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Home My WebLink About26297 , � ` ��_��,`_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702 PRESS .`,9��. suiLnnv�rE�T ArrLicAT1oN FIRMLY 0 ADDRIESS�,n��I�W� �S� DATE CATION NUMB R ;Z �'-7 #�� occ APN LOT TRACT DA EE� ��tf�� ONST. GROUP p OWNER � p ADDR SS • � � ZONING SETBACKS FRONT qyy � � CITY . ZIP� TEL. REAR p APPLICANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE p ADDRESS � CITY ZIP TEL. PROPOSED USE - 1C.. w ARCH/ENG/ ��Y�}Y�-+-�--,�-', n z DESIGNER � a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNEF-BUILDER DECLARATION SFq/ADD/REM O � I HEREBV AFFliiM UNDER PENAL?Y OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� GOffigB/COfPOfI W CENSE UW FOR THE FOLLOWINO REASON(SEC.7031.6 BUSINESS AND PROFESSqNS COpE:�M'pTV OR (n C� CWNTVWHICHREOUIRESAPERMRTOCONSTRUCT,ALTER,fMPROVE,DEMOUSH,ORFEPAIRANYSTRUC- W Petlo/Deck � NRE.PRqH TO RS ISSUANCE,AL50 REOUIRES THE MPLICANT FOR SUCH PERMIT TO FILE A SIONED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO iNE PROVISIONS OF hiE CONTRACTORS Ll- � � CENSE LAW(CHAPTER B(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PR0. POOVSPB FESSIONSCODE)OqTHATHEORSHEISE%EMP7THEREFROMANDTHEBASISFOR7HEALLEOEDEXEMP� C7 � TqN.ANVVI0LAT10NOF5ECTION7o31.58VANVAPPLICANTFORAPERMITSU&IECTShiEAPPUCANTTO Z Re-Roof A CIVIL PENAL7V OF NOT MOFE THAN FIVE HUNORED DOl1APS(f600).): � ❑I,ASOWNEROF7HEPROPERTY,ORMYEMPIOVEESWITHWAOESASTHEIRSOLECOMPEN5A710N, � (',pmm6fCi81 Z WILL DO THE WORIC,AND THE S7RUCTURE IS NO71N7ENDED OR OFFERED FOR SALE(SEC.iou,BUSI- J � � � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY VAiO BUILDS OR IMPROVES hiEREON,AND WHO DOES SUpi WORK HIMSELF OR HERSELF OR Q THiiOUGH HIS OR HER OHRJ EMPLOVEES,PROVIDEb THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVEf�THEBUILDIN40flIMPROVEMENTISSOLDWfTHINONEYEAROFCOA/PLE- � Z TIDN,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVIN(i THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR 7HE PURP0.5E oF SALE). � w ❑I,AS OWNEF OF 7HE PROPEHTV,AM EXCIUSIVELV CONTRACTIN(i WfTH LICENSED CONTRACTORS [[ TO CONSTRUCT THE PRQIECT(SEC,7oW,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI- V6N9�IOf1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPER7VWFIOBUILDSORIMPROVESTHEREON,AND � W/iOCONTRACTSFOq9UCHVR0.1ECT5WITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION Y TORS LICENSE UW.). � FE � �AM EXEMPT UNDER SEC.