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Home My WebLink About18125 (26)CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21825 E. Copley Drive 909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION JOBSITE C9 &? p ADDRESS '4+L!! APNT TRACT OWNER 1 ADDRESS CITY TEL APPLICANT TE CONTRACTOAPPLIANCE INSTAL FRg INC ADDRESS 1 CITY LaIPWnnd CA -2 TEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM LINDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS U - CENSE LAW FOR THE FOLLOWING REASON (SEC. 7071.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REONRESA PERMITTO CONSTRUCT,ALTER IMPROVE. DEMOLISH. OR REPARANY STRUC- TORE, PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 7 OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP• TON. ANY VIOLATION OF SECTION 7071.5 BY ANY APPLICANT FORA PERMIT SUBJECTS THE APPLICANT TO ACMLPENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (L5DO).7 O L AS OWNER OFTHE PROPERTY OR MY EMPLOYEES WITH WAGESAS THEIR SOLE COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC 7016, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES N0T APPLY TO AN OWNER OF PROPERTY WHO BUILDS WHORIMPROVESTHEREON. AND O DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE F, HOWEVER THE BUILDING OR IMPROVEMENTIS SOLD WITHIN ONEYEAROF COUPLE. TION, THE OWNER BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE on SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). D L AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7061. BUSINESS AND PROFESSIONS CODE'. THE CONTRACTORS LI. CENSE LAW DOES NOTAPPLY TORN DWNEROFA PROPERTY WHO BULDSOR IMPROVES THEREON.AND VMO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S) LICENSED PURSUANTTO THE CONTRAG TORS LICENSE LAW). O 1 AM EXEMPT UNDER SEC. B. a P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FLA R AND EFFECT. LICENSE CLASS LIC. N0. DATE CONTRACTO WORKERS' COMPENSATION DECLARATION 5Mi 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 7700 OF THE LABOR CODE. FOR THE PERFORMANCE Of WORKFOR WHICH THIS PERMIT IS ISSUED. VE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION 77000E T*ABOROR TNT PERFORMANCE OFTHE WORK FORVlHICH THIS PERMIT IS ISSUEDSATI SURANCE CARRIER ANDCARR+++ rPOLICYN_ [.{ IHS SECTION NEED NOT BECONIPLETEDOF THE PEMV IS FOR ONE HUNDRED DCl1ARS KIDD) on LEs.% I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMITS ISSUED. I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISKN SOF SOFSECTION7700OFTHELABOR G90 RT TH COMPLY WITH lR VI / NT _ OAT /' PPLICANT WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (7100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7709 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CIV. C.). LENDERS NAME LENDER'SADDRESS I CERTIFYTHAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE•MENTEDP OP ERTY FOR INSPECTION PURPOSES. I PEITT E NAM (PR /)1402- 4/ I/ SI NAT EOF nRMITTEF IfATE i PRESS FIRMLY PERMIT P DATE CATION / eZ NUMBER / 1 #! C ISSUE TYPE OCC DATE_4&CONST. GROUP ZONING SETBACKS FRONT RW REAR SIDEISIDE STREET RW SIDE PROPOSED USE NO.OWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. Fr. FACTOR PSF ADJ.AREANALUATION SFR/ADDIREM Garage/Carport WPatio/Oeck LL PooVSpa . ZRe Roof OJ Commercial m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE 1QU Q 1-- UWJW Zz m JIL a U ZQ2UW CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY PIC ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES l COMMENTS RECPT. NO.D PAID BY VALIDATION J WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN—Applicant's Copy CITY OF DIA MiOND BAR INSPECTIONI RECORD r I. j; ) 1 SET BACK I FLOOR UOIST Vo FTGS/FORMS/STEEL FIAA REQMTS ELECTRIC GROUND GROUND PLUMBING UNDER FLOOR DUCT UINDER FLOOR CONDUIT SLAB GRADEFOUNDATION TEMP POWER WATER SERVICE I FIREPLACE BOND BEAM h11D HT. BOND BEAM ROOF SHEATHING FRAMING,'VENTILIATION 1FINAL 1 8 FT. BOND BEAM ' BOND BEAM ROOF COVER 1 PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK L. NDSCAPE/IRRIG. SEEP PIT/L.L. 1 ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT FINAL FINAL HEATING 1 HEALTH DEPT. FINAL FINAL ELECTRICDEV. FINAL PLUMBING X FEES PAID ENERGY COMMENTS SEPTIC TANK SIZE SEEP PIT/IJ SIZE