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Home My WebLink AboutPR03-456VD D d d LU Z i2 G] O 0 LAI lr CL CL 2 b F— L LUIO J m Q T/] ll1,1HUD MIR[ MY OF DIAMOND BAR DEPARTMENT OF COMMUNTl Y & DEVELOPMENT SERVICES 21825 E. Copley Drive (909) NO -3195 F4X (969) 861-3117 BUILDING PERMIT APPUCATION . JOBSITE ADDRESS Z4 APN LOT TRACT OWNER Vx J.S t CITY v1 1-R xHS- ZIPS TEL. �,�] APPLICANT _ jf<IZ TEL CONTRACTOR SIDE/SIDESTREET RW L� ADDRESS PROPOSED USE CITY ,ZIP TEL ARCHIENGI DESCRIPTION SO, FT. FACTOR PSF ADJ. AREAIVALUATION DESIGNER SFWADOIREM ADDRESS GerayalCarPaR CITY ZIP TEL. OWNER -BUILDER DECLARATION 1 HEREBY AMRM UNDER PENALTY OF PERJURY THAT I W EXEMPT FROM THE LONTRACTOHS LF CENSE LAW FCrR'fHEFOLLDWIIYA AEA.RON (SEC.7Oa1.E BUSW ESa MID PFOFMIOW CLOS ANYMWOR LOlAFP151HICH REQLARESAPEITMITTOCOW87RUCT, ALTEFL IMPROVE MMDU%k OR RERAIAANYSTRUUI TUBE, PRIOR To ITS T&L'ANCE. ALSO AEOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SM MD STATEMENT THAT HE OR SHE IS LiCENam PURSUANT TO THE PALIMDNS OF THE CONTRACTORS LL CENSEUW PCHAPTERa ICOMM04MG WITHaECTDN 70001 OFOMSDNSOP THE SUSW "AND PRO FESNXIks CODE)ORMITRE OR SHEIS EXEMPT THEREFROM AND THE DMLS FORTHE NESS A FT(FDO' TXN.AHY VIOLATION 01F SECTION 70:11.6 RTANYAPPLICMH FORAPERMIT SUBIECTS THEAPPUCAMTO A CML PENALTY OF NOT MORETHAN FIVE HLNORED IIOlUAS )�SIpN). LD LAS aNNEROFTHE PROPERTY. OR MY EMPLOYEES WIITAALAOESAS THEIRSOLE COMPENSATION, WILL m 7NE WORC, ANO THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALL (SEC JAY, EUS4 NESS ANO PROFESSIONS COOS THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN DIMMER OF PFOPERTY WHO G` kCG*R IMPROVES TMEFIEOK AND WHODOES SUCH WORLHWSELFOR HERSELF OR THROUGH HIS ORHER OWN EFMPLOVEE& FW"LD THAT aUCH DAPRaVEMD TSARE NOT NTEADED OR OFFERED FOA SALE. IF, mwEVER. THE NmDRNGORPtPROVFMENTIS SOLD WR3-0NOFEYEAROFOCMR.E. T/DH, THE 01NIERSUILOER WILL HAVE THE HUMEN OF PROVING THAT HE OR SHE DD NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE► . OF THE PROPERTY. AM ED CONTRACTORS TO apNST'RUC TOWNEHE ➢gO,IECT [SEC TNM, BUSyHE95 AND P ELY TN(pN8 000 TRFIE CONTRACTORS U. COME LAW DOES NOTAPPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR UAPA IVES THEREON, AND WHO MORACTGFOR SUCH PHCLIECTS WITH ACOHTRACTOR(S) UCaN5EDPURSUWr7OTHECOHI'PAC. O TMUCENSEL.AW7. xI AM EXEMPT UNOERSEC E. A P.Cw FOR TH15 REASON LICENSED COWMAGTORS DECLARATION I KERREIY AFFIRM UNDER PENALTY OF PER URY THAT IAM UCENSM UNDER ,NcIs1 OF, CNA"" P (OOMMENCNO WITH SE=N MY LICENSE IS N FULL FORCE AND TomEF) FECT. OF OM51ON ] OF THE BUSINESS AIS PROFESSIONS DOC R, AND VOENSE CLASS LIC. NO. CONTRACTOR WORKERS' COMPENSATION DECLARATICN L HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOlLOWNG DECLAf1ATON5: I HAVE AND WILL MAWTUNA CERTIFICATE OF OOASENT TO SW_W3URE FOR WORMERS' COMPENSATION. AS PROVIDED BY SECTION 370O DF THE LABOR CODE, FOR THE PERFORMANCE OFTHE WORK FGR WHICH THIS PERMIT ISMWED. I HWWE ARD WILL MAINTAIN I'D—ERs'—P— IN-RANCIF AS REQUIRED BY 56OOON arm OF THE LABOR COOS FOR THE PERFORMANCE OP THE MAw FOR IWOCH THIS FFRMrT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE, POLICY Ntmgam UM-'ECTIONNEEDWTBECOMPLEMOFTNEPBMTBFORuCHUAD DDUA1SMRORUMn I CERTIFY THAT N THE PERFORMANCE OF THE WOR( FOR WHICATHIS PENCr LS ISSUED, I SMM.L NOT EMPLOYANY