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Home My WebLink About11-1121 � . _ _ .� �� CITY OF DIAMOND BAR �� ,,, DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �,�,�;�''��.U�' 21825 Copley Drive,Diamond Bar,CA 91765 ___ � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 - - PRESS „y'" "°"'+ BUILDING PERMIT APPLICATION ""'"� �,�� FIRMLY JOBSITE ; �/��/- �/� p/C � $ APPLICATION PERMIT � ADDRESS� O� DATE NUMBER # ' � APN LOT TRACT ATE /��I/ CONST. ��GROUP p OWNER A�C�1M .�A c►C,ti p ADDRESS SAn�►2 ZONING SETBACKS QCITY �ZIP TEL. FRONT qyy � APPLICANT TEL. REAR � �� + SIDE/SIDE STREET qyy p CONTRACTO . �� SIDE � o CDDRESS Z�P��.�y TEL.qYl��06-qa� PROPOSED USE � e�1'�o�/e � p�� o ARCH/ENG/ � z DESIGNER � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS � STORIES �_ gEDROOMS � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION . p SFq/ADD/REM 0 I MEREBV AFFIqM UNDER PEN�LTV OF PERIURV THAT I AA1 E%EMPT FROM THE CONiRACTORS LM GflfB 0/C8 R W CENSELAWFOHTHEFOLLOWINOREASON(SEC.703t.6BUSINESSANDPROFES510N5CODE:ANVCITVOR (n 9 � ZCOUNTYWHICHREQUIRESAPERMIT7000NSTRUC7,ALTER,IMPROVE,DEMOLISH,OFREPAIRANYSTRUF W P8f10/DBCk W TURE,PRqR TO ITS ISSUANCE,AL50 REWIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(C}iAPTER B(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO- LL' PooVSpa FESSqNS CODE)OR 7HA7 HE OR SHE IS EXEMPT 7HEREFROM AND THE BA515 FOR THEALLEOEO E%EMP- (� TION.ANV VKK.ATION OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU6IECTS THE APPLICANT TO Z @-R00 DU A CML PENALTY OF NOT MORE h1AN FIVE HUNDRED DOLURS(5500).): � OI,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � Ort1RIBfCIeI Z WILL DO THE WORK,M1D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7041,BUSI� J N NESS AND PqOFE5510NS CODE:THE CONTMCTOflS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPEHTY NM1iO BUIIDS OR IMPROVES THEREON,AND WHO DOES SUCH WOHK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPIOVEES,PROVIDED THAT SUCH IMPpOVEMEMS ARE NOT INTENDED OR C� Q OFFEREDFORSALEIF,HOWEVER7NEBUIIAINOORIMPROVEMEMIS50LDWfTMNONEVEAROFCOMPLE� Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPQSE OF SALE). w ❑I.ASONMEROFTHEPROPERTV,AMEXCLUSNELYCONTMCTINaWITHLICENSEDCONTRACTORS /� /� . Q TO CANSTRUCT THE PHOJECT(SEC.70t1,BUSINESS AND PFOFESSIONS CODE:THE CONTRACTORS LI- V8W9�IOfIX r LY�$D V ADJ.AREA W CENSELAWOOESNOTAPPLVTOANONMEROFAPROPERTVWHOBUtLD50RIMPROVESTHERC-0N,MlD � WHOCQNTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECANTRAG QUANTITY DESCRIPTION Y TORS LICENSE LAW.). FEE � ❑I AA1 EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � U � DA7E OWNER � Z U � LICENSED CONTFACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISKKJS OF CHAPTER � � e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSKKJS CADE,AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT. m 0 ICENSE C SSr � l UQ NO. �-RO/� � U ATE (.J CONTRACTOR S (.VN<G 5d`'�' d W � WORKERS'COMPENSATION DECLARATION � � I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLIOWING DECUfiAT10N5: Z Q � I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ � COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE UBOR CODE,FOP THE 7ERFORMANCE U Q OF TME WORN FOR WHICH THIS PERAIIT IS ISSUED. � Qw _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE.AS REOUIRED BV SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WOR)(FOR WHICH THIS PERMIT IS /�i/]�'J � ISSUED.MV WORK`ERS'CAMP ATION IN�yURANCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTIO (y •�'� � � CARRIER_S�I��I�CI PLAN REVIEVJ Z POLICY NUMBER I SI�. �D�I7 ELECTAIC ¢ � � (iHESEClIONNE�NO7BEOOMPLEfIDOFTiEPEPoATISFOHONEHUrDq�pOLLARS�St00)ORLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL � SHALL NOT EMPLOY pNV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO 7HE (,/) WORNERS'COMPENSATION UWS Of CALIFORNIA AND AaHEE THAT IF I SNOUID BECOME INSPECTION FEE SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR ~j CODE,1 SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. �SSUANCE ��/ �^ I � MIP I JX p DATE: APPL�CANT: J WARNING:FAILURE TO SECUflE WORKERS'COMPENSATION COVERAOE IS UNLAWFUL,AND SHALL BE NERGY P/C � SU&IECT AN EMPLOVER TO CRIMWAL PENALTIES AND qVIL FINES UP TOONE HUNDRED THIXISAND ENERGY PERMIT DOILARS(f100,000).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN /(,.� � SECTION 37oe OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. RETENTION F �•({/ OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: , � I HEREBV AFFIRM UNDER PENPLTV OF PENURY THAT THERE IS A CONSTRUCTION LENDING AGENCV �b^ �T Z FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.3oe7,CIV.C.). �j IT�K w 1/' � � LENOER'S WJAE F— LENDER'SADDRE55 g TOTAL FEES �. � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CORRECT. w I A6REE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE UWS REI.ATING TO BUIIDINa d � CONSTRUCTION,AND HEREBV AUTFiORIZE REPRESENTATIVES OF THIS CAUNTY TO ENTER UPON THE i Z ABOVE�MEMIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS ' � X �Y�awti �LQASe� m PERMITT (PRIhlT) . � � �a�--� !\ � �s��i I � REOFPERMITTEE DATE � RECPT.NO. PAID BY ' • VALIDATION WHITE—Department Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENFOD—File Copy,GREEN—Applicant's Copy J • � � � � , . - . CI�'V OIF DIAf�OND �AR If�S�EC�lO� ff�ECOIRD . o�p�c�oo� � �� o��Q�c�oa oa�p�c��ooa� " � �� , �1 :��.�: �-��:. 'r�� ° 0 D SET BACK �, ' - • FLOOR JOIST . FTGS/FORMSlSTEEL . • � 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. 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 INSUL,4TION 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 PAIQ FINAL PLUMBING ENERGY ��a � COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a �r Q �, �