HomeMy WebLinkAbout17632 _� .
, - - ,� �
- -_��— CIT'Y OF DIAMOND BAR
DEPARTMENT OF COIvIIvtUNITY&DEVELOPIv�NT SERVICES
21825 E.Copley Drive
- (909)860-3195 Fax(909)861-3117 PRE$$
��9*� BUILDING PERNIIT APPLICATION FIRMLY
JOBSITE
¢ ADDRESS �-S7 S. Valle V1St8 Dr. APPLICATION _ PERMIT /� p/C ,
o DATE ' � O�L NUMBER ���P� # ���
� APN Par e�LOT2 13 TRACT 9'6 ( ISSUE TYPE OCC�
� DATE CONST. V-N GROUP S-3 B
p OWNER � Attn: Linda Czar cows ti
o ADDRESS 1_5 7 5 S_ V 11 1 a� V i S t a 1�r ZONING SETBACKS � „ /�
z CITY Di mond BarZIP
q176f��.909/396-0 $ FRONT 20 -0 RW ❑
� APPLICANT T.;nda ('�arknw�ti7j��.9(19�.�9(=0 8 C-M- D�EAR �- "_ �
SIDE/SIDE STREET � q�/�/ p
� CONTRACTOR - v � -U� SIDE �
o CT RE S Z�P q2� E� ' � ' pROPOSEDUSEF1rSt Floor- ut mobile eI[IlSS10 S
w ARCWENG/ ) n, I /� p 1C1 1 y
z DESIGNER Dale Malcolm ���1 �� econ oor - ice
� ADDRESS NO�TS E�• N�A N�� NO.
� CITY Torrance ziP 9050��. 31 217- $ STORIES 2 BEDROOMS N/A
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION
p� OWNER-BUILDER DECLARATION �- � � . .
O � SFR/ADD/REM � '
p I HEHEBY AFFIRM UNDER PENALTV OF PERIURV THA7 I AM EXEMPT FROM 7HE CONiMCTORS LI- G8f8Q9/C8fF1011
W CENSELAWFORTHEFOLLOWINOREASON(SEC.7031.58USINESSANDPROFESSIONSCODE:ANYCITVOH (n
ZCAUNTYM?iIp1RE0UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANI'STAUG W Patio/Deck
W TURE.PRIOR TO ITS ISSUANCE.ALSO REOUIRES 7HE APPUCMIT FOR SUCH PERMIT TO FILE A SIONED w
� STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI�
� CENSE UW(CHAPTEH D(COMMENCINO WITH SECTION 7000)OF DNISION 3 OF THE BUSINESS AND PRO- � POOUSPB .
� FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEOEDE%EMP- (�
TION.ANV VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUalECTS THE APPLICANT T0 Z Re-Roat
� A CIVIL PENALTY OF NOT MORE THAN FNE HUNDRED DOLLARS(f500).):
0 ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMVENSATION, � Commercia� •].3 L�O
Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70lI,BUSI� J �
� NESS AND PROFESSIONS CODE:THE COMRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF �
PROPERTY MM110 BUILDS OR IMPROVES THEREON,AND WHO DOES SUCF1 WORK HIMSELF OR HERSELF OR .
� TMROUGHHISORHEROWNEMPLOVEE5,7ROVIDEDTHATSUCHIMPROVEMENTSAAENOTINTENDEDOR m
w OFFEAEDFORSALEIF,HOWEVEFL7}{EBUIlDUJ00RIMPROVEMENTISSOLDWfTHINONEVEAROFCOMPLE-
�� TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
IMPROVE FOR THE PURGOSE OF SALE). '
W
❑I,AS ONTJER OF THE PROPERTV,AA1 EXCLUSIVELV CANTRACTIN6 WfTH LICENSED CONTRACTOPS
; � TO CONSTRUCT THE PROJECT(SEC.7oN,BUSINESS AND PROFESSIONS CADE:7HE CONTRACTORS LI- V81U9�10I7 / / ADJ.AREA
W CENSE UW DOES NOTAPPLV TO AN OYMER OF A PROPERTY WHO BUILDS OR IMPHOVES THEREON,AND
= W11000NTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S�LICENSEDPURSUANTTOTHECONTRAG FEE
~ TORS LICENSE LAW.). OUANTITY DESCRIPTION �
I Y
� ❑I AM E%EMPT UNDER SEC. B.8 G.C.FOR THIS REASON Q . �
U
� DATE OWNER ~
Z U
� , LICENSED CONTRACTORS DECLARATION w
� I HEREBY AFFIRM UNDER PENALTV OF PERIURV TMAT I AM LICENSED UNDER PROVISKKJS OF CHAPTER � .
