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HomeMy WebLinkAbout13-093 CITY OF DIAMOND BAR �j -�"-1F�— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � �I���," 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �"�^'. BUILDING PERNIIT APPLICATION FIRMLY � JOBSITE n � ' i ¢ ADDRESS �I�I� p�O�Y�I.�'t4G� ul'. APPLICATION PERMIT�3—�}� p/C p DATE o NUMBE � � p � ISSUE TYPE � /��� pCC APN LOT TRACT DATE CONST.�'��4� GROUP °C OWNER a'�an� t/U1n o i o ADDRESS I n �:n c ZONING SEfBACKS z CITY � AL ZIP Y/9� TEL.4 -� �.-o Z.V FRONT RW O ' � APPLI ANT TEL. REAR p Z SIDFJSIDE STREET RW ❑ i m CONTRACTOR �QCJe"�eIC P�oo`�Z1�q _ SIDE p � � ADDRESS 1-S"1�W_ $f'� t'f �220 � � CITYC.ol /F/l��Pl ZIPYaCEI'� TEL.L22)Z�-l327Z PROPOSEDUSE �l(N cz,r � o ARCH/ENG/ � —. z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES �_BEDROOMS � � DESCAIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBY AFFlRM UNDER PENALTY OF PERIURV THAT I AM E%EMPT FROM 7HE CONTMCTORS LI- G8t2fJB/CafPOR W CENSEUWFORTHEFOILOWIN(3REASON(SEC.7031.SBUSWESSANDVROFESSIONSCODE:ANVqTYOR (� C-� COUNTYWHICMREWIfiESAPERMITTOCONSTAUC7,ALTER�PROVE.�EMOl15H2ORREPAIHMIYSTHUG � w NRE,PPpR TO RS ISSUANCE,AL50 REOUIRES THE APPLICANT WR SUCH PERMIT TO FlLE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LJCENSED PURSUANT TO THE PflOYI510N5 OF THE CONTRACTORS ll- � � � � CENSE UW(CHAPTER v(COMMENCING VA7H SECTION 7000)OF DIVISION 7 OF 7HE BUSINESS AN�PRO POOUSpO Q FESSIONSCOO�ORTHATHEORSHEISEXEMPTTNEHEFROMANDTHEBASISFORTHEALLEGEDEXEMP- � /� V TtON.ANVVI0U710NOFSECTION7o3i.5BVANYAVGLICANTFORAPERMITSU&IECTS7HEAVPIICANTTO Z RaRoof �OOO (��J � A CML PENAL7Y OF NOT MOPE THAN FIVE HUNDRED DOLURS(SSOD).): ❑I,ASOWNEROFTHEPROPEHTI,ORMYEMPLOVEESWITHWAGESASTHEIRSOIECOMPENSATON, � COrtifllBfCi81 Z N7ll DO iHE WORI(AND THE STRUCTURE IS NOT IN7FN�ED OR OFFEHEO FOR 9ALE(SEC.7o�a,BU51- J � NESS AND 7ROFESSIONS CODE:THE CONTMCTORS LICENSE LAW DOES NOT APPLY 70�N OWNER OF � VROPEHfY Vh10 BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w7HqOUGHHI50HHEROWNEAIPLOVEES.7ROV10EDTHA75UG11MPROVEMEMSARENO7INTEN�EDOR m � Q OFFEAmFORSALEIF,HOWEVERTMEBUIIDINGORIMPROVEMEMIS50LDWfTHINONEYEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL HAVE 7HE BUROEN OF PRONNG THAT HE OR SHE DID NO7 BURD OR � IMPROVE FOR THE PURPOSE OF SALE} - , w ❑1.AS OWNER OF THE PROPERTY,AA1 EXCLUSNELY fANTRACTINO WITFi IICENSED CONiRACTORS [[ TO CANSTRUCT THE VR0.IECT(SEC.7oN,BUSINESS AND PHOFESSIONS CODE:7HE CONTMCTORS 11- V81U0IIDf1 ADJ.AREA W CENSEUWDOESNO7APPLYTOANOWNEROFAPROPERiYWHOBUILD50RIMPROVESTHEAEON,AND � NM1IOCOHTRAC75FORSUCHPROJECTSWffHACOMMCTOR(S)IJCENSEDPUR5UAN770THECONTMG QUANTITY DESCRIPTION FEE � I Y ioRS uCENSE uw.). � D��M El(EMPT UNDER SEC. B.8 P.C.iOR THIS REASON Q i ?