HomeMy WebLinkAbout17836 �-.
�� CITY OF DIAMOND BAR --�-
i DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
2�s2s E.coPley Drive
(909)860.3195 Fax(909)861.3 i�� PRESS ,
��-���� SUILDINGPERMITAPPLICATION FIRMLY
o ADDRESS�S�D E(/�� eO(/Y�� DATECATION��CC' p'� NUMB R�I�S✓ p/C OOl I
��
a$ . ISSUE TYPE OCC
APN LOT TRACT DATE d CONST. GAOUP
p OWNER
� ADDRESS ZONING SETBACKS
g� FRONT RW ❑
CITY ZIP TEI. REAR ❑
APPLICANT TEL. SIDFJSIDE STREET RW O
� CONTRACTOR S ��- SIDE ❑
o CDDRESS � Z�P TE d' PROPOSED USE
o ARCH/ENG/
z DESIGNER
w NO.DWEL NO. NO.
n. ADDRESS
� CITY ZIP TEL UNITS STORIES BEDROOMS
cn
cn DESCRIPTION SQ.Fi. FACTOR PSF ADJ.AREANALUATION
o ', OWNER•BUILDER DECLARATION SFR/ADD/REM
p 1 MEREBY AFFIRAI UNDER VENALTY OF VERNRY TM�T I AM EXEUPT iROM THE CONTRACTORS LF Garage/Carport �
W CENSEUWFORTXEFOILOWINGREA50N(SEC.70.71.5BUSINESSANOPROFESSIONSCO�E:ANVCITYOR (n
C-� COUNTYWHICHREOUIRESAPERMITTOCONSTfiUCT.ALTERR.IPROVE.0EM0USH.ORREPAIRANYSTRUC• LLf
w NRE.PFIOH TO RS ISSUANCE ALSO f1E�UIRES THE APPIICANT fOR SUCH VERIJIT TO FlLE A SIGN[� W Patio/Deck
STATEIAENTTHIR NE OR SHE IS UCENSED VURSUANT TO THE PRONSIONS OF TNE CONTRACTORS ll-
� CENSELAW(CHAPTERO(COMMENCWaWITHSECTION7000)Of�IVISiON70FTHE8USINE55ANDPR0. u- PooUSpa
� FESSIONSCODE)ORiMATHEOR5HEI5IXEMPiTHEREFROMlWOTHEBAS�SFORTHEhLIEGEDE%EMP• (�
TION.ANYVIOUi1DNOFSECTION70]1.SBYANYAPGUCANTFORAiERMITSU&IECiSTHEMPLIGWTTO Z Re-Roof �
A GML�ENALT'OF NOT MORE TMAN FIVE MUNONED DOlUAS(f 500�.}.
zOL��NEROFTHEPROPEFTY,ORMVEMaLOVEESVnTNWAGESASTHEIHSOLECOIAVENSATqN, � COTrtfBtCi01
WILL DO THE WORK AND THE STHUCfURE IS NOi IMENDEO OR OFFERED FOR SALE(SEC.701�.BU51• J
N NE55 ANO�ROFESSIONS CODE:THE CONTMCTORS LICENSE LAW DOES NOT A7�LY TO AN OWNEF OF ?
