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Home My WebLink About17513 CTTY OF DIAMOND BAR :. �x� ��I �---��`--- DEPARTIv�NT OF COMMUNTII'&DEVELOPMENT SERVICES 21825 E.Copley Drive ' (909)8603195 Fax(909)861-3117 PRESS ""%�� BUILDING PERMIT APPLICATION FIRMLY JOBSITE I I � �+ 1 �� O�- � ¢ ADDRESS �G�DD �ir/:; /1�E%/,(/L) APPLICATION � ,, PERMIT P/C . o DATE NUMBER # � ISSUE TYpE pCC APN LOT TRACT DATE CONST. GROUP p OWNER _��\i'l4�4U'C��fCvl p ADDRESS i � �!�' .D i" ZONING SETBACKS oCITY � I ZIP C�A TEL.4a��.�,� FRONT RW ❑ � APPLICANT pW'r1�� I��'U� TEL. � REAR ❑ SIDE/SIDE STREET RW ❑ � CONTRACTOR � SIDE p � ADDRESS I � CITY ��f/I ZIP TEL. PROPOSED USE 0 w ARCH/ENG/ z DESIGNER d � a ADDRESS NO.DWEL. O. NO. cn UNITS STORIES BEDROOMS I � CITY ZIP TEL. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I MA E%EMPT FROM THE CONiRACTORS LI� GefegB/CflfPOft W CENSELAWFORTHEFOLLOWINOREASON(SEC.7o31.5BUSINESSANDPROFES510N5CODE:ANVCITYOR (fj U COUNTYWFiICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPqOVE,DEMOLISH,ORREPAIR/�NYSTRUG LQU w TURE,PRqR TO ITS ISSUANCE,AL50 REOUIRES TNE APPLICANT FOR SUCH PERMIT TO FILE A SI6NED w Patlo/Deck � STATEMENT h1AT HE Ofi SHE'IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 7o0a)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSPB 0 FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISGORTHEALLEGE�E%EMP- (� V TION.M/VVIOLATIONOFSECTION7031.SBYANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CML PENALTV OF NOT MOFE TFiAM FIVE HUNDRED DOLLARS(f5oo).): � ❑I,ASONMEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECAMPENSATION, ❑ COfillflBfC101 Z WILL DO THE WORK N��TME STRUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7014,BU51- J � NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV N?10 BUILDS OR IMPROVES THEREON.AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w THRIXIOH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREDFORSALEIFHOWEVER71iEBUILDINOORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE� Z TION,THE OWNER-BUILAER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVEFORTMEPURPOSEOFSALE). w ❑I,ASOWNEROFTHEPROPERTY,AMEX0.USIVELYCONTRACTINOWITHLICENSEDCONTRACTORS � TO CONSTRUCT THE PR0.IECT(SEC.7oN,BUSINE55 AND PROFESSIONS CODE:iHE CONTRACTORS LI- V9Il10fI0l1 ADJ.AREA W CENSELAWDOESNOTAPPIVTOANOWNEROFAPROPERTVWFIOBUILD50RIMPROVESTHEREON,AND � WFiOCOMRACTSFORSUCH7R0.1ECT5WITHACONTMCTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCAIPTION FEE � Y TORS LICENSE LAW.�. � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR REASON Q � � U LL DATE OWNER � �� %_ H ' • Z - U �Q LICENSED CONTRACTORS DECLAAATION w 2 I HEREBV AFFIRM UNDER PENPLTV OF PERJUflV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � � V(CAMMENCINO WfTH SECTKKJ 7000)OF DIVISION 30FTHE BUSINESS AND PROFESSIONS CODE,AND Z �� MV LICENSE IS IN NLL FO` AND EFFECT. �!" m � UCENSE CLASS � LIC.NO. ��' / ZI� � U DATE CONTRACTOR� � C�iY'l�](� d W � WORKERS'COMPENSATION DECLARATION Q U � I HEREBV AFFIRM UNDER PENALTV OF PERIURY ONE OF THE FOLLOWINO DECLARATKKJS: Z � _IHAVEANOWILLMNINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORNERS' a 2 Q COMPENSATION,AS PROVIDED BV SECTION 37Do OF TME LABOR CODE,FOR 7HE PERFORMANCE U OF 7HE WOHI(FOR WHICN THIS PERMIT IS ISSUED. W � 0 � Qw _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATKKJ INSURANCE,AS REOUIRED BV SECTION / 3�00 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICN THIS PERMIT IS �\ (l� ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIEi7 AND POLICV NUMBER ARE: CONSTRUCTION .