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Home My WebLink About11-331 • CITY OF DIAMOND BAR ' �� ---"�"— DEPARTMENT OF'COMMUNITY&DEVELOPMENT SERVICES I • �,� . 21825 Copley Drive,Diamond Bar,CA 91765 I (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-70 PRESS �'"^'� BUILDING PERMIT APPLICATION � FIRIIALY } JOBSITE �� J APPLICATI PERMIT p/C �P(Z a ADDRES , -�t") � c`�7�G;�'C�.r' ��C� �i~• � ,� p � �� DATE I I� NUMBER I # I\� �?�\ i � ISSUE f TYPE ,�OCC APN LOT TRACT DATE / p OWNE�—� ��.E� CONST. �6ROUP o ADDRESS � C�' �L�V�. C (�' ZONING ETBACKS Z CITY '� �' �(YN ` IP TEL. FRONT RW ❑ o APPLICANT � TEL. SIDE/SIDE STREET RW p ¢ � CONTRACTO , � SIDE p o ADDRE, S =� � ,. � �'� � PROPOSED USE �' =�`►u F i�Z� � L�(.x ��' 'E' o CITY ZIP TEL. �L � �� , C � ` w ARCH/EN('.�( � �� ' � z DESIGNEFj�` � �' a ADDRESS �(ti+�_ NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARAT�ON SFR/ADD/REM O � I HEREBV AFFIfiM UNDER PENALTV OF PERJURV THAT I MA E%EMPT FROM THE CONTPACTORS LI- G3f8AB/C2fP01I W CENSEUWFORTHEFOLLOWINGREASON(SEC.7o37.5BU51NESSANDPROFESS10N5CODE:ANVCITYOq (n U COUNTYWHICHREOUIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUG � w TURE.PRIOR TO ITS ISSUANCE,AL50 RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � S7A7EMENT THAT HE OR SHE IS IICENSED PUFSUANT TO THE PROVISIONS OF 7HE CONTRACTOHS LI- CENSE LAW(CHAPTER e(CAMMENCING WITH SEC710N 7o0a)OF DIVISION 30F THE BUSINESSAND PRO- � ' POOUSpO � FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR THE ALIEGED El(EMP- (� V TION,ANV VIOLATION OF SECTION 7031.5 BY ANV APPLICAN7 FOR A PERMIT SU&lECTS 7HE APPLICANT TO Z Re-Roof � A CIVII PENALTY OF NO7 MORE THAN FIVE HUNDRED DOLURS(S5ao).): Z ❑I,ASOWNEROFTHEPROPER7V,ORMYEMPLOYEESWITHWAGESAS7HEIRSOLECAMPENSA710N, � COrtIRIBfCiel 'WILL DO THE WORK,AND THE STRUCTURE IS NOT IN7ENDED OR OFFERED FOR SALE(SEC.7oII,BU51� J � NESS AND PROFESSIONS CADE:THE CANTRACTORS IICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPEHTV NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR CC 7HROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMEN7SARENOTIN7ENDEDOR m � Q OFFEREDFORSALE.IF,HOWEVERTHEBUILDINGORIMPROVEMEN71550LDWITHINONEYEAROFCOMPLE- . Z TION,THE OWNEF-BUILDER WILL HAVE 7HE BUiiDEN OF PROVING THAT HE OR SHE DID NOT BUIID OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPEHTV,AMEXCWSNELYCONTMCTINGWITHLICENSEDCONTRACTOPS r� i � TO CANSTRUCT THE PROJEC7(SEC.7ota,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS LI- V21112�i0f1 L'` � ADJ.AREA W CENSEIAWDOESNOTAPPLYTOANOWNEROFAPROPER7VWHOBUILDSORIMPROVE57HEREON,AND � I, � NM1iOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- OUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDEfi SEC. B.8 P.C.FOR THIS REASON Q U � U � � � DATE OWNER F- O W �''`� _ ' � LICENSED CONTRACTORS DECLARATION w �p�.a O • � I HEREBY AFFIRM UNDER PENALTY OF PERJUFV 7HAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d e�COMMENCING WITH SECTION 7000)OF DIVISION 9 0f THE BUSINESS AND PROFESSIONS CODE,AND Z X MV LICENSE IS IN FULL FOFCE AND EFPEC7. � S(� �i � `J(L ICENSE CLASS � LIC.NO. �� , m � w /DATE ��Z'r"�"� J CONTAACTOH ".L ' d w� C�� WORKERS'COMPENSATION CLA ION Q Dvc-E wo�/�C N.e.