�� B.8 P.C.FOR THIS REASON � `7 � ! � � DATE � � OWNER F � � Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENILTV OF PE0.IURV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(G�DMMENCING WITH SECTION 7000)OF DIVISION a OF THE BUSINESS AND PROFESSIONS CODE,AND Z ' XL� A(Y LICENSE IS fN FULL FOFCE AND EFFECT. m LLI � LICENSE CLASS LIC.NO. � V DATE CONTRACTOR . a W � WORKERS'COMPENSATION DECLARATION Q � U N I HEREBV AFFIRM UNDER PENALTY OF PER1UFtt ONE OF THE FOLIOWING DECURATpNS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF•INSURE FOR WORKERS' ¢ S Q COMPENSATION,AS PROVIDED BY SECTION 37000F THE UBOR CODE,FOR THE PERFOqMANCE U Q OF THE WORN FOR WHICH THIS PEqMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WOR)(ERS'COMPENSATION INSURANCE.AS REOUIRED BV SECTION Q 3700 OF TFIE LABOR CODE,FOR THE PERFOPMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INSURANCE CAARIER AND POLICY NUMBERARE: CONSTRUCTION J j CARRIER PLAN REVIEW � POLICV NUMBER � ZQ ELECTRIC �_ � (fFBSSEC�IONNE�NOTBE00MPLE7IDOFTHEPEp.T�ISFORONEFM�DREppqJ.Nv(ylpp�pqLESS} PLUMBING �- W Z I CERTIFV THAT IN THE PERFORMANCE OF 7HE WOR)(FOR WHICH THIS PERMIT I$ISSUED,I MECHANICAL G} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE [/� WORKERS'COMPENSATION LAWS OF CALIF-0RNI/�AND AOfiEE THAT IF I SHOULD BECAME INSPECTION FEE SU&IECT TO 7HE WORKERS'COMPENSA710N PROVISIONS OF SEC7KKJ 370o OF THE UBOR ^^ �j CODE,1 SHALL FORTHWITH COAIPLV WITH TFpSE PROVISIONS. ISSUANCE '�jl' 0 p DATE: APPLICANT: SMIP W 'J WARNING:FMLURE TO SECURE WOFKEfiS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C J � SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THWSAND ENERGY PEAMIT DOLLARS(f100.000).IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN w SECTION 3708 OF THE LABOR CODE,INTEHEST,AND ATTORNEY'S FEES. RETENTION FEE: '� O CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � I HEREBV AFFIRM UNDER VENPLTV OF PEFiJURY THAT THERE IS A CONSTRUCTION LENDWG AGENCV FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS GERMIT IS ISSUEO(SEC.3087,CIV.C.�. Z W � LENDER'S NAA/E � IENDERSADDRE55 � TOTAL FEES (.�� , g ll, � I CERTIFV TNAT I HAVE READ THIS APPLICATION AND STATE THAT 7HE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPLV WfTH ALL CITY AND COUNTV OqDINANCES ANO STATE UWS REUTINO TO BUIIDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF 7HI5 COUNTY TO EMER UPON THE ' � ABOVE-MENTIONED PROPER7Y FOR INSPECTqN PURPOSES. Z COMMENTS ' � ��b� _ m PERMITTEE NAME(P � � �9� � � SN3NATURE OF PERMfTT E DATE � RECPT.N0. PA1D BY VALIDATION WHITE—Depertment Copy,VELLOW�Inence Copy,PINK—Assessor Copy,OOLDENRO�Ie Copy,GREEN—Appllcant's Copy r_' . �� ' � 0�� aa�p�c�400a ��a4� �:�-�i��?�c��a� =F- -�s� ;��c��a:�� .�:�:�� ; � � SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRA�ING ROUGH NEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB 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 ENERGY C��o r:.