The URL can be used to link to this page

Home My WebLink About16474 (37)CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY N& DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 (909)860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION 1 L JOSSITE 1-3 JVrIr�CL 6,i ,,- T' V� w ADDRESS APN LOT TRACT OWNER 111 LL ADDRESS I i�S nis I,ti C C CC-,6- CITY - ' ZIPI TEL. l-I=aS J APPLICANT TEL. CONTRACTOR c T- ADDRESS A'-) v : =l _ ARCWENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS U. CENSE LAW FOR THE FOLLOWING REASON (SEC.7031.5 BUSINESS AND PROFESSIONS CODE: ANYCITY OR OCLMTY W4BCH 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 . LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS U. CERISE LAW (CHAPTER I (COMMENCING WITH SECTION 70DO) OF DIVISION S 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 703,.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSW) r O L 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 70I4. 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 IF. HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE- TION. THE OWNER BULGER WLL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). E7 L AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U. CENSE LAW DOES NOTAPPLY TO AN OWNER OF A PROPERTY UNDO BUILDS OR IMPROVES THEREON. AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PVRSUANT TOTHE CONTRAC- TORS LICENSE LAW.). ❑ IAM EXEMPT UNDER SEC, B. 6 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER I (ODMUENCNO WITH 5ECTION 7000) OF OMSK)N S OF THE BUSINESS AND PROFESSIONS COCE. AND MYLICENSE IS IN FULLFO CE AND EFFECT. —3 C LICENSE CLASS LIC. NO. " DATE �j 7 CONTMCTDR 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 FOq WORKERS' COMPENSATION. AS PROVIDED BY SECTION 77W OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AID W UL MAINTAIN WORMERS' COMPENSATION INSURANCE. AS REOUIRED BY SECTION .700 OF THE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15 .SUED. MY WORKERS, OOLNPENSATgN W SURANE CARRIER AND POLICY NUMBER ARE: CARRIER F /\�v it, T POLICY NUMBER -,-7 (TINS SECTION NE!DNOT BF CQ.iYET©CFM PERAT IS FORGIVE FL.FDRCD OOLLARS COM) OR LESS). 1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT LS ISSUEO.I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUDECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37W OF THE LABOR CODE. I SHALL FORTHWITH COMPLY IV1 E/P/R�O` CATS APPLICANT: ai L,��G�S=�_ WARMNG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SWILLBE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100.000), INADDITIONTO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 0705 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBYAFFIRM URGER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTICN LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED ISEC. 0097, CIV. C.). LENDERS NAME LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE WFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RE UT WG TO BUILD No CONST RUCT KXI, AND HEREBY AUTHORIZE RE PRE S E NTATIVE 5 OF THIS COUNTY TO ENTER UPON THE AfOuVE.MENTINNED PROPERTY YFFOR INSPEEcTTXUN PURPOSES. � PER yA4E (P \� I SIGMA )RE OF PEPMI TF DATE PRESS FI¢MLY APPLICATION V PERMIT P/C 11 DATE 1 NUMBER X ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ ] SIDEISIDE STREET RWr ❑ SIDE ❑ PROPOSED USE NO. DWEL NO. 7 NO. UNITS STORIES - BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/REM CIO Garage/Carport W PatiolDeck U- POOUSpa ZRe-Roof7-7001 0 Commercial - m ;7j;1av<' ,1 SI l f3 T'►�270�� .1 C -\ 166► Valuation ADJ.AgEA OUANTITY DESCRIPTION FEE Cr W LU w U Z m a U_ Z Q S U W �p- CONSTRUCTION •� �/ PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION F L. . ISSUANCE M SMIP ENERGY P/C ENERGY PERM Y• RETENTION FEE: PRE-ALT FEE: . TOTAL FEES COMMENTS Art RECP7. NO. _ PAID BYr U I V U VALIDATION WHITE —Department Copy, YELLOW —Finance Copy. PINK—AssesSOr Copy, GOLDENROD --File Copy, GREEN —Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD 1��.�-a;�ac��:R;1�►gyp SET BACY, ��.:�:�'= '.l►'.�- �%�'��c,l��' � I�� e1t1►�t.. ;i�,t�r= I�`!r �l. t FLOOR JOIST FTGS'FORMS!STEEL- ` ELECTRIC GROUND FHA REQ." ;TS UNIDER FLOOR DUCT GROUND PLUMBING � � UNDER FL'OOR,C0ND.UIT ISLA.EGRADE I I FIREPLACE FOUNDATION" TEMP POWER I I FIREPLACE BOND BEAM WATER SERVICE II MID HT: BO;dD BE Jl ROOF SHEATHING —� I S FT. BOND BEAM FRAMING.NENTILWHON I I I FINAL BOND BEAM I — ROOF COVFR .: Ir�{�_� I I PRE -GRADING BENCHING ROUGH GRADING I FINISH GRADING �— •ROUGH HEATING -- ROUGH ELECTRIC :ROUGH PLU4 SBING-- f SHGvVER•TUB TEST POOL ELECTRIC { EXT. LATH,'SIDING POOL FENCING _ ;WALL tNSUUMON POOL FINAL I CEILING INISULiATIONv I. - I OFF SITE I,N: PS. D:,%1VA' LL N AILI:'dG SE��v'cR J i •_ 'L. IONS FINAL ENG. �— 1 k SEPTIC TAN j LANIDSCAPc/IRRIG. SE_' FIT/L.L. I _ �.) l ON SITE I%IPS. I ! -- i-:',.c " TEST '. r11R TES I , FIN•JAL ZONING FI'IAI. CONIST. �_�� • I FIRE DEPT, FINAL I. I FINAL HEATING !''- ! I HEALTH DEPT. FINIAL ' `=i`.IA' ELECTRIC 1 I DEV. FEES FA!D I — --- 'l. PLUMBING ! Ei•1ERGY j — --- �0M,N(11EN TS SEPTIC TANK SIZE — SEEP P1TM SIZE — -- — ---------------- F_.. _, .... — -- --------------------- 1