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Home My WebLink About20230815111434362CO Ca i� O Li a w z g O 0 w 0 n_ rn Cn a W ZT) W Q� ti t— O Z z Lu W W O w z 0 Xd W O U w (13 O7 zn Q C W tR Ln N7 w Z CD C!) C =J J J w W n. O d. -TS�- 7 W O_ 2 a cc m Q [AD Cn CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861=3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS,l7 APN LOT TRACT OWNER ADDRESS, 4&P CITY ZIP TE APPLICANT TE . CONTRACTOR "�✓ r �2 S"- ADDRESS� CITY2 VS TIE ARCWENG/ DESIGNER ADDRESS CITY ZIP TELL 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.F BUSINESS AND PROFESSIONS CODE: ANY CITYOR COUNTYW'HICH REOUIRESA PERMRTO CONSTRUCT,ALTER, IMPROVE,DEMOUSH, OR REPAIRANYSTRUC• TORE, PROR TO 173 ISSUANCE, ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS Lim 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.E BY ANY APPLICANT FORA PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (IS00).): D 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 V640 BURRS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THATSUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FDR SALE IF, HOWEVEK THE BUILDING OR IMPROVEMENTIS SOLD WITHIN ONEYEAROFCOMPLE• TON, THE OWNEREUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DO NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE} 0 LAS OWNER OF THE PROPERTY, AM EXCLUSNELYCONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC, 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI, CENSE LAW DOES NOTAPPLY TOAN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON,AND VA4000NTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S)LICENSED PURSUANTTOTHE CONTRAC- TORS LICENSE LAW.). O [AM EXEMPT UNDER SEC. B. I P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION i HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCINO WITH SECTION 70001 OF DMSION 3 OF THE BUSINESS AND PROFESSKNS CODE, AND MY LICENSE IS N FULL FORCE AND EFFECT, LICENSE CLASS dog5p 1 LIC. NO. �� DATE— � �L�"" ae CONTRACTOR 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' COMPENSATON,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REWIRED BY SECTION 3700 OF THE LABOR COOS FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, MY WO C ' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER 1>ao POLICY NUTABER ��,!L L M-flS SECTION NEEDNOTBE COMPLETED OF THE PETW IS FOR ONE HISC7ED DOLLARS 51MOFILM 1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, i SHALL NOT EMPLOY ANY PERSON N ANY MANNER $O AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF 1 SHOULO BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVI lO S OF SECT ION 3700 OF THE CODE, I SHALL FORTHWITH COMPLY WITH THDS • YI DATE: ;;E: NA : WARNING:FAS.URCTOSEWREWORKERS' COMPENSAT RAGE 15 UNLAWFUL, AND SHALL BE SLIBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS 1$100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED ISEC. 3097,CIV. a), LENDER'S NAME LENDER'SADDRESS 1 CERTIFY THAT 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 -MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMFTT£E NAME (P I 7URE OF PEaw Tic DATE RECP7. N0, WHITE —Department Copy, YELLOW —Finance Copy, PINK —Assessor CL APPLICATION S �.0� PERMIT NUMBER (O DATE_ 1 ISSUE TYPE DATE CONST, ZONING SETBACKS FRONT REAR SID SIDE lSIDE STREET PROPOSED USE NO.DWEL UNITS PatfolDeck PoD'Spa Re-ROof Commercial U OCC GROUP NO. NO. STORIES BEDROOMS Valua(lon ADJ.AREA QUANTITY DESCRIPTION FEE CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY PiC ENERGY PERM)? RETENTION FEE: PRE-ALT PEE: TOTAL FEES , COMMENTS PAID BY 3 Copy, C VALIDATION MLY .�., d ..i- i..", t. ::c•... :�y.: tr-J;. .c. ...-0•.aaj.!'.."�:� '.w"r. � :l•r,:rif;•: ''✓�.: C'f.:.'.', r; aJ'. .- n.._ .r. ,.. ��.. r .'r., •, ... ,, OF DIAMOND SA I�.�v1„`�•.,,"r C�t� ^. I. A,C�:a alp•,: Ga�'.�ni-._....._-.-..-�y��'�"'y�a'.(+•)_�.I.._ �: �: I�R+ law SETBACK _ W- — _�I___�.__. _ _ _ -1ol 0:-lowlro Mao FLOOR JQIST _lOO—� . FTGS/FORMS;STEEL I _ FHA REOMTS ELECTRIC GROUND I UNDER FLOOR DUCT —� GROUND PLUMBING UNDEB FLOORaCONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER I FIREPLACE BOND BEAM WATER SERVICE �__ f MID HT, BOND BEAM ROOFSHEATHING _ '� Fi FT. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM I ROOF COVER _ , fj;_' '� - PRE -GRADING j ROUGH HEATING ` I BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING ; FINISH GRADING SHOWERTFUB TEST j POOL ELECTRIC EXT. LATH/SIDING j POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PITIL.L, ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST: c/� FIRE DEPT. FINA! FINAL HEATING --- I Ilk ( HEALTH DEPT, FINAL FINAL ELECTRIC DEV, FEES PAID FINAL PLUMBING ( ENERGY Pl COM MEN T s -. - -- ---_ . SEPTIC TANK. SIZE SEEP PIT/U SIZE i i ..0, ._.. _...'a'_...__,.._