�; . CONtMEfVTS , _ SEPTIC TANK SIZE SEEP PIT/U SIZE a `c� '� � ;� _1�,� CITY OF DIAMOND BAR . DEPARTD' T OF CONIMUNITY&DEVELOPMENT SER' 'ES ' . �w , 21825 Coplc, Jrive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 ��$� ��'� BUILDING PERMIT APPLICATION • FOR�IflLY � JOBSITE' tl �/ APPLICATION PERMIT !'r,�, o ADDRESS{I�� i��I��r DATE NUMBER �W�C� #/C � ISSUE TYPE OCC APN LOT TRACT DATE -�C{�� CONST. GROUP p OWNER � � � c . ZONING SETBACKS p ADDRF�SS � � z c�7y � ZIP �- t _ TEL. FRONT p�/y p � APPLICANT TEL. REAR p Z SIDE/SIDE STREET RW p � CONTFiACTOR SIDE p , � ADDRESS PROPOSED USE �� C.� r- � CIIY ZIP TEL ' oARCFUENG/ ��r�M'`Y-J 'C�3�'��-�� '1 W DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION cn � OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFlRM UNOER PENALTY OF PERAIRY THAT I AM EXEMPT FROM iHE CAMMCTORS L4 Garage/CarpoA � W CENSELAWFORTHEFOILOWINGREA50N(SEC.7o31.5BU5WE5SANDPROFE5510N5CO0EANYCITYOR (n U COUNTYWHICHREWIflESAPEqMITTOCANSTRULT,ALTER,IMPROVE,DEMOLISH,ORPEPAIRANVSTRUG W PBIIO/DBC1( w TUR�PRqR TO RS ISSUANCE,AL50 REWIRES THE APPLiCANT FOR SUCH PERIAIT TO FlLE A SIGNED W ' g STATEMENT iHAT HE OR SHE IS LICENSED PURSUANT TO THE PFOVISIONS OF THE CONTRACTORS LI- � CENSE LAW(CHAPTER D(COMMENCWG WITH SECTION 7DDo)OF DIVISION 3 OF THE BUSINESS AND PRD- � POOUSPB FESSIDNS CODE)OR THAT HE OR SHE IS EXEMPT THEREFFOM AND THE BA515 FOR THE N.LEGEO E%EIAP• � TKKJ.A77VVIOLATIONOFSECTION7a31.58VA1JYAPPLICAMFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Rool � A CML VENALTY OF NOT MORE THAN FIVE HUNORED DOLURS(S50o).): Q OI,ASOWNEROFTHEPROPERTY,ORIAYEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATNJN, 0 COrt1rt10fCIaI � Z WII100 THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BUSI� J � NESS AND PROFESSIONS GODE THE CONiRACTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF � PROPERTYWHOBUILDSOfiIMPROVESiHEREON,ANDWHODOESSUCMWORKHIMSELFORHERSELFOR � Q iHRDUGHHI50RHERON?IEMPLOYEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m w OFFEREDFORSALEIF,HOWEVEFI7HEBUILDINGORIM7ROVEMENT�SSOIOWfTHINONEYEAROFCOMPIE- � TION,THE OWNER�BUILDER WILL HAVE THE BUROEN OF PROVIN�THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PUR705E OF SALE). � _ ❑I,ASOWNEROFTHEPROPERTV,AME%CIUSNELYGONTRACTPI6WRHLICENSEDCONTRACTORS W � TO CONSTRUCT THE PR0.IECT(SEC.70dd,BUSINESS AND PROFESSIONS CODE THE CONTHACTORS LI- VeIUa�1Dfl ADJ.AREA I W CENSELAWDOESNOTAPPLYTOANOWNEflOFAPROPERttWF106U9D50RIMPROVESiHEREON,AND . � NMOCANTRACTSFORSUCHPPQIECTSWITHACOMRACTOR(5)LICENSEDPURSUAHTTOTHECONTF7AP QUANTITY DESCRIPTION . FEE TORS LICENSE UW.). � �AM E%EMPT UNDER SEC.