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Home My WebLink AboutPR12-2043Cn D 0 w O 0 LU z O D cc O 0 w 0 z w a Cn cn cc O 0 LAI U Z W O U O Z Q W CI Z W ccW 2 Y O F.L Z O O F Lu U) U3 C1 Q LAU H Z� W Z UJ t= O M w J LL J W CL O oC fl - LU w 9i F— M CC W T C7 Z O cc m a SDU�.)IONDRAW F CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOBSITE ADDRESS 0 Vr/ A- APN LOT TRACT OWNER JL-1—O�Irh !/� Cr �olI15) ADDRESS v CITY Z «Ct TEL. - $ APPLICANT TELd KCONTRACTOR C ADDRES d cJ CITY ZIP T ARCFVENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT N AM EXEMPT FROM THE CONTRACTORS LI- CENSE UW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRESA PERMITTO CONSTRUCT, ALTER IMPROVE, DEMOLISH, OR REPAIRANY STRUC- TURE, PRIOR TO ITS 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 UW (CHAPTER 9 (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 APPLICANT TO ACRAL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSW).): O I, 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 SALE (SEC. 7041, 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 YEAROFCOMPLE. TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ❑ I, 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 UW 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 CONTRAC- TORS LICENSE LAW.). ❑ 1 AM EXEMPT UNDER SEC. B. 8 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT IAM 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 FORCE AND EFFECT. LICENSE CLASS� r-36 LIC. NO. DATE I'- ?---I +-�I � CONTRACTOR WORKERS' COMPENSATIO D RATION 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 SOF THE WORK FOR WHICH THIS PERMIT IS ISSUED. 1 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 WORKERS' COMPENS/AT/�IONN,INSU CE CIER AND POLICY NUMBER ARE: CARRIER � �/ ^ / L— POLICY NUMBER (THIS SECTION NEED NOT BE COM'l.ETEDOFTHE PERMIT 5 FOR ONE HUNDRED DCLIRS (S10D)OR USS), 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 E SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, ANDA E T IF I SH OME SUBJECT TO THE WORKERS' COMPENSATION PROVIS SOF C 00 of THE OR 1 CODE. 1 SHALL FO HWITH COMPLY WITH THOSE ISI Dl�E./ �� r f APPLICANT: WARNING: FAIWRE TO SECURE WORKERS' P A71 IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENAL S ANO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE INTEREST. AND ATTORNEYS 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.). LENDERS NAME LENDER'S ADDRESS 1 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 P PERTY FOR INSPECTION PU /SES. l PERMITTEE NAM (PRI SIGMA E MI DATE 0�- PRESS FIRMLY APPLICATION 21 ' (rL PERMIT anti P/C „r - DATE NUMBER # ISSUE DATE TYPE OCC 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 U) Garage/Carport WPatio/Deck LL Pool/Spa Z Re -Root Commercial m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J Q U cc f— W LU K (L Q _U Z S W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: a - ri0 PRE -ALT FEE: TOTAL FEES 'si5 • d� COMMENTS RECPT. NO. 2) S49 1 PAID BY \ 7l _ VALIDATION �� WHITE -Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD --File Copy. GREEN—Applicant's Copy C�TY OF DIAMOND OAF, INSPECTd'ON RECORD F ¢ � •+• i ri ,y -t5 S � r � "x ^��y, .� �s��• # v� •s! F Y Cj s Lei L. -5 i{ a I ` Y.'?•i �1 -F�^ a..L4�71+¢,.�.. �'��.u'^; k..,a'Y_i.._w _: E' +.�.�-.-1.u_v-- �r-�`",`�R�RRk �•-.A�.R �', i�'s. :r��.•.-_�^� }� :. �-SiS,r ^'tom `• �t.1'' 'i^S•�sr�.:a''f"� '. � 'z',±"otL"�'-�:•i '�ij-�. . C i "�3a -.ice•-'-yea,'• �� •a 'a� �"- SET BACK r _ _ 1�1�"�i''F11:9'y. +fi e� 1FLOOR JOIST FTGS,/FORMS/STEEL; I - ---------- - --- - -j-._ _._ ...- - --- -- ----- ! H REC (vtT----------- ! F A, ------------ -- — ---- ELECT P,IC GROUND I UpiDI.R FLOOR DUCT GROUND PLUMBING --------------- ----------- _ I UNDER FLOOR CONDUIT_ �---------- •-- ---- � SLAB GRADE --- -- - --- FIREPLACE FOUNDATION ------- I-- - -r- -- - ---- FtMP PO4VER - FIREPLACE BOND BEAM --- WATER SERVICEi --- - — ----- ----------- M!D HT, BOND BEAM --- - �--- ROOF SHEATHING -- - l". BOND BEAM ----- FRAMING/VENTILATION {{ - ---- - ----- --- . - - ------ -- I ---- -- .._._. ----- — ---- FINAL BONDBEAM O D B ...._.._ .-- ROOF COVER -------_._----------------------------------I-------------___-...---- - - -- -- -N - ------- ---- - PRE -GRADING ----- - --- ------- --- ROUGHHEATING BEN_CHIfJG ROUGH ELECTRIC _ ROUGH GRADING - — ROUGH PLUMBING -�_ i I FINISH GRADING SHOVdER/TUB TEST POOL ELECTRIC EXT, LATH;SIDING POOL FENCING WALL INSULATION I POOL FINAL CEILING INSULATION-- OFF SITE IMPS. DRYWALL_ NAILING �- __ DEDICATIONS - --- -- -- - - -- ----- -------------- FINAL ENG. - SEPTICTANK iI -------.--------------_,-._._—.' --�-_---------- LANDSCAPE/!BRIG. -------- -- SEEP PIT!L.L � _-�_ ON SITE IMPS. ---------- GAS AIR TEST FINAL CONST. I— FINAL_ ZONING FINAL HEATING FIRE DEPT. FINAL - - HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY FINAL PLANING FINAL ENGINEERING ---------- --_ COMMENTS ----------------- ----------- SEPTIC TA N K SIZE --------- --- — ---- - SEEP PIT/U SIZE ----- — ---- — ----_ _ _ _ h -