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Home My WebLink About11-1634 ��_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES '• 21825�Copley Drive,Diamond Bar,CA 91765 � (909)839-7020 Fax(909)561-3117 Building Inspection Hotline(909)839-7 27 PRESS `�"'` BUILDING PERMIT APPLICATION 2 FIRMLY I � JOBSITE a,�-as , Q��„J ,[ �j ��' APPLICATION PERMIT � P/C o ADDRESS �1 DATE NUMBER l l-��v �# � issuE TYPE /� occ APN LOT TRACT DATE � CONST. LUM 1_! GROUP p OWNER � ADDRES ' ZONING SETBACK 0 FRONT R�/y p Z CITY IP TE . ' O ❑ o APPLICANT / TEL. s S DE/SIDE STREET RW ❑ z ¢ CONTRACT R / SIDE ❑ � � ADDRESS PROPOSED USE � CITY ZIP TEL. LY>• „� I Y� I o ARCH/ NG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION ' � SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALN OF PERJURV THAT I M1 EXEMPT FROM THE CONTRACTORS LI- G8189B/CefpOh W CENSEIAWFORTHEFOLLOWINGREA50N(SEC.7031.5BUSINESSAN�PROFESSIONSCODE:ANVCI7VOR (n U COUNTYWHICHREQUIRESAPEfiMI770CAN5TRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W Patio/Deck w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT THA7 HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON7FiAC70R5 LI- � � CENSE UW(CHAPTER 9(CAMMENCING WI7H SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSp2 , � FESStONSCODE)ORTHATHEORSHEISE%EMPT7FIEREFROMANDTHEBASISFOR7HEALlEGEDEXEMP- (� V TION.ANVVIOUTIONOFSECTION7031.5BYANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof �, A CIVIL PENAL7V OF NOT MORE THAN FIVE HUNDRED DOLURS(5500).): Z ❑I,ASONMEROFTHEPROPERTV,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrtIrtIBfCiel WILL DO THE WORK,AND 7HE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70��,BU51� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPEHTY NhiO BUILDS OR IMPHOVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THA7 SUCH IMPROVEMENTS ARE NO71N7ENDED OR m w OFFEREDFORSILEIF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- 0 TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT eUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). _ ❑I,AS OWNER OF THE PROPEHTY,AM EXCLUSIVELV CONTMCTING WITH UCENSED CONTRACTORS I w [[ TO CANSTRUCT THE PR0.IECT(SEC.7011,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS LI- V0IU8�1Of1 ADJ.AREA W CENSE LAW DOES NO7APPLV TO AN OWNER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND • � WHOCON M SUCHPROJECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE I Y TORS LI W.) � ❑1 AM EMP UND C B.6 P.C.FOR THIS REASON J o a � U lL � DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTV OF PERJURV 7HAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � /} d D(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PROFESSIONS CODE,AND Z �.t X MY IICENSE IS IN FULL FORCE AND EFFEC7. m LLI �� LICENSE CIASS LIC.NO. j V DATE CONTRACTOR d � W � WORKERS'COMPENSATION DECLARATI a � I HEREBV AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECLARATIONS: Z 0 /\ IHAVEANDWILIMAWTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' a �/� S ¢ 7 CAMPENSATION,AS GROVI�ED BY SECTION 3700 OF THE IABOR CODE.FOR THE PERFORMANCE W w Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WORKERS'CqMPENSATION INSURANCE,A5 REOUIRED BV SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS ISSUED.MV WOfiKERS'COMPENSATION INSURANCE CAFRIER AND POLICV NUMBER ARE: CONSTRUCTION J j cnaaiEa ' PLAN REVIEW Z POLICV NUMBER ELECTRIC - , Q � (iHISSECIqNNEmNOTBECOMREfEDOFiI-IEPEW�1f�ISFORONEHUPDREDOq1ARS(5700)ORLESS} PLUMBING S�i � I W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL L}' SHAIL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSA710N LAWS OF CALIFORNI!!!yyy ANDAGREE THAT IF I S OULD BECOME INSPECTION FEE SUBJECT TO THE WOHKERS'CAMPENSATION PR�ISIONS OF SECTIO 0 OF THE LABOR � CODE.I SHALL FORTHWITH COMPLV WITH PROVISI� 5. ISSUANCE /� / p OATE:/ � � // APPLICANT: SMIP J WARNING:FAIIURE TO SECUfiE WORKERS'COMPENSATION C VE GE IS UNLAWFUL,AND SHAIL BE ENERGY P/C � SU&IECTANEMPLOYERTOCRIMINAIPENA�TIESANDqVILFIN UPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f 100,000),IN ADDI710N TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION]708 OF THE LABOR CODE.INTEREST,AN�ATTORNEV'S FEES. RETENTION FEE: � � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � 1 HEREBV AFFIRM UNDEF PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY ' FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). . Z W � LENDER'S NAME F- LENDER'SADDRE55� I � I CERTIFY THAT I HAVE READ THIS APPLICATION AND S7A7E THAT THE ABOVE INFORMATION IS CARRECT. TOTAL F E ES � � �� W I AGREE TO COMPIV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS REUTING TO BUILDINC d � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOVE- EN710NED GROPERTV FOR INSPECTION PURPOSES. COMMENTS � . � J � � m PE NAME(PRI ) � � � � O� �/ . . � � 51 E OF PEFMI DATE � = RECPL NO. � PAID BY IDATION ~ WHITE—De artmenl Co YELLOW�inance Co PINK—Assessor Co GOLDENROD—File Co GREEN— P PY� PY. PY� PY. ApPlicant's CoPY ��'V �� 0�4�/d�V�� f�Al� ' _- I��f�f��'��Y� V�l�� - . Oa�pLC�400a DQ4C� Oa�3pGC�4Co�p Oa�3pC�C�4QOa DGJ�'@ �la�p�C�4Q��:�._ SET BACK FLOOR JOIST • ' ' ' '` " ' FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT _ � . . ' , GROUND PLUMBWG UNDER FLOORCONDUIT • � ' • ' SLAB GRADE FIREPLAC�:FOUNDATION" V ., '� � � � ' TEMP POWER FIREPLACE BON��BEAM ' � WATER SERVICE MID HL BOND BEAM� � • • • . , ROOF SHEATHING 8�'f'. BOND�BEAM � •• � � ' , FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING ' " �BENGHING � • ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC _ EXT. LATH/SIDING POOL FENCING WALL INSULATIQN POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK � � LANDSCAPE/IRR►G. 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 _j� ��S'_.�?� ENERGY _ __ ___ __________ ' C�3i' C�� ' ,., ' • COIVIMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � .� � . , . . , �.�� n �� .. � � . . . , • � � - i Prescri #�ve Cer�ficate c�f Co� I�nce: Re.�ide�#�al Water$�afina ��=1R AL3`-� j ��€e,�c�� . I Site A ddregs:'22�.� `�' Climsft�ai: . :i . 'r� i?aie: ,O- I'�-� I I Nt3TE:T�ris mm�r o�-usrri or aliaatir�n or ndrfi�an n wate9- . '� � WA I�+i2�EAT'ING _.r- f':: ,� : . _ .__ _ - � List woter heaters and boilers�or lioth riflmeslic 33ot water{I1fIA�}�ers m�d hydrorrie s�rrc�3+e�tir�g_ Individ�at cliv�dfing fI�Y ' heaiers m�cl he gv.s nr�ro�an�firt� and inay not exceer�Sf3 grrll�ns. I�at�er pipe°iicrrrlrgiiion fivm the Z3fI�hearer io #he kilcher�(s)and orr ull ztndergrarrnd hot sv�iPr pipes is reguired in rr�t compoi►ent paclrriges itr atl clima�e son�s. �erg,y Fac#Qr or - Water Heat�r`i'ype! Distrib�ior�Type '�a� " Tank Capacity 'Fhermal E��mal Taz�c �uet T ' (sta�dard)2 s#� ) F�fficiencv a#�o�R�atue � �-J� �—n �L.-c ; l.lndicate TYpe(�torage Gas,HeQt P�anp,lnrtrnri�ernrrs,ete.) ' ., � n 2_Recircrilatbig systa�u servurg mnitrple d�elling units skall m_eet tdie reciraJaiiorr requirements of I50{ir�. Ths Presrriptive reovirem�n�rfn �_ not allmv ikeimTull�ian of a raclrariutnr��vater hea�tgsvssf�farsi�le dw�&ri�u� . 3. 77�e water 1�eutmg}anx ur�d pipEs shalJ be�sulr�ted tn meet the r�qrc�re,mPntr'of I S11{`j). ' I - Contractor(Documentation A�thar'�/fZesponsible I?esigner's I3eclar�tiocc S#atemen#} _ ' 1 certify that this CErtificate o€Compliance daainieatation is a�urat8 ai�d cozsip�.#e; ...:.... ,:.._.. ,-..., , :. � l am el�gn�ile imder Ilivisiort 3 o�the Califor��ia Business�d Proiessi�ns Code to'aceept resFansa�bility.far.the buil�i�g design idea�iified on . . � this CertihcaEe ofCompliance_ , �: : -•. > .:� � I c�atify th�#he energy feat►ices and;perf�emm�s�ecificxtions for.t�e bezilld'utg�sign ideati€�ed on ttus Ce�tificate of Cvmpiiance e,oafoFm to tt3e requi�menrs of Title 24,Parts.I and 6 of tlie Califamia'Code of Reg�latio�s. , . r}• . • The bvildiflg design fratiu�s'idenfified'on fhis Gertific�e of Cumpli�ce are cansistent t�ri#h t�e iaformation pravided tn document dais +_ b"'1ri;�design on ifie ather appficable comp}i�ce fti�ic,wo�heefs;catca4ari ,P�ans a�d s�e�ifica#iQns s�bmi3led to the e,nforce�neut _en _ r — ai wiin iliis'�iuil�u " ':r�c� — — . Name• n� / Si .. KJ �P�y� WATEIZ HE9TEd2.S ONi,Y, ZNC. ➢a� • ' -.:: . : _ A�mss: 9.7,O :E.;MAIN..STREET.,��200 . . _. . _: . License> 3 7.45 73 __ . Ciry/StatelLip: GRASS VALLEY, CA 95945 ' ��(S00} 835—$345 : R� 2�JtJ8 Residentia.�Co -li� - _ . . __ __ � �----•-�- - m� c�►ce for"iri's'''`;.+...... _. ._....�..._- March 2fl1� � . ,