HomeMy WebLinkAbout16904 (663) � _ - - - --_._.. _ ___ _
�^� �\ l CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES EX PI R ED
21825 E.Copley Drive
��"" (909)860.3195Fax(909)861-3117 PRESS
'''r��' BUILDING PERMITAPPLICATION JUN 19 2002 FIRMLY
} JDBSITE ,/ J � / APPLICATION ��r_1� PERMIT l � P/C
o ADDRESS�3�-� !/ l � ( ' DATE .�-'��
� NUMBER tt p
� ISSUE TYPE OCC
APN 1�0T TRACT DATE CONST. GROUP
p OWNER � O _ � �� / �
p ADDRE � ZONING SETBACKS
z CITY ZI �S TEL.��� 6� � FRONT RW O
g APPUCANT Sp�l�, 7EL. REAR �
� SIDE/SIDE STREET RW O
� CONTRACTOR SIDE ❑
� ADDRESS
� CITY ZIP TEL PROPOSED USE
oARCH/ENG/
W DESIGNER NO.DWEL. NO. NO.
n_ ADDRESS
� CIN ZIP TEL UNITS STORIES BEDROOMS
�
cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNER•BUILDER DECLAHATION SFWADD/REM
O
p I NEREBV AFFIRM UNDER PENAL7Y OF VERRIRY THAT 1 AM E%EMP7 FROM THE CONTMCTORS ll• � GaregelCarport
W CENSEUWFORTMEFOILOWINCHEASON(SEG.70]1.SBUSINESSM70PROFESSIONSCODE:ANYCINOR
U COUNTYNrHIpiREOUIRESAPERMITiOCONSTRUCT.ILLTERIMFROVE,DEMOLISH,ORREPAIRMlYSTRUC• W PdtiO/DBtk
Z TURE VRIOR TD RS ISSUANCE.ALSO RECUIRES THE APGLICANT FOR SUdi PERMIT TO fILE A SIGNED
W STATEMENT THAT HE OR SME IS UCENSED VURSUANT TO TME PROVi510NS OF THE CONTRACTORS LI• w
� CENSE UW(CHAPTER 0(CdAMENCINO WITH SECTION 70W)OF DIVISION f OF THE BUSINESSAN�PRO- LL' PooUSpa •
fE5510NSOCOE)ORTHATHEORSHEISE%EMP7TMEREFROMANDiHE0A515FORTHEALLEOEDE%EMP- (�
� TION.ANYV10LA1�ONOFSECTION7o7t.5BVANYAPPLICANTFORAGERMiTSU&IECiSTHEAPPLIGANTiO Z Re-Rool
�„� ACMLPEIULTYOFNOTMORETHANFIVEMUNDREDDOLURS(I500�.):
O 4 AS OWNER OFTME PROFERTY,OR MY EMPLOYEES WIiH Wl1GE5115 THEIR$OLE COMPENSATION,
� Z WILL DO THE WOiiK,ANO THE STRUCNRE IS NOT INTENOED OR OFFEREO FOR SALE(SEC.70��,BU51• � �mmertial �
y NESS AND PROFESSIONS CODE:iHE LON7MCTORS IICENSE UW DOES NOTA7PLY TO AN OWNEH OF ?
PROPERTY MRp BUROS OR M7ROVES THEREON.AND WF70 DOES SUCH WORK HIMSELF ON HERSELF OR
� THROUGHHISOHHEROMMEIA7lOYEES,PRONOEDTNATSl1G11MPROVEAlENTSARENOTMTENDEDOR m
QOFFEREDFORSALEIF,fqWEVEi�7HEBUILDINOORMAVROVEAlEMI550LDWiTNINONEYEAROFCOAlP�E•
Z TION.TME OwNER-BInIDER MnLL HAVE THE BUROEN OF PROVRIQ TNAT ME OR SHE DID NOT BUIID OR
= IIAPROVEFORTHEPURPQSEOFSAIE).
