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Home My WebLink About18418 CITY OF DIAMOND BAR ----��' -- DEPARTIvIENT OF COMMLJNTI'Y 8c DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRE$$ �'%9�� BUILDING PERMIT APPLICATION FI RM LY y JOBSITE � APPLICATION r� PERMIT � P/C ¢ ADDRESS 1550 S. VAL=,Ey VISTA DRSVE �'• o DATE UMBER # � ISSUE �) � TYPE OCC APN LOT TRACT DATE ( CONST. GROUP p OWNER o ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT qyy p g APPLICANT TEL. REAR p zd SIDE/SIDE STREET RW O I � CONTRACTOR DDIVI,EE DEVELOPMENT CL9RPDRATION SIDE p ADDRESS ��. R `GH � crrvTeTFsSTMTNSTFR_�,A ziP�g� TEL. PROPOSED USE INSTAI,I, pREF'ABRICATID PAIAfT SpRAy o ARCH/ENG/ g97-2157 ��I3 z DESIGNER � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � I � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDEA DECLARATION � p SFR/ADD/REM I p I HEREBV AFFIRM UNDER PEN/�LTV OF PERNRY THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- G8l8Q6/COfPOR W CENSEUWFORTHEFOLLOWINGREASOIJ(SEC.7031.6BUSWESSMIDPROFESSIONSCODE:ANVCITVOR (n U COUNTVWHICHREOUIRESAPERMITTOCONSTpUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- w w TURE,PRIOR TO ITS ISSUANCE.ALSO RE-0UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W PBllO/DBCk � STATEMENT TiAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS ll� � CENSE LAW(CHAPTER G(COMMENCINO WITH SECTION 7000)OF DIVISION 30F THE BUSINE55 AND PRO- � PooUSpa � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� � V TION.M!V VIOUTqN OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS TFIE APPLICANT TO Z Re-Roof A CIVIL PEN/�LTV OF NOT MORE iH/W FIVE HUNDRED DOLURS(f5o0�.): � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrtIR18fC18I Z WILL DO THE WORK,M1D THE STRUCNRE IS NOT IMENOED OR OFFERED FOR SALE(SEC.70a4,BU51- J f � NE55 AND PROFESSIONS CODE:THE CONTRACTORS�ICENSE lAW DOES NOT APPLY TO AN OWNER OF � PROPERTV NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WOqK HIMSELF OR HERSELF OR w THROUGH HIS OR HEH OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT WTENDED OR m � OFFEREDFORSPLEIF,HOWEVERTMEBUILDINOORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE� Z TION,THE OWNEREUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I.AS OWNER OF THE PROPERTY,AM EXCLUSNELV CAMMCrING WITH LICENSED CONTRACTORS � TO CANSTRUCT THE PR0.IECT(SEC.7oN,BUSINE55 AND PROFESSIONS CADE:7HE CANTRACTORS LI- VflIUBtiOf1 ADJ.AREA W CENSE LAW DOES NOTAVVLV TO AN OWNER OFA PqOPERTY WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTMCTSFORSUCHPROJECTSWITHACONTqACTOR(5)LICENSEDPURSUANTTOTHECONTMC� QUANTIN DESCRIPTION —' Y TORS LICENSE LAW.). FEE Q ❑1 AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q A yj��tl MVl QR � DATE OWIJER F. � ��A IG� V1Y11� Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTEH � � B(COMMENCINOWITHSECTION�7000�OFDIVISIONJOFTHEBUSINESSANDPROFESSIONSCODE.AND Z �� A(Y LICENSE IS IN FULL FORCE AND EFFEC7. m � LICENSE C S � "�� .No. 510150 � V DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION a x ��A p�p�BRICATID � PAINT RAY B(}OTH N I HEREBY AFFIqM UNDER GENALTY OF PERIURY ONE OF THE FOLLOWINO DECLARATIONS: � Z Z0 I HAVE AND WILL MAWTAIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOR WORKERS' ¢ Q = COMPENSATION,AS PROVIDED BV SECTION 37ao OF THE LABOR CODE,FOR THE PERFORMANCE U � OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � Qw _I HAVE AND WILL MAINTAIN WOflKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION A 3700 OF 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS `� ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION jCARRIER �TE FUND J PLAN FiEVIEW Z POLICVNUMBER ��71�g�y,� ELECTRIC Q � (IH6SECIXJNNE�NOTBE�A�LEfEDOF7NEPERMTtSFOqONEF1U�DFaEDDOLLAR5�t700)ORLESS� PLUMBING W Z I CER7IFV THAT IN THE PERFOHMAtJCE OF THE WORK FOR wHICH 7HI5 PERAIIT IS ISSUED,I MECHANICAL � CJ SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE • (n WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I SHOULD BECAME INSPECTION FEE = SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR COD I SH FORTHWITH COMPLV WITI{THOSE PROVI510N5. ISSUANCE � 0 T,Tr1 ��1�,�1, (�� p DATE: � �� O� APPLICANT: Ar� �+�"'�' / �`^�'� SMIP � . � W J WAANINO:FAILURE TO SECUi7E WORKERS'COMPENSATION COVERA(3E IS UNUWFUL,AND SHALL BE ENERGY P/C � J � SU6IECTMIEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOIURS(5100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN J SECTION 3�oe OF THE LABOR CODE,INTEREST,lWD ATTORNEV'S FEES. � I w RETENTION FEE: O CONSTRUCTION LENDING AGENCY� PRE-A T FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CANSTRUCTION LENDING AGENCY ' � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEHMIT IS ISSUE�(SEC.3087,CIV.CJ. - Z W � IENDER'S NAME � LENDER'SADORESS w ICERTIFY7HATIHAVEREADTHISAPPIICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT. TOTAL FEES J -/�) ' � I AGREE TO COMPLV WITH ALL CITY AND CAUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING V ! � CONSTflUCTIOtJ,ANDHEREBVAUTHORIZEREPRESENTATIVESOFTHISCWNTYTOENTERUPONTHE Z ABOVE�MENTIONED PROPEFTV F-0R INSPECTION PURPOSES. ' COMMENTS � A.��p �� AGENT � m PERMIT7EE NAME(P � � 3/29/02 � SIGNATURE OF PEF EE TE = RECPT.NO. PAID 8Y VALIDATION � ~ W T e artment Co YELLOW—Finance p py. Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy �0�� c�� 1u16�]�fr�� QG� �f��(�(�(�`�'��GR� f�C�(�(��D 0(i�� , � �� , �. ° �a� . . . �[� � a �GJ� 0f�� a ' , 5ET BACK � ; �- F�OOR JOIST ; ' - - � - -- --- --_,_� FTGS/FORMSISTEEL � � FHA REQMTS EI.ECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING lJNDER FLOOR CU�IDUIT � SLAB GRADE FIREPLACE FOUNDATION TEMP PtJ`NER _ � �_� FIREPLACE_¢OND BEAM � WATER SERVICE MID HT. Bt7ND BEAM _ �- ROOF SHEATHiNG � 8 Ff. BOND BEAIVT , � FRAMIfVGNENT(UATION FtNAL BOND`�EANi� � ROO�COVER PRE-GRADING ROUGH HEATING BENCHING � ROUGH ELECTRlC R�UGH GRADING ROUGH PLUMB�NG FINISH GFiADiNG SHOWER/TUB TEST POOL ELECTRIC EXT. 1�4TH/SIDING PC�OL FENCING WAI.L INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAiUNG DEDICATIONS SEWER F(NAL ENG. � SEPTIC TANK ��_ � LANDSCAPE/iF�RIG. SEEP PIT/LL. � - ON SITE IMPS. GAS AIR TEST FINAL ZONING y FIN.4L CONST. �� _f�,� . �IRE DEF�T. Fl�IAL ��-� — FINAL HEATING L� ' HEALTH DEPT. FINAL FINAL ELECTRIC ,�'-.�--�-.�_��~ DEV. FEES PAID FiNAL PLUMBWG �� I ENERGY ;.�� a'� � , . G��5 y_ ' � � �� ... . � - - . � , SEPTIC TAI�IK SIZE SEEP P17/U SIZE --- � , _ _ � . � r � r; _. � � � ° ,-�; �, � � � � � � . ;,. .