HomeMy WebLinkAbout21744 - 21119 Silver CloudDIAMOND HAD
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CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES--T----
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21FIRMLY
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909) 86044'95-Fax (909) 861-3117
BUILDING PERMIT AI'PLICA1
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OWNERit/i /KC 4n,y)e4rrot-yA/&-z:1-
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CITY0 iA/Ind Air, 131A.ZIP q/74c-- TEL "r6 V IST if -21 07
APPLICANTgIca 1"w) 144-4.-41-0-4444./TEL
CONTRACTORi c*kri I- a• ...
ADDRESS'Mir
CITYI4 ' --144"it=ZIP9 > 7 S. -0 TE L. . 9091 3 2.,
ARCH/ENG/93 Vy
DESIGNER
ADDRESS
CITYZIPTEL.
OWNER-BUILDER DECLARATION
IHEREBY AFFIRM UNDER PENALTY OF PERJURY THAT INA EXEMPT FROM THE CONTRACTORS LI-
CENSE LAW FORTHE FOUDWING REASON (SEC. 7031.5BUSINESSAND PROFESSIONS CODE: ANY CITY OR
COUNTY WHICH REQUIRESA PERMIT TO CONSTRUCT. ALTER, IMPROVE, DEMOUSH2OR REPAIRANY STRUC-
TURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE ASIGNED
STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI-
CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3OF THE BUSINESS AN) PRO-
FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROIA AND THE BASIS FOR THE ALLEGED EXEMP-
TION. ANY VIOLATION OF SECTION 7031.5BY ANY APPLICANT FOR APERMIT SUBJECTS THE APPLICANT TO
ACIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (S500).):
0t. AS OWNER OFTHE PROPERTY,OR MY EMPLOYEES WITHWAGES AS THEIR SOLE COMPENSATION,
WU DO THE WOW, AND THE STRUCTLIRE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI-
NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF
PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR
OFFERED FOR SALE IE HOWEVER, THE BUILDING OR RIPROVEMENT IS SOLD WITHIN ONE YEAR OFCOMPLE-
TION, THE OWNER-BUILDER IMU. HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
IMPROVE FOFI THE P(JRPOSE OF SALE).
0I, AS OWNER OF THE PROPERTY AM EXCLUSIVELY CONTRACTING WITH UCENSED CONTFIACTORS
TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI-
CENSE LAW DOES NOT APPLY TO AN OWNER OF APROPERTY WHO BUILDS OR NAPROVES THEFIEON, AND
WHO CONTRACTS FOR SUCH PROJECTS WITHA CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC-
TORS UCENSE LAW )
0IAM EXEMPT UNDER SECB. & P.C. FOR THIS REASON
DATEOWNER
LICENSED CONTRACTORS DECLARATION
IHEREBY AFFIRM UNDER PENALTY OF PEFtJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER
9 (COMMENCING WITH SECTION 7000) OF DMSION 3OF TIE BUSINESS AND PROFESSIONS CODE, AND
DAY UCENSE IS INFULL FORCE AND EFFECT.
LICENSE CLASS73LIC. NO.g 2,341SY
DATE/0/510 yCONTRACTOR
40-1A.4-14F744V
WORKERS' COMPENSATION DECLARATION
IHEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
IHAVE AND WILL MAINTAIN ACERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS
COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
IHAVE AND WIll MAINTAIN WORKERS' COMPENSATION INSURANCE AS REQUIRED BY SECTION
3700 OF THE LABOR CODE, FOR THE PERFORIAANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE
CARRIER
POLICY NUMBER
IHS SECTION NF_EDNOTBE CONFUTED °FIFE PERMIT'SFOR CNE FUFDRED DOLLARS ($100)OR LESS).
ICERTIFY THAT INTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I
SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE
1NORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREEI SHOULD BECOME
SUBJECT TO THE WORKERS' COMPENSATION P • • SIONS OF S., 3700 OF THE LABOR
CODEJ SH.LFORTHIMTH COMPLY WITH•Aly • -.••
i 6/0-11
DATE:APPLicANT.Ar•.wiLrAr
WARNING: FAILURE TO SECURE WORKERS' COWEN•RAGE IS UNLAINFUL, AND SHALL BE
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESI FINES UP TO ONE HUNDRED THOUSAND
DOLLAFIS ($100000)., IN ADDMON TO THE COST OF • .. PENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3709 OF THE LAI3OR CODE, INTEREST, AND ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
IHEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT ISISSUED (SEC. 3097, CIV. C.).
LENDER'SNAME
LENDEFrS ADDRESS
ICERTIFY THAT IHAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT.
IAGREE TO COMPLY WM4 ALL CITY AND COUNTY OFIDINANCES AND STATE LAWS RELATING TO BUILDING
CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATNES OF THIS COUNTY TO ENTER UPON THE
ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSE&
eCIANAA3 Nkri. GAA-41)
PERMITTEE N .,"
AL.ib/S-10y
SIGNATU - OF PERMITT 91DATE
ON
CITY OF DIAMOND BAR INSPECTION RECORD
7. •I
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V,141.14,4%,""•zity,•2 r•r
SET BACK. ': FLOOR JOIST.
FTGSIFORMS/STEEL. .*FHA REQMTS
LECTRIC GROUND _-_ _I
GROUN-D. PLUMBING*_UNDER FLOOR DUCT
UNDER FLOOR. CONDUIT
SLAB GRADE_-
TEMP- P-OWER __ __
WA-T-ER SERVICEi
FIREPLACEFOUNDATION
FIREPLACE BOND BEAM
MID HT BOND BEAM
ROOF SHEATHING.8F-, BOND BEAM
FRAMING/VENTILATION::- FINAL BOND BEAM
ROOF COVERPRE-GRADING
ROUGH HEATING.- . BENCHING
ROUGH ELECTRIC.- • ROUGH GRADING
ROUGH PLUMBING1. FINISH GRADING
SHOWER/TUB TEST.' POOL ELECTRIC
EXT. LATH/SIDING.. POOL FENCING
WALL INSULATIONPOOL 'FINAL-
CEILING INSULATION,'OFF SITE IMPS.
DEDICATIONS
DRYWALL NAILING.FINAL ENG
SEWER:- : LANDSCAPEIIRR la
SEPTIC TANK.:.,
SEEP Pri/L.L.: :ON SITE IMPS.
GAS AIR TEST.,
FINAL ZONING
FINAL CONST'An'.----W Arr : IFIRE DEPT FINAL
RNAL HEATING- :HEALTH DEPT. F:NAL
IAL ELECTRIC....
4,/-DEV, FEES PAID
COMMENTS
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SEPTIC TANK SIZE
SEEP PIT/U SIZE