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Home My WebLink About23653r i� Q O LL_ 0 LU Z O D 2 O 0 LU 0 Z LU CIL- co U3 rn U3 CE .O D w U Z W 8 1-- O Z Cn Q W O Z W LU LU 2 CIC O lL Z O xd W OO U LU U3 N Cn M Q 0 W Q D Z Q LU W Z C:3 Tn O L4 J LL cc J W a O O_ Z W F W CL. c7 Z O In CO Q N 00 UI,UIII% BAR' CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES C� 21825 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION ADDRIESS�v�11 Lark's yne Dr P/C ISSUE / APNLOT TRACT OWNER D U ADD SS rKs o e r _ CITY kam O r ZIP , TEL ' OI APPLICANT L TELl�lO�SIS-I�i11 CONTRACT.OR YI r Q u YS ADDRESS - ISD 4CL WCw CITY ZIP 1 E If) i ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REOUIRESA PERMIT TO CONSTRUCT, ALTER, IMPROVE, DEMOLISH, OR REPAIR ANY S7RUG TUBE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER B (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPUCAN7 TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ($500).): 01, 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 SME (SEC. 7044, 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 IS SOLD WITHIN ONE YEAR OF OOMPLE- TKON, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). 01, 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 70 AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TITHE CONTRAC- TORS LICENSE LAW.). 0 1 AM EXEMPT UNDER SEC. B. 8 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 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL ORC,En•AND EFFECT. &52 5 ;�S LICENSE CLASS v LIC. NO. DATECONTRACTOR et10 Cvm1ll• WORKERS' 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 OF THE WORK 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. MY WO Cpp MCPPENNSATION INSURAyN�CE CARRIEP.AND POLICY NUMBER ARE: VERS' CARRIER a i ` '5TLC �, `5 • W POLICY NUMBER ' /(d X37 PHIS SECTION NEEDNOT BE COMPLETED OFTHE PERMIT IS FOR ONE HU DREDDOLLAAS (i1aD)ORLM% I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS COMPENSATION PROVISIONS OF SECTION 37M OF THE LABOR CODE. I SHALL FORTHWITH COMPLY WI THOSE PROVISI(Q�S�., `f C DATE: �f.� Zr APPLICANT: / & L�n vV I1111A ) WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER 70 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (f 100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CIV. C.). LENDER'S NAME LENDER'S ADDRESS I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CRY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FO NSPECTION PURPOSES. PERMITTEE NAME (PRINT) SIGNATURE OF PERMITTEE DATE PRESS FIRMLY APPLICATION DATE PERMIT Z3 `�-� P/C ISSUE / NUMBER TYPE # OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/REM Garage/Carport WPatio/Deck LL Pool/Spa 0 Z Re -Roof 0 Commercial - M Valuation ADJ.AREA QUANTITY DESCRIPTION . FEEcc Q U H W LU I Z r fD a Q U_ Z 2 W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING Ir U MECHANICAL INSPECTION FEE ISSUANCE ZS, BO SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: I• �O PRE -ALT FEE: TOTAL FEES 67. ro COMMENTS RECPT. NO. PAID BY VALIDATION WHITE—Department Copy, YELLOW--Finanoe Copy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN—Applicant's Copy CITY OF DIAMOND D : :. INSPECTION ORD SET BACK FLOOR JOIST FHA REQMTS --- ---- -- - - ......... - FTGSIFORMSISTEEL ----- ... --- --- - - -._... - - .._..._.. - ELECTRIC GROUND UNDER FLOOR.DUCT ' I UNDER FLOOR CONDUIT :-------_.__..._._......--..._........_._.._...._.:._.....__._.._..._ ....... - - - - ------ ---- .._.. -- -- -.._.. - _ GROUND PLUMBING --- - -=...................._._._.._...._.._......------- ...--- - - .._.._.....,_..._.._..- - - --- .._._...__.........._._....._. - SLAB .... __..._..--..... - - -.._......... ........ _.........._.._...-..._..._..__...;....._.......__........_............_....,_._.......__........._._......._....._.__.......... FIREPLACE FOUNDATION ,-........._......._._.........._...............__.............................._.._......_......_...._........_.........._.__........- - - ....._.__._... _ - TEMP POWER --- --....... -----._,.......-----._.._..---...._..........................._...._._..._.........._.........._.............._._...._................._..._. FIREPLACE BOND BEAM ............... ...... .... ......... _...................._........... _._.. _.......... _...... -- - --.................__.._........_............ _............... ---- WATER SERVICE MID HT, BOND BEA��i ROOF SHEATHING 8 FT BOND BEAM _ FRAMINGNENTILATION 'FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING ' BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING I FINISH GRADING POOL ELECTRIC SHOWER/TUB TEST' 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. j I FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC_ i DEV. FEES PAID FINAL PLUMBING i ENERGY .---._ ....... _........ __........ _..__..._._..... _..... _......... _...... --............. -... _....._..._._......_....._........ __...._...__.._ _.. . - NA COMMENTS -.- SEPTIC TANK SIZE SEEP PIT/U SIZE