PROPEHfY Mh10 BUlD50R IAAPROVES TNEREON,ANO WNOOOES SUf71 WORK NIMSELF OR HERSEIF OR
Q THROUGHHISORHEFOWNE4VLOVEES,PROViDED1HRTSl.ICHWVROVEAIENTSARENOTMTENDEDOR m
Q OFFEREDfORSALEIF,IqWEVERTMEBUIIDINGORIMPROVEAIENTIS50LDWITHINONEVEAROFCOMPLE-
Z TION.TME ONT�ER-BUILDER WILL FUVE THE BUROEN OF PRONNO THAT HE OR SHE DI�NOT BUILD OR
� IMPitOVE fORTHE PURP0.5E OF SALE}
0 4�OWNER OF TME PROPER7Y,AM E%QUSNELY CONTMCTINO WITH LICENSED CONTMC�ORS
� TO CONSTRUCT THE PROJEC7(SEC.70I1.BUSMESS AND PFOFESSIONS CODE:iHE CONiMCTOR3 LI• V81118t1011 �C `� ADJ.AREA
W CENSEUWDOESNOTMPLYTOANONMEROFAVROPERTYNRiOBUILD50RdAPROVESTHEREOttANO
� NM1fOCONTMCTSFORSUpIPRO,lECTSNATHACONTMCTOR(S�LICENSEDPURSUANTTOTHECON7M6 QUANTITY ESCRIPTION FEE
Y T00.5 LICENSf LAW.). �,
¢ O IAM E%EAIPT UNDER SEC. B.8 BQ FOR THIS REASON Q ,
� " " � 6 0
�, a
Z DA7E OWNER � r �
0 W
� LICENSED CONTRACTORS DECLARATION W
� IHEAEBVAFFIRMUNDERPEW�ITYOFPEIWRVTHATIAMLICENSEDUNOENPROVISIONSOFCHAPTER
p� 0(COMMENCP7OWfT11SECTION7oo0)OFDMSION�OFTNEBUSINESSANDPROFESSIONSOODE,AND Z Q
`L MY LICENSE IS W FUII fORCE IWD EFFECT. � ` •
� UCENSE CL.A�SS C'y-���UC.NO. � ��� /�� � q� � _/�
V .DATE�l�et� GONTRACTOIi_ l/�t/t�� d V `�?
W J ZV
� +'WORKERS'COMPENSAT�ON DECLARATION � � 1
NIHEREBYAFFIRYUNOERPENAlTYOFPEFWRYONEDFTMEFOLLOWWGDECUMTqNS: Z
� _IHAVEINDWILLMIVNTAINACERTIFICATEOFCONSEMTOSELF-INSUREGORN9RKERS' $
� COMPENSA710N,A57ROVIOEDBYSEGTIONa70oOFiHEtA80i1COOE,FORTHECERFORMANCE W
OF THE WORK FOR WMlpf iH15 VEHMIT IS ISSUED. �
0
_I HAVE AND MALL MAiMAW WORKEPS'COIAPENSAiION INSl1RANCE,AS REOUINED BV SECTION
Q J70oOFTHEUBORCODE,FORTNEPERFORAIANCEOFTHEWORKFORWHiCHTNISPERMRIS � O
ISSUFA.Rf'/WORKERS'COMPENSATIONWSU ELARRIERMIDGOIICYNUMBERARE: CONSTRUCTION
jc�RaieA PLlW REVIEW
o aa�crr�u�eER ELECTRIC
¢
0 (nassEcnor+r�IDwTeEm.at�oaFn+Evcaurswnau��ooa.utisK+�toa�ss) PLUMBING (' r v
w 1
Z ICERTIfYTMATMTHEiERFORMMICEOFTHEWORI(FORWMICMTHISVERMiTI515SUE0,1 MECHANICAL t�l �
C} SHAII NOT EMPLOYANY PERSON IN ANV MANNER SO AS TO BECOME SU&IECTTO TNE
y NqRNERS'COIdPENS�TqNLAW50Fd0.1FORNIA.ANDAGREETHATIFISIiDULDBECOME INSPECTIONFEE
S 5116)EC7 TO TME YJORNERS'Cd.IPEN5AT10N PRONS10N5 0F SECTION]700 0F iME IABOR
cooE.isxulcoatNwinrca+a�vwin� osevarnnsar�s. ISSUANCE �
� + u��l� SMIP
p DATE: APPLICANT:
� WANNING: U SECUR RKERS'CAMPENSATION COVEFAGE IS UN WFUL AND SNALLBE ENERGY P/C
�y SUBIECTIWEMPLOYERTOCRWINALVEIULTIESANOCNILFWESUPTDONEHUNDREUTHOUSANO ENERGYPERMIT
DOLLAFIS(f 100.D00�IN ADDITON TO TNE COST OF COMPENS�TqN,DAMAGES AS VROVIDEU FOq IN
J SECTqN�7ooOFTHEtADORCOOE,WTEREST,ANDATTORNEYSFEES. RETENTIONFEE: �u
Q
� CONSTRUCTION LENDING AGENCY PRE•ALT FEE: ' �
� IHEREBVAFFlqMUNDERPENALT/OFPERIURVTHAT7HERE15AC0115TRUCTIDNLENDINCAGENCV �
n- FOR iHE PERFORMANCE OF THE WORN FOR WHICH TNIS PERMIT IS ISSUED(SEC.7ov7,CN.G).
