HomeMy WebLinkAbout13956 (1078) • .:
. CITY OF DIAMOND BAR ���f�
�---�`�� -- DEPARTMENT OE COMM[.TNITY&DEVELOPMENT SERVICES
�.j �,- ' 1 � . 21660 E.Copley Diive Suite!90
(909)860-3195 Fax(909)861-3117 PRESS
''���� BUILDING PERMIT APP'LICATION FIRMLY
o ADDRIESS � ! b �/ V <<-1�1.� '�"�'"� DATEICATIO ' �'� NLE�RBE Z */C
.J
� ISSUE TYPE OCC
APN LOT TRACT pATE CONST. GROUP
� OWNER
ADDRESS _ ZONING SETBACKS
CITY ZIP TEL, FRONT RW ❑
APPUCANT TEL. REAR ❑
SIDFJSIDE STREET RW ❑
G� CONTRACTOR � SIDE ❑
g ADDRES �" PROPOSED USE
CITY ' ZIP EL.
� ARCHJENG/
DESIGNER NO.DWEL. NO. NO.
AODRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNEF-BUILDER DECURATION SFRlADD/REM
O
I HEHEBY AFFlRM UNDER GENALT/OF PERIURY TMAT 1 AAA OfEMP7 FROM 7HE CON�IUCTOFiS LI- G8R9fl�CefpOh
CENSE�/1WFOR1HEFd10WINORF.A:AN�5EC.7037.68U51NE6SM7DPROFE5510N5CO0E:ANYCITVOR (A
GOUNP/YMICHREOUIRESAPERMRTOOONSTRUCT,IILTEF�WPROVE,DEMOLISH.ORREPA�RANYSiRUG W Pptq/�BCk
NNE,PNIOFi TO RB ISSUANCE.ALSO REOUIRES 1HE�PPLICMIT PDR 9UCH PERNIT TO FILE A 610NE0
BTATEYENT 7F1AT ME OR SHE IB LICENSEO PURSUANT i0 7ME PHOYISION9 OF 7HE CON�MCiDRB L4
CEN6E LAW(CHAPTEH i(O�MMF.NCINO WIiN SECTION 7000)OF WVISqN 70i THE BUSINESSAND PRO� � P�VSpd
FESSIONS OO��OR TNAT NE OR3HE IS EXEYGT TNEHEFROM ANDTTIE BASIS FOR THE ALLEOED EI(EMP-
TION.ANYVIOIATIONOFSECT10N7a�1.6BYANYAiPLIGNTFORAPERMITBU&IECTS7HEAPPLICJlJTTO z pq-Rpp}
� ACML PFNiILTY OF NOT MORE TMAN FNE MUNDRED OOLLMS(f600�.�:
OI.ASOYNIEROFTHEVROPEATV,ORMVEYPLOVEESWITHNMGESASTMEIR90lECOMPENSATION, L� Cpmm6fGlal
WILL00 THE WORK 11ND THE&TRUCIURE�8 NOT INTEND6D DR OFFERED FOR SALE(SEC.7Mt,BUSI� J
NESSAND PROPESSIONS CODE:TNECONTRACTON3IJCENSE UW OOE9 NOT ACPLY TO AH OWNER OF j
� PROPEIIT'/WF106URDSORlA7i1DVE5TMEREON,ANDMhqDOE5SUq1WOqNNIMSEIFORNEP3ELFOR
¢ TNMUGH W S OR HER OMM EMPLOYEES,PROVIDm 7MJ47 6UO11MPROVEMEM6 AHE NOT RITENDED OR �
� OFFEREDFORSAI.EIFIpWEYEq7NEBURWN00RIMPROVEMENT185IXD1MTMINONEYEAROFCOMPLE�
TqN,7HE OWNERSUILDEN NfILI FiAYE iNE BURDEN OF PRONNO iH�T HE OR SVIE D�D NOT BUILD OR
tiPHOVE FOR 7ME PURPOSE OF SALE�.
