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Home My WebLink About15014CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 961-3117 BUILDING PERMIT APPLICATION - ' 1 JOBSITE ADDRESS APN LOT - TRACT .. OWNE ADORE CITY P TEL APPUCA T TE CONTRACTOR 1P ' ADDRESS '' I CITY zipT L ARC NG/ 0 IMF DESIGNER - ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PEIUURY THAT I AM EXEMPT FROM THE CONTRACTORS LF CENSE LAW FORTHE FOLLOWING REASON (SEC. 7001.E BUSINESSAND PROFESSIONS CODE ANY CITY OR COUNTY WHICH REQUIIESA PERMrTTOOONSTRUCT,ALTER IMPROVE. DEMOLISH, OR REPAIRANY STRUC• TORE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT 70 THE PROVISIONS OF THE CONTRACTORS Ll- CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7DOO) OF DIVISION S OF THE BUSINESS AND PRO- FESSIONSCODE) ORTHAT HE OR SHE IS EXEMPT THEREFROM ANDTHE BASIS FOR THE ALLEGED EXEMP- TON. ANY VIOLATION OF SECTION 7031.E BY ANYAPPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ($Soo).): ... ... . O 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. 70". BUSI• . NESS AND PROFESSIONS COOS THE CONTRACTORS LICENSE LAW DOES NOTAPPLY TO AN OWNER OF PROPERTY WHO BUILD9 OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIUSELFOR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT MENDED OR OFFERED FORME. IF. HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OFCOMPLE- ' TON. THE OWNEWS&IEA WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). I I O 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- DENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FDA SUCH PROJECTS WtTHACONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC- TORS UCEHSE LAW ). I.. O I AM EXEMPT UNDER SEC B. E P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I- LICENSED UNDER PROVISIONS OF CHAPTER f (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PROFESSIONS CODE. AND AI'/ LICENSE 6 N Ml FORCE AND EFFECT. �� ' LICENSE C UC. NO. DATE . CONTRACTOR WORKERS' COMPENSATION DECLARATION 1.1Tn� f�� I HEREBY AFFIAI UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DCLS EARATION'V _1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELFNN9URE FOR WORKERS' COMPENSATION. AS PROVIDED BY SECTION 3700 OF THE LABOR COOS FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. _I HAVE AND WNN ILL LUTAN WORKERS COMPENSATION SUR A NCE. AS REQUIRED BY SECTION S700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS'COMPENSATION INSURANCE C HER AND POLICY NUMBER ARE: CARgt iy/S'-`/,i I�r�1PI_LT'•11v POLICY NUMBER _ l-/ /I 'ONEH ITls SECTION N®NOT BE OONFLETEDOFTHE PERMITS FOR NDFREDDDUARS WOO) OR LESS) -1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR VA41C l THIS PERMIT IN ISSUED. I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. ANDAGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS'COIAPENSATION PROVISIONS OF SE ION E7OD OFTHELABOR ' COD S FORTIGWTH COMPLY WITH T(';' IONS. eO DA APPLICANT: WARN O: FAILU TO SECURE NOiiKERS'CO0 P"%'AT10N COVERAGE IS UNLAWFUL, AND SHALL BE BUD,AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARSISI00,000), IN ADDITION TO THE COSTOF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 770E OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY -1 HEREBY AFFRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. SOFT, CIV. C). LENDERS NAME LENDERSADDRESS I CERTIFY THAT I VINE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CRY AND COUNTY ORDINANCES AND STATE LAWS RELATNO TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE . ABOVEJIENTIDNED PROPERTY FOR INSPECTION PURPOSES_ ERMIII 11T) NR RMI7T E E PRESS .: PIRMI V APPLICATION l PERMfT O P/C �/�„ l I 0/� DATE 1 NUMBE ,11 I ISSUE TYPE OCC I DATE CONST. GROUP.' ZONING SIETBACKS FRONT RW - ❑ REAR. ❑ SIDMDE STREET RW ❑ SIDE ❑ PROPOSED USE 7, NO. DWEL. O. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ.AREAAIALUATION SFRtADD/REM _ co Garage/Carport W Patio/Deck �- Pool/Spa ZRe -Roof Commercial m Valuation ADJ.AREA OUANTITY DESCRIPTION FEE Q LU C7 Z m a _... _. .. 2 W 5 CONSTRUCTION v v' V • PLAN REVIEW ELECTRIC. L PLUMBING MECHANICAL - - - -- INSPECTION FEE ISSUANCE SMIP ENERGY P/C -ENERGY PERMfT RETENTION FEE: A y . PRE•ALT FEE: f.TTVij RTTTr TA 1 1'. A,.. u TOTAL FEES COMMENTS RECPT. NO. PAID BY VALIDATION `I WHITE-0epartrnent Copy, YELLOW —Finance CGpy, PINK —Assessor Copy, GOLDENROD —File Copy, GREEN —Applicant' Copy .. ... �. v .r+ -, ... ,. _ i• •a:v 'r'cj •n n .: x ..hr•r i... �. ` "�-„.r,.. - r r"t - �. �.: ^'tt ,, .'r r.n...� rb u•n:�5 :�k.:fi^.bws. i •ter n./ r � , ,;. C�TX OF DIAMOND BAR SPECTION'R-ECORD ' tvG..�t. .t :.f:k '�"�:✓ } �.u� C•f: !! f,'. ,tt'r. r' ,i .. I Lai�. SETBACK_ FLOOR JOIST• f := ; i { .. "Y I1 {. r�ll r' _ ; ! rd F_F�fG:SFORMS/STEEL -,I i 1 FHA REQMTS _ LECTRIC GROUND - UNDER FLOOR DUCT , GROUND PLUMBING UNDER FLO •R'CO(•IDUIT. o i :'1�S"`. ! :: ' • - fir- ` SLAB GRADE — --- . - -- - - _ FIREPLACE FOUNDATION •:' + - `�': +: ; ; �.:.' 1..t:it; j: T { . I . ' TEMP POWER - - - _ . r _ __. _-•_- __ r i-. , t : FIREPLACE BOND•BEAM WATER SERVICE.. .._._ -__ _ r ._ - . -._. -MID AT. BOND BEAM '-_'=:', ROOFSHEATHING 8 FT BOND`BEAM{ i, f j FRAMINGA:�ON A • Ob f; _` _ ;.± � ti-' FINAL BOND.BEAM ROOF COVER' `; PRE GRADING _ I _. .. , .:. ,• . • I ". -ROUGH HEATING ---,---- ---- - __ _ __ .. BENCHING ROUGH ELECTRIC - ROUGH GRADING ,,•. I ROUGH PIUMBING__I_._-- _ .. - - -- .-- . -_ _ _. . _ _. _. FINISH GRADING T- _ _.. _ - - - - - _ . _ _ , -POOL ELECTRIC ' • .':'• : • ., :' - EXT.- LA WSID DING -POOL FENCING WALL INSULATION POOL FINAL . CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS, SEWER_-_---- ---__ ___ FINAL ENG. .SEPTICTANK ___________ _ _. -;�, - r LANDSCAPE/IFIR IG. -SEEP PIT/L.L. - -.. _- �� ..' ON SITE IMPS. ,GAS AIR TEST-' - . — FINAL ZONING T FINAL CONST - - -. -_. • _ . _...: FIRE DEPT. FINAL - - FINAL HEATING -- - - - - - HEALTH DEPT. FINAL . -FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY " - ,,•, - ., t.l •—_ I I -COMMENTS - - , `SEPTIC TANK SIZE ------------- wt !� - - -i - -- . n • 1 I T • j S t • �