HomeMy WebLinkAbout17686 (1332) _...._ .:-' --. -• — - :_..: .i.— - . -
J� CITY OF DIAMOND BAR � � -
� DEPARTMENT OF COMMUMTY 8:DEVELOPMENT SERVICES
21825 E.Coptey Ihive PRESS
'" (909)860-3195 Fax(909)861-3117
'"�.�»' BUILDINGPERMITAPPLICATION FIRMLY
� JOBSITE � ��j.� 2 S�J APPLICATION �����BER J��/C
o AODRESS ( Y DATE
� � TRACT DATE ONST. GROUP
APN LOT
°C OWNER +r L E �
O
o ADDRESS � S / - ZONING SETBACKS
Z CITY . ZIP TEL-_����°J I FRONT RW ❑
S APPUCANT �— TEL SID SIDE STREET RW O
� CONTRACTOR' F' SIDE ❑
� ADDRESS PROPOSED USE
� CITY ZIP�� TEL. J
w ARCW
� DESIGNEF
� ADDRESS N0.DWEL NO. NO.
UNRS STORIES BEDRDOMS
� CITY ZIP TEL.
N DESCRIPTION SQ.FT: FACTOR PSF ADJ.AREANALUATION
�
Q OWNER•BUILDER DECLARATION SFWAOD/REM
p I HEREBY AFFlRM UNOER VENAITV OF VE0.NRY THAT I AM EXEIAPT FPOM TH[COHfMCTOR3 L4 FI GaregelCarport
W CENSEU`1�FORTHEiqlOWINOREASaN(SEC.70Jf.60U51NE5S/�NOiROFE4510N5CODE:ANYCfTYOR' (n
U COlMT1WHtlIREGURESAFEfIMRTOCONSTRUCTALTERR.�PROVEDEMOLISH.ORHEVMRANYSTAUG� W PetlO/DOCk
u� TURE,PRIOR TO RS�SSUANCE.ALSO REWINES TME APPUCANT fOR SUCH PERu1t TO FllE�SIGNEO, �
.� STATEMENT 7HAT HE OR SNE IS LICENSEO PURSU�NT TO T/1E iROY15�ON5 OF THE LOMNACTORS LI•j
.� CENSE UW(�PTEN i(GOIAMENqNO WfTH SECTION 7000)OF DIVISION]OF TXE BUS�NESS AND PRO-�. � POOVSD�
� FESSIONSC9DE)ORiW1THEORSHEISEXEMMTHEREFROMFNOTME8AS15fORTHEILLIECEDEXEUP."`.
TION.ANYVIOLATIONOFSECTION70�1.68VANYMPIICANiFORAVEfiMIiSU81ECf5T11EAPPUC�NTTO��,; Z Re-Roof
� A pVIL VENALTY OF NOT MORE TNAN FNE HUIORE�DOILARS(fsao)J� +
� ❑4��'NNEROFTMEPROPEHN,O0.MYEAtOt�YEESNnTNWAGESASTHEiRSOIECOMPEN5A7pN,'�p 0 Commercial
Z NALL DO THE WORK.AND THE STRUCTUFE IS NOT INTENDED OP OFFEFED FOR SUE(SEC.7a�,BU56. J
N NE55 ANO PROFESSiONS C�OE:THE CONTMCTORS LICENSE Uw DOES NOT ACPLY TO M!OVMEH OF� ?
iR07ERT'N'NOBU4DSORIMPqOVESTNEREON.ANDW110DOE55UCHN"ORKHIMSEIFORMEflSELFpR�' m
� TNROUGNHISORHERONMEMPLDYEES.VROVIDEDTF7ATSUdfIMPROVEMENTSARENOTNTENOEUOf1'F
w O�EAEOFORSALEIF,F10YVEYER7HEBUILOWOOftIMOROVENEMI550lDWITMNONE'/EMOFCOMPIE�'
0 TION,THE OWNER-BURDER VALL HAVE T11E BURDEN OF PROVWO TWIi NE OR SHE DID NOT BURD Ofl'r
Z p.1VROVE FORTHE PURP0.5E OF SALE} '
= O�J50wNEROFTMEPROPERTY,AMEXCIUSNEIYCOHTMCTMQMIRMLICENSEJCDNTRAtTORS'
Q TO CONSTRUCTTHE PR0.IECT�SEC.7W�.BUSINESSAND PROFESSIONS[DOE i11E CONTRACTORS U-'�� VdlUetiIX1 ADJ.AREA
� CENSEUWDOESNOTMFIYTOANOWNEROFAPROPER7YMn10BUMSOR111PROVE3TIEREON.AND',
Yh1000MMCTSiORSUCHPROJECISMnMACONiMCiOR(S�UCENSEDPURSUlNTIOTNECONTM6�, Q�J/{�JT�'N �ESCRIPTION FEE
TORS LICENSE LAW). .
� O INA EXEMPT LINDEA SEQ D.8 P.F FOR MIS REASON�i U
�
�=" DATE OWNER ~
Z tVi1
� LICENSED CONTRACTORS DECLARATION W
� INEREBYAFFIRMUNDERVENALttOiPE1WRYTHATIAMLICENSEDUNDERVRONS�ONSOFCMAVTER � �
p. Y(COMMENdM�WRHSECTiON)0oo)OFOMSWN�OFTHEBUSINE SANDPROFESSIONSGODE,AND Z
� MN I�CENSE 15 W FULL nFOFCE ANO EiFfCT. m
U�ENSE C11155� G���' �IC.N0. � � �
V DAT�'"'^7 �Z- Z ZAdL CONTRACTOR_� ' a
W
� WORKERS'COMPENSATION DECLAFtATION , Q
� U
� INEREB�AFFIPAIUNDEROENALTVOFPER1UFiYdJEOFTHEfOLLOVANODECLAMTION3: Z
Q
� _IHAYEANDN7LL►WNTAINACENTIFlCATEOFCONSENT705ELFaNSUREFCRWORKERS' S _
� COMPENSATION,ASPROV�OEDBVSECTION970oOFTHEUBOPCOOE.FORiHEDERWPMANCE W
OF THE WORK FOR WNlpl THIS PERMIT L4155UEO. �
O ;
I HAVE AND WILL MNNTAv!WORICERS'COMPENSAT�ON MSURANCE,AS REOUiRED 8Y bECf10N
Q �tooOF TFIE LABON COOE.FOR i}1E iERiORMANCE OF TME WORK iOR WMldi iNIS PEAMITIS ±
� ISSUEO.tAYWOPICERS'COMPENSATIONINSURANCECARN�ERANDVOLICYNUMBERARE: � CONSTRUCTtON �/�
> WIRRIER N� PLANAEVIEW �V� T �t��
� POLICY NlMBE�� GI� �O
� ELECTRlC 1
Q ������ppr,�+�ppFncpEa.rrs�oqpae�urnr�uoou�ns�s�ao�oat�ssy PLUMBING
Z ICERIIFYT1u�TIN7MEVEAFORMMICEOFTNEWORKFORWVdCHTHISPERMITI5155UED.l MECHANICAL
�J SHMLNO7EMPLOVANVVERSONNlANYMANNERSOASTOBECOMESUBJECfTOTME
� WORKERSCOMPENSATqNUW50FCALIFONIIA,ANDAGREETHATIFISNOIADBECOAIE ', INSPECTIONFEE
S SUBJECTTOTHEWORKERS'COMPENSATqNPRONS10N50FSECTiON77ooOFi11ELA80R ISSUANCE -
CODE.I SWli1 FORT nTH CdAPIY M7TH TNOSE VRONS�ONS.
� SMIP
p o�rE: 2 APPLICA�� .
w ENEHGY P/C
� WARNiNO:FAILUHE TO SEGUHE WOPXEAS'CO�.�PENSATION COVERAGE IS UNUWNL.AND SHALL BE
SU8IEGTANEMPLOYERTOCRIIAWALPENALTIESANDCNILFWESUPTOONEMl1NOttEDTMOUSAND ENERGYPERMIT
OOl1ARSIS10D,0001,NADD�TONTOTHECOSTOfCOIAVENSATqN.0A1AAGE5A5PPOVIDEDFORN ;
� SECTION 770!OF THE LABOR CODE,WTEFE51/WDATTORNEYS GEES. ; pETEN'RON FEE
W CONSTRUCTION IEND�NG AGENCY � PRE-ALT FEE:
n.