� 04�+�WNFROF7fiEPROPERTY,AMEXCLUSIVELYCOMRAC7IN(IN7THLICENSE�CONiMCTORS
TO OONSTRUCT iHE PROJECT(6EC.7oM,BUSINESS AN�PROFESSIONS COOE:7HE CONTRACTORS LI- VeIUBtIOn ADJ.AREA
CENSE LAW DOES NOT MPLY 70AN OWNEfi OFA PROPERTY WFiO BUMAS OR IMPROVES h1EREON.AND
YYNOCONTMCT6FORSUGIPRO.IECT6MAh1ACONfMCTOR�6�LICEN9EDPUReUAHTTOTHECONTWiG QUANTITY �ESCRIPTION FEE
� ro�s ucersE uw.�.
� O I AM EXEAIPT 11N0ER SEG B.8 P.C.FOR TMIS REASON �
U
� ¢
O�TE OYMER V
� LICENSED CONTRACTORS DECLARATION —�
� W
1 HEREBYAFFIiW UNDEfI PENKTYOF PENIIRY TXAT IAM LICENSE�UNDER PROVISKKJS OF CHAPTER
Y(OOIAUENCINGWITFISECTION70001�OMSION70FTHEBUSINESSANOPRDFESSIONSCOOE,AND Z L
X MY LCENSE IB N RAL FORCE ANO EFFECT. f
0 LICENSE � UC.NO.��/ / � J jJ
� OATE CONTRACTOR a ,
NlORKERS'COMPENSATION DECLARATION a
� 1 HEREBYAFFIRM UI�ER PENA�TV OF PERIURV ONE OFTHE FOLLOWINO DECLAMTIONS U
N Q
� IMAVE/1N�WILLMNIN7NNACERiIFICATEOFCONSENT70SELF•IN5UREFORWONKEHS' _
OOy�NSATION.ASPRONDEDBYSECTON�7000FTNElABORCODE.FORTHEPERiORMM10E `U
�4 TY16 WORK FOR WHICHTHIS PEHMR 161SSUE0. �
r/IHAVEIVNWRLMAMAINWORKERS'COMPENSATIONINSUfUNCE,RSRE'�U�HEDBYSECTION
� 97000F7HELABORCOOEWHTHEPERFORMANCEOFTNEWORKFORWHICHTMISPERMITIB
� RSUEO.MY WORKERS'COMPENSATION INSUMNCE GRRIER ANO POUCY NUMBER ME: CONSTRUCTION
� cu+AtEA ��,�� PWJ REVIEW
� POLICYNLMBER�oP^I I�_T ��. ' ELECTRIC
� f�6ECilONNE�Noi6EmhpiE7moFn£PEwdiswHaVEMJN7Fi�oataisR�wlattE5s4 PLUMBING ��R,_,� t
ICEHTIFYTNATINTHEPENFOHMANCEOFTNEWORKFORWHICHTNISPERMITISIS6UED,1 MECHANICAL ����
(� 6HN1 NOT EMPLOY�NY PERSON IN ANY MANNER SOAS TO 6ECOME SUBJECT TO TNE
vj WOqKERS'COMPENSATION U1W5 OF CALFORNIA,AND AGREE THAT IF 1 SHOl1L0 BECAME INSPECTION FEE
6UBJE TO M/ORKERS'COMVEN9ATION 1910NSOFSECTION97000FTHEIABOR
O E sHai nrnwimcoMvirvwni isrows. ISSUANCE A���° � �� '���� LV'�
—��—.—��s.i�
� ��: Z L APPLICANF.
