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Home My WebLink About18684 (19) �� CTI'Y OF DIAMOND BAR � - --� DEPARTME?`'T OF COMMUNt"I'Y&DEVELOPIvIENT SERVICES F � 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS ��'�� BUILDING PERMIT APPLICATION FIRMLY N JOBSITE APPLICATION PERMIT /C o ADDRESS � DATE '_� NUMBER�_ # � ISSUE TYPE OCC APN LO � TRACT _ DATE CONST. GROUP ' °C OWNER O p ADDRESS ZONING SETBACKS Z CITY ZI 7EL. � FRONT Ryy ❑ o APPLICANT TEL. REAR ❑ zQ SIDE/SIDE STREET RW ❑ � CONTRACTO SIDE p ADDRESS � � CITY ' ZI TEL. � � PROPOSED US oARCH/ENG/ �Xs� �z DES�GNER NO.DWEL. ..•NO. NO. N ADDRESS UNITS STORIES• BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUIIDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER 7ENALTV OF PERIURV THAT I AM E%EMPT FROA1 THE i.ONTRACTORS LI- G8f8gB/C2fP011 � W CENSE LAW FOR THE FOLLOWING REASON(SEC.7071.5 BUSW E55 AND PROFESSIONS CODE:ANV CITY OR (n U. �OUNTyWMICHHE�UIRESAPERMITTOCONSTRUCT,ALTER,IMoqOVE,DEMOLISH,ORREPAIRANVSTRUG w w NRE.PRIOR TO ITS ISSUANCE.ALSO REQUIRES THE APPLICANi FOR SUCH PERMIT TO FILE A SIGNED w P8I10/DBCI( � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � � CENSE UW(CHAPTER B(COMMENCIN6 WITH SECTION 7000)OF DIVISION 3 C1F THE BUSINESS AND PRO� � POOUSp2 � FESSpNS CODE)OR T}IAT HE OR SHE IS EXEMPT TNEREFROM AND THE BASIS FOR THE ALIEGED E%EMP- (� V TION.ANVVIOLATIONOFSECTION7031.SBYANVAPPUCAN�FORAPERMITSU&lECfS'fHEAPPLICANTTO Z Re-Roof , A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOIURS(SSUO).): � �I,ASOWNEROFTHEPROPERTV.ORMVEM7LOVEESWITHWAGESAS7HEIRSOLECOMPENSATiON, 0 COR1rt10fC181 Z VlILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7044,BUSI� J � NE55 AN�PROFESSIONS CODE:TNE CONTRACTORS LICENSE LAW DOES NO'APPLV TO AN OWNER OF � PROPERTV WHO BUILDS OR IMPROVES THEREON,ANO NMO DOES SUCH WORK HIMSEIF OR HERSELF OR � THROUGH HIS OR HER ONRJ EMPLOVEES,VROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFERE�WRSALEIF,HOWEVERTMEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE- Z TION.THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO'MAT NE OR SHE DID NOT BUIID OR � IA/PROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERTV,AMEXCLUSIVELVCONTRACTINGWITHLICENSEDCONTRACTORS [[ TO CANSTRUCT THE PRQIECT(SEC.7oN,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� VeluA�ioll A0.1.AREA � W CENSEUWDOESNOTAPPLVTOANON?JEROFAPROPERTYNM1103UII.DSORIMPROVESTHEREON,AND � WFIOCONTRACTSFORSUCHPRp1ECT5WITHACONTRACTOR(5)LICENSEDPURSUlwTTOTHECONTRAC- QUANTITY DESCRIPTION ' Y roasucENSEuw.�. FEE � ❑I AA/EXEMPi UNDER SEC. B.S P.G FOR THIS REASON Q U � DATE OWNER H � Z U � LICENSED CONTFACTORS DECLARATION W � I MEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AA1 UCENSED UNDER PROVISIONS OF CHAPTER � d 9(COMMENCWG WITH SECTqN 7000)OF DIVISION 30F THE BUSINESS AND PP.OfESSqNS CODE,AND Z `X A/Y LICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CLASS �� UC.NO. _/' �� 1 J U DATE ~�L� � A]i CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION � � U � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OFTHE FOLLOWING DECLARATIONS: Z O _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELFdNSUREFORWORKERS' a � COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE.FOR TME PEHFOqMANCE U Q OF 7HE WORK FOF WHICH THIS PEFMIT IS ISSUED. � Qw _I HAVE M!D WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION 370o OF THE LABOR CODE,FOR THE PERFOFMANCE OF THE WORK FOR WHICN THIS PERMIT IS I /7 �, '� ISSUED.MV WORNERS'COMPENSATION INS E CARRIER AND POLICV NUMBER ARE: CONSTRUCTION J j CARRIER PLAN REVIEW - Z POLICV NUMBER ELECTRIC Q 0 (IHISSECiY)NNE�NO7BEttY.1PLEfmOF7HEVERNTISFORONEMX�OPEDDq1AKS(5700)OqLESS�. PLUMBING W Z I CERTIFY hIAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL C} SHPLL NOT EMP�OV ANV PERSON IN ANV MANNER 50AS TO BECAME SU&IECT TO THE (n WORKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECAME INS?ECTIONFEE '� SU&IECT TO TME WORKERS'CAMPENSATION PROVISIONS OF SECTION 37ao OF THE UBOR . COD .ISHALLFORTHWIiHCOMPIVWITHTNOSE ROVISIONS. ISSUANCE ,`�6 � � �O— p DATE: APPLICANT: SMIP w ENERGY P/C J WARNINCi: ILURE TO SECURE WORNERS'COMFENSATION COVERAGE IS NLAWFUL,AND SHALL BE J � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCMLFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f 100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 37oB Of THE UBOR CODE,INTEREST,AND ATTORNEV'S FEES. � CC RETENTION FEE: vI� OCONSTRUCTION LENDING AGENCY pRE-ALT FEE: ' ' � I HEREBV AFFIqM UNDER PENAITV OF PERIUFV THAT THERE IS A fANSTRUCTION LENDING AOENCV FOR THE PERFORMANCE OF THE WORK FOR wHICH THIS PERMIT IS ISSUED(SEC.]oel,CIV.C.). Z W � LENDER'S NMIE F— LENDER'SADDRESS w I CEflTIFV THAT I HAVE READ THIS APPUCATION AND STATE THAT TNE ABOVE INFORMATION IS CORRECT. TOTAL F E ES ��/ . � I AGREE TO CAMPLV WITH ALL CfTY AND COUNTV OROINANCES AND STATE LAWS REUTING TO BUILDING . J p � CONSTRUCTION,AND MEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPUN THE Z A80VE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � ��L � J � � -- � m PERMIREE N E IM) Q Cn �... .� � � SIONATURE EE DA = RECPT.YO. PAID BY �VALIDATIO ~ WHITE—Depariment Copy,YELI.OW—Finance Copy,PINK—Assessor Copy,GOLDEN D—File Co GREEN— py, ApplicanPs Copy �8�'� C�� [�8��lR� ��4R b�S��`�9�P� ��t��3d� ,,.. , . � ._.� o . Q �.� � : . .o �� e ;. �- �, o ,a �:��•� F .�� - '' ��7. p .� '"� p `�''•'�� fl ,. � � ' , .> F ' n '' , '.� `.�• b�. 4 . .., ., .... , � .. �.. . . . '"v a .. h . o= . .. z. e'" . . .��.. �: . _.-. ,,. .. ... .._ . .._. .. ,. SET BACK � � � � FLGOR JDlST" FTGS/FORMSlSTEEL ^ I � FNfj REQMTS ELEGTRIC GRUUNO f v ---- _�_� --_��_---_ �__ _ �_UNDER�LOOR DUCT GROUND PLUMBING � UNDER FLOOR CU�!DUIi" � SLAB GRADE � FiREPLACE FOUNDA710N TEMP POWER FIREPLACE B�ND BEAM WATER SERVICE � '/ �}*�--. � MID HT. BOND BEAM � ROOF SHEATHING ~ /pl�('o c�L � �%`f�+'�-^ ' � 8 Fl-. BC}ND BEAM _ FRAMINGNENTILIATION � ' ____ �TFINA� F30ND BEAM ____ ___ _` ROOF COVER b Z�c,2- _�T"-`"� PRE-GRAufNG ROUGH HEAT(NG BENCHING ROUGN ELECTRIC RCIUGN GRADING ROUGI-f PLUMBING FINfSH GRADING ~ � ' SH(�WERffUB TEST � POO�EL�EGTRIC EXT LATH/SIDlNG I PGOI FENCING WAI.I lNSULATION � PQ(3L FINA� CEILING INSULATION � � OFF SITE IMPS. � DRYWALL NAIUNG ^ � DEDICJ�TIONS SEWER FINA�ENG. SEPTIC TANK LANDSCAPE/IRRIG. �� SEEP PIT/L�. � ON StTE IMPS. GAS AIR TEST .�p, , FINAI ZONrNG F(NAL CC}NST. �J��wvC�C, FIRE DEPT. FINRL �� d�t-�6 Z _ �------ F1tVAL H�ATING l � � HEALTH DEP-L FlNAL � � F+NAL ELECTAIC �� ! DEV. FEES PAlD FINAL PLUMBING ! ENERGY -- t----- -- --- -- � .O .,A i� Ct�MMENTS SEPTIC TANK SIZE ' SEER P1T/U SIZE . � �' �'"` ��` ' «.> a . �s ` .�Y — � Q; �Y' �, � � , . '� .�. .. . . ry . tia.;� a'r� . . . � � ,��.�� 1 � .