� U LL' DATE OYMER � � �Q LICENSED CONTRACTORS DECLARATION w CC I HEREBYAFFIRM UNDER PENAL7Y OF PERIURV iNAT IAM LICENSED UNDER GROVISIONS OF CMAVTER � p� G(COMMENCINO WITH SEC�ION 7000)OF�IVISION]OF hIE BUSINESS AND PROFESSIONS CODE,AND Z X 4Y LICENSE LS W FULL FORCE AND EFFECT. m � LICENSE CLASS Gy / LIC.NO. O ' (����J� � � V DATE j�� Z.��,_ COMRACTOR /!./� a W � WORKERS'COMPENSATION DECLARATION Q � U � 1 HEREBV AFFIRM UNDER PENALTY OF VERIUflV ONE OF THE FOLLAWING DEClARA710N5: Z . ' . � _IHAVEANDWILLMAINTAINACEqTIFICATEOFCONSENTTOSELF-INSUREFOHVARKERS' a COAIPENSATION,tiS PROVI�ED BY SECTION J7oo OF 7HE UBOR CDDE,FOR THE PERFORMANCE U OF TiE WOFIC FOR NM1iICH THIS PERMIT IS ISSUED. W � � W � Q � �1 HAVE AND WILL AWMAIN WOqKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION /� 37oa OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORI(FOR WHIOi THIS PERMI715 - ��v•�/ �� ISSUED.MY WORKERS'COMFENSATION INSUWWCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION Q L/ J j CAHRIER S'���G ��� PUW REVIEW 0 PouCYNUMBER (q{�'���ri ELECTRIC Z Q 0 �sSEcnonN�r�o7eEm's�ErEooFn�varxr�swap�r�x�mppl�ns�sioo�pqt�ss� PLUMBING w Z 1 CEFTIFY 7}iAT IN hiE PERFORMANCE OF THE WORK FOR WHIGi TNIS PERMIT IS ISSUED,1 MECHANICAL CJ SFiAL1 NOT EMPLOY ANY PERSON IN ANY MAtJNER SO AS TO BECAME SUBJECT 70 THE - ' (/� WORKERS'COMPENSATION UWS OF CALIFOqN1A,AND AGREE T1AT IF I SHOULfl BECAME INSPECTION FEE = SUBJECT TO THE WORKERS'COMFENSATION PROVISIONS OF SECTION J7oa Of THE LABOR COUE.I SHALL FORfMHIT/COYPLY WITIi THOSE P S10N5. ISSUANCE ✓ 0 p OATE: � �'� APPLICANL � -SMIP y � W � J WARNINO:FAIWRETOSECUREWORKERS'COMPENSATIONCAVERAGfISUNUWFUI,ANDSHALLBE ENERGYP/C � SUBJECT AN EMPLOYER TO CRIMINAL FEHALTIES ANU CNIL FlNES UP TO ONE HUN�PED 7FKKISAND ENERGY PERMIT DOLURS(Stao,000J,IN ADOITON 707HE COST OF COMPENSATION,�AMAGES AS PROVIDED FOR IN J SECTION 37a!OF THE LABOR COD�IN7ERE5T,ANO ATTORNEY'S FEES. � ¢ RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HER�Yl�FlRM UNDER PENALTY OF PERIURV THAT THERE IS ACONSTRUCTION I.EN�INO AGENCY � ��(� //�� ZFOR T1E PERFORAUNCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.CJ, j�-�y - I "� �� w v!