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Home My WebLink About1523 AUTUMN HILL RDU5 0 _m Q O ILL. 0 W cc 0 z O in W M w a C0 ti cc O W U Z W O F- O Z cc W M Z UU W Q W 2 H ]G cc Z O d O F- U W U3 U3 ¢ LU W Q 0 M Z LU W Z ['3 in O M W J J J LU W CI- d Z W 9i F- LU W d Z 0 m L7 0n UI,I�III�U U '_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT 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 k 1 i;Z-� '41,1 T unif, APN LOT TRACT OWNERY Albe ASS 2 m r CuI ZIP 917 TELgD�J• Q 2 APPLICANT TEL I CONTRACTOR ADDRESS J CITY ZIP TELjL- 6 C _ - ARCWENG/ /J L1 D 3f DESIGNER`4 Q< Lt `4-'Q. O 0Y� ADDRES 7 DYi --r 7 CITY W'hLt l2'Y' ZIP Will TEL.S 21,L 9 A17 IS 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. 7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE, DEMOLISH, 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 LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER B (COMMENCING WITH SECTION 7-0) 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 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ($500).): ❑ 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 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 -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. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). ❑ 1 AM EXEMPT UNDER SEC. S. & P.C. FOR THIS REASON I DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 8 (COMMENCING WITH SECTION 70DD) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. 9 ` `IACTE SE CLASS CONTRA? J 7�� 'yb 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 FORWORKERS' COMPENSATION, 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 REQUIRED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WOO KE COMMPENSATION U ANCE CARRIER AN^LICY NUMBE R CARRIER J A C POLICY NUMBER V (THIS SECTION NEED NOT BE OOMPLETED OF THE PERMIT G FOR ONE HUNDRED DOLLARS ($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 SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE, 1 SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10),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 I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097. CIV. C.). LENDER'S NAME LENDER'S ADDRESS I CERTIFY THAT 1 HAVE READ THIS APPLICATION 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 ABOVE-MENTIONED_•PROPERTY FOR INSP CTION PURPOSES. �P/ERMITTEE /�' / SIGNATUR F ITT E DATE PRESS FIRMLY PPLICATION ,I j • %„ •U (� 7 38 i DATE L U/ NUMBER Q(CPERMIT A �Gi p/C ISSUE TYPE OCC DATE /� c8 CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ / PROPOSEDUSE ��(rt,P �10 1%- =q?ALA[_ NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SF DD EM oko U) Garage/Carport LwL.I Patio/Deck LL POoUSpa Z Re -Roof Commercial - m Valuation lA ADJ.AREA QUANTITY DESCRIPTION FEE Q c. 17�5 vs W ?/ L!d �r J W 7--- 0 op ' 41 • f J o_ Q . SO 0 Z Q W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING 4-I • j� MECHANICAL -A-0k• So INSPECTION FEE ISSUANCE OO -Qcz, SMIP co ENERGY P/C Z. �q ENERGY PERMIT �T�J • ip� RETENTION FEE: 1 ' PRE-ALT FEE: TOTAL FEES COMMENTS 1=` RECPT NO. fi41 8 PAID BY VALIDATION WHITE —Department Copy, YELLOW --Finance Copy, PINK —Assessor Copy, GOLDENROD —File Copy, GREEN —Applicant's Copy CITY OF DIAMOND BAR INSPECT�ON RECORD oa@p9@400a SET BACK FLOOR JOIST FTGS/FORMS/STEEL % dg 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 ROOF COVER FINAL BOND BEAM PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING L FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC T LATH (DING WALL INSULATION CEILING INSULATION __'� POOL FENCING POOL FINAL OFF SITE IMPS. DRYWALL NAILING SEWER �� %17%° _! T— DEDICATIONS FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FINAL HEATING ' (G� FIRE DEPT. FINAL HEALTH DEPT. FINAL FINAL ELECTRIC FINAL PLUMBING I _' JIN DEV. FEES PAID ENERGY COMMENTS l4c4 jz_p_ %>N ,L /vfl SEPTIC TANK SIZE SEEP PIT/U SIZE a