The URL can be used to link to this page

Home My WebLink About238667 14- z 3' - ss9 G <4AtLr CITY OF DIAMOND BAR I DEPARTMENT OF COMMUNITY & 6EVELOPMENT SERVICES 21825 Copley Drive, Diamond Bar, CA 91765 909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOBSITE ADDRESS G '7 4'O0i.,, jz,-; •l .D/^ APN LOT TRACT OWNER r ADDRESS CITY ZIP TEL d APPLICANT TEL. CONTRACTOR CZAJ7&f AAU-f- ADDRESS971 R16 5 / '(1 err .e r CITYiC/L re ST ZIPARCH/ ENGTEL 9f 770-875 DESIGNER Iti N", G iKra ( T2170 ADDRESS V p1Z CITY CA ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.6 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER IMPROVE, DEMOUSH, OR REPAIR ANY STRUC. TURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED 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 3 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 7031.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSOO).): O I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE 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 HIMSELFOR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFEREDFFERW FOR SALE. IF HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE. TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7011, BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC. TORS LICENSE LAW.). O 1 AM EXEMPT UNDER SEC. B. 6 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 FULL FORCE AND EFFECT. UCENSECLASS A Yi c/LtyL LIC. NO. DATE 7//' / CONTRACTOR CW/OC/1lJT- a v. WORKERS' COMPENSATION DECLARATION I 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 3700 OF THE LABOR CODE. FOR THE PERFORMANCE THE WORK FOR WHICH THIS PERMIT IS ISSUED, I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER S%4-rL- r4 A." L) POLICY NUMBER THOS SECTION NEED NOT BE OXFLEIEDOFTI-E PERMIT IS FOR ONE HupNORED COU" ($100) OR LESS? I CERTIFY THAT IN THE 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 WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJEC TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37MOF THE LABOR CODE, HALL FORTHWITH COMPLY WITH THOSE P/ROVII PONS, DATE: 0 APPLICANT: s WARNI :FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJE TAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ZTGS OPTHE LABOR CODE, INTEREST, AND'A7f6RNEY'S EEES.y, •y,, T, .,'.; 4+,, 1 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THS WORKBOR WHICH THISS/ PE IT IS ISSUED (SEC. 3097, CIV. C.). LENDER'S NAME S/az?%' rRi!•A H ' ` • t) LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I 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_ 1- ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. , PERMITTEE NAME (PRINT) + SIUNAI UHh OF PERMITTEE DATE PRESS FIRMLY DATEICATION 1 6 NUMB R ?- 5919PERMITg/C ISSUE TYPE OCC DATEL I Q CONST. ROUP ZONING SETBACKS FRONT q REAR p SIDEISIDE STREET RW SIDE p PROPOSED USE o rim O NO. DWEL. NO. NO. UNITS ^ STORIES2 4,tL5C1.e1rEDROOMS DESCRIPTION SO. FT. FACTOR PSF DJ. AREANALUATION SFR/ADD/REM U) Garage/Carport W Patio/Deck ' LL Pool/Spa 0 Z Re -Root 0 Commercial 3 r 7- 1 8a a - 3-q.6-43?- - m c perS / 7V r! Ati4y, 1 Valuation O ' A0.1.AREA QUANTITY DESCRIPTION FEE U ccF- UWJW C7Z_ m J d Q U ZQ2 P, W CONSTRUCTION .7a PLAN REVIEW S' ELECTRIC PLUMBING MECHANICAL . INSPECTION FEE ISSUANCE SMIP 0-0 ENERGY P/C ENERGY PERMIT oZ 1, 1-7 4ETENTION fEEa : tt,-' oil PRE-ALT FEE:'. l y, •h TOTAL FEES COMMENTS ibTA'(, 361'"180.8 ¢ RECPT NO. PAID BY e VALIDATION YY 1 m— apanmem gopy, YtLLuw-+mance ropy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN—Applicant's Copy j 7 1 ^+' Zti.SF f nrty cj n-1 its i i..e L Wy'c / •` ' " lge INSPECTION ECORD r J C_w-r„ / s -r o -e -,-r . c -o,- is zvn_Jf_4 Xc* -o r T oa@pg@,TO@a mug SETBACK FLOOR JOIST FTGS/FORMS/STEEL, 1 5 /t.--- FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING,. UNDERFLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT BOND BEAM ROOF SHEATHINGS 8 FT. BOND BEAM FRAMING/VENTIL'ATION- FINAL BOND BEAM ROOF COVER t PRE -GRADING ROUGH HEATING i` 1 ' BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC , EXT LATH/SIDING C ' POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST, J! FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY Chi. f — 3cIAck COMMENTSc^> i. •tet' Z 61 2-2 0-7 V 97 SEPTIC TANK SIZES- SEEP PIT/U SIZE - a fU.4 Yv r2 A 4 7_ it 7-a7 rl