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Home My WebLink About12-2172 CTTY OF DIAMOND BAR � �-�-1�! — DEPARTMENT OF COMMUNI'1'Y&DEVELOPMENT SERVICES � I 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ��'^^'� BUII,DING PERMIT APPLICATION FIRMLY y�, JOBSITE U� � .n ' ' APPLICATION �_ I�� Z� PERMIT j'Z_�,�/E o ADDRESS � DATE �� NUMBER� ii � ISSUE y �y TYPE ��. OCC APN LOT TRACT DATE < < <� CONST. Lf . � ROUP p OWNER i S � ADDR S b 1 � ZONING SETBACKS oCIIY Z q I l b�i TEL b5O" FRONT RW ❑ • APPLICANT TE REAR •❑ � SIDE/SIDE STREET RW O ¢� SIDE ❑ CONTRACTOR �.V ¢ ADDRESS ' PROPOSED USE � ' 0 CITY�noj'cn�nA L��M ZIP Q2 TEL ` - 10 / [ o ARCWENG/� —�- �� z DESIGNER a NO.DWEL. NO. NO. a ADDRESS 'i�ob� I .�.�I�nK ' 1. � —� UNITS STORIES BEDROOMS � cirv l �•�' ZIP TEL��5� cn DESCRIPTION Sd.FT. FACTOR PSF ADJ.AREANALUATION p� OWNEi7-BUILDER DECLARATION SFR/ADO/REM O � �. I HEA�V AFFlRM UNOEA�EWLiY OF VERWRY THAT 1/W O(EMVT FROM THE CONTRACTORS LL Garage/Carport W CFNSEUWFORTHEFOLLOWWORFJ�40N(SEC7m1.6BU5WE5SPNDPROFESSJON5CO0EANYCITYOR (n U CpUMYWHICMpEWIqESAPERMITTOCONSTAUCT,ALTERDAGROVE.DEMO11511,ORRE➢AIRANYSTRUG W patiolDedc � TURE,PRIOH TO rt5 LSSUANCE,ALSO REOUIRES THE APPUCAHf FOR SUCH VEAMR TO FlLE A SI(3NE-0 w STATENENT THAT HE OR SHE IS LICENSED FUiLSUANT TO THE PflOVI510N5 OF T}IE CONTRACTORS U- � CENSE UW(GHAPTER 9(COMNENCWO V/fiM SECTIO!!'lo00)OF OIVISION 7 OF TNE BUSWE55 ANU PF6 � PooVSpa 0 FESSIONS CODE)OR iHAT HE OR SNE 19 E%FMPTTHEREFROM AND THE B/SIS FOH h1E ALLEGED E%EMP- C7 � V T10N.ANY VIOIATION OF SECTION 7o3t.5 BYINY APVLICANT FORA PERMIT SUBJECTS THE APPLICANT TO Z R9-ROOI A CMl PENAIJV OF NOT NORE THAN FNE HUNORED DOLURS(fSOD).}. � ❑1A50WNEHOFTNEPROPEHiY,OR1AYENPLOYEESWT/WAGESASTMEIRSaIECOMVEN5A710N, �,pmmBfGTI -. � Z YALL DO THE WORI(MA hIE 9TRlKTURE 13 NOT INTEN�ED OR OFFEREO FOH SALE(SEC.7oN,BU54 �J � NE55 MIO GROFESSIONS COOE TME CONTMCTORS LICFNSE LAW DOES NOT A7V�Y TO AN OWNER OF � PROPEHTVYVFiOBUIl0.40RIMPROVESTHEREON,MIDWHODOESSUCHWORKHWSELFORHER5EIFOR� Q THiqUGHW50RHEHOWNFAIPLOYEES.PFOVmED7HATSUp/WPROVENENTSMENOTPlTENDEDOR m Q OFFERIDFORSKEIF,HONkl�ER7NEBULDINGORWPROVEA/ENTI550LDYATHINONEYEMOFCON%.E- Z TION.THE OWNER�BULLDER WILL NAVE TiE BUFlOEN OF 7ROV WO TiAT HE OR SHE DID NOT BUILD OR � NIPROVE FOR TNE PURPOSE OF SALE} . w ❑I.ASOWNEROFTHEPROPEH7Y,AAIEXp,USNElYCO1RRACTW6NTf1ilICENSEDCONTRACf00.5 Q TO CONSTHUCT THE VRQIECT(SEC.7w1,BUSINESS ANO Pi�FESSIONS CODE:iHE CANTiUC70R5�l- Valuation D 0 - ADJ.AREA W CENSEUWDOESNOTMRYTOANOWNEAOFAPROPER7YH?tOBUqD50RIMPROVE97NEREON,MID � WHOCONTAACTSFORSUCHPRO.lECr9WfTHACON7MCTOfi�SJLICENSEDPURSUANiTOTHECOHTMG qUANTITY DESCPoPT70N FEE � Y 700.5 LICENSE Uw.