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HomeMy WebLinkAbout11791 (5) �J� 3 -�`"'� CTCY OF DIAMOND BAR - � " COMMUNITY DEVELOPMENT DEPARTMENT � , ..,..W .> 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS '""'� BUILDINGPERMITAPPLICATION ', ' . FIRMLY o� JaBSITE �57Cd' �����C'n�%1.-I- OATEICATION NUMBER '�` � 1Pt/C -d�3 ADDRESS /�-1 � APN LOT 7RACT ZZ Z �SSUE � TYPE OCC — DATE �, CONSI; � GROUP �j OWNER �L LL ADDR SS ZONING �SETB�ACKS; : ., ,'' i . � CITY Of 21P�?.� TEL. . FRONT . � RW ❑ APPLICANT TEL. REAq ❑ ;.$IDE/SIDE'S.T�iEET ; ��rtT- '' RW � � CONTRACTOR � SIDE ' p QCDDRESS zIP TEL. PROPOSED USE S� L-.�PJ wo ARCFVENG/ DESIGNER n�. ADDRESS NO.DWEL. NO. 2, NO. � CITY ZIP TEL. UNITS I STORIES BEDROOMS � u� DESCRIPTION 8Q.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BI:ILDER DECLARATION SFR/ADD/REM O � I HEREBY AFFIpM UN�ER 7ENALN OF PERAIHY THAT I AM EXEMP7 FROM THE GONTRACTORS LI- G8f8gB/C9IpDlf W CENSEUWFORiHEFOLLOWINOREA50N(SEC.70.71.6BUSINESSANOPHOFESSIONSCOOE:ANYCITYON (f� U CAUNTVWMICIiflEOUIRESAPERMITTOCONSTRVCT,PLTER,IMPROVE.DEMDUSH,pflflEPNRANYSTRUC- W W TUpE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLIClIN7 POR SUCH PERMIT TO FILE A SIGNE� W PBIiO/O6Ck � STA7EMENT THAY HE OR SHE IS LICENSED PURSUANT TO THE GROVISIONS OF TNE CON7MCTONS IJ• � � , CENSE LAW(CHAPTER B(COMMENCINO NA7H SECTION 7000)OG UIVISION sOF iHE BIISINESS Nl�PRO- PDOUSpB FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREFROAAANOTHEBASISFOHTHEALLEOEDEXEMD- (� , � TION.ANYVKKHTIONOFSECTION7091.6BVANYAPPLICMlTFORAPERMITSU&lECTBTHEAPPLICMlTTO � Z Re•Root � A CIVILPENAL7Y OF NOT MORE THAN FIYE HUNORED DOLUAS(5500).): � ❑I,A90WNEROFTHEPROPEF7Y.ORMYEMPLOYEESWITHWAOESASTHEIRSOLECOMPENSATION, CORIRIBfC18I . WILL 00 TXE WORK,AND THE STRUCTURE 15 NOT MIiENDED OR OFFEflEO fOR 6ALE(SEC.7W1.BU51� � � NE55 AN�PflOFE5510N5 COOE:THE GONTRACTORS LICENSE LAW OOES NOTAPPLV TO AN OWNER OF :� PROPERiY WHO BUIL0.5 OR 61PROVES THEREON,ANO WHOOOES SUCN WORK HIMSELF�OR HERSEIFOR � THRWGHHISORHERONMEMPIOYEES,PROVIDEOTFNTSUCHIMPRDVEMENTSMENOTWTENOE�OR Ln WQ OFFEREOFOR5QEIF,MOWEVER.THEBl11LDMGDRIMPROVEMENTIS50LDWITHINONEYE0.ROFCOMPLE- Z TqN,THE OWNER�BUILDER N7LL HAVE THE BURDEN OF PROVING THAT HE OR 9HE