�� B.d P.C.FOR THIS REASON Q ,7 m� � (� � � l` � 1 � �'� �C. } LL DATE � �'' \.] ONRJER � ' / L Z w � � IICENSED CONTRACTORS DECLAFATION w . - � I HEREBV AFFIRM UNDEH PENFLTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d Y(COA/MENCING WfTH SECTION 7000)OF DIVISION J OF THE BUSINESS ANO PROFESSIONS CO�E,AND Z LX MY UCENSE IS IN FULI FORCE AND EFFECT. m �� LICENSE CLASS LIC.NO. � � J V DATE - CONTRACTOR. a W � WORKERS'COMPENSATION DECLARATION ¢ � rn U � I HEREBV AFFIRM UNDER 7ENALTY OF PEfiJUFlY ONE OF THE FOLLOWING DECIARAT10N5:� Z ' Q 0 I HAVE AND WILL MAWTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORNERS' _ �' COId7ENSATION,AS Pi70VIDED BV SECTION 3]Do OF TNE LABOR CODE.FOfl THE PERFORMANCE w Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � W t HAVE AND WILL AIAINTAW WORKERS'CAMPENSATION INSURANCE,AS REWIPED BY SEC710N Q 3700 OF THE UBOR CODE,FOR 7HE PERFORMMICE OF THE WORK FOH WHltli THIS PERMIT IS ISSUED.MY WORNERS'COMPENSATION INSURANCE CAqRIER AND POLICY NUMBEH ARE: . CONSTFlUCTION J j CARRIER PLAN REVIEW� o Pa�cYNUMBER ELECTRIC �_�(�, Z ¢ (fFpSSECTIONNE�ND7BENAE�EfmOFhEPEPMTISFORONEM1�OfiEDDOLLARS(ft00)ORLESS} PLUMBING � � W Z I CERTIFV THAT IN THE PERFORMANCE OF THE N'ORK FOR WHICH THIS PERMIT IS ISSUED.1 MECHANICAL L}' SHALL NOT EMPLOY ANY FERSON IN ANV MnNNER 50 AS TO BECOME SU&IECT TO THE � � � WORKERS'COMPENSATIDN LAWS OF CALIfORN1A,AND AGREE THAT IF 1 SHOVL�BECOME INSPECTION FEE S SUaIECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37DOOF 7HE LABOR ` �-y CADE,I SHALL FOFTMMTH COMPLY WITH THOSE PROVISIONS. �SSUANCE j' �76� � SMIP p DATE: APPLICANT: J WARMNGFAILURETOSEQ/REWWiKERS'CAMPENSATIONCAVERAGEISUNLAWFUL,PNDSHALLBE ENEAGYP/C � SU&IECT AN EMPIOYER TO CRIMINAI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOlUAS(f70o.o0D).IN ADDITION TO THE COST OF COMPENSATpN,DAMAGES AS PROVIDER FOR IN �, � SECTION370BOFhIELABORCODE,INTEREST,ANDATTORNEY'SFEES. RETENTIONFEE: �_( ��. � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PEN/�LTY OF PERIURY THAT THERE I5 A CONSTRUCTION LENDING AGENCY ' � FOR 7HE PERFORMANCE OF THE WORK FOR wHICH THIS PERMR IS ISSUED(SEC.3091,CIV.CJ. Z W = LENDERS NAME � H LENDERSADORE55 � TOTAL FEES j�,G�, g� � 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE MFORAIATpN IS CARRECT. w 1 AGREE TO LOMPLV WITH ALL CITV AND COUNTY OPDWANCES AND ST�TE Uw5 RELAT WG TO BUILDINCi � CONSTRUCTION,AND HEREBY AU�110RIZE REPRESENTATIVES OF THIS COUNTV TO ENTEF UPON THE ' � ABOVE�ME1filONED PROVERTY FOR INSPECTION PURPOSES. Z COMMENTS � ��'� _ m VERMITTEE NAME(P � Q � -7`J- C.'►� � N SIGNATUREOFPERMfTT E DATE RECPT.NO. PAID BY � I =VALIDATION \ "`l 2 ~ WHITE—DepaAment Copy,YELLOW--Finance Copy,PINK—Assessw Copy,GOLDENRO�File Copy,GREEN—Applicanl's Copy ; a. � � �7,�,rr. . _...— � � __._�._._— + r �t�. �� 4� �t�, ,�ir { , '�;:.. —� ' .� �..—_� �... �__—... 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