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Home My WebLink About18931 - 3302 DIAMOND BAR BLVDCITY OF DIAMOND BAR DEPARTMENT OF COMMUNTII' & (DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861-3117 <: BUILDING PERMIT APPLIq?�114?N TE ADDRIESS APN tOT TF�CT OWNER F ADDRESSh' ICITYZIP' UG TEL. AT (ITO-5.30C APPLICANT TEL/3)3.R f� CONTRACTOR to hP ADDRESS CITY ZIP TEL. ARCH/ENG/ DESIGNER /1�. Ftn ADDRESS CITY Lon t/ P ZIP 500n, TEL a13 33 � OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI. CENSE LAW FOR THE FOLLOWING REASON (SEC. 7O01.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REOUIRESA PERMIT TO CONSTRUCT,ALTER.IMPROVE.OEMOUSH.OR REPAIR ANY STRUG TORE. PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUM/T TO THE PROVISIONS OF THE CONTRACTORS LH CENSE LAW (CHAPTER S ICOMMENCING WATH SECTION 7000) OF DIVISION a OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THE IOREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TN. ANY VIOLATION OF SECTION 7051.5 BY ANYAPPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOTMORE THAN FIVE HUNDRED DOLLARS (LSO0) H OIL AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WALL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7O44. 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 15 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). ❑ L 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 A PROPERTY WHO aUI1.DS 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. B. A P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER 5 (COMMENCING WITH SECTION 7000) OF DIVISION aOF THE BUSINESS AND PPOFESSIONS CODE, AND MrLICENSE RINf}1La Rai j I� DIIO LICENSE CLASS 7, LIC. NO. DATE Il-7—I_,,2-�� CONTRACTOR WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _ I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELFJNSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 0700 OF THE LABOR COOS, FOR THE PERFORMANCE -OF HAE WORK FOR WHICH THIS PERMIT IS ISSUED. I VE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION 5700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WijI�RN�E-RS�'(C..OMPE/N�jATION INSURA�NFCE CARRIER AND POLICY NUMBER AAE: CARRIER /[ A( FJ l Di% �CA`� D/LJ�/76 • �% LLAA POLICY NUMBER :P �I I a - o I (THIS SECTION NEED NOT BE COMPLETEDOFTHE PERM fr 6 FORCNE H UNCRED DOLLARS (5100)ORLESS1 I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. 1 SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 0700 OF THE LABOR CODE, I�SHHALL FORTHWITH COMPLY WITH/jam// .1PROVIS�IO�NS. ) T(//J� DATE: II - / -D�_ 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 ($10O.0O0), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0705 OF THE LABOR CODE. WTEREST, AND A7TORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE 15 A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED (SEC. 3M7, CIV. C.). I LENDERS NAME LENDERS ADDRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CrTY ANO COUNTY OROINANCES AND STATE LAWS RELAT W O TO BUILDING CONSTRUCTION. AND HEREBYAUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOV ENTIONED PROPERTY FOR INSPECTION PURPOSES. 1 PERM1 E (PRINT) EL, r- v� O SI AURE OF PERMITTEE GATE PRESS FIRMLY CATION'7 / 1 /O� I CVIJ v / � � DATE ISSUE NUMBER TYPE 0PERMIT OCC DATE CONST. GROUP ZONING SETBACKS FRONT RVV ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE � /' �-� ✓C NO. DWEL. NO. / NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADDMEM N Garage/Carport W PatiotDeck LL- PooVSpa ZRe -Roof Commercial F60 OF 100 R K � .UVL2t' J!i Valuation - ADJ.AREA QUANTITY DESCRIPTION FEE < it L79.3 Z OD J G_ Z Q S U W 0 CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: d" PRE-ALT FEE: ' TOTAL FEES S. O5 L COMMENTS J'- ' lilt RECPT. NO. PAID BY UDATION WHITE —Department Copy, YELLOW —Finance Copy, PINK —Assessor Copy, GOLDENHUU> Fee COPY. GHLLN—Applcant's Copy V05.05 CiT' OF DIALTiOND BAR INSPECTION' RECORD SET BACK ; J FLOOR JOIST I FTGS/FORMS/STEEL ! _ _ j FHA REGMTS ! UNDER FLOOR DUCT -t ELECTRIC GROUND GROUND PLUIBING _� I _ I UNDER•FLO_OR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER _ _ _ FIREPLACE BOND BEAM WATER SERVICE PAID HT. BOND BEAM T ROOF SHEATHING rT 8 FT. BOND BEAM FRAMING,NENTILIATION _ _ _FINAL BOND BEAM PRE -GRADING _ ROOF COVER _ j ROUGH HEATING _ BENCHING ROUGH ELECTRIC _ ROUGH GRADING _ ROUGH PLUMBING FINISH GRADING _ i POOL ELECTRIC i POOL FENCING SHOWER/TUB TEST _ EXT. LATH/SIDING WALL INSULATION _ POOL FINAL CEILING INSULATION OFF SITE IMPS. _ DRYWALL NAILING _ DEDICATIONS SEWER FINAL ENG. SEPTIC TANK _^_ LANDSCAPEIIRRIG. SEEP PIT/L.L. I ON SITE MAPS. GAS AIR TEST T 1 �fI ' i FINAL ZONING FINAL CONST. FIRE DEPT FINAL (- FINAL HEATING FINAL ELECTRIC-(p-j I ,HEALTH DEPT. FINAL j DEV. FEES PAID - FINAL PLUMBING 1 ENERGY COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE .III I i _ J - - - _