OID NOT BUILD OR = IMPROVEFOfITNEPUFPO5E005ILLE�. . � . ❑1.AS OWNER OF THE PROPERTY,AM EXCLUSIVE�V COMMC7 WO WI7H LICENSEO CONTMC70R5 ¢ TO CONSTRUGi TNE PRQIECT(SEC.70U,BUSINESS AN�PROFESSIONS WDE:iME G1�NTRACTORS U• VBIU811011 ADJ.AREA W CENSElAW00E5NOTAPPLYTOANOWNEROFAPROPERTYWFIOBIJILDSORIMPROVE9TMEHEON,IIND � WFqCON7RACTSFOqSUCHPROJEC75WITHACON7MCTOR�S)LICENSEDPURSVANTTOhIECONTRAC- OUANTITY OESCRIPTION �E Y TORS LICENSE UW.). ¢ CJ 1 AM EJCEMGT UNDEF SEC. B.6 P.C.FOR THIS REASON Q � U .. LL DATE OWNER U O W � LICENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNOER PENALTY OF PERIURV THAT I AM LICENSED UNDER GFOVISIONS OF CNAPI'ER � p� O(COMMENCING NA7H SECTION 7000j OF DiVISION 30F THE BU51NE63 AND PROFESSIONS COCE.IlNO Z `X MV UCENSE IS IN NlL FORCE ANO EFFECT. �7�— � � IICENSE CU55 LIC.NO. � � V � V DATE� . CONTRACfOR � d LL � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIPM UNDER PENALTY OF VERJUM ONE OF THE iOLIOWINO DECU1MTqN5: Z � _I HAYE AND YALL MAINTAIN A CERTIFICATE�F OONSENT TO SELF•INSURE FOR MIOqKERS' _ COAIPENSATKKJ,AS PFOVIDED BV SEC710N 370o OF TME LABOR CODE.FOFiT/E PERFpRMANCE �U Q OFTXE WORK FOR WHICH THIS PERMIT IS ISSUED. _ � QW �I HAVE AND NALL MAINTAIN WORKERS'COMPENSATqN INSURANCE,1�4 REOIIIAED BV 6ECTION 3f00OFTHELABORCODE,FONTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS ��Q { � C/� ISSUED.MV WORKERS'COMPENSAT N IN9URANCE q1RRIER AN�POLICV NUMOEFl ARE' CONSTRUCTION l( J�� j CARRIER C�� PLAN REVIEW Z—Z� j�� � ao��cYNUMBER ,` r ELECTRIC Z Q � (IHI6SECT10NNE�NOTBEOOAIOLETEDOF'MEPEA-MISFORONEF0.PDIiEDDIXLAFLS({7o0yOqLE5S1 PLUMBING W Z I CERTIFY THAT IN THE PEFFORMANCE OF THE WORK FOR WFIICM TMIS PERMIT IS ISSUED,1 MECHANICAL C,'} SHALLNOTEMPWYANYVERSONNMIYMANNERSOA5109ECOMESU9JECT70THE � WORKERS'COMPENSATqNLAW50FCALIFORNI0.NNDAGREETHATIFISHOULDBECOME INSPECTIDNFEE S SU&IECTTO THE WORKERS'CAMPENSATION PRDVISIONS OF SECTION 77000F THE LABOR CODE.I SHALL FORTNWITN COMPLV WITH THOSE VFOVISIONS. ISSUANCE / � p DATE: APPLICANT. SMIP 3 [ a � ENERGY P/C WARNING:FAILUqE TO SECUHE WORKERS'COtdPENSATIDN COVERAGE IS UNLAWFUL.AN�SHAIL BE , �y, SUBJECTAN EMPLOYER TO CRIMINAL OENAI.TIES AND CML FINES 11V TO WiE MUNDHEDTHWSAND ENERGY PERMIT ( OOLURS(f100.000).N ADOITION TO THE COST OF COMPENSATqN,DAMACES AS VFOVIDED FOR IN J SECTIDN 970!OFTHE UBOH CODE,INTEREST,�NDATTORNEY'S FEES. � ¢ RETENTION FEE: !�Q OCONSTFiUCT10N LENOING AGENCY PRE-ALT FEE: ��' R� � 1 HEREBV AFFIRM UNOEH PENAL7V OF PERIURV THAT THERE Ib A CON6TRUCTION LENDING AGENCY FOR TME PERFORMMICE OF THE WORN FOR WHICH THIS PERMI715 ISSUED�SEC.9087,CIV.C.�. Z -- W �� IENDER'S NAME F— LENDER'SAODRE55 ^ W ICERTIfYTHATIHAVEflEADTNISAPPUCATIONAfJDSTATETHATTHEABOYEINFORMATIONISCAqRECT. TOTAL FEES r���I ! 3 ���� �f.'y � IA6REETOCOMPLVWITHALLCITYANDCOUNTYORDINMICESMIDSTNTELAWSREIATINGTOBUIL0ING - � CONSiRUCT10N,AN�MEREBY AUTHORIZE REPRESENTATIVES OF TMIS CWNTV TO ENTERUPON THE � Z 1180YE•MENTIONEO PROPERTY FOR INSPECTION PURVOSES. COMMENTS � P����..1,� _ m PERMITI'EENAMEIPNNn � � �/s'� ' Uj 610NANREOFPERMITTEE OATE r 2 RECPT.NO. PAID BY VALIDATIO f— WHITE—Department Copy,YELLOW—Flnance Copy,PINK—Assessw Copy,GOLDENROD--File Copy,GREEN—ApplicanPs Copy CITY OF DEAMOND BAR. INSPECTION RECORQ �9- S'' 4-.` ' • e � E - � r � • s - SET BACF< , � � FLOOR JOIST. FfGSlFORMS/STEEL _/5-S� FHA REQMTS : ELECTRIC GROUND � ,�'- UNpER FLO��pUCT � , _ ;i .z�.� �� � GRQUNa PLUMBING -30-� UNDER•FL'C1C}R�OGNDUIT � '" � ' .^.-� ' �;� � :. -. S�AB GRADE -JS /►+'� FIREPLACE FOUNDATION TEMP PflWER FIREPLACE BQND BEAM ' � � ' � � -` WATER SERVICE � ' 3� M!D HT. BOND BEAM ROOF SHEATHING i�� I $�T• BOND BEAM FRAMiNGNENTILIATION L' FINAL•BOND BEAM ROCJF COVER PRE-GRADlNG ROUGH HEATING z � BENCHING ROUGH ELECTRIC RQUGH GRAQING ROUGH PLUMBING - FINISH GRADING SHOWERlTUB TEST L .s � POOL ELECTRIC EXT, LA7H/51DING P�OL FENClNG WALL INSUTATION PUOL FINAL CEILiNG INSULATION OFF SITE IMPS. DRYWALL NAILING I � DEDICATIONS SEWER ej � FINAL ENG. SEP71C TANK ' � ' ' � LANDSCAPE/IRRIG. SEEP PIT/L.L I ON SITE IMPS. GAS AIR TEST ,�f�.j I FINAL ZONING i FINAL CONST. � t ; FIFiE DEPT. FINAL i FlNAL NEATiNG ' ! HEALTH DEPT. FINA� FINAL ELECTRIC ! ! DEV. FEES AAID FINAL PLUM1ABING y . � � j ENEflGY ' � + ` ' �,, ' � � o.: �: E , C01Vf IVI E NTS , , , ,.. • � . . . , ��� , . ( - t , . � ; .. SEPTIC TANK SIZE � ' SEEP PET/U SIZE. '�=" M ,�;,�, `, t , , `. `• . ; ., i , ... e. R . .�1 ss` • •t�',... • � 7 . r •"Y .y r .,�, '.�t � ..%Z � . . ... � � 1