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HomeMy WebLinkAbout13706 ;r -=��• � CITY OF DIAMOND BAR � COMMUNITY DEVELOPMENT DEPARTMENT � , .,,.� . 21660 E.Copley Drive Suite 190 PRESS (909)860-3195 Fax(909)861-31I7 '""' BUILDING PERMIT APPLICATION FIRMLY y JOBSITE L�•�� V I�S �fA vf'- DATEICATION NUMBE #'C o ADDRESS r c� ISSUE TYPE OCC APN LOT �s TRACT DATE CONST. GROUP p OWNER �- ADDR�ESS � 4F ZONING SETBACKS Z CITY J�'l9'71Yf��– ZIP92&? TEL. FRONT RW ❑ g APP�ICANT TEL. REAR p � SIDElSIDE STREET RW ❑ � CONTRACTOR Vd' �.s' '/�' __^__ SIDE ❑ o ADDRESS CITY M�N?T"�'��M� ZIP fI• TEL. � - (r PROPOSED USE / o ARCH/ENG/ z DESIGNER NO.DWEL. � NO. NO. a ADDRESS UNITS STORIES Z BEDROOMS�� � CITY ZIP TEL. � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BI:iLDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFIRM UNDER PENqLTY OF PERJURY THAT I AM EXEMPT FROM THE CONTMCTORS ll- G81'egB/C81p011 LI,J CENSEIAWFOflT11EFOLLOWINOFEA50N(SEG.7031.68USINESSANDPROFESSIONSO�DE:ANYCINOR (f� V CWNTYWMICHREWIRESAPEflMITTOCONSTHUCT,ALTERIMPROYE,DEMO11511.ORREPNRANY5TRUG W Z NRE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPIICAN7 FOR SUCH PERMIT TO FlLE A SIGNED PatldDack W STATEMENT TIiA7 NE OR SHE IS IICENSED PURSUANT TO TME PpOVI510N5 OF TNE COMTMCTOR5 LI- W � CENSE UW(CHAPTER 9(COAAAAENCINO NATH SECTqN)D00)�F�IVISION 3 OF THE B1151NES5 AND�RO. LL' POO�SpB GESSIONSCODE�ORTHATHEORSHEISE%EMPTTHEREFROMMIDTHEBASISFORTHEALLEOEDEXEMP� (� � TION.ANYVIOLATKINOF6ECTION7IXlI.SBYANYAPPUCANTFOflAPEHMIT6UBJECTSTHEMP4CANTTO Z Re•Root F A CIVIL PENALN OF NOT MORE THAN FIYE HUNDRED OOLLARS(65oa�,): � ❑I.ASOWNEROFTMEPROPERTY,ORMYEMPLOYEESWITlIWACiE5R5TNEIR50LECOMPENSATpN, �0 COTRIBfC18I WILL 00 THE WORK,AND THE 97RUC7URE IS NOT IN7EN�E0 OF OGFEFED PoN BALE(6EG.7DN,BU51� J � NE55 AND VROFESSIONS CADE:THE CONTRAC70R5 LICENSE UW OOES NO7 APPLY 70 AN OWNER OF j YROPERTV YhlO BU0.DS OR IMPROVES THEREON,ANU WHO OOES SUCH WORK HINSEIF OR HERSE�F OR Q TFiROUGHMI50fiHENOWNEMPLAYEES,PROViDE�THAiSUqi1MPROVEMEM5APENOTWTENOEDOR m QOFFEREDFORSALEIf,FIOWEVER,THEBUILDINGORIMPROVEMEN7165dDW1TwNONEYEAROFC0IARE- z TION,THE OWNER-BUILDER WILL HAVE TME BVROEN OF PROVINO THAT ME OH SHE�ID NDT BINID OR � IMPROVE FOF THE PURPOSE OF SALE). W ❑I,ASONMEf10FTHEPROPERTY,AMEXCLUSNELVCONTRACTINOWITNUCENSEOCANTMCTORS � TO CONSTflUCT THE PROUECT(SEC.70sq,BU91NE55 AND FROFESSIONS CODE:THE CONTMCTOflS U- V8W8�Ip1 AQI.AREA W GENSEIAWDOESNOTAPPLYTOANOWNEROFAPflOPERTYNMOBUILDSORIMPROVESTMEREON,MO F WHOCANTMCTBFORSUCHPRO.lECTSWITHACONrMCTOR(S�LfCENSE�PURSUANfTOTFiECONTMC- QUANTTY DESCRIPTION FEE Y TORSLICENSELAW.). � ❑I/JA E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON a 3 U ODATE OWNER U � LICENSED CONTFACTORS DECLARATION W � IHEREBYAFFIRMUNDERiENALTVOFPERtt1AYTNATIAAILICENSEDUNDEHPROVI510NSOFCHA7iER � d 0(COMMENCING WRH SECTION 7000)OF OIVISION 30F i11E BUSINE55 AND PROFESSIONS CAOE,�ND Z �C YY LICENSE IS IN FULL FDRCE AND EFFECT. m �J� q�/ � `� LICENSE SS �� ^�' UC.NO. r S C V OATE L Z _ COMrRACTOR � � WORKERS'COMPENSATIONDECLARATION � Q L� �'— 2�S r � IHEREBY FIRMUNOERPENALTYOFPERJURYONEOF7HEFOLLOWINGDECUMTqN& Z .