The URL can be used to link to this page

Home My WebLink About182800 O 0 w Q Q 0 0 w 0Z IL3 a C0 Cn tn Q O O w U w O U t— Z W O Z W cc Lu w F_ ]G IS O lL Z O x� W OO V w co CIO N ZG Q Q O ZO C W Z C7 co S O M W lL J Q W O cc CL Z W F- Lu W Ll C� Z 0 m Q CO \ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861-3117 %» BUILDING PERMIT APPLICATION JOBSITE IG�S jg: ► S !fin I / ADDRESS APN LOT TRACT OWNER Pj Iz-,*. w« ADDRESS4(i.?S ef02S .txH_444,11,, CITY jtefW0A4VZIP /�!/� TEL/� DIiT�� APPLICANT' TEL. CONTRACTORL•4-Tel-WeGS R�4 Cn►ar,C w�►z�� ADDRESS}S�O/ Lsn.��ricG- CITY Zw"we— GS i9' ZIP g0282TElldnm. � 9 ARCFVENG/ �� DESIGNER ADDRESS CITY ZIP TEL OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS L4 CENSE UAW FORTHE FOLLOWING REASON (SEC. 7031.6 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTYYMICH REQUIRES APERMRTO CONSTRUCT ALTER IMPROVE.DEMOLW. 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 9 (COMMENCING WITH SECTION 70D0) OF DIVISION 3OF THE BUSINESS AND PRO_ FESSIONSCODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7031.E BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (S500).): D LAS OWNER OFTHE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL 00 THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LA'& 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 BUILDINGOR IMPROVEMENT IS SOLDW77HINONE 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). C3 I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTINO WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7014, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOTAPPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTONS) LICENSED PURSUANT TO THE CONTRAG TORS LICENSE LAW.). ❑ IAM EXEMPT UNDER SEC. B. & P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER B (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PROFESSIONS CODE. AND MY LICENSE IS IN FULL FORCE AND EFFECT. eJf LICENSE CUSS C40, Wi436 LIC. NO. 6 IAI^ DATE CONTRACTOR �r0 W0109RI 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 FOR WORKERS' COMPENSATION. AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE HE Won" 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. MYWORKJEj7S�' COMPEN/JSATION INSURANCE CAR RI RAND POLICY BERARE: CARRIER St�L�/ /• L,�/5IS POLICYNUUBER (IDES SECTION NEED NOT BE ODMPLETEDOFT/E PERMIT IS FOR ONE WORM DOLLARS (S100)OR LESSL 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON N ANY MANNER SOAS TO BECOME SUBJECT TO THE WORKERS' COMPENSATKN LAWS OF CALIFORNIA. AND AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR IS HWTH COMPLY W7TH THOS ROVISK)N DA APPLICAN WARNING: AILUR TO SECURE WORKERS' OM SATK3N COVERAGE IS WFUI.,AND SHALL BE SUBJECT AN EMPL YETI TO CRIMWAL PENAL ANO CML FINES UP To HUNDRED THOUSAND DOLLARS (%10D.CM), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 370E 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.). LENDERS NAME LENDER'SADDRESS 1 CERTIFY THAT I HAVE READ THIS APPUCATION 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 INSPECTION PURPOSES. PERMITTEE NAME (PRINT) It SI RE OF PERMITTEE DATE (� PRESS FIRMLY APPLICATION ., PERMIT (Y T P/C DATE NUMBER g ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW p REAR p SIDEISIDE STREET RW ❑ SIDE p PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM CO Garage/Carport WPatio/Deck LL Pool/Spa 0 Z Re -Root Commercial 5 m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE Q U Or F W w 0 Z O m J EL. U_ Z Q W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP U. v - - ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE•ALT FEE: • �- TOTAL FEES- COMMENTS RECPT. NO. PAID BY VALIDATION WHITE —Department Copy, YELLOW —Finance Copy. PINK —Assessor Copy, GOLDENROD --File Copy, GREEN —Applicant's Copy CiTV OF DlAmOND BAR- INSPEC T IOINI RL-COt lD ►�F-'7:� '.r;►��►�i SET BACK FTGS/FORMS/STEEL �i t;'- ►��-i 1`` �ca� `I _ �E-'1.' ICU t➢A.r FLOOR JOIST _l FHA REQMTS ELECTRIC GROUND I � ( UNDER FLOOR DUCT GROUND PLUMBING I _ UCMER FLOOR CONDUIT SLAB GRADE I FIREPLACE FOUf.DATION I TEMP POWER _ --` I FIREPLACE BOND BEAM WATER SERVICE -Q p� i � I MID HT. BOND BEAM ROOF SHEATHING 18 FT. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM I _ ROOF COVER - PRE -GRADING ROUGH HEATING _ BENCHING ROUGH ELECTRIC � ROUGH GRADING ROUGH PLUMBING I ! FINISH GRADING SHOWER/TUB TEST ; POOL ELECTRIC EXT. LATH/SIDING ; I POOL FENCING _ WALL INSULATION POOL FINAL i CEILING INSULATION I 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. I F!RE DEPT. FINA! FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC i DEV. FEES PAID FINAL PLUMBING ENERGY l COMMENTS SEPTIC TANK SIZE SEEP PITIU SIZE