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Home My WebLink About12-1037 �� CITY OF DIAMOND BAR � � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS '°^'. BUILDING PERMIT APPLICATION FIR QJOBSITE /LLL1/b �j� I ef� �� DATECATION Q � Z NUMB RIZ la3' #�C rZ, /'Q-�/ Q ADDRESS �� O ( �, � � APN LO TRACT D TEE D NPE p OWNER �Q�O C'� � � CONST. GROUP o ADDR /�O Q►'� 'Q..I C ZONING FRONTCKS RW ❑ z CITY � a'►— ZtP 9/74,S TEL. ' � � APPUCANT TEL � REAR p I Z SIDE/SIDE STREET RW ❑ ¢ CONTRACTOR S5A! v SIDE p � CITY II�IGE FU t%ESt Z�p�2I�'ZD TEL PROPOSED USE Z� �� 1�'''4�S 3 zy � o ARCH/ENG/ � �� z DESIGNER a ADDRESS '.i NO.DWEL. NO. NO. cn UNITS STORIES BEDROOMS � CITY CvP�� ZIP_� TEL. v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFqlADD/REM O p I HEREBV AFFlRM UNDER PEN/�LiV OF PERIURV THAT 1 AM E%EMPT FROM TME CONTRACTDRS LM Garaga/Carport W CENSEUWFORTHEFOILOWINGREASON(SEC.7031.5BUSINESSANDPROFESSIONSCADE:NJYCITYOR , (n �. U COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOl15H;ORREPAIRANYSTRUG � � � i w TURE,PRIOR TO RS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W� Patio/Deck � � STA7EMENT THAT HE OR SHE IS LICENSED PURSUANT TO TiE PROVISIONS�OF THE CAMMCTORS U- � � � CENSE UW(piAPTER B(COMMENCING WITH SECTION 7D00)OF DIVISION 3 OF THE BUSINESS AND PRO PooUSpa , 0 FESSIONSCOD�ORTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (' _ V TION.ANV.VIOLATIONOFSECTION7037.SBYANYAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z RaRoof � A CIVIL VENAL7Y OF NOT MORE THANFIVE HUNDRED DOLURS(f5oD)J: 0 ❑I,ASOWNEROFTHEPR07ER7Y,ORMYEMPLOVEESWITHIVAGESASTHEIRSOIECOMPENSATION, � Commercial �- Z WILL DO THE WORK�ND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.�oW,BUSI- J � � � NE55 AND PROFESSIONS CODE:THE CONTRAC70RS LICENSE LAW DOES NOT A7PLY 70 AH OWNER OF � � PROPEHTY NM1iO BUILDS OR IMPROVES 7HEREON,PND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGH HIS OR HER OWN EMPLOYEES,VROVIDED 7HAT SUqi IMPROVEMENTSARE NOT INTENDED OR m � 0 OfFEREDFORSALEIF,HOWEVERTMEBUILDINGORIM7ROVEMENTISSOLDWfTHINONEVEAROFCOMPLE Z TION,THE ONMER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUIID OR � � IMPROVE FOR THE PURP0.5E OF SALE). � w O�ASONMEROFhIEPROPEHTY,AAIE%CLUSNELYCANTRAC7WOWfTHIICENSEDCONTRACTORS � TO CONSTRUCT THE PRQIECT(SEC.7os1,BUSINESS AND PROFESSIONS CODE:THE CANTMCTORS LI- V81U8fIOf1 ADJ.AREA� W CENSE UW DOES NOTAPVIV 70AN OWNER OFA PROPERTV WHO BUILDS OR IMPROVES 7HEREON,AND � � � � �� WHOCAMRACTSFORSUCHPR0.IECTSWITiACONTMCTOR�S)LICENSEDPUR&UANTTOTMECONT{UG pUANTITY DESCRIPTION FEE . �' roas uceNSE uw.�. Q ❑�AN EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON Q I � U � ¢ DATE ONMER F� � w � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTY OF PERIURV 7HAT I AMlICENSED UNDER PROVISIONS OF CHAP7ER � � � � � Y(COMMENCINO�WITH SECTION 7000)Of DIVISION 30F THE BUSINESS AND PROFESSIONS CODE,AND Z X�, AIY LICENSE IS IN FULL FORCEy�D EFFECT. m LLJ L,}'�/`� � UCENSE�.A s �� v LIC.NO. � � �- � . �� . U DATE kr � wrrrnncroa a� a �� . . . . . w � WORKERS'COMPENSATION DECLARATION Q � 1 HEREBV AFFIRM UNDEH VENAL7Y OF PERJURY ONE OF THE WLLOWING��ECLAMTqNS: Z � � � _I HAVE AND WILL MAIN7AIN A CERTIFICATE OF CANSENT TO SELF•INSURE FOR WORKERS' _ . - Q COMPENSATION,AS PROVIDED BV SEC710N 3700 OF THE UBOH CODE,FOR THE PERFORMANLE W� Q OF THE WORK FOR NM1iIGi THIS PERMIT IS ISSUED. � � � ' w v 1 HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSUMNCE,AS REQUIRED BY SECTION � � / � Q 370o OF�THE IABOR CODE,FOR THE PERi'ORAWJCE�OF THE WORK FOR WHldf THIS PERMIT IS '`' f ISSUED.MY WQfHOqRS'�C.O.MPENS�ON iNSUi�WC,�CMRIER ANp POLICY NUMBER ME: CONSTRUCTION� � �f ��, V j CARRIER J"`-v� N0.