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Home My WebLink AboutPR 13 633.pdfOn 0 0m UI,IMIND UL11ti CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOBSITE ADDRESS 6 Yi 6'cL dl wJ S iN J Z APN LOT — TRACT OWNER (,L{OC_ 7, ADDRESS L3 G yL. (• CITY I>/ A'!2 ZIP 9— TEL. 0 9006 APPLICANT a,(ZN cE T-LjO / CONTRACTOR 4u r L ADDRESS ,1/ q N _ CITY bIL 44A ZIP 6/ ITEL JF f COS 1/ ARC W ENG/ DESIGNER e- r ADDRESS/7-Ire- CITY e CITY j ZIP TEL OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE C WRACTORS L4 CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE ANY CRY ORCOUNTYWHICHREQUIRESAPERMRTOCONSTRUCT,ALTER, IMPROVE DEMOLISH. OR REPAIR ANY ITYOR TUBE, PRIOR TO RS ISSUANCE, ALSO REOUIRES THE APPLICANT FOR SUCH PERMrr TO FILE A STONED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LM CENSE LAW (CHAPTER 0 (COMMENCING WITH SECTKM 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. TION. ANY VIOLATION OF SECTION 7031.3 BY ANY APPLJCANT FOR A PERMIT SUBJECTS THE APPLICANT ToACIVILPENALTYOFNOTMORETHANFIVEHUNDREDDOLLARS (1500).}. 01, AS OWNER OFTHE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORT( AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SAE 19EC. To". BU51- NESS AND PROFESSIONS CODE: THE COMPACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH W ORI(WMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER THE BUILDING OR IMPROVEMENT 6 SOLD WITHIN ONE YEAR OF COMPLE- TION. THE OWNER-SUILDEA WILL HAVE THE BURDEN OF.PROVNG THAT HE OR SHE DID NOT BUILD ORIMPROVEFORTHEPURPOSEOFSALE): L AS OWNER OF THE PROPERTY, AM ExcLusNELY CONTRACTNO WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AHD PROFESSIONS CCOE THE CONTRACTORS LJ - CENSE LAW DOES NOT APPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE COHTTAOTORSLICENSELAW.). a'07 -EXEMPT UNDER SEC. B. & P.C. FOR THIS REASON DATE 3 OWNER j LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER Y (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS ODOR ANDMYLICENSEisINFULLFORCEANDEFFECT, LICENSE CLASS LIC. NO. . DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIDNS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS• COMPENSATION, AS PROVIDED By SECTION SJOO OF THE LABOR CODE, FOR THE PERFORMANCEOFTHEWORKFORWHICHTHISPERMITISISSUED. 1.IIEAND WILL MAINTAN WORKEW COMPENSATION INSURANCE; AS MOM rD BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHO, THIS PERMIT IS ssu ED. MY Won(mv COMPENSATION INSURANCE CMjQW4A D P//OJJLFrIICCY NUMB ER ARE: CARRIER POLICY NUMBER L? rJ — Ms SECnON N® NOT BE QtRLETEDOFTE PERMIT 6 FOR ONE HUHOREDDOUARS (Slcq OR LESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. 