� /�,fJ� .I? i_[�� �G L ✓ /�7 [fY I � IHAVEANDWILLMAMTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' _ COMPENSATION,AS PROVIDED BY SECTION 370o OF THE LABOR CODE.FOR TFIE PERFORMANCE W Q OFTriEWOflKfORWHICHTHISPERMIT1915SUE�. � p O � � i � _IHAYEANDWILLMAN7AINWORKERS'COMPENSATIONINSURANCE,ASREIXIIREDBYSEC710N Q 87000FTHEI.ABORCODE,FORiHEPERFORMANCEOFTHEWORKFORWHICHTN45PEAMITIS ISSUEU.MY WOi1K C PENSATION I 'URANC ARRIEA AND POLICY NUM6ER ARE: �CONSTRUCTION } CARRIER � "� � ,�Nr• PLAN REVIEW ZVOLICYNUMBER � � ..�:.��� ELECTRIC d � (TFI6SECfqNNE�NOTBE00A1REfEDOFhEVERhMTISFORONE/1UnDRE00ttlAJiSISI�MORLES31 � 1 W � lZ I CERTIFYTNAT IN THE PERFOPMANCE OF 7HE NlORK FOR WHICM h115 PERMIT IS ISSUED,1 MECFIANICAL C� SHIILLNOTEMPLOYANYPERSONPIANYMANNERSOAST08ECOMESU&IECTTOTHE 7 v Uj NpRKERS'COMPENSATIONLAWSOf IFORNIAANOACREE7/UTIF16HOULDBECOME SUBJEC7TOTH WORKERS'COMPEN IONPROVISIONSOFSECTION37000FTHEUBOR � CODE. SHALL RTHWITHCOMPLYWIT SEPROVIS 5. ISSUANCE � � p OATE: �APPLICANT: SMIP � ENERGY P!C WARNIN6:FA RE TO SECURE WORKENS'COMPENSATION OOVERAGE IS UNLAWFUL.AND SHALL 6E � SUBJECTANEMVLOYERTOCRIMINALPENNLTIESANDCIVILFINESl1PTOONEHUNOREDTNOUSAND ENERGYPERMIT }, DOIURS(5700,0OO�,INADOITIONTOTNECOS70FCOM7ENSA710N,DAAIAGESASPROVIDEDWRIN J BECTqN 3708 OF THE LABOR CODE.MTEREST,ANDATTORNEI^S FEES. RETENTION FEE: � � CONSTRUCTION LENDING AGENCY PRE-AlT FEE: � 1 NEREBV AFFIRM UNDER PENALTV OF VERIURV THAT THERE IS A CONSTRUCTION LEN�INO AfiENCY FOR THE PERFORNANCE OFTNE WORK PoR WHICH THIS PERMIT IS ISSUED(SEC.9071,CIV.C.). Z W � LENDER'S NAME F- LENDER'SADDRE55 w ICERTIFYTFi11TIHAVEHEPDTHISAPPLICA7IONANDSiATETM�TiHEABOYEINFORMATIONISCORRECL TOTAL FEES �/ � 1�GREE TO ODA7PLV WITH ALL CITY AND COUNTI'ORDINNlCES AND BTATE UWS RELATINO TO BUILpING � CONSTRUCTION,ANDHEqEBYAUhqRIZEREPRESENTATIYESOFTHISGOUNTYTOENTERUPONTHE PBOYE�M IIXJEO PROPERTY FOR INSPECTION PURPOSES. C C�� COMMENTS m ��F'� Q PE E IP 1 l] �/ � �^ cn YL..��--�— FI Vj SIaN�TU�OF P Tf �ATE � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessar Capy,GOL�ENROD—File Gopy,GREEN—AppllranYs Copy - - _._ .. ..�_--- �---"�--" CITY OF DIAMOiVD BAR INSPECTItJf�! RECORD - a o � • s - � o e �. � . SET SACK � FLOOR JOIST FTGS/FORMSlSTEEL FHA REQMTS ' ELECTRIC GROUND UNOER FLOOR DUCT GFtOUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIAEPLACE FOUNDATION � TEMP P�WER FIREPLACE BOND BEAM- � � WATER SERVICE -� - MID H7.,B�NQ BEAM � � ROOF SHEATHING � � 8 FT. BOND BEAM FRAMINGNENTILIATIOIV FINAI:BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING RC)UGN ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TU8 TEST PODL ELECTRIC EXT.LATH/SIDING POOI:FENCING � WALL INSULATION � POOL FINA� CEILING INSULATION OFF S�TE IMPS. DRYWALL NAILING DEpICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSGAPFJIRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. � ) ; FIRE DEPT. FINAL FINAL HEATING /f o 4 f HEALTH DEPT. FINAL i FINAL ELECTRIC � DEV. FEES PAID FINAL PLUMBING I ENERGY , � . . . . . ---- - a � — _ CDA�lMBI�T�'.� � � � � ' . „�t , �� � . � . : ... , • � � `, SEPTIC TANK SIZE SEEP PIT/U S1ZE � i +. .