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Home My WebLink About11-1018CITY OF DIAMOND BAR C/ - • DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765w 909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS BUILDING PERMIT APPLICATION P FIRMLY JOBSITE poADDRESSDATENl,..Q NUMBER I ' O I #/C r° APN y OT RACT D TEE D /ZtS I I ONST. Lv/1 GROUP p OWNER luE Sf71 1 /IiYCL'lTI O ADD ESS ZONING SETBACKS Z CI«a Zl l. (C e p-- FRONT RW o APPLICANT TEL.REAR p Z SIDE/SIDE STREET RW CONTRACT SIDE p ADDRp , T -. PROPOSED USE o ARCH/ENG/ z DESIGNER w NO.DWEL. NO.NO.a ADDRESS CITY ZIP TEL. UNITS STORIES BEDROOMS n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p OWNER-BUILDEF DECLARATION SFR/ADD/REMO p I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT I AM EXEMPT FPOM 7HE CONTRACTORS LI• G8f2gB/CefPORWCENSEUWFOR7HEFOLLOWINGREASON(SEC.7o31.5 BUSINE55 AND PROFESSIONS CADE:ANY CITV OR (nUCOUNTYWHICHREUIRESAPEFiMI77000N5TRUCT,ALTER,IMPROVE.DEMOLISH,ORREFAIRANYSTqUC- W 7URE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNEO W Patio/DeckSTATEMENTTHATHEORSHEISLICENSEDPURSUANTTOTHEPROVISIONSOFTHECON7RACTORSLI CENSE LAW(CHAPTER 8(COMMENCING WI7H SEC710N 7000)OF DIVISION 3 OF 7HE BUSINESS AND PRO- POOVSPe 0 FESSIONSCODE)OR7HATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFOR7HEALLEGEDEXEMP V TION:ANVVIOLATIONOFSECTION7031.5BVANVAPPLICANTFORAPEflMITSU&IECTSTHEAPPLICANTTO Z Re-Roo(A CIVIL PENALTV OF NOT MORE THAN FIVE HUND{iED DOLLARS(f500).): Z I,ASOWNEROF7HEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrt1ffI0fC181WILLDOTHEWORK,AND 7HE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7ou,BUSI- J NESS AND PROFESSIONS CODE:THE CONTRACTOFiS LICENSE UW DOES NOT APPLV TO AN OWNER OF jPROPERTYWHOBUILOSORIMPROVESTHEREON,AND WHO DOES SUCN WORK HIMSELF OR HERSELF OR CC TMROUGH HIS OR HER OWN EMPLOYEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m 0 OFFEREDFORSALEIF,HOWEVERTNEBUILDINGORIMPqOVEMENTIS50LDWITHINONEVEAROFCOMPLE- Z TION,7HE OWNER-BUILDER WILL HAVE 7HE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OH IMPROVE FOR THE PURPOSE OF 5/LE). w I,AS ONRJER OF THE PROPER7Y.AM E%CLUSIVELY CONTRACTING WI7H LICENSED CONT{iACTORS TO CANSTRUCT THE PRQIECT(SEC.70 1,BUSINESS AND PROFESSIONS CODE:THE CONTRAC70RS LI- V81U8Si0n a ADJ.AREAWCENSEUWDOESNOiAPPLVTOANONTJEROFAPROPERTVWHOBUILDSORIMPROVES7HEREON,AND NMOCONTRACTSFORSUCHPRQIEC7SWITHACONTRACTOti(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). O I AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON Q U u" DATE OWNER F- Q w LICENSED CONTRACTORS DECLARATION w I HEREBY AFFIRM UNDER PENPLTV OF PERJURV THA7 I AM LICENSED UNDER PROVISIONS OF CHAPTER d 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND ZXYYLICENSEISINFULLFORCEANDEFFECT. m 1 ZLLIVy LICE SE CLASS LIC.NO. j V DA CONTRAC d W WORKERS'COMPENSATION pE_ Q n U I HEREBV AFFIRM UNDER PENALIY OF PERIURY ONE OF THE FOl WING DECLARA710NS: Z I HAVEAND WILL MAINTAIN ACERTIFICATE OF CONSENT70 SELF-INSURE FOR WORNERS' a2 Q COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE w Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w 1 HAVE AND WILL MAINTAIN WORKERS'CAMPENSA710N INSURANCE,AS RE UIRED 8V SECTION Q3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS J ISSUED.MV WORKERS'\ PENSA ON INSURANCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION CARRIER C f PLAN REVIEW Z POUCYNUMBER i ELECTRIC 0 (IHISSECf10NNEmNDTBEUJMi'LEfEDOFTHEPE FO I DRED (f100)ORLESS PLUMBING S Z I CERTIFV THAT M THE PERFORMANCE OF WORK F ICH S PERM IS ISSUED,1 HANICAL C}SHALL NOT EMPLOY ANY PERSON IN AN ANNER S T B ME SUBJ T WORKERS'COMPENSATIONLAWSOF LIFORNIA, R TH DBECOME INSPECTIONFEE SUBJECTTO7HEWORKERS'COMP SA710NPR I 10 ooOFTHELA n CADE.I SHALL FORTHWITH COM WITH ONS. ISSUANCE 7 p DA P CANT; SMIP J WARNING FAILURE TO SECURE RKEfiS'CO TI UNIAWFUL,AND SHALL BE ENERGY P/C SU&IECT AN EMPLOVER TO CR INAL PENA D CIVI ES UP TO ONE HUNDRED THOUSAND ENEFGY PERMITDOLLARS(5700,000),IN ADDITI TO THE S CO SATION,DAMAGES AS PROVIDED FOR IN SECTION 37oB OF THE LABOR DE, RE oaNErs FEEs. RETENTION FEE: OCONSTR TION LENDING AGENCY PRE-ALT FEE: I HEREBYAFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). ZW LENDER'S NAME H LENDER'SADDRESS ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT. TOTALFEESwIAGREETOCAMPLYWI7HLLCITVANDCOUN7YORDINANCESANDS7A7ESiiEUTINGTOBUILDING CANSTRUCTION,AND H BV AUTHORIZE REPRESENTATIVES OF 7HI5 CO TY TO ENTER U70N THE ABOVE MEN7 NED G PERTY FOR INS EC71 SES. Z COMMENTS J ERMITTEE• (P ry•- N U N SIGNAT E E ITTE DATE RECPT.NO. PAID BY AUDATION WHITE—De aAment Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN— i P PY. PY PY, PR ApPlicant's CoPY CB V O D8A iO4 Bl ff BI S[C UO (OR oa p c 400a op4 :a t c :h: aa pc c ao . . o 4 ,oa r r SET BACK FLOOR JOIST FTGSlFORMS/STEE FHA REQMTS ELECTRIC GROUND UNDER F OOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'L 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 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 o COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a x