1 SHALL NOT EMPLOY ANY PER$OI IN ANY MANNER SO AS TO BECOME - TO THEWORKERS'COMP LAWS OF CALIFORNIA, REE THAT OF. 1 BECOME SUBJECT TO THE WOMERV COMPENSATION PR rSIC SOF SECTM 7 OF THE LABOR CODE RTMWITH COMPLY WITH O SK)NS. DATE APPL)CANi: WARNNG: FAILURE TO SECURE WORKERS' COMPENSATION G UNLAWFUL. AND SHALL BE SUBJECT AN EMPLOYER TO CAWNAL PENALTIES AND CM UP TO ONE HUNDRED THOUSANDDOLLARS (SI C0.000), N ADDITION TO THE COST OF COMP S N, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST. ANO A FEES. c=sTkuc-ThION LENDING AGENCY 1 HEREBY AFFIRM UNDER PAT THERE IS ACONSTRUCijON LENDING AGENCYFORTHEPERFORMANCEOHTHISPERMITISISSUED (SEC. 3007, CAV. C). LENDERS NAME LENDERS ADDRESS 1 CERTIFY THAT I HAVE READ TWS APPJCATION AND STATE THAT THE ABOVE INFORMATION is Q6RRECTIAGREETOCOMPLYWITHALLCRYANDCOUNTYORDINANCESANDSTATELAWSRELATINGTOBUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESEMA S OF THIS COUHTYTO ENTER UPON THEABE-MENTIONED PROPERTY FOR INSPECTION PU SOV N e- . PERMITTEENAM SgNATURE DATE V vvnl I t—uepanment Cc", YELLOW--FInanCe Copy, PIN PRESS FIRMI V APPLICATION PERMIT DATE NUMBER C ISSUE1 DATE 1 TYPE OCCla \3 CONST. GROUP ZONING SETBACKS FRONT Rey REAR 0 SIDE/SIDE STREET RW SIDE 0 PROPOSED USE Q NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/REM U) Garage/ Carport W PatWDeck LL POGVsPa Z Re -Roof Commercial M Valuation QUANTITY DESCRIPTION ADS ApE FEE U U— WJW C72 m JOIL oo Z Ll CSP Affil, M o nj CONSTRUCTION S -S PLAN REVIEW 06*Nv- ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMTP ENERGY P/C ENERGY PERMIT RETENTION FEE a vo PRE -ALT FEF-- EETOTALTOTALFEES3cj49a COMMENTS RECPT. NO. PAID BY O, 3 Asewcw r•,..... rsl ncun..n VALIINiTION pi- ,....p7, ncrrr WpI anTE L:opy O D SET BACK FTG5 lir-ORMS1STFEL EILECTMC GROUND ROUND FLU 1P,IHG SLAB TEMP POWER kl' —'e FLOOR JOIST FH.-, RE010TS UNDER iI.00RDUCT UNF?-R FLOOR CONDUIT FIREPLACE FOUNDATION FIREPLACE BOND BEAM MID HT BOND BEAM 8 FT BOND BEAM j FINAL BOND BEAM PRE -GRADING L 8_-E-NCHING----- i ROUGH GRADING I FINISH GRADING I POOL ELECTRIC POOL FENCING WATER SERVICE ROOF SHEATHING At( FRAMING/VENTILATION ROOF COVER ROUGH HEATING ROUGH ELECTRIC ROUGH PLUMBING I SHOWER/TUB TEST EXT. LATH/SIDING WALL INSULATION POOL FINAL CEILING IflSULATION OFF SITE IMPS, DRYWALL NAILING SEWER SEPTICTANK DEDICATIONS FINAL ENG. LANDSCAPEARRIG. SEEP PIT!L.L. I ON SITE IMPS. GAS AIR TEST FINAL CONST FINAL HEATING tl Ul U I I Y FINAL ZONING FIRE DEPT. FINAL I HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING IENERGY FINAL PLANING FINAL ENGINEERING COMMENTS 3 SEPTIC TANK SIZE SEEP PIT/U SIZE MIAMUNI) IIXIIit it pub\ cca e "fr CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOBSITE ADDRESS r43G Y2 G"O A S iA/d J !Z> Z APN LOT TFjACT OWNER U J ADDR SS s CITY ZIP /,7 TEL • Opo APPLICANT --1A T p CONTRACTOR::_u r L ADDRESS i_IJ CITY 90 ZIP f-ZM(''YEL %rrs 0y i ARC WENG/ DESIGNER G 0j. L% C ADDRE L CITY t ZIP Q0Ob TEL j OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PEFIAURY TWIT 1 AAI EXEIM FROM THE CONTRACTORS LYCENSEUWFORTHEFOLLOWPqREASON (SEC 7001.E BUSINESS AIA PROFESSIONS CDDEANV C/ry ORCOUNTYWHOHREOUIRESAPERWTTOCONSTWCF,ALTER, WrAMDELOOUSK OF, R,PAIRJNYS WU1TUBE. PRIOR TORS SSUANCE; ALSO REO bees THE APPLFIJWF FCR aUON PERALT TO FILE A SMMSTATEMENTTHATHEORSHESLICENSEDPURSUANTTOTHEPROVISIONSOFTHECONTRACTORSLLFEasCENSES (CHAPTER(CHAPTERr (COMMFNCINO WI, SECTION 7000) OF DMASIONN a OF THE BUSYNESS AND PRO. IOHVOLE) OR THAT HE OR SHE IS EXEMPTYMEREFROM AND THE BASS FOR THE M I N ED OX - 7HON.AM vIOtATIOfI OF SECTION 7W1.9 BY ANY APPLICANT FOR A POUT SUBJECYa THE APPLICANT roACfVLPENALTYOFNOTMORETHANFINEHUNDREDDOLLARS (gS0".k O L AS OWNER OF THE PROPERTY( OR WY EMPLOYEES WATHiNAGES AS THBR SOLE COAlIPE7SATHON, WALL DO THE WON( AND THE STRUCTURE S NOT INTENDED on OFFERED FOR SALEDE: (SEC 70044. KSFNESSANDPROFESSIONSCOTHECONTRACTORSLICENSELAWDOESNOTAPPLYTOANOWNEROFPROPERTYWHOBUILDSORIAPROVESTHEREON. AID WMOOOES SUCH WORKOSO. NF ORH10pHF ONTTHSLOUGHHISDRHEROWNEMOLOYEES. 6ROVOED THAT SUCH IMPR& ADITS ME NOTM9AED OROFFEREDFTIRSALEIF, HOWEVER THE MA.DPO OR WPPOVENBR R EODILTTHM ONEYEAROFCOAWLE- T10N. THE OYMEA-BUILDER WALL HAVE THE BURDEN OF PROVING TWLT HE OR WE DD NOT SURD 011YAPROVEFORTHEPURPOSEOFSALE): L AS OM MER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTm WITH LXMC;ED CXWr,ACr D STOCONSTRUCTTHEPROJECT (SEC 7044. BUSYNESS AND PROFESSIONS CODE THE CONTRACTORS U. CENSE UW DOES NOT APPLY TOM OWNER OFA PROPERTY WRO ERADS OR Up OYES THEREON. MIOVMOCONTRACTSFORSUCHPROUECTaWITHAOOHTRACTORtS) UCe4SEO PURWANNT TOTHE CONTRAC- TORS LICENSE L.AWL GHw'EXEMPT UNDER SEC B. a h.1 FOR THIS REASOII DATE OWNER r LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFPM u NDEN PENALTY OF PERJURY THAT I AM LXENSED UNpp1 PROWSICM OF CNAVTEAItCOMMENCYKlWITHSECTIONTOM) OF DIVISION 7 OF THE BUSINESS AND PROFESSK7NS LODE, ACCOMYLICENSEISINFULLFORCEANDEFFECT LICENSE CLASS W4 NO. DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFRM UNDER PENALTY OF PERJURY DNP OF THE FOLLOVVM DECLARATIONS: I HAVE AND WILL MAINTAINA CERTIFICATE OF CONSENT ro 6FFTHEWORKFCRCORDONTMCERWTd SSUM. SELF -INSURE FOR WORIER7' ONOPBaATION, Ai PMNMCD 9Y $ECTld1 STIP OF 11iE LLABORCODE. FDR THE PERFORMANCE v I NMEMID WTLL MAYTAN WORO_RFS CDMPEHSAT" MSLRIANM AS REOURED AY SECTION3700OFTHELABORLWE. FOR THE PERFDR.AHCE OF THE WOW FTN} WHICH THIS PERMT b MWEXX WY WOR(EAT COMPBSATION *MfiUk ICE CARNSAAjp POLICY NUMBER ARE CARRIER POLICY NUMwR UOS SECTIOfNNFFPDNOT BE D?