WARNtNO:FA0.URE M SE W RE WOIiNEN9'COMPENSATKK�OOVERAQE IS UNLMNFUL,ANO SHALL BE Tp�� 7^
ENERGYP/C CITY OF:lilii+'Ili'�k1J Ii
�y BUBJECTANBAPLOYERTOCRIMINALPEN�LTIESNYDCIVILFINESUPTOONENUNDREDTHWSMID ENERGYPERMIT BU�Dl1�IG r�'TAJ J.RCLTlf
DOLURS(i100.OW).IN ADDITION TO iHE COST OF COMPENSATION,DAMACiES AS PROVIDED FOR IN
J SECfpNl7aeOfTHEU80RO0DE,INTEREST.ANDATTORNEV5FEE3. RETENTIONFEE:
� CONSTRUCTION LENDING AGENCY pRE-ALT FEE:
O
� IHEHWYAFFIRMUNOERPENALTYOFPERJURYTHATTHEREISACONSTRUCTIONI.ENDINGMiENCY
FOR THE PEHiOfiMANCE OF TFIE WORIC FOR WHICH THIS FERMIT IS ISSUEO(SEC.70W,CIV.G�.
� IENUER'S NAME
C LENOER'SMORE54
� ICER�IfYTHATIYUVEREAL7h11511PPlICATIONlJiDSTATET11AT7MEABOVEINFORMATqNISCORFiECT, TOTAL FEES � `
w 1 AC7REE TO COMPLY WITH ALl CRY M1O GDUNTY OHDI CES AND STATE UWS RElAT1N0 70 BUILDWO /�'/ /�
� CONSTRUCTION,IND MER�Y�LITFIORRE HEPRESEN TIVES OF THIS COUNiY TO ENTER UPON THE ^ /�/J T ��/J' `/� /yy
ABOVE•YEMIONEO PROPEATY FOR IN PECTION PU oses. COMMENTS � v��� 7�i ��J�
�,� � d
a PERMITTEE �
(A BIGNATUFE OF ITfEE DA7E RECPT.N��i �� PND BY r ^���—YALIDATION , vL
� WHITE—Oepartment Copy,YELLOW—flnance Capy,PINK—Aasassor Copy,GOLDENHOD—File Copy, REE�pI' nt'x� s Copy' r�
1A �1� 1�
�� n,— ..��.
. • , . . . .. ... . � . � . , � . „ , r , .. . i. � • . `: .v, . , . , , • ,. , . • . . � .. .. • ' � • � .
�"��'�OI'+!D B�R
� � � INSPECTiQhi� REC(at�D� � �
� E � . � . . e � � • s -
SET BACK ' FLOdRJ01$l'z � `. . . • ` `
FTGSlFORMS/STEEL ' �� FHA REQMTS
ELECTRIC GROUND ` UNDER FL OR DUGT , . •
GROUND PLUMBING UNDER FLQOR CURIDUIT� : � �
StAB GRADE FIRE�L'ACE�FOUNDATION• -� '
TEMP POWER FIREPLACE`BOf�t7�EAM " "
WATER SERVICE MID HT. BOND BEAM " .. � ' �
ROOF SHEATHING � 8 F1'.BOND BEAM � '
FRAMINGNENTILIATION FINAL 80ND BEAM
R�OF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELEC7RiC ROUGH GRADING
ROUGN PLUMBINC� FINISH GRADING
SHOWERlTUB TEST POOL ELECTRIC �
EXT. LATN/SIDING � POOL FENCING
WALL INSULATION i POOL FINAL
CEILING iNSULATION OFF SITE IMPS.
DRYWAt�L NAILlNG DEDICATfONS
SEWER FINAL ENG. '
SEPTIC TANK ; LANDSCAPE/IRRIG.
SEEP PIT/l..L. � I ON SITE IMPS.
GAS AIR TEST FINAL Z.C)NING
FlNAL COIVST. � FIRE DEPT FINAL
FINAL HEATING � � � NEALTH DEPT. FINAL � � ^`
FINAL ELECTRfC I ' ' DEV. FEES PAID ��
�
FINA!PLUMBING ' •. • � � , � �ENERGY _
, . . . .
I . i � _°- � � -- ---
CONiMENTS
._ . ----
_ _ . . �� . ; .=�
5EPTIG TANK SlZE `
SEEP PIT/U SiZE � --�—��-----" - ----
---- --------- ----
. � � J
, ' , . ..