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HomeMy WebLinkAbout11782 �i� I --��--, CITY OF DIAMOND BAR �� � � COMMUNITY DEVELOPMENT DEPARTMENT � -,,.� • 21660 E.Capley Drive Suite 190 (909)860-3195 Fax(9�9)861-3117 � PRE.SS •�'"`"� BUII.DINGPERMITAPPLICATION �.t•�. ''.�'. ' . •t�.. � �• ...-` .� - , ;Fi.RMLY � JOBSITE Qp �`,❑ �/ �� ��v��! ' Q ADDRE5S l� +D Jw!R7 )k'i � . APPLICATION. ,�,i' PERMIT /I'�2 P/C � �� p — DATE�� NUMBER # O' � APN LOT TRA T ISSUE TYPE OCC p OWNER S ��(� DATE CONST. GROUP LL ADDRESS � ZONING SEtBACKS , . , � 't z CITY COS'���_ ZIP�°j�p��TEL� -� . FRONT RW Ci APPLICANT TEL.� R�A� � " � G �z � SIDE/SIDE STFiEET_. pN/ r�_ Q CONTFACTOR �_ D1.t��L SIDE � ADDRESS n � CITY ZIP TEL. PROPOSED USE�FK� �L� oARCH/ENGJ z DESIGNER w NO.DWEL. NO." Np, a ADDRESS = CITY ZIP TEL. UNITS STORIES �_BEDRDOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION O OWNER-BI;ILDEF DECLARATION SFWADD/HEM 4 p I HEFEBV AFFlRM UNOEfl PENAL7Y OF PEFWRY THA'I I AM E%EMPT FROM 7HE CONiMGTOHS L:- GefBJB/(..'31FfOR QZ W CENSELAWFORTHEFOLLOWINGflEASON(SEC.70d1.68USINE55NNDPHOFES510NSCO0E'.ANYCITYOR (n U COUNTYWFIICMREWIRESAPERMITTOCONSTRUCT,AITEF{IMPROYE,DEMOLISH,OflHEPAIRANYSTRUC� (�f paliWDeck S8 W TURE,PRIOR 70ITS ISSl1ANCE,QSO RE�UIRES TNE APPLICAN7 FOR SUCH P[RMIT TO FlLE A SIGNED � W � STA7EMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PRONSIONS Of THE CONTRACTORS U- � , QCENSE LAW(CHAPTER D(CAMMENCING WlTl45ECTION 7000)OF DIVISION 30F THE BUSINESS AND PRO- POOUSpB FESSIONSCAOE70RTHATHEORSHEISEXEMPTTHEREfNOMANDTHEBASI5FOF7HEALLEGEDE%EMP- (' � V TION.ANVVIOLATIONOFSECTION7o31.5BYANYAPPLICl.NTFORAPERMITSU&lECT9THEAPPLICANTTO Z Re-Roof A GVIL PENALT'OF NOT MORE THAN FIVE HUNDRED DOLUIRS(S5o0�.): Q ❑I,ASOWNEROFTMEPROPERTY,ORMYEMPIOYEESW�THWAGESASTHEIRSOLECOMPENSATION, � Commercial ' ' � Z WILL 00 iHE WOflK,AN�THE STRUCTUft:IS NOT INTENOED OR OFFEREO FOR SAI.E(SEC.70d1,BU51� J � NE55 AND PHOFESSIONS COOE:THE CONiRACTORS LICENSE LAW DO[S NOT APPLV TO AN OWNER OF PFOPER7YWHOBUILDSORWIPROVESTHEREON.ANOWHODOESSUCHWORKHIMSELFORHEHSELFOR = CL THROUGHHISORMER�WNEMPLOYEES,PROV!DEOTHATSUCHIIAPROVEMENTSARENOT!4TENDEOOR m Q OFFEHE�FORSALE.IF,HOWEVER.THEBUILDINGOPIMPROVEMENTISSOlDW17HINONEVEAROFCOMPLE- Z TION.THE OWNER-BUILDER WILL HAVE TNE&1RDE-N OF PqOVIKG THAi HE OR SNE D!D NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SRLE�. ' ,i,'� ❑I,AS OWNER OF TME PROPERTY,AM E%C WSIVELY CONTRP.CTING WITM LICENSEU CONTRAC70RS ' � TO CONSTRUCi THE FR0.IECT(SEC.704a,BUSINESS I1N0 