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Home My WebLink AboutPR13-1112CITY OF'"r MOND BAR i� DEPART: 1T OF COMMUNITY R ? yELOPMENT SE CES 21$10 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 PRESS BUILDING PERMIT APPLICATION FIRMLY W JOBSITE APPLICATIO PERMIT ! PIC C' ADDRESS � �` f DATE ti NUMBER d ® V Q. # �, 1 mv ISSUE TYPE rY__ OCC Y? APN LOT I TRACT DATE—1 CONST. �1F— GROUP p OWNER iJL � ADDRE S d a /�% O S �i - ZONING SETBACKS LLL CITY IPI EL. FRONT RW ❑ APPLICANT /gal "'%M4" TEL. 7s I REAR r� SIDEISIDE STREET RW LJ m El CONTRACTOR '� SIDE ADDRESS CITY ZIP r` TEL. ' IL .( PROPOSED USE F �1 a -- ARC EI DESIG i L iLf is I 1�T�a a . ADDRESS CITY 6. 'V>' i f -r ZIP QPM TEL.'v Cn I d ) cn CC OWNER -BUILDER DECLARATION O p 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THA71 AM EXEMPT FROM T}iE 0014TRACTORS Ll - III CENSE LAW FOR THEFOLLOWVNG REASON (SEC.7031.5BUSINESSAND PROFESSIONS CODE:ANY CiTYOR U COUNTYWHICH REDDRESAPERMITTO CONSTRUCT, ALTER, IMPROVE. DEMOLISH. OR RLPAIRANY STRUG W TUBE, PRIOR TO ITS ISSUANCE, ALBO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED � VATFMENT THAT HE OR SHE NT E IS LICENSED PURSUANT TO THE PROVISIONS OF THE CORACTOAS U - CENSE LAW {CHAPTER 9 {COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO- ( FESSIONS CODE) ORTHATHE OR SHE IS EXEMPTTHEREFROM AND THE BASIS FOR THr ALL ExEMN TION. ANY VIOLATION OF SECTION 1031 .S BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT 70 A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (;5003.1 ❑ I, AS OWNER OFT HE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, Z WILL Do THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC, 7044, BUSI- NESS USKNESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOTAPPLY TO AN OWNER OF PROPEFRY WHO BUILDS OR IMPROVESTHEREON, AND WHO DOES SllCH WORK HIMSELF OR HERSELF OR CG THROUGHNIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH iMPROVEMENTSARE NOT INTENDEDOR W O:;rF; JFOR SALE TF, HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WRH]NONEYEAR OFCDMPLE- G TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). LL] ❑{, AS OWNER OFTHE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACCORS TO CONSTRUCT THE PROJECT (SFC. 7044, BUSINESS AND PROFESSIONS CODE: THE CCNTRA(:TORS U- MCENSE LAW DOES NOTAPPLYTO AN OWNER OF APROPERTYWHO BUILDS OR IMPRov(S)HEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITfACONTRACTOR(S) LICENSED PURSUANTTOTHECONTRI Y TORS LICENSE LAW.). ❑ I AM EXEMPT UKDER SEC. B. A PC, FDR THIS REASON CATE OWNER ¢O LICENSED CONTRACTORS DECLARATION CC i HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PRI OF CHAPTER B (OOMMENCING WITH SECTION 7000) of DIVISION 3 OF THE BUSINESSAND PRDr:SSIONS WDE,AND X MY LICENSE IS IN FULL FORCE AND EFFECT. LLI UCENI CLAS- - 1 LIC. NO. DATE I P CONTRACTOR c , z[rrT �I�T�� LL! c� WORKERS'COMPENSATION DECLARATION 00 1 HEREBY AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FCLLOW WG DECLARATIONS; CIS !