�1o..eM PLAN REVIEW - - - - ' . � POLICY NUMBER S W C. �i�R- _ ELECTRIC � (iHi55EC1qNNE�NOTBE00APlEfmOF7T¢PEAMTBFORONEMR�DREDOOUJd4S�f100)ORLESS) PLUMBING � Z �CEHTIFY THAT IN THE PERFORMANCE OF THE WOH7C fOR WHICH TH�S PERMIT IS ISSUE0,1 �MECHANICAL� (�} SHALL NOT EMPLOY ANV PERSON IN ANY MlJJNER SO AS TO BECOME SU&IECT 70 THE � � WORNERS'COAIPENSATION UWS OF CaLIFORNIA,AND AGREE THA7 IF I SHOULD BECAME �NSPECTION FEE ? SUBJECT TO THE WORKERS'COM7ENSATION PROVISIONS OF SECTION 3700 OF THE LABOR � -�-� ' � C.O�E,I SHML fOHfHWITH COMPLY WI7H THOSE PROVISIONS. �SSUANCE � . � �SMIP ,�. ��_ � p DATE: APPLICANi:� J WARNINa:FAILURE TO SECURE WORKERS'COMPENSATbN CAVEMGE IS UNUWFUL,AND.SHALL BE ENERGY�P/C � SU&IECTANEMPLOYERTOCRIMINALPENALTIESAN�CIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(i100.000),IN PDDI710N TO7HE COS70F CAMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 37oe OF 7HE LABOR CODE,IN7EREST.AND ATTORNEY'S FEES. � p� RETEhfTION FEE: OCONSTRUCTION LENDING AGENGY pp�T p� � � I HEREBY AFFIRM UNDER PENALTY OF PERIURY THA7 THERE IS ACONSTRUCTION LENDINO AGENCY � ��1. n- FOR TME PERFORMANCE OF THE WORK FOR N?iICH THIS PERMIT IS ISSUED(SEC.30Y7,C�V.C.). '•� �; v Z W �� LENDER'SNAME F— LENDER'SADDRESS � W ICERTIFYTHATIHAVEREADTHISMPIICATIONAtJDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES �jj�' � I AUREE TO COMPLY WITH ALL CITV ANO COUNTV�ORDINANCES AND STA7E LAWS REUTING TO BUILDINO � ION,AND HEREBV AUTHORIZE REPRESENTATNES Of THIS COUNTV 70 ENTER UPON THE � Z ABOVE-ME bNEDPROP RTYFORINSPECTIONPURPOSES. �COMMENTS � _ � l��J� m `� a ' 8 /� vZ�- � � � SI TURE OF PERMtTTE DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Deparlment Copy,YELLOW--Finarae Copy,PINK—Ascessor Copy,GOIDENROD—Fite Copy,GR N— pllcanCs Copy ciTv oF �ia�no�o B�R i�s�ECTion� R�coR� Y F ,. �_ � ..,. � � , r� .. � _ � , y , �. . . _� - . � � �� ._ � a � .; � � „� o� m �" ' 0 �.. .::�� : ° � �� • ��-` D � �� 0 �, � _,�_,r. �„m . .. ;� � _ �-. . - � � , �. � , ,:� SET B��K FLOOR JOIST FTGSlFORMS/STEEL FHA REQMTS ___.._ ._.____._____..__ _...._.___ ._._.__ _.... _.__ _..._.__ _ ._..----- —._._..— --- __-- ------__ _.__._.._._. _.__._ _______ _._.____. _._._.._ ___._.._ _ . ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE tv11D HT.BOND BEAM HOOF SHEATHING 8 FT.BOND BEAM FRAMING/VENTILATION �FINAL BOND BEAM ROOF COVER PRE-GRADING --------------------- -------------- �-------__.__..--------- ----- —--------------------..__...- ROUGH HEATING BENCHINC ---------------------------------- ------------------._._ ,__------------------------.._.__._._...__._..------.._.._.--------------- ROUGH ELECTRIC i ROUGH GRADING ROUGH PLUMBING 'FINISH GRADING SHQWER/TUBTEST PQOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION i POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. ----------------..-------------------- ------------------------- -------------____.....----_...-------...---.....----.---.- ----...-----...------..---------- 5EPTICTANK LANDSCAPE/IRRIG. ---- — --- — — ---------- ;-- --.___.__.....----------------- --...------------------------ SEEP PIT/L.L. ON SITE IMPS. GAS AIRTEST FINAL ZONING FINAL CQNST. FIRE DEPT.FINAL FINAL HEATING �, -- i HEALTH DEPT.FINAL FINAL ELECTRIC `QEV.FEES PAID FINAL PLUMBING � � ENERGY FINAL PLANING ----- ' -- —- ---- --- FINAL ENGINEERING ' 8 9 COMMENTS /lN�c� _�i�� _ ��- �. �— 3 --�Z-�� ` ----- --- -- � � SEPTICTANKSIZE SEEPPITIU SIZE -------..__..._.....__.__..._....---_.__.—..—_._.._.—______—...__._.....—_.._...----.___....._—._._.__..—....---------- r- ---- - -- � ��' .� � _ 5 _ _ �� - �,�,�r 51 ��. ;;. g,,:r x.�� g 't"�+ � ��. �'� i�, ��,s�a,y,.��' — -- -- -' ---- -- i: ' �" - u#�r + .. ��a= .� Y�.vyf � ... . ..�. _' . ..'i __ _ -