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Home My WebLink About10-1154 _. . . . 1 ... . . __ _ _ _. .. ... . . . - . -� . . . I . . .. . .. � . � _��_ 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 PAE$$ '�"' BUILDING PERMIT APPLICATION FIRMLY N JOBSITE q�� I' Q �n � n APPLICATION PERMIT�o��,/pJC o ADDRESS IX;J I I`l iJE�i/I �w'/' i�� DATE NUMBE �� I � `'� ISSUE �/�j/_� j/� TYPE �'�. „ � OCC APN 7v -�RI-Il�P� TRfACT DATE 10 /"V coNsr.��GROUP p OWNER GFJC":'.�fF�A�J�} tnC'�.��,r_LC-(� � ADDRESS ' ZONING SETBACKS Z CITY � �� ZIP�� TEL. - - FRONT q�/y p � APPLICANT r1�t�/L�L U'//k3e� TEL. ;S � REAR p � SIDE/SIDE STREET RW O z ¢ CONTRACTOR � nA 7 orv SIDE ❑ � ADDRESS cT � CITY w ZIP TEL.�,373'BrYS PROPOSED USE 7� /- o ARCH/ENG/ • z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS v� u� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADD/REM I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM EXEMPT FROM THE CANTRACTORS LI- G8f89BIC8fpOR W CENSE UW FOR THE FOLLOWING REASON(SEC.7031.5 BUSINESSAND PROFESSIONS CODE:ANV CI7V OR (n U CAUNTVWHICHREOUIRESAPEfiMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- � w TURE,PRIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck � STATEMENT 7HA7 HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CONTRACTORS LI� � � CENSE LAW(CHAPTER B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF TNE BUSINESS AND PRO- POOVSPB , � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEM7- (� V TION.ANYVIOLATIONOFSECTION7031.58VANVAPPLICANTFORAPEHMITSU&IECTSTHEAPPLICANTTO Z Re-Root � A CIVII PENALT/OF NO7 MOpE THAN FIVE HUNDRED DOLLARS(f500�.): Z ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � CORIrtIBfCl81 WILI DO THE WORN,AND THE STRUCTURE IS NOT INTEN�ED OR OFFERED FOR SALE(SEC.70u,BU51- J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NO7 APPLY TO AN OWNER OF � PROPER7V NTiO BUILDS OR IAIFROVES THEREON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPIOVEES,PROVIDED THAT SUCH IMPROVEMEN7S ARE NOT IN7ENDED OR m Q OfFEHEOFORSALE.IF,HOWEVER7NE8UILDINGORIMPROVEMEN7ISSOLDWI7HINONEVEAROFCOMPLE� Z TION,7HE OWNER-BUILDER WILL HAVE 7HE BURDEN OF PROVING THA7 HE OR SHE DID NOT BUIID OR = IMPROVE FOR THE PURPOSE OF SALE). w ❑�,ASOWNEROFTHEPROPEFTY,AME%CLUSIVELYCqNTRACTINGWI7HLICENSEDCONTRACTORS � TO CONS7RUCT THE PR0.1EC7(SEC.70�1,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V81118fi0f1 ADJ.AREA W CENSE lAW DOES NOT APPLY TO AN OVMER OF A PROPERN WHO BUILDS OR IMPROVES 7HEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY ESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q J� � U �/� c � DATE OWNER F I �Y' �/VCQC�l/I 0 W �Q LICENSED CONTRACTORS DECLARATION w 2 1 HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT 1 AM IICENSED UNDER PROVISIONS Of CHAPTER � � B(COMMENCINCa WITH SECTION 7000)Of DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� AIY IICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CLASSZ ^�.(J LIC.NO. T�I� � V DATE �I�JD "i�� CONTRACTOR � S I� a W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOILOWING DECURATIONS: Z Z _IHAVEANDWILLMAINTAINACERTIFICATEOFCqNSENTTOSELF-INSUREFORWORKERS' _ ¢ COMPENSA710N,AS PROVIDED BY SECTION 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE �U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w �HAVEAND WILI MAINTAIN WOFKERS'CAMPENSATION INSURANCE.AS REOUIRED BV SECTION n Q3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �, /� ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: ONSTRU J j CARRIER r �( LAN RE �IE I° ZPOLICV NUMBER �` S�1) � lV CT Q � (iHISSE(.TqNNE�NOTOECOMFlFfEDOFT}IEPERMfTISFORONEMII�DREODOLLAHS�5100)ORLESS� PLUMBING � Z I CER7IFVTHA7IN 7HE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (} SHALL NOT EMPLOY ANV PERSON IN ANV MANNER 50 AS TO BECAM BJECT TO THE Uj WORKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREET IFISHOULDBECOME INSPECTIONFEE = SU&IECTTOTHEWORKERS'COMPENSATION R VISIO F 37000FTHELABOR �/}�,�1 CADE SHALL ORTHWITH COMPLY Wlhl T � RO �SS ANCE� '"7 (J a � p DATE:�� APPLICANT. ` M ��-�� J WARNING:FAILURE TO SECURE WORKERS' MPENSATION COVER IS UNLAWFUL,AND SHALI BE ENERGY P/C ' � SUAIECT AN EMPLOYER TO CfiIMINAL PENALTIES AND CIVIL FINES UP 70 ONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(5700,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATfOFNEV'S FEES. NTIO � OCONSTRUCTION LENDING AGENCY P LT FEE: � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY t��/� � FOR THE PERf-0RMANCE OF THE WORK FOR WHICH TMIS PERMIT IS ISSUED(SEC.3097,CIV.C.). ia� rl ,//C� �.� Z W � LENDER'S NAME H LENDER'SADORE55 � TOTAL FEES � � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. � I ACaREE TO COMPLV WITN ALL CITY ANO COUNTY ORDINANCES AND STATE UWS REUTING TO BUILDING � � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE /�/ Z ABOVE-MEN710NED PROPERTV FOR INSPECTION 7URPOSES. COMMENTS �`�� J � m PERMITTEE NAME(PRINT) - � Q � � SIGNATURE OF PERMITTEE DA7E = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy I' CB�'1f �IF �GANVO�I� ��ff� � „� 91�SV�I��OCD� V�(�C06�� Oa�pGC�400a o �4C� Oa�pC�C�40Q Oa�3pGC�4DOa Qa41� Oa�pL�C�� SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE ' MID HT. B�ND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING j ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING i 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 /2_�6-�0 � DEV. FEES PAID FINAL PLUMBING ENERGY - i --- C�'1 �o � -- --- COMMEfVTS — SEPTIC TANK SIZE SEEP PIT/U SIZE a � c� :::� fl