PROFESSIONS CADE:THE CONTRACTORS LI- V81UetiOfl ��_ADJ.AREA` W CENSELAWDOE5NOTAPPLYTOANOWNEROFAPROPERTYWHOBUI�DSORIMPNOVESTHEREON,AND = WNOCANTRACTSFORSUCH�ROJECTSW�THACONTRACTORIS)LICENSEDPURSUAN7TOiHECONTRAG FEE ~ roRSUCEHSEuw.). QUANTITY DESCRlPTION Y � C I AM EXEA7PT UNDER SEC. B.8 P.C.FOF TH!5 REASON Q � U LL DATE OWNER � Z U � LICENSEO CONTRACTORS DECL4RATION � � W; I HEREAV AFFIRM UNDER PENALTV OF PE0.IURV TNAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �i � D(COAIMENCING WITH SECTION 700D)OF DIVISION 3 OF iHE BVSINE55 AND PROFESSqNS CODE.AND Z � X MY LICENSE IS IN FULL FOFCE�ND EFFECT. m . LLJ '^ �r�,� � LICENSE CLA � LIC.NQ__��-�+�--.+��Y+��W � V DATE Q CON7RACTOR 5 f F�i/'� a W � WORI(ERS'COMPENSA710N DECLARATION Q ( � I MEREBYAFFIRM UN�ER PENALTY OF PERJURY ONE OFTHE FOILOWING DECLAFUTpNS: V � Z � _IHAVEANOWILLIAAINTAINACEFTIFICATEOFCONSEN7TOSELF-INSUREFORWORKERS' ¢ COMPENSATpN,AS PROVIDED BV SECTION 9T0a OF THE LPBOR CODE.FOR THE PEflFORMANCE U OF THE WORK FOR W HICH THIS PERMI7 IS ISSUEO. � � �W �HAYEAND WILL MAINTAIN WORNERS'COM7ENSRTION INSI;RANCE,AS REOUIREO BV SECTION 3700 OF THE LABOR CO�E,FOR THE PERFORMANCE OF iHE WORK FOR WHICH THIS PEFlMIT IS � ��Q r SO ISSVED.MY WORKERS'COMPENSATION INSl1FUNGE CARRIER AND POLICYNUMBER ME: CON$TRUCTION J � j CARqIER ��" �� _ PLAN REVIEW f 1 � � ZPOIICV NUMBER �. ��� _ ELECTRIC Q 0 (MISSEC110NNEmN0TeE00MPLEfEDOF7FEPERMffI6fbRONEHIMIXif.OD�U,IRS�StW�ORLE55) PIUMBING W Z I CERTIFVTHAT IN THE PERFORMnNCE OF TME WOFK FOq WHICM THIS PERM1715 155UED,l MECFiANICAL C7 SXALL NOT EMPLOY ANY PERSON W ANY MANNER SOAS TO BECOME SU&IECT TO THE (n WORNERS'COM7ENSATI�NL4WSOFCALIFORNIA,ANOAGREETHATIFISHOULOBECAME INSPECTIONFEE SU&IECT TO THE WORNERS'COMPENSATION PROVISIONS DF SECTION 77 F T DOR � j DU Q CO �` A FQ R�THWITHCOMP�Y WITH THOSE PR ISION ISSUANCE p OATE:�,���if�/ ij� qppLICANT. � (' SMIP 3I f�O J ENERGV P/C ,J WARNINQ:FRIWRE O SECURE WORKERS'COMPENSATpN COVERAGE IS UNL4WFUL,/.N�SHALLBE .�t �y SUBJECTAN EMPLOYER TOCRIMINAL PENALTIESAND CIVILFlNES UP TOONE HUNDRED THWSANO ENERGY PERMIT �(�� DOLLARS(5100.000),IN AODiTION TO THE COSTOF fAMPENSA7pN,DAMAGES A3 PROYIDED FOR IN J SECTION]TO!OF iHE LABOR CODE,INTEREST,AND ATTOqNEr'S FEE5. �O � RETENTION FEE: 0 CONSTRUCTION LENDING AGENCV PRE•ALT FEE: � I HEREBV AFFIHM UN�EF PENALN OF PERJUHY 7HnT TNERE IS ACONSTRUGTION LENDING AGENCY � FOR THE PERFORMANCE Of THE WORK PoR W IGH TF115 PERMIT IS ISSUED�SEC.Jo9�,CIV.C.). —' '–"— Z W , � lENOER'SNAME _ � F– IENDER'SqDDRESS � � 1 CERTIFV