PERSON IN ANY MANNER 80 AS TO BECOME SUBJECTTO THE W )MMM' COMPENSATION uWS OF CJILIFORMA AND AOREETHA71FISIIOLlLp BECOME SLA3JE0T 70 THE 1PFN?RKERS' COMPENSAT04 PROISONS OF SECTION 3700 OF TME LABOR ERTHMTH COMPLY LA'T'HjTH/O%SE�PJR041arIQ/FIT ., OA 0 APPLICANR " • ' I WARNING: FAILURETO SEDURE WORIMW COMPETISATION COVERAGE IS UNLAWFUL. AND SHALL BE SUBIECTAN EMPLOYERTO CRAONAL PERALTIES MWD ONk FIWES UP m OWE W-NORED TFIOUSAND OG1.MS (i1A0.m0} W ADOfOaNTOTHE COSF OF COMPENBATXM. DAMAGES AS PROVoM FOR W SECTION9TOA OF THE LADOR ODOE, INTEREST. ANDATTCRNEY'S FEE& CONSTRUCTION LENDING AGENCY I HERESY AFRRM UNDER PENALTY OF PERAIRY THAT THERE ISA CONSTRUCT" LENDING AGENCY FOR THE PERPORNANCE OF THE WORK FOR WHICNTWS PERMIT 3ISSUED (SEG 3m, CN, C.). LENDERS NAME. LENDERS ADDRESS I OFF OIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE *ffOMALICN IS CCgRECT. I AGPEB TO COMPLY WUH AL.CRY AND CDeJNT/ORDPUW CEB AND STATE LA, RELATW0 TO 0=,MB DONSTRICTION, ATO HEREEIYAUTHORQEFILPRESERTATNES Eng CDLWTYTO ENTER UPON THE ABOVE-MENTIONED PROPERTY FDR 1NSPECTIDN PURPOSES, CDP!'. EXPIRED' SEP X 0 AM PRESS FIRMLY APPLICATION i 7► _�. 3 j V DATENPELINER 20J'v 461 p'cO3— ISSUE TYPE 00c DATE CONST._ GROUP ZONING SETBACKS FRONT RYy REAR ❑ SIDE/SIDESTREET RW L� SIDE p PROPOSED USE NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO, FT. FACTOR PSF ADJ. AREAIVALUATION SFWADOIREM cn GerayalCarPaR W LU PatiolDarJt U- POOVSPa 0 Z RB -Roof O CGIRmarClal m v Valuation AIMARF.A OUANTI'fY DE CRIPTION FEE C U ft H U W J w Z40 ED OL U_ qZ 2 U W CONSTRUCTION _. - i �, •f PLAN REVIEW ELECTRIC PLUMBING'Q MECHANICAL Z 0 INSPECTION FEE ISSUANCE w G SNIP Cr ENERGY FIC ' ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES .C_L fl"�- � df COMMENTS �� V RECPT. NO. PAID BY VALIDATION CITY OF DIAMOND BAR INSPECTION RECORD SETBACK !FLOOR JOIST FTGS,'FORMS/STEEL 1 FHA REQMTS ELECTRIC GROUND uNL)EK FLOOR- UCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 1 8 FT BOND BEAM FRAMINGJVENTILATION1 JFINAL BOND BEAM ROOF COVER I = PRE-GRAbiNG ROUGH HEATING BENCHING ROUGH ELECTRIC I lROUGH GRADING ROUGH PLUMBING FINISH GRADIN, SHOWEFUTUS TEST !POOL ELECTRIC EXT. LATHISIDING POOL FENCING WALL INSULATION E POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS FINAL ENG. SEWER SEPTIC TANK !LANOSCAPF-IIRRIG SEEP PIT/L.L. I[qN SITE IMPS, GAS AIR TEST ' FINALZONING FINAL CONST. -F 1 FIRE DEPT FINAL FINAL HEATING [HEALTH DEPT. FINAL FINAL ELECTRIC DEV, FEES PAID FIN &PLUMBING! !ENERGY 0 &A, 1(147-12 J C COMMENTS - SEPTIC TANK SIZE SEEP PITIU SIZE Vicki Kaiser 24300 Hardy Dr. Diamond Bar, CA 91765 August 11, 2017 City of Diamond Bar Dept. of Community & Dev Services 21825 E. Copley Dr. Diamond Bar, CA 91765 Re: Pool Permit To Whom it May Concern: Attached is the original Building Permit Application. I would like to request my permit reinstated. I sincerely apologize for the delay. I am recently divorced and my ex-husband at the time took care of this for me. I did not know that he never had the final inspection. Now that we are divorced, I have to sell the house and to my surprise, came across this. I am respectfully requesting the reinstatement of this application. Please let me know if there is anything you need from me. Thank you very much. Sincerely, Vicki Kaiser Attachment via email