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Home My WebLink About10-1267 � ' ��` _ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 ��w (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ' �""^'� BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE //f APPLICATION PERMIT /,, p/C ADDRESS (/� ��L-- �� DATE NUMBER ��Y �# o ISSUE TYpE °^ APN LOT TRACT DATE 7� ��c/� OCC p OWNER iLT�A yJl /� a /� CONST.-1—�� • GROUP p ADDRESS Z_ ZONING SETBACKS Z CITY �'tv�^On1 ' ZIP � � T . � FRONT qW ❑ REAR p o APPLICANT � Q-- TEL. SIDE/SIDE STREET RW ❑ z' Q CONTRACTOA �K-� � �1�NJ7 SIDE ❑ � ADD S � � —� �� CITY W�p ZIP TEL 3(D/ - PROPOSED USE o ARCH/ENG/ iz DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � v� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADD/REM p I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CON7RACTOqS LI- G8f89B/CBfZIOfI W CENSEUWFOR7HEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCOOE:ANYCITYOR (� U COUN7YNMICHREOUI{iESAPERMITTOCANSTRUC7,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUG � w NRE.PRIOR TO ITS ISSUANCE,ALSO REDUI{iE5 THE APPLICANT FOR SUCH PERMIT TO FIIE A SIGNED W Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PFOVISIONS OF THE CANTRACTORS ll� � � CENSE UW(CHAPTER e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSP3 Q FESSIONS CADE)OR THAT HE OR SHE IS EXEMPT THEREFROM AN�THE BASIS FOR THE ALLEGED E%EMP- (� V TION.ANY VIOLATION OF SECTION 7031,5 BV ANY APPLICAN7 FOR A PERMIT SUBJECTS 7HE APPLICANT T0 Z Re-Roaf A CIVIL PENAL7V OF NOT MORE THAN FIVE HUNDRED DOLLARS(f5oo).): � Z ❑I.ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, � COf1lfnBfC101 WILI DO THE WORK,AND THE STRUCTURE IS NOT INTEN�ED Oq OFFEfiED FOR SALE(SEC.7ou,BUSI- J N NESS AND PROFESSIONS CADE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPER7Y WHO BUILDS OR IMPROVES THEREON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m 0 OFFEREDFORSALE.IF,HOWEVER,THEBUIIDINGORIMPROVEMENTISSOIDWITHINONEVEAROFCOMPLE- Z TION,7HE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING 7HAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SA�E). w ❑I,ASONRJEROFTHEPROPERTV,AMEXCLUSIVELYCON7RAC71NGWI7HLICENSEDCONTRACTORS Q TO CANSTRUCT THE PRQIECT(SEC.70�/,BUSINESS AND PROFESSIONS CODE:THE CON7RACTORS LI- V81U8fi0n ADJ.AREA W CENSE LAW DOES NOTAPPLV TOAN ONMER OFAPROPERTV WHO BUILDS OR IMPROVES THEREON,AND � NM1IOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE TORS LICENSE UWJ. � ❑I AM EXEMPT UNDER SEC. B.8 P.4 FOR THIS REASON � � � e�T,� �'l � � ¢ ►.� ��'_ DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION W � 1 HEREBV AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d D(COMMENCING WITH ECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X MV LICENSE IS IN FU FORCE EFFECT. Q9 ��/�/ J � LICENSE -O LIC.NO. � � / ' '�+ � � V DATE � ~ � CONTfiACTOR�� ' �1�y9Qf`�� d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLIOWING DECLARATIONS: Z 0 I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' a Z Q COMPENSATION,AS PROVIDED BV SECTION 37000F THE UBOR CODE,FOR THE PERFORMANCE �U Q / OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. � w L I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE.FOH THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORK `CAMPENSATION IN NCE CAR IER AND POLICV NUMBER ARE: CONSTRUCTION � CARRIER �� '�l PLAN REVIEW � Z POLICVNUMBER \ � ELECTRIC Q Q (IFiISSECi%XJNEmNO7BE�MFiEfEDOFTHEPEWMISFORONEFiIX�D ORLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE OF WHICH THIS PERMIT IS ISSUED,I MECHA ICAL � i U' SHALL NO7 EMPLOV ANV PERSON IN ANV ER SO AS TO BECOME SUBJECT TO THE � WORKE 'COMPENSATION LAWS OF FORNIA,AND AGREE THAT IF I SHOULD BECOM INSPECTION FEE � SU&IEC TO THE ORNERS'COM SATION PROVISIONS OF SECTION 3700 OF T OR � � SH/�F THWITM CO LY WITH THOSE PROVISIONS. U O DATE/- � / �D AP SMIP � J WARNING FAIIURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHAILBE ENERGY P/C � SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(S10u,00o),IN ADDI710N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN �J� � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNE�"S FEES. � ENTION E: �•'�V OCONSTFiUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBYAFFIRM UNDER PENALTV OF PERJURY THAT THERE IS ACONS7RUCTION LENDING AGENCV � FOR THE PERFORMANCE OFTHE WORK FOR WHICH 7HIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME ' F- LENDER'SADDRESS � R71FV THAT I HAVE READ THIS APPLICA710N AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES �W� /� w 1 AG E TO COMPLV WITH ALL CIT'AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � � CANS RUC710N,ANDHEREBYAU REPRESENTATI ESOFTHISCOUN7V70ENTERUPONTHE Z ABOV�MENTIONED PROPERTY F R INSP CTION PU POS�. COMMENTS � o � Q ►,� -E- �- J � �� I m � - � � N SIGNATURE`9 � MITTEE TE I — RECPT.NO. PAID BY VALIDATION I ~ WHITE—Department Copy,YELLOW�inanca Copy,PINK—Assessor Copy,GOLDENHOD—File Copy,GREEN—Applicant's Copy �B�V �� Vc��V�D��D ��R � 6�5�[��801� 6��8� �� a�p�c�400a ` oa4� oa�p�c��Q oa�p��ooa oa�� ' oa�pr��oa � SET BACK ' FLOOR JOIST FTGS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLO�R CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. 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/�RRIG. SEEP PIT/L.L. ON SITE IMPS. � GAS AIR TEST FINAL ZONING FINAL CONST. ^ FIRE DEPT. FINAL FINAL HEATING ,.,(, _a,� `� ��Z'`�l� HEALTH DEPT. FINAL ---- --- FINAL ELECTRIC v DEV. FEES PAID FINAL PLUMBING ENERGY • (�3��Q� COMMEfVTS —__ SEPTIC TANK SIZE SEEP PIT/U SIZE a � � - �