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HomeMy WebLinkAboutNo Permit Number . �J �� 1�� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � � 21660 E.Copley Drive Suite 190 � (909)8bQ3195 Fax(909)861-3117 PRESS ��'� BUII.DING PERMIT APPLICATiON �IRMLY � JOBSiTE .',_ APPLICATION v- b�i( PERMI �O P/C a A�DRE55 DATE � NUMBE it ISSUE TYPE OGC � APN LOT � AC DATE CONST. GROUP S OWNE - ADD SS ZONING SETBACKS � CI Z� FRONT R1N ❑ � APPUCANT - �',�,_ REAR p � SIDE/SIDE STREET RW ❑ CONTRACT R SIDE ❑ � ADDR S � � PROPOSED USE L CITY ZI ,� TEL. ` ' � ARCFUENG/ 67��r, � DESIGNER «����' ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BUILDER DECLARATION S' ' p $FRlADD/REM 1 HEREBY AFFIRM VNDER PEN�LTY OF PE0.IURY THAT I 1lM E%EMPT FN01A TME OONTMCTORS ll- G8f99B/GBIp011 CENSEtAWFOR7HEPOLL0IMNOREASON(SEC.7031.6BUSINESSANDPROfESS10N64:ODE:l1NYC17VOR (n 1:OUNTVVNi1GMRE0UIRE5APENARTO00NSTRUGLALTER,MPROYE,OEMOU9H2ORp@PAIRANY9TRUC• W Pa�a�� � TURQ PRIOH TO RS ISSUIWCE,PL9011EDUWES TiE APPLICANT POR SUqi PERMIT TO HLE A 61ONW � BTATEMEM THAT XE OR SME IS UCENSm R1R5UMIT TO T11E PRDVISiONS OF TME WNTRAC70R5 LI• CBI5E LAW(CNAPTER Y(COMMENCINO Wlhi BECTION 7000)OF UiVISION 9 OF 7HE BUSINESS AND FR0. � POOVSpH FE8310N5OOOE)Oil TlUR NE OR SHE IS EXEWPT TNEREFROM ANO iiiE BASIS FOR THE hlLEOED EEENP• TION.ANYVpLAiqNOF8ECT10N70J1.68VANVAP7LICANTFORA►ERMITSUBJECTSTHEMPLICMlTTO Z Pa-Roof � ACMLPENAI.T'OFNO'TMDRE171NIFIVENLNDREDDOlL+1R5It500).�: . . . ' 04ti:��EROFTHEP110PEHfY,ORMYEMPLOYEESWITHWAGESASTHE1RSAlECOMPEN&ATIDN, Q CORIRIBfC181 WILL DO THE WORK,AND iHE STRUCTURE IS NOT IMENOED OR OFFERED FOR S�LE(SEC.T014,.BUSI� J NES9 AND PROFESSIONu GaOE:iME CONTMCfORS IICENSE LAW COES NOT APPLY TO MI OAMNER OF y PIpPER(YWFq8U0.U50RIMPROVESTIERC-0N.ANOWHOOOESSUpIWORKHIMSELFOqMER$ELFOR = � TNRDUGHWSORNEROWNEMPLAYEES,PRONIDEOTHATBUCHYAPROVEMENTSARENOTMENOEDOR m OFFERED FOR BALE IF,NONIEVER7HE BUlD�NO OR IMPRDVEMENT IB SqD 1MTFpN ONE Y6AR OF COMPLE� TqN,IItE ONMER�INLOEH WILL NAYE TME BURDEN OF PRONNO THAT NE OR SME DIO NDT BUIID OR IMPHOtlE FORTME PURPOSE OF tALE). � O1�60WNEROFTHEPROPERTV,AMEXCLUSNELYCONRUCTIN�WITHLICEN9EDCONTRACTORS TO CONSTRUCT THE PROJECT(BEC.7a14,BUSINESS AND PROFESSqNS CODE:THE CONTAACTORS U- VBIUgt10n ADJ.AREA CENSE lAW DOES NDTMPLYM AN 01MNER OF A PROPERTYYYIfO BUMS ON IMPROVE9 THEREON.ANO � 1MpWNTRAf.'TSFORBUCHVROJECfBWIlMA00NTMCfOR(9)LIGENS�PURSUMliTOTHE00NTRAG pUANTITY DESCRIPTION FEE � 70i16 4CEN6E UW.�. O I MA IXE11PT IMOER 9EC. &8 P.C.WR 7HIS Rfi1150N � " U � � !e ii DATE 01MiER V � LICENSED CONTRACTORS DECLARATION w � 1 NERFBY�FFIRM UNDER PENALTY Of PE0.IURY TFI+U T AM UCENSED UNDER PpOVIS10N5 OF CHAPTER � i�C01IYENGNO WITH SECTION 700D)OF DNISION 7 OFTNE BUSINE55 ANO PROFESSIW�S COOE,AND Z X MY UCENSE IS IN FULL PD AND EFFECT. LLl ..� � o u��� s u�.No. 7.�- _ � � a� ���� � WORKERS'COMPENSATION DECLARATION � � 1 HEREBY i1FFIRM UNDER GENAL7Y OF PEitJUFiY dJE OF THE FOLLOWINO DECLARATIONS: U C!� Q � _INAVEMDYVILLMAINTNNACENfIFICATEOF0ON5ENTT080.F•INSUHEFORWUFKERS' � OdAGENSATI0N,.4SGHONDE09VBECTIONDWOFTHELABORCODE,FORtHEVERfORMANCE W OF THE NfORK FOH WHIp17H1S PERMIT 18155UED. � C i FMVEAND WILL MAR7TNN WORI�RS'COMPENSATION MSUMNCE.AS REOUIREO BY$ECipN Q s7oo OF ME IABOR CODE.FOF THE VERFOHMRNCE OF THE 4YORK FOR WHICH iHIS PERMIT IS ISSUED.MV YYORKERS'COMPENSATIDN INSUMN�'°AIIRIER ANO POLICY NUMBEN ARE� CONSTRUCTION j �pp�Eq ,�'��'T)c r r�f7,L A�D PLAN REVIEW � � POLICVt1UlAeER ,o EIECTRIC - p (Ri6SH.'110NNE�NDT8E001.FLEfmOFTifPEFMf16FORONE�a11ARE000LLN15R70010RLE5sG BING Z I CERTIFYTMAT W TVIE PERFOfiMANCE OF THE WORK FOR WNICH TNIS PERMIT IS ISSUE0.1 MECHANICAL �j' SFW.L NOT EMPLAY ANY PERSON IN NJY MANNER 50 AS TO BECAME SUBJECT TO THE � IMORKERS'COMiEHSATION lAW3 OF CALIFORNI�ANO AGREE THAT IF 18FqULO BEOOME IN FEE S SUBJECTTOiF1EVYORKERS'CMIPEN9ATION►ROVISqNSOF3ECTION87oaOFTHEIABOR CADE.ISHALL ITHCOMPLYMAIMT PROVISpNS. � SUANCE � J' � 0 1 p DA7E:���APPLICANT: P�1 L 9� �� � U � ENERGY P/C WARNINO:FAIIURE TO SE W HE 1WAKEH3'COMPENSATION COVERAOE IS UNIAWFl1L,ANO SHALL BE � 611BJECTAN EMROYERTO CRIMINK iENALTIES AND CIVII FINES UV NONE NUNDRED TMOUSMD ENERGY PER � OOILMS(i700,0001,INADDITIONTOTHECD570FCOMPEN5ATION,DMI�GESASPROVIDEDFOXIN � SECTION 37oe OF THE LABOA OODE.IN7EiiE5L AND ATTORNEV'5 FEES. RETENTION CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFIPMUNDERVENALT'OFPERJURY7HA7TNEREISACONSTPolCTIONIENDINOAOENCY z FOR TiIE PERFORMANCE OF 7HE WORK FOR YYIiICH iHIS VERM�715 ISSUE�(SEC.9GY7.CIY.G�. {l] � LENDER'3 NMAE . F- LENDER'SADDHE55 � ICERTIFYIHATIHAVERE�D7}USAPpIICATIONMIDSTATETNA77HE�80VEINFORMA7qNI5CORFiECL TOTAL FEES I KiREE 10 COMPLY N77N ALL GTY AND COUNTY ORDINANCES MID STATE LAWS FEU71N0 TO BU0.DIN0 CDNSTRUCTION.ANO NEREBV AIIfHOIiIZE i1EPRE5ENTATIYES OF THIS COUNiY TO ENTER l/PON Zl/E ��►[�/J�[/�� � ABOYE�MEMIdJEDPROPERTYFORINSPECT�RP08ES- COMMENTS .� /��1� � -�. N m pM Q � � SIOWINREO DATE � � RECPT.NO. ___ PAID BV VALIDATION 1NF11TE—�epartmenT Copy.YELLOW-finance COpy,PINK—Assessar Copy,GOLDENRO�File Copy,GREEN—AppliceM'a Capy ' '�, �' � CITY OF D1�41�ONQ BhR ' INSPECTION RECO�'iD .. e � � � s - � � � � . � . SET BACK ' FLOOR JOIST,� � . . . F�GS/FORMS/STEEL FHA REQMTS �. - ELECTRIC GROUND UNDER�FtIIOR-D[.�C'f-` : _ • - ' � �� - GROUND PLUMBING � UNDER FLUOR GOnI_C�UIT`_,�` _.�:..�_� ._.' ; ' � SLAB GRADE FIREPLAC�FO�NDATION ----- .' �- • � - � ! � TEMP POWER � FIREPLACE BOND BEAM WATER SERVICE , MID HT. BOND��AM-.. � ` '-'- '• - - ' ROOF SHEATHrNG� i . ' �: - • - ' ,. 8 FT'.B�ND BEAM ^� --—. . . . . i FRAMINGNENTILIATION FINAL BOND.BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC 2 � �� ,_ __ ROUGH GRADING ROUGH PLUMBING `� FINISH GRADING � SH�WER(TUB TEST POOL ELEC�RlC " EXT. LATH/SIDING P�OI FENCING WA�L INSULATION POOL FINAL CEILING INSULATION (�FF SITE IMPS. � DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTtC TAfVK �ANDSCAPFJIRRIG. SEEP P1T/L.L. ON SITE IMPS. I ^ GRS AIR TES7 FINAL ZON{NG � -FIi�JAL CONST. - '; - • •- - — -} �FIRE QEPT. F!NAL FItdAL HERTING '' ` ' j ' '� � HEALTH DEP7. FINAL FINRL ECECTRIC z J� �� �` � DEV. FEES PAID i _, FINAL PLUMBING I ENERGY I I i � � __ COM�tlrEIVTS ; .�_. 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