The URL can be used to link to this page

Home My WebLink AboutPR121998D ;1JIDND BAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES(D 21810 Copley Drive, Diamond Bar, CA 91765 I' (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 tto I BUILDINNGG PERMIT APPLICATION AODDRESS X M3, APN LOT TRACT OWNER X AR?/4V4 f 0940 t- fF�2rLLn ADDRESS / 9&i 4-i/41T£- angri in - CITY binamor*0 WA✓ -ZIP 9/74r TEL.J a9 861-7&S/ APPLICANT)! TEL. CONTRACTORyW V1CV - �01�1 \ dry ADDRESS CITY ZIP TEL. ARCFVENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS COOS ANY CITY OR COUNTY WHICH REQUIRES A PERMITTO CONSTRUCT. ALTER IMPROVE. DEMOLISH, OR REPAIR ANY STRUG TORE, PRIOR TO RS 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 B (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PR6 FESS)ONS 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 FORA PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSW).): ❑I, AS OWNEROFTHE 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. 70x1, 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 YEAROF 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 OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAG TORS LICENSE LAW.). 0 11 AM EXEMPT UNDER SEC. B. & P.C. FOR THIS REASON DATE{_.� - L OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER Y (COMMENCING WITH SECTION 7000) OF DIVISION 3OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. LICENSE CLASS LIC. NO. DATE CONTRACTOR 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 WALL MAINTAIN WORKERS' COMPENSATION INSURANCE AS REWIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPIZMOFTHE PERMIT IS FOR CNE HU NDREDOUTAAS (5140) OR LESS) 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 BECAME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE, I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: J�( IIS I / ' Z/ APPLICANT: Y �. �. 11141 .{/1 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 (51 00,00)), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3708 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. 3047, CIV. C.). LENDERS NAME LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 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. /altiHv/t- E. H�n/t PER NA�My�tPRI7TT) SIGNATURE OF PERMITTEE DATE PRESS FIRMLY APPLICATION PERMIT *112 1a P/C DATE NUMBER 9� g 0 -T, -- ISSUE \ TYPE OCC DATE \ I a. CONST. GROUP ZONING SETBACKS FRONT RW REAR 0 Ll SIDE/SIDE STREET RW CI SIDE 17 PROPOSED USEY_ 41/OQ t a ID Va NO. DWEL. NO. NO, UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport walio eck l7 LL 0 Pool/Spa Z Re -Root CI Commercial m Valuation k:p , ADJ.AREA QUANTITY DESCRIPTION FEE Q U Cr H U W LU 0 Z Fn J a Q U_ Z Q 2 U W CONSTRUCTION "RS PLAN REVIEW "Sp—L'. OI b ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP 1 �j ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: Caci TOTAL FEES s COMMENTS RECPT NO- JZI! t• S PAID BY VALIDATION WHITE—Department Copy, YELLOW --Finance Copy, PINK Copy, GOLDENROD—File Copy, GREEN—Applicant's Copy S C �, ^31' Y 0 F D, � AlWill 0 N D GJ, A ill H'l �6; P E (" T it 0 1,i R 1E. C0 R D BACKF 1- T LOOR JOIS I -T IG F 0 RM S/ S T E E L GROUND j UNDER FLOOR DUCT GROUND PLUJ',,,lBING 1 UNDER FL( -),OP, CONDUIT SLAB GRADE TEMP POWER FIREPLACE FOUNDATION FIREPLACE BOND BEAM WATER SERVICE ,116 HT. BOND BEAM 18 FT. BOND BEAM FINAL BOND BEAM ROOF SHEATHING FRAMING/VENTILATION ROOF COVER PRE -GRADING ROUGH HEATING ROUGH ELECTRIC i I BENCHING ROUGH GRADING ROUGH PLUMBING FINISH GRADING POOL ELECTRIC SHOVk,lER/TUB TEST EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION DRYWALL NAILING, OFF SITE IMPS. 'DEDICATIONS SEWER FINAL N , LANDSCAPE,'IRRIG.--.--- SEPTIC TANK SEEP PIT/L.L, ONSITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. I I FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC j DEV. FEES PAID FINAL PLUMBING ENERGY FINAL PLANING FINAL ENGINEERING UdWli COMMENTS IV SEPTIC TANK SIZE SEEP PIT/U SIZE ;7q OgF -;b THESE P1 �31 CIO AL L N OT B E THE APPROVA — odY VIOLATION CONSTRUED TObi.PP TY, 0R ) R U i N -A N C' OF ANY CODE THESE PLANS SHA! L_ bE 0 JOB L REOIJES7ED tNSPECTiONSf gal kq . 10 t 8 -AR I'Division FIF ...[l4— �,Approva- I nurriber.— v 1�7 * &t, . chedA Wqor plan 8l Enrlinee,incLton ShaAt41nsuwlant — The const me� roved by e andlof SubsequentdeveWns 3P� �h he arch-ftectufa - IXdministrative compliance Ingwite Planning (planning commmioCoun' s olid,and oficeflCM �fs�3nt to the .pOO IAeaflng ffiedpsuch app Divisior,,mod 0A n Comorman - thereafter �-r qA4 FAC -C o P 0IV�: ! ESE'�� IA I all APp,� Nov VClS�7. �gOVAL OF. TT YrtrTE M5LA )LL SOT 8EOFgNyC�Ft OOg 0'O LS HRDI OASLBON� T AN 0h L -R 2 x 2 t.. -t n cd 1AA t c,o �lb �� ,-vj le44 4 mlp µ► me p.rfj . TH + W+4E- M otto' .E LA,/ 1/, ! ec S— 1 A-4 , 5 NC6w em.- 01"0 S ',ALC— �4/ I�� amx Ate,Th Ol tiet