/1'�0 � LENDERSNAME � f-- LENDERS ADDRESS � TOTAL FEES �'�,[l(� � I CERTIFY THAT I HAVE READ THIS APPLICATIOH AND STATE hIAT 7NE ABOVE INFORMATION IS COfiAECT. w IAGHEE7000MPlYWRHALLCIIYANOCWNTYORDINANCESM105TA7EUW5HEUITINGTOBUILDING � CONSiRUCf10N,ANDHEREBYAUT}iORIZEREPRESENTATIVE50F7HI5CWNTYTOEHfERUPONTHE ' �� �BOVE-MEMIONED VROPERiY FOR INSPECTION PURPOSES. o COMMENTS J � Ton --F� J N PERMfTT�Nn � ��� � . � � SIGNANREOi'PERMITTEE� -- DATE � ✓– � RECPT.NO. PAID BY VALIDATION � �,-_.. J WHITE-Department Copy,YELLOVJ--Finance Copy,PINK—Assessor Copy,GOLDENRO�Ie Copy,GREEN—Applkant's Copy j,. ,.��. ..�.� �•-�„ r �; ,;�, ,,;..� _ ::< .M�F� e i..J �_ a i•�'�i'"i.l ,�i`:i:_. ;f'.i 3t.,1�"� . N'�Yj p'�..8' 1�.;.�,n+J`�•9�,�Y'�'� a�...�✓�{����� ��.:'. . ' �5 " . . " . . ` . �..r . 4.'. .�rr�� � � '' y�. Y'a ,."��L! � .,A:y6k �.t�'��� .���•�6 P •-(�Iti � .�.l��f.' } ....1; 1 p. 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FRAMING/VEN1lLATION j FIPdAL BOfdD BEAM -- --- --- -- . _.__ . __. -- .--_- -----�--------- -- -- ----- --- -- - - `- 1 ROOF��� ..._ _ _�_ H F�J- --- �PRE-GRADING . ------------- - _ --- - _ ROUGH H�ATI�JG � REPICHING -- ---- - ---- _---- ------ - ____ -- --------------._ _._._.----.. � _....., ._...__...------ ---- - --------- ROUGH ELE��TRIC __ ROUGH GRADING _ __ ROUGH PLUMBING � _ FINISFI GRADING __ SHOV�/ER/TU6TEST _-I- IPOOLELECTRIC _ EXT.LATH'SIOING I POOL FENCIiVG 4VALL Ih15Ul_ATION I POOL FINAL CEILING It�dSULATION � ��OFf-SITE IMPS. DRYb�/AlL P�!,41LING �DEDICATIOiVS .. -------......_._._---.....__....._._. � -------------- — - _ .. ------..----._.__..._..------_._.._._.---__.__.__._._._.___..__ SEN/ER �FINAL ENG. -------------- - _.. ..----- - --- �--- -------------- __ --------------..._ . ------- ------------ SEPTICTANK i LANGSCAPE/IRRIG. ____ _.. _--- ------- - �- - ---_. .---------- ----- - - ------_ ---- ----. _.._ SEEP PIT!L.L. ,OhJ SITE INiPS. ----- ---- --- ----- r-- -- - ---- GAS AIRTEST ;FINAL ZO�IING _ _ FINAL CONST. (FIRE DEPT.FINAL �INAL FIEATING � _ �HEA TL H DEPT.FINAL • _ ��- FIN�L ELECTRIC DEV.FEES PAID FINAL PLIIMBI�IG ENERGY FINAL PLANING --- -__..------------------------------ ----------------- -�---------�- FINALFNGII�ItERING h��'��� -,�-��'� ' . �- connMEr��s �fl SEPTICTANI<SIZE � SEEP PIT/U SIZE -�,M;,; � �, A + .� _ �.1 R � •.,� - �� � p•� r } �f.. �I -���, ��r - �,�� V