� 1HAVEANO WILT IN7AINA CERTIFICATE OF CONSENTTO SELFINSURE FORWORKERS' COMPENSATON,AS PROVIDED BYSECTION3700 OFTHE LABOR CODE, FORTHE PERFORMANCE _ OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, G7 W —i HAVE AND WILLMAINTAIN WORKEITODMPENSATION INSURANCE, AS H£OUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE CF THE WORK FOR WHICH THIS PERMIT IS ISSUED-MYWOHKERS' MPENSATlgkLINBUII CAARIERANOPOLICYNUMBERARE CARRIER 4 l�l1 Y POLICY NUMBER - — (i}IIS Sti,-LY'NNE®NOTBECORL�LETED Cf T1 -IE PETV.ifiIS FORONE K IhK)iIW0DI-I-ARi (&IMI CR LESS), LiM I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I (j SHAILNOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BEC[SME SUBJECT TO THE CID WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME F-- SU60ECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE, I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. O p DATE: APPLICANT. _ J WARNING! FAll1IRE TO SECURE WOFIKERS'COMPENSATION COVERAGEIS UNLAWFUL,ANO SHALLBE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRFD THOUSAND DCLLAHS ($I00,0W), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVEOED FOR IN 3 SECTION 3708 OF TIE LABOR CODE, INTEREST AND ATTORNEY'S FEES. Cr Eli EL_ O Ir LU t[J C— CIZ LU H- Z O CJD 16. CONSTRUCTION LENDING AGENCY I HERESY AFFIRM UNDER PENALTY OF PERJURY THATTFIERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICHTHIS PERMIT IS ISSUED ISEC. 3097, CIV, C.), LENDER'S NAME LENOER'SAODRESS -- I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT - AGREE AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HERESY AUTHORIZE REPRESENTATNES OF THIS COUNTY 70 ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. — PEAMHTEE NAf E (PRINT) _ IGNATURE OF PEAWFFTEE v ,;� DATE NO. DWEL. NO. NO. o_ UNITS STORIES BEDROOMS I1-il 6 I/ .dam 4 IV h I %_01 -ry I - -.] DESCRIPTION SGL. FT. FACTOR PSY ADJ. AREA/VALUATION SFRIADDIREM bZj Cl) GaragelCarperi ILU Pa)ioIDacR _ LI- Pool/Spa �.. .. zRe -Roof Commarofal Y �� • �"� INSPECTION FEE m ISSUANCE SMTP ENERGY PIC ENERGY PERMITS RETENTION FEE:' 41-75 - Valuation ' _a_Q 0 ADJ.AREA QUANTITY DESCRIPTION U S31 TOTALFEES y COMMENTS I1-il 6 I/ .dam 4 IV h I %_01 -ry I - -.] WHITE—DepaAmenL Copy, YELLOW ---Finance Copy,Plrvn nsan��, -;'Y' 11..E+7' w r••w,,• ��r� ZL U W �.. .. CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL �� -� �. �� • �"� INSPECTION FEE ISSUANCE SMTP ENERGY PIC ENERGY PERMITS RETENTION FEE:' 41-75 - PRE -ALT FEE:— TOTALFEES _ COMMENTS RECPT. NO. PAID BY VALIDATION WHITE—DepaAmenL Copy, YELLOW ---Finance Copy,Plrvn nsan��, -;'Y' 11..E+7' w r••w,,• ��r� p en On -Fl, 7'la-: _'_�c-ze�+s�•�-1+Y'-+'•- 'i ai�""z_ a--� -?}.mss., .3u1.! _gip _52-_Yf YI =f jam - _T -f l 156+-.�.WilIfSxi1�-, w..a „.�� tJ iF ; I"c�L7F�f kpa 2�i^�T�S*,�..-G.4�`�:' r,,,� "'� I SET E CK f TGS/F0RfkAS,/SI•I EL r t OI�A !UE FHA. REQ,,,0 "S ELL:! RIC GRf ONO _ UNDER NDEi, FLU?R DUCT._..- GROUND PLUMBING I_� ' UNDER FLOOR t.ONDUfT �-IPL?�LI-`ICC FGU{5[nAT101�! � ----_ ._ _--_-- �5LA Es �,R=`GF� -FEMP PO'vt'ER _�---- -----_- FIREPLACE B^WD BE,a,Tf- WATER SERVICE ROOF SHEATHING_-_._..— --.__.. � =� � � ` t-° —__ ' � M D I1.8W,1D BEAM 8 FT. BOND BEAM I=RA VIIN& VENTILATION FINAL AL LOND BEAM ROOF _ - — - — - PRE -GRADING �_----.---__-_ ROUGH HEATUG5— i �T ROUGH ELECTRIC i-- _-- I - BENCHING _-_-_ POUa12 GRADING �. ----- ROUGH PLUS,"1BING—� �� FINISH GRADING SF[aL'k ER/TUBTEST EXT LATF115!DlnlG WALL INSULATION CFiI_ING INSULATION _ I POOL ELECTRIC ' POOL FENCING POOL FINAL OFF SITE INfPS. DRYWALL NAILIG tCA f0N_S ID FIN AL ENG, SEPTCTANKS_F1E.R 5EcP PIT/LL, GAS A,R TEST _ i , f LA DCAE/IRRIG_. aim SETS IrVlPS-_-__-- ' FINAL ZONHNG _ _ j FR~ AL CONSTFIRE FINAL HEAT& -IG FINAL ELECTRIC T —�-- -- _ I 1 DEPT I , F€idAL. _. HEALTH DEPT. FINAL DEV. FEES PAID _ _ FINAL PLUMBING ERGY '` FINIAL PLANING E �FINAL FNGiNEERINGir w -_ U4 6_1- -W _ - _ --- - -- - --"- -� ------- I...✓ 6�'F ,-8iz',._d.. `'✓J -.o p.._A_�p��BF' I pry - .. S PTiC-fANKSIZE _ 4 SEEP P1T/U SIZE_— a I NIL - y I { i f