� D(COAUIENCWOWfTHSECTION7000�OFDIVI510N30FTHEBUSINESSAND7ROFESSIONSCODE,AND . Z '
LLI MV LICENSE IS IN FULL FORCE AND EFFECT. m
� LICENSE C S N`�• LIC.NO. A � .7 I� �
V DATE OZ CONTRACTOR N d
W
� WORKERS'COMPENSATION DECLARATION Q
� I HEREBV AFFIfUI UNDER PENALTY OF PERIURV ONE OF THE FOLLOWINO DECLARATIONS: Z
� _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORNER5 � T ' ' '
'� COMPENSATION,AS PROVIOED BY SECTION 3700 OF THE IABOR CODE,FOR THE PEHFORMANCE U � �
Q OF THE WOR)(FOR WHICH THIS PERMIT IS ISSUED. � � �
Qw �I HAVE AND WILI MAINTAIN WOR)(ERS'COMPENSATION INSURANCE,AS HEOUIRED BV SECTION �/''/((yy�� �` h/�
3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �\ �\� '� ���Q�� y
ISSUED.MY RKERS' PENSATION INSU CE CARRIEFi AN/D PO'`LICV NUMBEFARE: CONSTRUCTION �_J��V �J �� �:L
� CAARIER�mQ�.'f:r �N�,y`A PLAN REVIEW '
� POLICV NUMBER—T—S+-�1-`S��1'�Aa, ELECTRIC
Z
Q �1 �— '_. '�---�-����
p (MssEctpnNE�NoreE00MPLE7moFirEpEqA9it5waoNElax�Dampouqqs(L1roIpqLESSy PLUMBING �J I 1 k—� ,i� I (' �: i -\
Z I CERTIFV THAT M THE PEFFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL l � �J
C.�3 SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE -
� WORKERS'COMPENSATqNIAWSOFCALIFORNIA,ANDAGREETHATIFISFIOULDBECOME INSPECTIONFEE � � �J(�
= SUBJECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37ooOFTHELABOR �-'�' -
CO I ALLFORTHWITHCOMPLVWITHTHOSEPROVISIONS. ISSUANCE � D
�
DATE:� �� APPLICANT: NV� E��� SMIP ��*-1s—
,w WARNINO:FAILURE TO SECURE WORKERS'COMPENSATqN COVERAGE IS UNUWFUL,AND SHALLBE ENERGY P/C �� � �._ . ( •
�y SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT 1 � �
DOLLARS(5700,000).IN ADDITION TO THE COST OF COMPENSATKKJ,DAMAGES AS PROVIOED FOR IN 1 � J
� SECTION 3�oE OF 7HE LABOR CODE,INTEREST,AND ATfORNE1^S FEES. RETENTION FEE:
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIqM UNDER PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDIN�AOENCV
FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.90B7,CIV.C.). . ,
Z
W
� LENDER'S NAME
F_— LENDER'SADDRESS
� TOTALFEES � �•3
� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I
w I ApREE TO COMPLV L CITV AND COUN DINANCES AND TE LAWS RELATINO TO BUILDING �
� CANSTRUCTION ER V AUTHORIZ RES TATIVE IS ENTER UPON THE
� ABOVE�M ED PRO TV FOR I ECTION P S . y���� , T
Z COMMENTS � 1� �VCi ` I�~�� v�
� •
_ � (� e.�-� C• 0 .
m PERMITTEE NAME(PR ' V A,
Q /'� C��/� y� �
� `�SI�I��RE O�RMITTE� �7`��� w1���^1�I.�
� - RECPT.NO. PAID BY 2 �VALIDATION
WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy .
_ . �. �� -.- - ,, . I . _
� ���8"V �I�Q��l�a���9� I���i , ,
Q6�xr'f���'B��l ����6�� :
. �,. .,�. . x _
.e.JG�G� � DD , , ��;�.� : 0�� � ., C�C'�`u� . g.. � ' � ' �: �
5ET Sr�CK ' _ �`�`�� FLOOR J�IST
_ / ____ _.__,_._-_-_—l------
FTGS/FORMS/STEEL �,��6� � FNA REQMTS _ •
ELECTRIC GROUND UNRER FLUOR DUCT
GROUND PLUMBING �� UNDER FLOOR CU�IQUIT
SLAB GRADE ��c;,-o'z � FIREPLACE FOUNDRTION
TEMP POWER FIREPLACE BOND BEAM
WATER SERV�CE, MID HT. BOND;BEAM '
ROOF SHEi4THING ` � � $ FT, BOND BEAM�
FRAMING/VENTILIATION • � � FINAL BQ,ND BEAM - �
ROOF COVER � PRE-GRADING '
ROUGH HEATING BEPJCHING •
ROUGH ELECTRIC �/Q�� _ _ RIJUGH GRADIiVG
ROUGH PLUNIEiING FI��IISH CRALIING '
SHOWER/TUB TES7 PCOL E'�ECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION PQOI., FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSGAPE/IRRiG. •
SEEP PIT/L..L. ' ON SfTE IMPS.
GAS AIR TEST � � FIf�AL ZONING �
FINAL CONST. s FIRE DEPT. FINA�
FINA�HEATING f�� - HEALTH DEPT. FINAL
FINAL ELECTRIC lV DEV. FEES PAID
FIIVAL P�UMBING ENERGY
_ — _ o � �Q� �
� �o��E�Ts --_����:�-s ��-�--��,,� S�r���i,� . �';� r� ���.���-�
� � - - ---__s,��,.�. _,�� :c���,�� ������,�i-- . �. ___-
���'�= �
`�..1=(o_`D"L Nr'1_lpX-���Q– '��,G f�S�bt,T(p�� —D— 5�?T- I-���� 5�-� s>R-'F�io�,du5 �
� Z��-�Dz- ►��`'F�/Z_F2U�'r�s� u6�R a�l-d�►U�_�4f3�'°v�`' �J '1..Z2-oz 1��o(i- c�� �. n�� .r�sP�.-r«, �
e•-0 2 1�� �-�� �
��2_1�."1��l.v�.: o•S�' t�; �!-1I�- D� '�c � (� �
2 in►S (��t�J-� f S z f��t� o�L�
' � '11`�� �f.-eD��c,t5 �tc�
Q �'�-�+-�.�" � �l�z_ t�iv9-v►�-f�Z�J-v-e_ �.t�dl,L N,d'�L�/�L,
SEPTIC TAiVK SIZE
SEEP PIT/U SIZE --- �-6�' uCG_Co�k�tT YA��c.��°-tl.t�-py�,� _-�-
a^y� , ���a Z ��Qo2- (gR�1�1.�@ a�«�a��
°
�� �� � �. .��
� � , , �
�� ,
B
� �� �
/