HomeMy WebLinkAbout1724 MORNING CANYON RD (2) , �� �
CITY OF DIAMOND BAR �
----�'� ---� DEPARTME?�1T OF COIvA�IUNTfY&�DEVELOPMENT SERVICE
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21825 E.Copley Drive /�' ��.
(909)860-3195 Fax(909)861-3117 /�/�G� � PRESS
�`'%»�� BUILDING PERMIT APPLiCATION F
� JOBSITE APPLICATION RMIT I
o ADDRESS1 ,� DATE NU � #
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� ADD ESS ZONING SETBACKS
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p� OWNER•BUILDER DECLARATION SFR/ADD/REM
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I HEREBY AFFIRM UNDER PENAITY OF PERIURV THAT I AM E%EMPT FROM THE CONTRACTOiiS LI� GeI290/CefPOft
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w 7URE,PRIOR TO ITS ISSUANCE,�LSO REOUIRES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED w
� STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � �
� CENSE LAW(CHAPTER V(CAMMENCING WITN SECTION 7000)OF DIVISION]OF THE BUSINE55 AND PRO� POOVSP3
O FESSIONSCADE)ORTHATHEORSHEISEXEMPT7HEREFROMAND7HEBASISFORTHEALLEGEDE%EMP� (�
V TION.ANVVIOLATIONOFSECTION7091.SBYANYAPPLICANifORAPERMITSUBJEC�S7HEAPPLICANTTO Z Re-Roat _
A CIVIL 7ENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(5500)J: �
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WILL DO THE WORK,AND THE STRUCTUAE�5 NOT INTENOED OF OFFERED FOH SALE(SEC.70aa,BU51- J
� NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DO'eS NO�APPLV TO AN OWNER OF �
PROPERTV WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HEHSELF OR
� THROUGH HIS OR HER OWN EMPLOVEES,7ROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m .
QOFFEREOf-0RSALE.IF,HOWEVERTMEBUIL�MGORIMPROVEMENTISSOLDWITHINONEVEAHOFCOM7LE�
Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING'HAl HE OR SHE DID NOT BUILD OR
� IMPROVE FOR TME PURPOSE OF SALE). �
w ❑I,ASOWNEROFTHEPROPERTY,AMEXCLUSIVEIVCONTRACTINGWITHLICENSEDCANTRACTORS
[[ TO CANSTRUCT THE PROJECT(SEC.7oN,BUSINESS AND PROFESSIUNS CADE:THE CONTpAC70R5 LI� V81U3�1On ADJ.AREA �
W CENSELAWDOESNOTAPPLYTOANONMEROFAPROPERTYWHOaUI1,D50RIMPROVESTHEHEON,AND
� MM1iOCANTRACTSFORSUCHPRQIECTSWITHACON7RACTOR(S)LICENSEDPURSUAN7TOTHECONTRAC- QUANTITY DESCRIPTION FEE
Y TORS LICENSE LAW.).
� O I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q
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DATE OWNER _ � '
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� LICENSED CONTRACTORS DECLARATION w
� I HEREBV AFFIRM UNDER PENALTV OF PERIUHY THAT I AM LICENSED UNDER PFOVISIONS OF CHAPTER �
d e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PP.OFESSiONS CODE,AND Z
`X AIV UCENSE IS W FU L FORCE ND EFFEC7. , m
� LICE E C S LIC.NO.� y j
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� WORKERS'COMPENSATION DECLARATION �
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� I HEREBV AFFIRM UNDER PENALTV OF 7ERJURY ONE OF 7HE FOLLOWING DECLARATIONS: Z '
Z _I MAVE AND WILL MAWTAIN ACER7IFICA7E OF CONSENTTO SELF�INSURE FOR WORKERS' _
¢ MPENSATION,AS PROVIDED BY SECTION 37o00F THE LABOR CODE,FOR THE PERFORMANCE W
-OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �
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w I HAVE AND WILL MAIN7AIN WOHKERS'COM7ENSATION INSURANCE,AS RE�UIRED BY SECTION �
Q 7700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WMICH THIS PERMI7IS
ISSUED.M ORKERS'COMPENSATION INSU CE CAR[iIER AND POLI Y MBER ARE: CONSTRUCTION
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� CARRIER PLAN REVIEW
� POLICY NUMBER , �
Z ELECTRIC
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� (iHISSECIqNNE�NOTBEOJMPIEffDOF7F�PERMfT4SFORONEVrtN�DREDDOLLFAS(5100)OfiLESS). PLUMBING
Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOF7 WHICH THIS PERMIT IS ISSUED,I MECHANICAL
C�} SHALL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE
� � WORKERS'COMPENSATION LAWS OF CAIIFORNIA,AND AGREE THAT IF I SHOULD BECOME INS?ECTION FEE
SUBJECTTO THE WORKERS'COMPENSATION P OVI51 �IS OF SECTION 3700 OF THE LABOR
� ODE.1 SHALL FORTHWITH COMPLV WITH O PR /l IONS. ISSUANCE .�°iy'��
� SMIP �/ ( J
p DATE: PIICANT: � • �-��
J WARNING FAILURE TO SECURE WORKERS'COM TION CAVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C
LL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT
DOLURS(f100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: /
� CONSTRUCTION�ENDING AGENCY PRE-ALT FEE:
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� I HEREBV AFFIRM UNDER PENALTY OF PEfUUi1Y THAT THERE IS ACONSTRUCTION LENDING AGENCY
� FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.).
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� LENDER'S NAME
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� I CERTIFY THAT I HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL F E ES � ` ` J ,�
w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE UWS REIATING TO BUILDING '%
� CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE
ZABO � N710NED PROPERTV FOR INSPECTION P POSES. COMMENTS
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~ WHITE—DepaAment Copy.YELI.OW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy
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FTGS/FORMS/STEEL �___ ; __ �`_,�_ , i FHA REC�MTS ` �
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ELECTRIC GR�UND � ' ! UNDER fLOOR DUCI' � !
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S L A B G R A Q E i i ; FIRFPLaCE FOUNDATION_ i ___ ' � I ' �
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TEMP POWER ' ; FIREPLALE BUND BEAM � ___
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WATER SERVICE ' MID HT. EiOND F3EAM � '
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ROOF SHEATHING _ '� � ' ._
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FRAMING!VENTILIATION � _ ._. . � FINAI EiC�fidD C-3�,�M 1 ._..._._.___ � �
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ROOF COVER � � PRE-GRADING ___ i __
ROUGH HEATING � BENGHING I
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ROUGH ELECTRIC ! ! RC)UGH GRADING
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SHOWER!TUB TEST � ; POOL ELEt�.TRIG
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EXT. LATH/SIQING � ; POOL FENCING �
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WALL INSULATION 'T i POOL FINAL _ _ _
CEILING IN�ULATION j ; OFF SITE IMPS. __ _ �
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DRYWALL NAILING ; i DEDIC�TIONS
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SEWER ' � FINAL�NG. �
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SEPTICTANK ; ' • 1 LANDSG�tF'E;IRRIG. '
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SEEP PIUL.L � � ON SITE IMPS.
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GAS AIR TEST � FINAI_ZONING ___ _
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FINAL CaNST. � , ; FIRE �EPT. FINA�
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FINO�L HEATING � � HEALl�W !�i r�-T FINAL �
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FiNAL ELECTRIC ' ; I DEV. FEES PAID
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FINAL PLUMBING _` i ; ENERGY - ------- -- � ------
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