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Home My WebLink About11-540 ��_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS '��" BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE �� m b�� DATE CAT� NUMBER `�7� #/C ADDRESS � ISSUE TYPE OCC APN—�r� LOT TRACT DATE CONST.�e�F GROUP p OWNER �[�! �O� " ADDRESS cS'l�-✓�`-�- ZONING SETBACKS � FRONT Ryy p Z CITY ZIP TE�=`�� o APPUCANT, CL.+4FTQ�— TE ( SIDE/SIDE STREET RW ❑ z � CONTRACTOR iQ DF� C�� SIDE ❑ ADDRESS ` �a0 c�crs. o .Bcj�, wooc sh�h le � CITY n ' ZIP T .� 'n PROPOSED USE�ea'� � n VL� w ARCH/ENG/ fj'r�Q�/3� t� �� z DESIGNER ' _ w NO.DWEL. NO. � NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS cn cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDEF DECLARATION SFR/ADD/REM O p I HEREBY AFFIRM UNDER PENALN OF PEfiIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G8f090IC8fPOft W CENSE UW FOR THE FOLLOWING REASON(SEC.7o37.5 BUSINESS AND PROFESSIONS CADE:ANY CITV OR (n U COUNTyWHICHRE�UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- � w NRE,PRIOR TO ITS ISSUANCE.ALSO REOUIRES 7HE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT TiAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CAN7RAC70RS LI- � � CENSE LAW(CHAPTER B(CAMMENCING WI7H SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSpB , 0 FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� (� py V TION.ANVVIOLATIONOFSEC710N703t.58VANVAPPLICANTFORAPERMITSU&IECTS7HEAPPLICANTTO Z Re-Roof 2�OL/ �l A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(SSoo).): �� Z ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � Commercial � �� ' WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENOED OR OFFERED FOR SAIE(SEC.70a�,BUSI� J � NESS AND PROFESSIONS CADE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNEP OF ? PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HEHSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED Oq m Q OFFEREDFORSALEIF,HOWEVER,hiEBUILDINGORIMPROVElAEN71SSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNEH-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SA�E). w ❑I,AS OWNER OF THE PROPERTV,AM E%CLUSIVELY CON7RACTING WITH LICENSED CON7RACTORS � TO CANSTRUCT THE PROJEC7(SEC.70a/,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- ValUe110f1 ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN ONTJER OF A PROPER7Y WHO BUILDS OR IMPROVES 7HEREON,AND � WHOCONTMCTSFORSUCHPR0.1EC75WITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y TORS IICENSE UW.). QO I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ?� U � � DATE OWNER f- � w � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRM UNDER PENALTY OF PERIURY THA71 AM LICENSEO UNDER PROVISIONS OF CHAPTER � � � B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CODE,AND Z X MV LICENSE IS IN FULI FORCE AND EFFEC7. �` � LICENSE ClA S ��7 � UC.NO.v� � � V DATE G�D CONTRACTO d W � WOfiKERS'COMPENSATION DE LARATION Q � '•I HERE FFIRM UNDER PENALIY OF VERJURV ONE OF THE FOLLOWING DE RA710N5: Z ZI HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ Q COMPENSATION,AS PROVIDED BY SECTION 37000F THE LABOR CODE,FOR THE PERFOFiMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w I HAVE AND WILL MAIN7AIN WORKERS'CAMPENSATION INSURANCE.AS REOUIRED BV SECTION Q 370o Of THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS /, /�/^ ISSIJED.MY WORKERS'CA,�.IPENSATION�NS�RANC CARRIER AND POLICY NUMBERARE: CONSTRUCTION ��O c� J j CARRIER S'YLJ�'�-- T�- PLAN REVIEW ZPOLICV NUMBER �Z ^Z�IZ_� ELECTFIC Q 0 (iHISSECTqNNE�NOTBENA1R.FfEDOFiF�PEPMfTISFORONEHUPDREDDOLLARS(5100)ORLESS� PLUMBING � Z �CER7IFY 7HA7 IN 7HE PERFORMANCE OF THE WORK FOR WHICH TNIS PERMIT IS ISSUED.I MECHANICAL �} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE Uj WORKERS'COMPENSATION UWS OF CALIFORNIA, GREE THAT IF I SNOULD BECOME INSPECTION FEE � SUBJEC7 70 THE WOqKERS'CAMPENSATION P NS OF SECTION 370o OF HE B '— /'� (/ CAD,I SH LL FORTHWITH COMPLV WITH � ROVI510 6. ISSUANCE � // J�y�� p DATEJ S �a�IAPPLICAN. SMIP ..�J / J WARNING:FAILURETOSECUREWORKERS'COMPE IONCOVERAGE NLAWFUL,ANDSHALLBE ENERGYP/C � SUBJECT AN EMPLOYEF TO CRIMINAL PENALTIE ND CIVIL FINES UP ONE HUNDRED THOUSAND ENERGY PERMIT DOLURS(f100.000),IN ADDITION TO THE COS F COMPENSATIO , MAGES AS PROVIDED FOR IN y� � SECTION 3708 OF THE LABOR CODE,MTEREST,AND ATTORNEV' Es. RETENTION FEE: ��Gl � OCONSTRUCTION LENDING AGENCY PR�ALT F_ EE:_ � � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV Jj j jj`� / FOR THE PERF-0RMANCE OF THE WORN FOR WHICH 7HI5 FERMI7IS ISSUED(SEC.3097,CIV.C.�. Y-• Z W � LENDER'S NAME F— LENDER'SADDRESS � TOTAL FEES ��D.2�fo � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE MFORMATION IS CORRECT. w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDINC d � CANSTRUCTION,AND HEREBY AUTHORI2E REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE�MENTIONED 7ROPERTY FOR INSPECTION PURPOSES. COMMENTS � �� m PER NAME(PRINT) - � a � �1� � IGN REOFPERMITTE TE = RECPT.N0. PAID BY Q VALIDATION ~ WHITE—DepaAment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOIDENROD—File Copy,GREEN—Applicant's Copy CB�Y O� D6��Il��BD ��ff� 9�Sf�[�C�U�� (�I�C�R� oa�p��400a o�4� oa�p�c��a oa�p�c�4aoa aa4� oa�p��4oa SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT ' GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWEH 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. LATHlSIDING 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 __ t ---------- ------- - ---- ----- ------. -------- �� " �rh COMMEiVTS -!�c:�r ��;�,��:�< ��, ��:�� , S � `�a�—�� SEPTIC TANK SIZE SEEP PIT/U SIZE a -- - ---------- --- -- - c� � ---- ---------------- ---------- �