Z
W '
� LENDEH'S NAME
•
� LENDERSAODflE55 '
� TOTAL FEES ���O�a� ' (pQ Z��j�
� 1 CERTIFY THAT I HAVE READ THIS APPLMJ�7�ON ANO STATE THAT THEABOVE WFOWAA7qN IS CORRECT.
� IAGREETOCOMPlYN7THKLCfTYANDCOUMYORDWANCESANDSTATELAWSREUTINOTOBU0.DIN0
� CONSTRUCTION,NiOHEREBYAUTHORIZEREPRESENTATIVESOFTHISCWNTYTOENTERUPONTHE
Z ABOVE�MENTIONEDVROP RTYFOflWSPECTIONPUHPO5E5. � COMMENTS
_ ��0'���� �111
¢ PER/ArtTEE NAME(FPINT) � �� �
d7 � _
� SIGNANREOFPERUITfEE � DA7E
� ' RECPL NO. PAID BY VALIDATION
� WHITE—O¢partment Copy,YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—Applicant's Copy
.. .. . . . . ''�"!' . . ... .�J�.. �i' .. . .... ).� a �..—�1 . �� . . . . . . ��,.,r . . .p�.. . ' . . . . .• — . . ... . . .., -
1!T`�' �� [�'.�:i�J(r!�7 �3���
st�S��_C�3�iC)f'� F�LCa.7F:�
�..}.
��.�►��,-�.a::;c1rl��►,e_� G},t�, ��:1►�E�.a:�c ��,a�-;�..____..�._i�;Ey�� dc �r�9��1 �m ej���'= � �I��l��;lc.,c'�F'c�,��, '
;; �- -� ----._ ---- - __..._ __ . _ . .. .�_. � �____.�_�_._._-�._�.____.__Y__.
_ ._ ..__...____.� .__..._._. ._._
• SEl'BACf: � I j FLOOP,JOIST �
FTGS/FOR"�1S,STEEL ���2 �� � , � I FH�;REQ^�1TS �
� ELECTRIC GROUND ( � ' ( UNDER FLOOR DUCT
GROUND PLUMBING I _ _ I U(;DER FLOOR CU�'�!DUIT _
SLAB GRADE FIREPLACE FOUfJDATI�JN
TEMP POWER I FIREPLACE E30NG 6EAM
WATER SERVICE P,4iD HT. �OND BE�1"�1 �
ROOF SHEATHING . 8 F7. BOPJ� EEAh:t �
FRAMING,NENTILIATION I FIfJAL BOND 6EAM
ROOF COVER � ' PRE-GRP.DING
ROUGH HEATING BE��I�NING �
ROUGH ELECTAIC ROUGH GRADING • �
ROUuH PLU"�18IPJG � �D Z ' 'T-i1VtSH GRADING � /
; SHOWtR,rTUBTEST ____ � POOLELECTRIC �"�/��pL �
� EXT. LATH/SIDING ' I PCOL FENCING �, i E7lo Z ' �
b"JALL IfJSULATIOPJ —� POOI.FI�AL _ �2r,l�2� ��
CEILING INBULATION OFF SITE Ih1PS. / I
� DRYVv'ALL NAIUNG DEDICATIONS � ,
SE1�4'ER FINAL ENG.
SEPTICTANK LANDSCAPE/IRRIG. �
SEEP PIT/L.L. I ` ON SITE 1��1PS. �
G.AS AIR TEST ��� GL I FINAL ZOMfJG '
Fif�lAL CONST. � � � GIRE DEPT. r=1tJA!
FINAL HEATING ^ ; __ �_� HEF�.!TH DcPT. FINAL
FINAL ELECTRIC i � DEV. FEES PAID
FINAI.PLUMBING _{� ENERGY
.I
�,._,,. .�.-._. ..._--...�._____-__..._....
, � �C � , s.�o � i����
Y---_ _--------- ---..._..LL_ �_ ._ _ _ .: ._. .._
COMMENTS
SEPTIC TANh 51ZE
SEEP PIT/U SIZE
__,�y i�.,
; :
�}r� `
::� � � � . -
.�. .