&RET®ffTHE PEFMI R FORCNEHUPpIaE DajAil1(Flm)CRLeM I CERTIFY THAT IN THE PERFORMANCE OF THE WOW FOR TWECN TNS PEFW S ISSUED. ISWILLNOTES/ROY ANY PETI,Tp/ MANY MA/NIIEII SOA! TO BEOOFAE, TO 1HEWORKERSTOMLAWSOFCAY:IFONAA REE THAT IFI BECOMESUBJECTro7FNEWORKERSCOEFjNSATONPS .1OF SECTIO 7 OF THE LABORCOOS1I1IHLCOMR.T WITH 7H SONS, DATE ApPLICJIHP WARMNO: FAILURE TO SECURE WORKERS,OOMPEISATON UMAWFTUI. AND SHALL BESUMCTANEMPLOYERTOCRIMINALPENALTIESANOUPTOONEHIIINDR® D OUSNADOLLARS (1100.OW , IN ADORON TO THE COST OF DAMAATES AS PROVIDED FOR INSECTION3MIROFDHELABOROODEINTEREST. ANO II FEES CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY TUR THERE S A OOISTRUCIjON L940ING Mmwy FOR 74E PERFORMANCE OF THE WORT FOR WHICH THS pERSI S SSU® OEC SOFT, CN. 4 LENDERS RAJAS LENDERS ADDRESS . 1 CERTIFY THA" 1 HAVE READ THIS APPLICATION ANO STATS THAT TNG ABOVE I60N4/IT10N S).'OIV1E0{ 1 A(SfTEE TO CQIPLY YVTRN ALLClIY AND CbYU. n1F.. T.Y. OIDNANCES AND STATE LAWS FIELATINO TO SUIDYDCONSTRUCT)ON. AND HE3IEBT AUITIpSZE ..CRCs.. .1 1. COUNTY TO E)nVR UP. THEABOVE-MENT"4M pgp =; ROTI YSpECTON Toil/ PETICT7EE SONATURE I./ ...n."SP1 reuvTr—rruuxe"Vy' PRESS FIRMLY APPLICATION PERMIT A PLAN REVIEW ELECTRIC DATE NUMBER tP 3 PIC ISSUE aN- \3 TYPE OCC— DATE CONST. GROUP SMTP ZONING SETBACKS ENERGY P/C ENERGY PERMIT FRONT RW REAR PRE -ALT FEE SIDE/SIDE STREETLlRW SIDE O PROPOSEDUSE &124112 r Q' NO. DWEL UNITS DESCRIPTIO SMADMEM GBragalCBTporl U PIIW D,* UL PNi,Y 7 Re -Rod D CaRMRemwJ_ D Vegretlm OUANTTTY NO. NO. STORIES BEDROOMS Z.Lel-7 • AD.I.AREA DESCRIPTION a FEE . CONSTRUCTIoN PLAN REVIEW ELECTRIC PLUMBING MECHAMCAL INSPECTION FEE ISSUANCE SMTP S ENERGY P/C ENERGY PERMIT RE:TTEMMN FEE a PRE -ALT FEE TOTAL FEES 3g,, Ncia COMMENTS - NO. TA C l Ste. PAID BY CLOS;. Cam C, CITY OF DIAMOND BAR " INSPECTION RECORD SET BACK ' FTGS/FORMS/STEEL - - -_--_ 3 _ I_ ELECT-RIC GROUND FLUOAJOIST FHP, REQMTS- - -- - -— ----- -- UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BUND BEAM WATER SERVICE MID HT. BOND BEAM - ROOF SHEATHING 8 FT. BOND BEAM FRAMING/VENTILATIONfel FINAL BOND BEAM ROOF COVER . PRE -GRADINGi ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUBTEST POOL ELECTRIC EXF. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. NAILING DEDICATIONSDRYWALL SEWER FINAL ENG.—_— SEPTICTANK LANDSCAPE/IRRIG_ SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY FINAL PLANING--- LANING_ FINAL ENGINEERINGFINAL COMMENTS e _.---- ----_---.-- SEPTIC TANK SIZE SEEP FIT/U SIZE