} . ¢ ❑I AY D(ENPT 111�ER SEG B.i P.C.FOR TMU^REASON � � U � . Q DATE OWNER F- Z w QLJCENSED CONTRACTORS DECIARATION w � OC I HEREBY AFFlRM UNDER PEWLL7Y OF PERAIRY THAT IAM LICENSED UNDER PROVISIONS OF ClUPTEA � d Y�COMMENCINO WITH SEC�ION 7oao)OF DMSqN]OF THE BUSINE55 M!D PROFESSIONS CODE,IND , Z X W LICENSE 49 M FULL FORCE AND EFFECL /,' m � UCENSE CLAiSS �� lK.N0. ✓ � I .I`� � j V DATE �2 1�Z.I�Z CONTRACTOR � a w . .. j' � � WORKERS'COMPENSATION DECIARATION '" � � � ' � I HEREBY AFFIRAI UNDER PENAl7Y OF PERIUM ONE Of TNE FOLLOWINO DECLAiUT10N5: � Z � _I NAVE AND YALL MAIMAW A CERTIFICATE OF CANSENT TO SELF-WSURE FOR WOPoCERS = Q C011PENSATiON.tiS PROVID�BY SECTION 7�0o Of tHE LAeaR cOOE,FOR THE PERFOHMANCE �U Q E WOPoC FOR NMICH TNIS PERMIT B ISSUED. , � � 1 HAVE AND WILL MAINTAW WORKERS'COMVENSATION INSUHANC�Il5 REWIRED BY SECTION � Q J7oo OF THE LABOR CODE.FOR THE PERFOf7MNJCE Oi THE WOPo(FOR WMCH TMIS PEH1,aT IS � I%�-+ ,/ O issum.r+r worix COMPENSATION INSUMNCE CARqIER AND PoIICY MIMBER AAE CONSTRUC'fION b � j h cu�w� �t� �'�,'�n n �,C . �r� PL{W REVIEIN C S '1• 33 . Z vauw r+un�e� �q�' R ELECTRIC "�� II ¢ p (rrossecna+r�IDr+oreE�FrIDavn�aw.�rsFoaor+e�xa�oamooueasK�mlaa��s1 PLUMBING Z �CERTIFY THAT W h1E PEiiFORMINCE OF iHE WORK FOR WFIItl1 TNIS PEMUT IS ISSUED,I MECHANICAL C'J SHN1 NOT EhIPLOY AHY VERSON W ANY MMlNER SOAS TO BECOAIE SUBJECT TO THE � WORKERS COMPENSATION LAWS OF CALIFORNI/�µD A6REE 7HAT IF I SHOUlO BECOME INSPECTION FEE = SUBJECT TO 7HE WORKEFS COMVENSATqN PROVISIONS OF SECTIdJ a7ao OF THE l�1BOH COOE,IS/iALLFORTHWITNCOMPLVN77H PROVISqNS./ ISSUANCE .�� p DATE J Z�/ �/I�Z APPLICANT: T�/)`�/ � .s1�A�P � :. � w ENERGY P/C � � WARNWCi:FAWRE TO SECVRE WOAlCERS LOMPENSATION CAVERAGE IS UNUWFUL,AND^uMALL BE ' � SLJAIECT AN EMPLOYER TO CAIMM�L PENALTIESlWO tlVIL FWES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOLURS(f100.000�W AOD1710N TO7HE CO3T OF COMPENSATqN,DAMAGES AS PROVIDED FOq IN J SECTKIN�70A OF THE LABOR CODE,WTEAEST,ANO ATTORNEYS FEES. ¢ RETENTION FEE: •QD OCONSTRUCTION LENDING AGENCY Pq�-ALT FE� �' I MEREBY AFFlRM UNDER PENAL7Y OF PERIUqY THAT THERE IS ACONSTRUGTION LENOINO AIiENCY �/`/ � .