THAT I HAYE REAO TNIS APPLICATONANO STATE iMAT THE�BOVE WFOFMATION IS CORRECT. TOTAL FE ES 1�3 3� �� • 7 3�L -!S ` IAGREE TO COMPLV WITH ALL CITY AND COUNTY OR�INANCES RNO STATE LAWS RELA7ING TO BUI:DING "NlSTRUCTION,M10 HEREBY AUTHOR2E REPRESENTATIVES OF THIS COUNTY TO ENTFR UPON 1'ME � '�E�MENTIONED PROPERTY FOR INSPECTION PURPOSES. J� COMMENTS � � 1'�L�� -- —,._ � � '�VRI _ �� � -- — ' . iTTEE � DATE� - RECPT.NO....., L� � PAID BY __VALIDATION WHITE—Deperlment Copy,YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Appllcant's Copy . . , _�-.� � .. GITY OF DIA16lIUIVD Bp,R INSPECTItJI"d F3ECt�RD L'c- 7- —9 8' �iis-�-./.�.�✓0�-.; �.� , , � E , . � . • t � ' -�.�.� `„:.. ' ,, ' FLOOR JC115T � _ ._.._T.. SET BACK� _�.—. ' �" \ -- ------..........-------- _.,�.— - �,... ,. .•.. / .,� ' FHA REQMTS .... .. ._ . , � FTGSfFORMSlSTEEL °�-�_� al1,v�` i ^ + _ __ __ . , �-,..�.�;.-.-.:. � .: ELECTRIC GROUNQ ../�I-°I� �X UNDER FLPOf3 f:�UCT : . � '".�t � r;:> r,� � � , ,'; ------- ------- ' _... GROUND PLUMBING = 0�_ ���KLf'1^� FIREPRACEO�FOUNDA�T ON .+ -' , --'--_..-___.�_ SLAB GRADE _ _�rJ-`�__,_� � ----..__.._----- TEMP POWER I � FIREPLACE BOND BEAM __ � '� ' � _____________ --------••--t- — � . VUATER SERVICE I O' Yi� � MID HT. BOND BEAM _______,_ ROOF SHEATNING i z. � � � 8 FT. BOND BEAM � ____ FRAMlNGNEIVTILIATtON s� ) � � FINAL BOND BEAM _ _.__ —_ _._...�_. AOOF COVER I I ' PRE-GRADING _ _ _ FlOUGH NEATING L 7 BENCHWG �� _` R�UGH ELECTRIC - `• ' ' ROUGH GRADING ______� ROUGN PLUMBING I FINISH GRADING — I -----_-----._-- --..._.^ .. ,.. �..-- SHOWEHII'UBTEST__�ti/� P�" POOL ELECTRIC _______ EXT.LATHISIDING � POOL FENCING — — —.-------....__..._._. WALL INSULATION POOL FINAL �__ _____� CE6LING INSULATiON U1=F SITE iMPS. , _ __ _ DfiYWALL NAILING '. � DEp1CATfONS { __ SEWER �/�3-98i � _ ��INAL ENG, i � , . SEPTIC TANK � _' �'s r� iT � � LANDSCAPEJIRRIG. j --------_.-----...----------- SEEP PI7/L.L. I ; ON SITE IMPS. GR5 AIR TEST Z, y � ; FINAL ZONiNG ; __ FINAL CONST. � � i FIRE DEPT. FlNA� ' �� FINAL HEATING ' HEALTH DEP7. FINAL � � FINAL ELECTRIC ; : DEV. FEES PAID i _� FINAL PLUMBlNG y� i ENERGY � ; --- — � , . . . , , , -----� i I ��� a �s. — � :-. ----� � — ------� COMMENTS � . , , , � �'; :.1 ' �:.. — ., , �: ` , , ;.' `-� 3 ;•�• ti SEPTI�TRNK SIZE .� � .. , , . � ,.. ..�.�`-*�_.--,.�.__r.:..._.._..:.. SEEP PIT/U SIZE � �:y � . , ----- ---- � ` . µ�........:. _. _.....------- . .4 . , ;.� ,. ,�� -------j , , . , is, : �. +. .. ,� o- . � _ 1: , f; .\ ' —T----Y � �- - , __.