W 04�OMmEflOFTHEGHOPERTY,AMDfCIUSNEIYfANTMCiW�WITHLICEN5EDC0AfTMCTOq3
[[ TO CONSTRUCT THE PROJECT(SEC.7o�1,BVSINE55 AND VFOFESSIONS CODE:THE GONTMCiORS LI• V21t1BtI0f1 ADJ.AREA
L11 CENSEUWDOESNOTMPLYTOANOwNEROFA7ROPERTVWHOBURD50RIMPROVESTMEREON.MID
� NTqCONTMCT5FOR5UCM7qQIECTSWIiHACANTMCTOR(5)LICENSEOPURSUANTTOiHECOMMG OUANTITY DESCFIPTION �E
� TORS LICENSE UW). y
� ❑IA/ADtE1APTUNOERSGG'� 9.1CGF0 IS ' 4
� U
� �
OAtE o V .
Z W
� LICENSEDCO CT ECLARATION W TJ
� IHEFlEBYAFFIRMUNDEiiPENAL71'OFPERJURVTHATIAMLICENSEDUNDERPROVISIONSOFCHAPTER �
O., 9(COMMENCINOWITHSECTION700010FDIVISION�OfTHE0U51NE55ANDCHOFESSIONSC00E.AND Z
X MYLICENSEISINFULLFORCEANDEFfECL m
t1J �
� IICENSE CUSS LIC.NO. �
V DATE CONTMCTOR a _
W
� WORKERS'COMPENSATION DECLARATION a
� IHEiiEBYAFFIRMUNDERPENALTYOFPfRIURVplEOFTNEiOLLOWING�ECURATIONS: Z
� �IHAVEANDWILLMAINTAINACERTIflCATEOFCONSENTTOSELF•INSUREFORWOfiKERS' _
Q COAIPENSATqN,ASPROVIDEDBY5EC7ION77000FTHElA60RCO0E,FOHTHEGERFORMANCE W
Q OFTHE WOqK FOH WHIdiTHIS PERAlIiI51S5UED. � �
� �IHAVEMIDVALLMNNTAINWORK[RS'GOMPENSATIONINSURANCE,ASREWIflEDBV5ECT10N
O 070o OF TNE LABOR CODE,fOR THE PERFORMANCE OF THE WORK FOR WHICH 1H�5 FERMIT IS
ISSUEO.MYWOPo(ERS'COAiPENSATqNINSURIWCECARFUERIWDPOLICYNUMBERARE: CONSTRUCTION
�j CARRIER PLAN FEVIEW
� POLICYNUMBER ELECTRIC
� �niss[crar+r�mr�ore[oa.n�ooFnEaEnr.+tsFonwe��oaurs�s�a�ar��ss� PLUMBING � �
Z ICERTIFYTHATINTHEPERFORMANCEOFTHEWORKFOHWHICHTHISPEftuI715155UED,l MECHANICAL
(7 SMALINOtEMP�OY�M'PENSONWANYMMINERSOASTOBECOMESU&IECTTOTHE =� I �L ��
�/j WOPo(ERS'COAIVENSATIONUWSOFCALIFORNItiANDAGREETHATIfISMOULDBECOME INSPECTIONFE .. ��
-� SUBJECTIOTHEWORKERS'fAA1PENSATIONVROVISIONSOFSECTION�7a00FTHELABOR ' ` •
�CODE,ISWILLFORTHWITiCOIAPLVWITHTHOSFPROVI5lON5. ISSUANCE _��'""+ �O
� SMIP ) .
p DATE: APPIiCANT.