- � I HEREBY AFFIRM UNDER 7ENALTV OF PERJURV ONE OFTHE FOLLOWING DECURA710N5: Z "'t • �` Q rW J Z _I HAVE AND WILI MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ � Q COMPENSATION,AS FROVIOED BY SEC710N 370o OF 7HE IABOR CODE,FOR THE PERFORMANCE W Q OF THE WORN FOH WHICH THIS PERMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION � Q 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS �,�,�y ' ISSUED.MV WORKERS' MP NSATION INS ANCE CAR IER AND POUCY NUMBER ARE: CONSTRUCTION ..,�'T]�� j CARRIER � ' -� �� • PLAN REVIEW � • T z � POLICVNUMBER �'�� ELECTRIC � Q � (IFiLSSECiK)NNEmNOTBECOMR.EfEDOFTHEPERMITISPoRONEMNDREDDOUARS(f100)ORLESS} PLUMBING rI Z I CERTIFV THAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PEAMIT IS ISSUED,I MECHANICAL /��l r 3 C7 SHALL NOT EMP�OV ANV PERSON IN ANV MANNER SO AS 70 BECOME SUBJECT TO THE Uj WORNERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � il = SUBJECT TO THE WORI(ERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR � •� - CADE,�SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. �SSUANCE � SMIP �` �� p DATE: APPLICANT. J WARNING:FAIIURETOSECURE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHAIL BE ENERGY P/C � SU&IECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT � DOLLARS(5700,000),IN ADDITION TO THE COS70F COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION37080FTHELABORCODE,INTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: � CONSTRUCTION LENDING AGENCY PR ALT FEE: • O 1 HEREBV AFFIRM UNOER PENALN OF PERJURV THA7 7HERE IS A CONSTRUCTION LENDING AGENCV � ,�,l:7 � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30D7,CIV.C.). -' � Z W � LENOE(1'S NAME F— LENDER'SADDRESS � TOTAL FEES a►q� -�� f, �o�. � I CERTIFV THAT I HAVE READ TNIS APPLICATION AND STATE THAT THE ABOVE MFORMATION IS CORRECT. w 1 AGFEE TO COMPLY WITH ALL CI7V AND COUN7Y ORDINANCES AND STATE UWS REIATING TO BUILDING d � CANSTRUCTION,A EREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE ` Z ABOVE�MENTIO PROP RTY FOR INSPECTION PURP ��s. COMMENTS - � � �it.%2�ir ��%4'YY,��fU m MITTEE NAME(P T) � I ¢ �� i'�ZL�� lC �7B ✓ _�$� � SIGNATU DATE ' I = RECPT.NO. PAID BY VALIDATION ~ WHITE—De aAment Co YELLOW—Finance Co PINK—Assessor Co GOLDEN OD—File Co GREEN— P PY, PX PY, PY. ApPlicant's CoPY , CBTV OI� �O��li�d�� ff� . � _. � _�.. • I�S�IEC�00�9 IRI�CO�D. � • ;;5:..,Qr��p��400a o,:��r. � ��i�� ,.�,�: oa��a o � o .�.�_,oa�� . �t�r��c�4oa_: SET BACK • FLOOR JOIST � FTGS/FORMSlSTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOFi DUCT � GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BONO BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING � g�l�� 8 FT. BOND BEAM _ FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER �_��jZ/ � PRE-GRADING � ROUGH HEATING � BENCHING ROUGH ELECTRIC �`r ROUGH GRADING ROUGH PLUMBING �`' FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION �� , OFF SITE IMPS. ________ _ DRYWALL NAILING IQ� -�2 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 � t�` DEV. FEES PAID _ FINAL PLUMBING �. �'f)�� ,�I, ENERGY � (��o � COMMEfVT� t-'-�-(� "i-��t2.( _�-� �l��C-�� . �_ cs_.� �iU 4_��3� , Y SEPTIC TANK SIZE - SEEP PIT/U SIZE a ;a � .,� Q � .