The URL can be used to link to this page

Home My WebLink About11-778 ��_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 �._¢ I (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PIRESS �'""' BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE Q�s e�� ' �� APPLICATION PERMIT /'] /C ADDRESS �� ✓" r 'p_�]YO DATE NUMBER � / # °-° APN LOT TRACT �SSUE ,�^� /! •/ TYPE OCC 1 DATE �� /� CONST. R�f GROUP p OWNER �7�.1'i�v�h L _5��r�C� 0 ADDRESS ZONING SETBACKS Z CITY ZIP TEL. O - FRONT Ryy p ' o APPLICANT w TEL. 'Z REAR ❑ Z SIDE/SIDE STREET RW ❑ ¢ CONTRACTOR U SIDE ❑ ADDRESS � "`r � crrv M�5�5� �"�� Z�P�1`�� TEL. PROPOSED USE , �fi tiC�5� , �` w ARCH/ENG/ j 2'� ' z DESIGNER fi��'�_ w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STOFiIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIFiM UNDER PENALiY OF PERIUFY THAT I AM EXEMPT FPOM 7HE CONTRACTORS LI- G8fe9B/C2fPOfI W CENSEUWFORTHEFOLLOWINGREASON(SEC.7o37.5BUSINESSANDPROFESSIONSCADE:ANVCITYOR (f� U CAUNTYWHICHREQUIRESAPEfiMIT7000NSTRUCT,ALTER,IMPROVE,DEMOLISH,OfiREPAIRANY57RUC- w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTOfiS LI- � � CENSE LAW(CHAPTER B(CAMMENCING WI7H SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSp3 Q FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFOR7HEALLEGEDEXEMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICAN7 TO Z Re-Roof F, A CIVIL PENALTV OF NOT MOfiE THAN FIVE HUNDRED DOLLARS(SSoo).): Z ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COfI1mBfCi31 WIIL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70�/,BUSI� J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR I CC THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMEN7S ARE NOT MTENDED OR m 0 OFFEREDFORSALEIF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,7HE OWNER-BUIL�ER WILL HAVE 7HE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR , = IMPROVE FOR THE PURPOSE OF SALE). I ❑I,AS OWNER OF 7HE PROPERTV,AM ERCLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS � � TO CONSTRUCT THE PRQIECT(SEC.7o�a,BUSINESS AND PROFESSIONS CADE:THE CANTRACTORS LI- V81U3I1Of1��I.�'7�(�L7 C> ADJ.AREA � W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERNWHOBUILDSORIMPROVESTHEREON,AND � � HMOCANTRACTSFORSUCHPROJEC75WI7HACONTMCTOR(S)LICENSEDPURSUANTTOTHECONTRAC- OUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � U � � DATE OWNER H � W � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTY OF PERJURV 7HA71 AM LICENSED UNDER PROVISIONS OF CHAPTER � d e(COMMENCING WITH SECTION 7000)Of DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND z X 4Y LICENSE IS IN FULL FORCE AND EFFECT. �q � LICENSE C[fASS ( `^—.J—l LIC.NO. �✓�� U DATE 67��O� • ` CONTRACTOR Y=U d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDEF PENALTV OF PERJUFV ONE OFTHE FOLLOWING DECLARATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIfICATE OF CONSEN7 70 SELF-INSURE FOR WORKERS' _ ¢ CAMPENSATION,AS PROVIDED BY SECTION 37000FTHE LABOR CODE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � � w �I HAVEAND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS FEOUIRED BV SECTION Q s7oo OF 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMI715 /�Q ISSUED.MY WORKER 'CO ENSATION INSUR CE CARRIER AND POLICY NUMBERARE: CONSTRUCTION 1G� ¢ ��,"�,��' � CARRIER F PLAN REVIEW Z POLICV NUMBER;� �� ELECTRIC Q � (iHISSECTK7NNEmNOTBECOMREfEDOFhiEPERMfTISFORONEHUPDREDDp1ARS(5100)ORLESS). PLUMBING Z I CER7IFY THAT IN 7HE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL (� SHALL NOT EMPLOYANV PERSON IN ANV MANNER SOAS TO BECOME SUBJECTTO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&JECT TO THE WOqKERS'CAMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR CODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE �� SMIP p OATE: APPLICANT: J WARNING:FAILURE TO SECUflE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJEC7AN EMP�OYER TO CRIMINAL PENALTIESAND CIVIL FINES UP 700NE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(5100,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,WTEREST,AND ATTORNEV'S FEES. RETENTION FEE: �� OCONSTRUCTION LENDING AGENCY PRE-AL FEE:y^/ � I HEREBYAFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AGENCY g�/�-�� CJ� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). . Z W � LENDER'S NNAE F— LENDER'SADDRESS .r� w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL F E ES �� • '�� I AGREE TO COMPLV WITH ALL CITY AND CAUNTY ORDINANCES ANO STATE LAWS FELATING TO BUILDING � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESEN7A71VE5 OF THIS COUN7V 70 EN7ER UPON THE � Z ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS � � �� U � m PERM NAME(PRIN � ,/ - � �r�— D � S ERMI77EE DA7E , = RECPT.N0. PAID BY VALIDATION ~ WHITE—De aRment Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN— p py. py, py, py, ApplicanPs Copy CETV �� DAI�� 4F$ I�ISI��'006� O��CO�iD ��lJ U oOW M�� s }.�:, �� '��Y��4 s �.��• �Y D � s • . SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REG�MTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR 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/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 _ ,� ' �1�� ; r�; COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE :�� . a �.�� u, ,'r` -�� :c.+ �: .3 . �u'�'yg�,-, . . � F,?;• �J• .F?