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Home My WebLink About128 PROSPECTORS RD (3) CITY OF DIAMOND BAR ^-"�"��`— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ��(�A� I �� 21825 Copley Drive,Diamond Bar,CA 91765 `�`�� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 '�+�v PRESS "9^'� BUILDING PERMIT APPLICATION � ` ' '"" FIRMLY p� JOBSITE n c � � APPLICA ON PERMIT P/C ADDRESS ` O t �� DATE ��QT_ NUMBER�5�7 I # $ _ - ISSUE 8/ / TYPE , OCC AP L TRACT DATE / ��v/�-�I CONST._ . GROUP p OWNER � ADDRESS ZONING SETBACKS 0 Z CITY IP 1�? TEL. '' FRONT q1/y ❑ � APPLICANT TEL. � REAR ❑ Z 3 SIDE/SIDE STREET RW ❑ � CONTRACTOR . SIDE ❑ O ADDRESS � �C _ PROPOSED USE � i CITY � ZI TEL` w ARCH/ENG/ z DESIGNER I a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERIURV THA7 I AA1 EXEMPT FROM THE CANTRACTORS LI- Gyfe9B/CBfpOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.5BUSINESSANDPROFESSIONSCADE:ANVCI7VOR (n U COUNryWHICHREOUIRESAPERMITTOCONSTRUCT,A�TER,IMPROVE,DEMOLISH,ORqEPAIRANYSTRUC- w TURE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSEO PURSUANT TO THE PHOVISIONS OF 7HE CON7RAC70R5 LI- � � CENSE UW(CHAPTEfi 9(COMMENCING WITH SEC710N 7000)OF DIVISION 3 OF 7HE BUSINESS AND PRO- POOUSPB � fESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� TION.ANVVIOUTIOHOFSECTION7031.SBVANYAPPLICANTFORAPERMITSU&IECTSTHEAPPUCANTTO Z Re-Roof � A CIVIL PENAL7V OF NOT MORE THAN FIVE HUNDRED DOLURS(5500).): ZOI,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESAS7HEIRSOLECOMPENSA710N, � COrt1RIefClel . - WILL DO THE WORK,AND THE STRUCTURE IS NOT IN7ENDED OR OFFENEO FOR SALE(SEC.701�,BUSI� J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLY 70 AN OWNER OF � PROPERTV WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w7HROU�HHISORNERONMEMPLOVEES,PROVIDEDTHA75UCHIMPROVEMENTSARENOTINTENDEDOR m 0 OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWI7HINONEVEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING 7HAT HE OR SHE DID NO7 BUILD OR � IMPROVE FOR THE PUFPOSE OF SALE). ' . W ❑I,AS OWNER OF THE PROPERTV.AM E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTOqS Q TO CANS7RUCT THE PR0.1EC7(SEC.70t/,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V81U2flOn ADJ.AREA W CENSE UW OOES NOTAPPLV TO AN OVMER OFA PROPERN WHO BUILDS Ofl IMPROVES THEREON,AND � NMOCONTRACTSFORSUCHPROJECTSWI7HACONTRACTOR(S)LICENSEDPURSUANTTOTHECANTRAC- �UANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). - � ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � U � � DATE OWNER H � w � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRM UNOER PENALTV OF PERJURV THAT I AM LICENSED UNOER PROVISIONS OF CHAPTER � � e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z � XL� MY UCENSE IS IN FULL FORCE AND EFFECT. m LLI � � UCENS �LASS LIC.NO. � . V DATE � CONTRACTOR � � J W � I�+ WOA S'COMPENSATION DECLARATION Q � I HEREBY AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DECURATIONS: Z � _I HAVE AND WILL MAIN7AIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ COMPENSA710N,AS PROVIDED BV SEC710N 3700 OF 7HE UBOR CODE,FOR THE PEfiFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � � I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BV SECTION Q 3700 OF 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORN FOR WHICH 7HI5 PEqM1T IS ISSUED.MY WORI 5'COM ENSATION INS CE CA IER AND POLICV NUMBERARE: CONSTRUCTION �� Q � CARRIER 'e PLAN REVIEW Z POLICV NUMBER � ' o �' ELECTRIC ¢ � (iHISSECf10NNE�NOTBE00A1i'LEfEDOFTFIEPEPMfTISWRONEFNI�DREDDOLLPAS(5100)ORLESS� PLUMBING Z 1 CERTIFY 7HA7 IN THE PERFORMANCE OF THE WONK FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL C7 SHALL NOT EMPLOY ANV PEHSON IN ANV MANNER 50 AS 70 BECAME SUBJECT TO THE y WORKERS'COMPENSATION IAWS OF CALIFORNIA,AND AGREE THA71F I SHOULD BECOME INSPECTION FEE � SUBJECTTO7HEWORKERS'COMPENSA710NPROVISIONSOFSECTION37o00FTHELABOR W � CODE.I SHALL FORTHWITH COMPLV WI SE PqOV}}}��IONS. ISSUANCE S• � r 'y�,� •� p OATE:-�Z� APPLICANL � µ��`� �I1n� SMIP J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C � SUBJECTANEMPLOYERTOCRIMINA�PENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5100,000).IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIOED FOR IN � SECTION 3700 OF THE LABOR CODE.INTEFiEST,AND ATTORNEV'S FEES. RETENTION FEE: I •f].]:� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEREBYAFFIFIMUNDERPENALTYOFPERJURY7HATTHEREISACONSTRUCTIONLENDINGAGENCY FOR THE PERFORMANCE OF THE WORK FOq WHICH 7HIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W �Z LEN�ER'S NAME i H LENDER'SADDRESS � TOTAL FEES ��. � � I CER7IFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS COHREC7. w I AGREE TO COMPIV WITH ALL CI7V AND COUNTV ORDINANCES AND S7A7E UWS REUTING TO BUILDING � CANSTRUCTION,AND HEREBV AUTHORIZE REPflESEN7A71VE5 OF 7HIS COUN7V 70 EN7ER UPON THE � � A80VE�MENTIONED VROPERTV FO INSPECTION PURPOSES. Z COMMENTS o �.�`� �� _ m P MITTEE NAME(P INT - (n �� ' N NAT REOFPERMITTEE DATE r = RECPT.NO.C9� PAID BY ��3 VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy � ��YV Of� �O�IfV��l� f��ff$ � ��'" I�IS�[E�� (R(c��ff�� Oa�p@C�400a DG�J4C� OGI�pGC4Qp '' Oa�pC�C��O�[�1 0 �4C ' }Q[�1�pC�C��.� �..�� SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE � MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING • ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOI ELECTRIC EXT. LATH/SIDING 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. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL E�ECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY _ _ _. ___ �� 4 COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � Q �