tq i l: I
' •�'f
� SIGNA7UREOF E fTTE DATE
� RECPT.NO. AID B VALIDATION
WHITE—OepaAment Copy,YELLOW--Finarae Copy,PINK—Assessor Copy,GO ENROa–Fi Copy,GREEI�ApplicanYs Copy
���� �� [?a,�6�OIV€77 ��� �
�i��&���TIC�h'� �E��3��r
. . <
a�i�`' � � � I� � ` 4��;� •� t,� � ' � � �, g , p �
__, ��.. �.,�,. � _ :��ti �_.
,:,. , ,, � • � . ,. � � ' _`� .-
SETB;�CK � rL00RJ01ST _____ _
FTGS/FOR�15/STEEL FHA REQNlTS __ ___ _ ____
ELECl-P,IC GRGUPJL7 � UNDER FLOOR DUCT
GROUND FLUibiBING � r UNDER FLOOR CONDUIT
SLAB GRADE � FIREPLACE FOUNDATI01�!
TEN9P PO�VER I � FIREPLACE BOt�Q BE?,M -
�VATER SERVICE tJID HT.BOf�1D BEAM
RVOF SHEATFIING �8 FT.BOND BEAIvI
FRFlfvIING/VENTILATIOM ��� FINAL BOND BEAM__ ___
ROOF COVER ' T PRE-GRADING _ _ __ ____`_
ROUGH HEATING _ __u__ � _ �BENCH�hdG ____ _ _ __
ROUGH ELECTRIC � � �ROUGH GRADING
ROUGH PLUM61�lG FINISH GRAGING
SHOVdER/TUE3 TEST POOL ELECTRIC
EX��.LP;TH/SIDING POOL FENCING
bVALL INSULATIO�I POOL FINAL
CEILI�dG I�dSULAT10N � QFF SITE IMPS.
DRY�VALL NAILING DEDICP.TI�NS
SEWER FINAL ENG.
SEPTICTAtdK LANDSCAPE/IRRIG. _ _ __
SEEP PITiL.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL�QNST. /� /a., Q, FIRE DEPT.FINAL -
FI�IAL HEATING HEALTH DEPT.FINAL
FINf1L ELECTRIC DFV.FEES PAID
FINAL PLUMBING ENERGY
FINAL PLANING
FIN�L ENGINEERING ° � e
C�MMENTS ____ _ -- -- -.
SEPTICTANKSIZE
SEEP PIT/U SIZE
:,