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Home My WebLink About1050 GRAND AV (17) _�� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 PRESS "M" BUILDING PERMIT APPLICATION FIRMLY o DDRESS �D�O S'G � /iVv V' P DATE CATION I � / 11 NUMB R ��,�o� #/C Lp .�_ � issue � TYPE occ APN OT � TRACT DATE �l� I1 1 CONST. GROUP °C OWNER i O " ADDRE S ZONING SETBACKS 0 w CITY � ZIP TE � FRONT qyy p � APPLICANT T6{� REAR p � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE p ADDRES � � � CITY ' ZIP� TEL. »5 PROPOSED USE o ARCWENG/ DESIGNER tzu NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES Z� BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNEF•BUILDER DECLARATION � p SFR/ADD/REM p I HERE6V AFFIRM UNDEF PENALTV OF PERJURV THAT I AM EXEMPT FAOM THE CONTMCTORS LI� G8f8QB/CBfPOf1 W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPPOFESSIONSCOOE:ANYCITVOR (f� U CAUNTVWHICHREOUIRESAPERMITTOCONSTflUCT,ALTER,IMPROVE,DEMOUSH,ORREPAIRANVSTqUC� W P0II0/DBCI( � NRE,PRqR TO ITS ISSUANCE.ALSO REOUIRES THE AP7LICANT FOR SUCH PERMIT TO FILE A SIONED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO TME PROVISIONS OF THE CONTRACTORS LI- � CENSE UW(CHMTER V(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSPB � FESSIONS CODE)OR THAT HE OR SHE IS E%EMPTTHEREFROM AND THE BASIS FOR THE ALLEOED E%EMP� C7 TqN.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPUCANT TO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLUFiS(5500).): 0 ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrtlfl'IBfC18I Z MALL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oN,BU51� J � NE55 AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT A7PLV TO AN OWNER OF ? , PROPERTV N?10 BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGH HIS OR HER OWN EMVLOVEES,PROVIDEO THAT SUpi IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDPoRSALEIFHOWEVERTMEBUILDINGORIA/PROVEMENTISSOLDWITHINONEYEAROFCOMPLE- z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILA OR � IMPROVE FORTHE PURPOSE OF SALE). W ❑I,ASOWNEROFTHEPROPERTV,AME%CLUSIVELYCONTMCTINGWITHUCENSEDCONTRACTORS � TO CONSTRUCT TNE 7HOJECT(SEC,7aN,BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LI- V8W9�lOf1 ADJ.AREA W CENSE lAW DOES NOTAPPLV TO AN OWNER OF A PqOPERTV WHO BUILDS OF IMPROVES THEHEON,AND , � N?fOCANTRACTSFORSUCHPR0.1ECT3WITHACONTRACTOP(5)LICENSEDPURSUANTTOTHECONTRAC� QUANTITY DESCRIPTION Y TORS IJCENSE LAW.�. FEE � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � I/FJ�_s � U u" DATE OWNER � Z U � LICENSED CONTFACTORS DECLARATION w � I HEREBV AFFIiUI UNDER PENALTY OF PERJURV THAT I AM UCENSED UNDEF PROVISbNS OF CHAPTEH � � � Y(COAIMENCINO WI7H SECTION 7000)OF DIVISKKJ J OG THE BUSINESS AND PROFESSIONS CODE,AND Z G X�� MY LICENSE IS M FULI FOFCE AND EFFECT. m LLI �/ � UCENSE C l,IC.NO. v � � U DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q C U � � I HEREBV AFFIPM UNDER PENAL7Y OF PERIURV ONE OF 7HE FOLLOWING DECIARATIONS: Z O _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' a � _ Q COMPENSATION,AS PROVIDED BV SECTION 370o OF THE UBOR CADE,FOR THE 7ERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � � _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BV SECTION Q 37o00F THE LABOR CODE,FOR THE PERFORMANCE OFTHE WOfiK FOR WHICH 7HI5 PERMIT IS ISSUED.MV WORKERS'COMPENSATKKJ INSURANCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION jCARRIER PLAN REVIEW � POLICV NUMBER � ELECTRIC _ � �-• p (I}NSSECIIONNE�NOTBEOOMfiEfmOFh�PERMfTISFOqpNElll.rDRFD001.lARS(5100)ORIESS} PLUMBING {j�,�� 5�^ w Tb' �� Z I CERTIFY THAT IN THE PERFORMANCE OF THE WONN FOR WHIq1 THIS PERMIT IS ISSUED,I MECHANICAL CJ SHALL NOT EMPLOV ANV PERSON IN ANV AIANNEF SO AS TO BECAME SU&IECT TO THE (/j WORNERS'COMPENSATION UWS OF CALIFORNIA,AND AGREE THAT IF I SHOUL�BECAME INSPECTION FEE = SU&IECT TO THE WORKERS'COMPENSATqN ROVISIONS OF S� TION 3700 O THE UHOR � �� CODE.I HALL ORTHWITHCOMPLV WITHT E OVISIONS ISSUANCE 0 � p DATE: APPLICANT: SMIP w ' ENERGY P/C � � WARNING FAILURE TO SECURE WORNERS'COMPENSATION CAVERAOE IS UNLAWFUL,AND SHALL BE � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f 100.000),IN�DDITION TO THE CQST OF CqMPENSATION,DAAIAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. OC RETENTIONFEE: �,. C7O OCONSTRUCTION LENDING AGENCY PRE•ALT FEE: G � I HEFEBV AFFIqM UNDER PENALTV OF PERJURV THATTHERE IS ACONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oe7,CIV.C.�. W � LENDERS NAME H LENDER'SADDRESS � I CERTIFV THAT I HAVE READ THIS APPUCATION AND STATE THAT TME ABOVE INFORMATION IS CORRECT. TOTAL FE ES ��` � I A6REE TO COMPLY WITH ALL CITY AND CAUNTV ORDINANCES AND STATE lAWS FEUTWG TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTYTO ENTEFi UPON THE Z ABOVE-MENTqNED PROPERTV FOR INSPECTqN FURPOSES. COMMENTS ' o � �� m PER E N (PRINT) ' � ¢ y z >� � E I E A7E � RECPT.NO. � PAID BY � VALIDATION WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,C30LDENHOD—File Copy,OqEEN—Applicant's Copy CIYV O� D9AhViO�D ��,R I�S��@Oi� B�ECORD ��4 0a�p[�C�4�Oa : ��o �� . �' Q[�}�pC�CC�4OG� � :.;. 0�1�3G°�f�C�40Q�r�' � `C��15�G,`; - �o ` * . � .� �-�, . ,,. SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUfVDATION ` ' TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM � ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING �l FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION 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. FIRE DEPT. FINAL FINAL HEATING HEALTH'DEPT. FINAL FINAL ELECTRIC -�,�'�( DEV. FEES PAID FINAL PLUMBING (p i3-�( � ENERG`( �� . COMMERITS SEPTIC TANK SIZE SEEP PIT/U SIZE a m� � �_ �`x ;� �