� WMNIN�:FAILURETOSECUREM/ORNERS'COMPENSATIONCOVEMGEISUNUWFUL.ANOSHALLBE ENERGYP/C '
�y SU6IECTANEIAVLOYERTOCPII.IINAL7ENALTESANDGVILFWESIIPTOONEMINDREDTHOUSAND ENERGYPERMI T'] �
} DOLURS(t100.000),INADDITIONtOTHEfASTOFCOMPENSATION.DAIAAGESASPHOVIDEOFORIN j�i� _�
J� 6ECilON970eOf7HELABORCODE,WTEREST,ANDATTORNEY5FEE5. RETENTIONFEE: - � " "ff
d CONSTFUCTION LENDING AGENCY PRE-ALT FEE:
O
� INEREBVAFFIRIJUNDERDENALTYOFPE0.NFVTHATTHEREISALONSTRUCTIONLENDINCAGENCY
Z FOR iNE DERFORAIANCE OF TME WORK FOR NMICH TNIS OERMIT IS ISSUED(SEC.]07),CIV.G�.
W
� lENOER'S NAME
� LENDERSADDRE55
W IAGREETOCOMPI WRH/�iL CITYAIJDCOUNTYOPDTNANCES�STATEUWSREUTWGIS,BOILDINO TOTAL FEES ��( ` b
� CONSTRUCTIIXJ,ANOHEREBVAUIHORIZEREPRESEMATNESOFTXI OUNTVTOiM ONTHE v
ZABOVE-1AENT EDDROVEHTYfO SPECTION UHPOSES.
o /r COMMENTS
�
Q E(PRM
N
� iaNANHEOFPERMITfEE DA1E
� pECPT.NO. PAID BY � VAUDATION
WHITE—DeDartment Copy.YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Capy,GREEN—AppliwnYsCopy
�
. ..�.'-i.r.l�' . .✓...��..ti.:t�t-�t.,�•�n�.... w,.n ""i�"�.r �';.'.. ' :1.- ...'h .'�4„ .,. K',�.f�-' �,�r� �Hi"/�.1-. . . . . . ...
c�-��f OF Di�.P�C.�f�"D BP��
if�lSPGC'p iOTv ��CUI�D
_..�._._.___.____.____.___.__..�. c,
_ �. __ _ �..
I�rE`3:a=,c�;^C(e��►+� o}��e'= iJ►��'1��, ��c1�{ (��k=1�'=�,;'��C�,Y►°t �y:tii'� I►��-y:��c�,t`o�l�1 I
------.___.__._._._____.__.___... .__._...._ . ___.____�_�.. _._._. - -_ _.. ...�___.__ ..__.._ .._.__.___..__.___.________..__.__.___....____..Y__..______
SET BACY. ; �FLOOR JOIST _ I 1
Fi'GS,'FORMS/STEEL � FHA REQ�ATS
ELECTRIC GROUND '; UNDER FLOOR DUCT �{ �
GRDUND PLUUIBING UNDER FLOOR CU�IDUIT I
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER i FIREPLACE 60ND BEAM I
WATER SERVICE MID HT. BOND BEA��I I
ROOF SHEATHING £3 FT. BOP�D 6EAM i
FRAMINGNENTILIATION FINAL BONU BEAM I
ROOF COVER PRE-GRADING I j
ROUGH HEATING BENCHING I '
ROUGH ELECTRIC ROUGH GRADING �
ROUGH PLUMBING FIi�ISH GRADING
SHOWER/TUB TEST � POOL ELECTRIC
EXT.LATH/SIDING POOL FENCING I
WALL INSULATION POOL FINAL i
CEILING INSULATION OFF SITE IMPS. �
DRYVJALL NAILING DEDICATIONS
SEWFR FINAL ENG.
SEPTIC TANK L�INDSGAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST � FINAL ZONING
• FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING t�EALTH DEPT. FINAL
FINAL ELECTRIC ' DEV. FEES PAID
FINAL PLU��!BING ENERGY
� �
IE�.'"". '",�� f l`75 i
- - .__ i.:c.. ._..�.._.___.
COMPJIENTS��iu-o� .��'_/z�� N� to1���cYe p�N����__����—
�
SEPTIC TANK SIZE
SEEP PIT/U SIZE
�, .
�'�I I
i
i
�����, �,; .
,�
;
`
I
_ -�- ----_....-�� ._.__.._-•--_• t