� O �Z FOR TNE PEAFOHAIANCE OF THE WOPo(FOR WHICN THI9 PERIAT IS ISSUEU(5EG]097.CIV.G} �'�� W � LENDER'S NAl1E � . , • � . � LENDERSADORE55 w I CERTIFY THAT I HAVE READ hll$APPUCATION AND STATE THATTHEA90VE PlFOHA1ATION IS CORAECT. TOTAL FEES . � G f�� .�� I A6REE TO COMPIY NAhI ALL CfTY/�NO COUNTY ORDINANCES PND STATE UWS REUTW 6 TO BU0.dN0 � CONSTRUCTION,AND HEREBY AUh10RIZE REPRESENTATIVES OF hI15 COUNTY TO EHfER UVON 7HE . : , � ' . _ Z A80VE-MENTIONED PROPERN FOR WSPEC7ION PURPOSES. COMMENTS 0 m L�r�.�►� CjCe�C�� . Q �ERM�T7EE NMIE( � �✓� � � Z.� 1�� . . � StONATU PERMfTTEE DATE � � RECPT.NO. PAID BY VALJDATfON - � WHITE-0epartmenl Copy,YELLOW--Flnance Copy,PINK—Assessor Copy,GOIDENROD--File Copy,GR ApplkanYs Copy ' � � a;�`�';� x��` ��4�`�� :�a�=a �'s�+�,�.o�d�h��3�'� ��.'�� JI];�^:{tA��`��i��'''�F 'fJ�.y�\��+f�L��t+�_��'jFr �'i'.T JV��,�+��'��G-��i�"Y�W� ��z�`��'k��c�3� �,�t�r'-'Tk��a+ '� 4f h�-...F�,�r�.rs� �yX,,f _. :r.o �' ,�.� m. "T . ..1.�_. � .P.t�^! _ :� .. 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I UPdDEP,FLUOR DUCT ---- — GROIIi•!DFLUi��16INV � —�---------------j I � UhJDER FLuOF CONDU(T SLAB GF�1DE � r— _� � _ FIRE?LA�E FOUlJDaTIUhJ —� __ -�EN9F FOI�V[f; , ----� FIREFLICE cOf�Q BEah� � VdAfER�EFVICE __I _ i �w�llD HT.BOf�ID eEANt _ R��OF SHEATHIf��G �_ �3 F�C BOfJD BEP.h� FRP,iV11f�1G/VEMTILA.TIO�I _I I FINAL BOND BEP.�YI_ __ __ _ ROOF COVER � PRE-GRaDING ROUGH HEATING f I BEfdCI-�IfdG ROUGH ELECTRIC � � ROUGH GRADING P,OUGH PLUP�131NG �— �FINISH GRADING SHOG�lER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING �NALI INSULATIO�J POOL FI�dAL CEILI�JG IPdSU�ATION i CFF SITE IMFS. DRYVVALL NAILING DEDICATIONS SE��/ER -------- -- --- �------ — FINALENG--- -- — -- — SEPTICTA�dK LP,NDSCAPE/IRRIG SEEP PITiL.L----------- �— �--- ON SITE IMPS. - --- -- GAS AIRTEST FINAL ZONING FIt�JAL�ONST. �-2I- f3 FIRE DEPT.FIP�IAL FINAL HEATING HEALTH DEPT.FINAL FINAL ELECTRiC DEV.FEES PAID FINAL PLUN1E31NG ENERGY � FINAL PLANING --------- ------ -- ___...—-- --- ---- -- FINAL ENGIi�EERING _ _ _ ° � � " C�MMENTS _.---- ---.------ --- — — SEPTICTANKSIZE SEEP PIT/U SIZE �– , � _ _— - – ---- - E ' � , ,