�' _/ J V J '�.--, j CAARIER PLAN REVIEW ��i1II � POLICV NUMBER - Z¢ ELECTRIC,�---- .---^-.-r:..'- � (IWSSECI%JNNE�NOTBECONPLEfEDOFTHEPEAAYTISFORONEMII�DREDD0U1�A5(S1ao)OqLESS} PLUM 18NG��i�^1 _� �j � .�c ► � � w I` Z I CERTIFY 7HAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL _ U SHALL NOT EMPLOY ANV PEFSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE I n r/� � � ` � � WORNERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION�EE�l. SU&IECT TO THE N/ORKERS'COMPENSATION PROVISIONS OF SECTION 3]00 OF THE LABOR I � S COOE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � f��: �� p DATE: APPLICANE SMIP W : ENERGV-P/G--'—'——"'�-- - J WARNING FAfLURE TO SECURE WORKERS'COMPENSATKKJ CAVERAGE IS UNLAWFUL,AND SHALL BE J �y SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDiI-IOUSAND ENERGYPERMIT DOIURS(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 37oB OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. OC RETENTION FEE: w O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFlRM UNDER PENALTY OF PERIURV THAT THERE IS ACONSTRUCTION LENDING AGENCV FORTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.CJ. Z W � LENDER'S NAME ' H LENDERSADDRE55 � w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CORRECT. TOTAL FE ES ��P��I� � I AGREE TO COMPLV WITH ALl CITY AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILOINO ^ ``� I ��I� CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF THIS CAUNTV TO ENTER UPON THE `f`1 '� ZABOVE-MENTIONED PROPEFTV FOR INSPECTION PURPOSES. JV , � COMMENTS J �1►'Q / � m PERMITTEE NAM�(pRINn Q � � SIG A FiE F PERM EE ' t' DATE _� � RECPT.NO. PAID BY VALIDATION � WHITE—Depariment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy C�O1T'� (�(� fCD�@ G�li�I�Q� (��lF� �f�'�f�f�(��"9�f�1 f�$[��ff$@� OL`� ° �c o DQ� � o � 0 ° �� o �� D ' �cfo � . SET BACK FLOOR JOIST FTGS/FURMS/STEE� -- ---f- _�-_ I FHA REQMTS - - ELECTRIC GROUND UNDER FLOOR DUCT � GROUtVD PLUMBING URIDER FLOOR CUt�IDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOtVD BEAM ROOF SHEATH(NG j 8 FT. BOND BEANI --� �, FRAMfNGNENTfLIATION �L.2�� FINAL BOND BEAM ROOF COVER � PRE-GRADING � ROUGH HEATlfdG BENCHING R�UGH ELECTRIC ROUGH GRADING ROUGH PLUNIBING FINISH GRADING SHOWERITUB TEST , POOL ELECTRIC EXT. LATH/SIDlNG�, POOL FENCING WALL INSULATION �jr�pZ � ! OOL FINAL � � CEILING INBULATION OFF SITE IMPS. DRYWALI NAILING DEDICATIONS i SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/1RRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST F1NAL ZONING �1NAL CONST. ; - FIRE DEPT. FINA� � � FINAL HEATING I HEALTH DEPT. FINAL � FiNAL ELEC7RIC � DEV. FEES PAID � FINAL PLUMBING ENERGY �� o GUMf�IEi�TS SEPTIC TAfVK SIZE SEEP PIT/U SIZE � , ° ____ � [� , .�, —