� IHEREBYAFFIHMUNDERVENALT/OfPE0.)UMiHATTHENEISACONSTRUCTIONLENDW6AGENCY
FOR THE PERFORMANCE OF TNE WORK FOR WMlp/TNIS PERMIT IS ISSUED�SEG]av7,CN.G�.
W
� LENDERS NAME
� LEN�ER'SADDRESS �
wIGER71FYhNTINAVEREADTM15MPlM.AT10N�'f1DSTATETHATTHEABOVEINFORMATqNISCARRECT. ; TOTAL FEES � .�
� IAGREETOCAMPLYWRH�ILCRYANUCOUNTYORDWANCESMIDSTATEUWSREUTW0T09uIL01N0
� CDNSTAUCTION.ANDHEAEBYAUhiORIZ£REDRESENTATNESOFTHtSCOIJNttTOEM£RUPONTkE ;
Z ABOVE•MENTIONEO VR07ER R IN57ECTION PIIRPOSES. r COMMENTS
� !
�
¢ VER TEENAM� � � �;
N �� ;
y swr+er E ERMITT o�TE I RECPL NO. PAI�BY VALIOATION
� WHITE—Department Copy.YELLOW—Finance Copy,P�NK—Assessor Gopy.GOLDENRO�FileCopy,GREEN—Applicant's Copy
!
. ... ,�..+'7:..� ....'i'.,,, �...1�.�":r'.a: .. . . �.c., � _J:�; ...nr,.T'f1r^.�y:c�yn:..rv��.,*..w.�Ty...w�-+rr,.y[:.�x....�..��.!e...t3..9._ ",•,..i..., ,�,.,5�.. ..nT.:.y;..p.,.,�,..,,... �•a�-r.T:-;
. . . . '.��'�4jT
ClT�` C7F DIAMQPND SA(�
ih3SPEC?"iOt�! RECORD
� ::il��������� ::��;��_ .����E-�Fz�������: , :. �r�.�;���:,����o� .�. ��'��� : �1��-��� m�
SET BACK • - ` - �-� _� �. � ���FLOOR JOIST�4: � �� � '
FTGS/FORMSiSTEEL ^ FHA REQMTS
ELECTRIC GROUND UNDER FLODR DUCT . :,
GROUND PLUMBING UNDER FLOOR CU�IDUIT , r s• '
SLAB GRADE I FIREPLACE FOU�DATION - �
TEMP POWER �//L FIREPLACE BOND BEAM - � '
WATER SERVICE I MID HT.BOND�EAM� �
ROOF SHEATHING - 8 FT. BbND BEAM.� � '
FRAMINGNENTILIATION I I FINAL BOND BEAM
ROOF COVER . ( � PRE-GFiADING
ROUGH HEATING BENCHING I
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING �
SHOWERITUB TEST POOL ELECTRIC
EXT.LATH/SIDING � i ! POOL FENCING
i WALL INSULATION i i POOL FINAL
, CEILWG INBULATiON � OFF SITE IMPS.
pRYWALL NAILING DEDICATIONS
SEWEA FINAL ENG.
i SEPTIC TANK LANDSCAPE/IRRIG. �
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST: , FINAL ZONING
F1NAL CONST. � ' . FIRE OEPT. FINA!
FINAL HEATING I HEALTH DEPT. FINAL
FINAL ELECTRIC . 1 DEV. FEES PAID i
FINAL PLUMBING ENERGY i
- j
I f n R I,C *',U 1�tr,. -
COMMENTS
i- - - __ _ --- — _ - _ _ _ _. ---- � ...,_ _ _ - -- --_- _ . .. .- -- . --- � -- --_- - -- - -
SEPTIC�ANK SIZE
SEEP PIT/U SIZE
����,�.��----....�--� -
,
. - � ,
y�� . ., ���
: . . . ��
. - . � "
� , -- � ,
. , � ;� _ ! - . � : , ...
���