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Home My WebLink About11-601 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 PRESS 4'��" BUILDING PERMIT APPLICATION FIRMLY N JOBSITE d�, >- APPLICATION PERMIT ` �/C o ADDRESS �O� FJVX GC� �;,�►� �� DATE NUMBER ��V1� � APN LOT TRACT �SSUE TYPE /� � OCC DATE O� � CONST.�_C/GROUP p OWNER I p ADDRESS ZONING SETBACKS z CITY IP �, FRONT pyy � � APPLICANT TE�. REAR � ¢ SIDE/SIDE STREET qyy p � CONTRACTOR ` SIDE � ADDRESS ^�� G��.Gy� f�� CITY ZIP TEL. PROPOSED USE �r., i ��,, o ARCH/ENG/ - ��SL-� �.�. z� DESIGNER NO.DWEL. NO. NO. ' a ADDRESS v� UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNE(�1-BUILDER DECLARATION p , SFR/ADD/REM � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FpOM THE CANTRACTORS LI� GefBQB/C6fPOR W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.60USMESSANDPROFESSIONSCODE:ANYGTVOq (n U COUNTYWHICHREWIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUG patlo/Deck w NRE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES 7HE APPLICANT FOR SUCH PERMIT TO FILE A SIONEO W � STATEMENT THAT HE OR SHE IS LICENSED WRSUANT TO THE PPOVISIONS OF THE CONTqACTORS ll� � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � POOUSPB � fESS10NSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO Z Re-Raof A CIVIL PENALTY OF NOT MORE THAN FIVE HUNORED DOLLI.RS(i500).): � ❑I,ASONRJEROF7HEPROPER7Y,ORAIYEMPIOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COfI1rtIBfCI81 Z WILL DO THE WORK�ND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7M�,BUSI- J ' � � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV WHO BUILOS OR IMPROVES THEREON,AND NM1IO DOES SUCH WORK HIMSELF OR HERSELF OR w THROUGH HIS OR HEH OMRJ EMPLOVEES,PROVIDED THAT SUCH IMPROVEMEMS ARE NOT INTENDED OR m � OFFEREDPoRSALEIF,FqWEVER,THEBU0.qNGORIMPROVEMENTIS50LDWITHINONEVEAROFCOMPIE� z TION,THE OWNER-BUILDER WILL HAVE THE WRDEN OF PROVWG THAT HE OR SHE DID NOT BUILD OR IMP�FOR THE PUPPOSE OF SALE). w AS OWNER OF THE PROPERTV,AM E%CLUSNELV CANTMCTINO WRH LICENSED CONTMCTORS [[ TO STRUCT THE PR0.IECT(SEC.7Wt,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS U- V81U0f10l1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANONTJEPOFAPROPERTYWHOBUILDSOFIMPROVE57HEREON.AND � WHOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION Y TORS LICENSE LAW.). FEE � ❑I AM E%EMPT UNDEH SEC. B.8 P.C.FOR THIS REASON � ?� � • U u' DATE � OWNER H Z U � LICENSED CONTFACTORS DECLARATION w � I HEREBV AFFIRN UNDER PEN/�LTY OF PERJURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � � D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z ' �� IAY LICENSE IS M FULL FOACE AN�EFFECT. m � LICENSE CLASS- LIC.NO. � � U DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIRM UNDER PENALTV OF PEFJURV ONE OF THE FOLLOWING DECLARATIONS: � � � Z � _I HAVE AND WILL M/JNTAIN A CERTIFICATE OF CONSENT TO SELF-INSUFE FOR WORKERS' a . ' 2 � COMPENSATION,AS PqOVIDED BV SECTION 3�00 OF THE LABOR CODE,FOR THE PERFORMMICE U OFTHE WORN FOR WFIICH THIS PERAl1T IS ISSUED. W � � � Qw _I HAVE MID WILL MAINTAIN WOR)(ERS'COMPENSATION INSUqANCE,AS REWIRED BY SECTION 37oa OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS � ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUA/BER ARE: CONSTRUCTION ] CARRIER PLAN REVIEW Z aouCVNUMBEa ELECTRIC ¢ — ' 0 (iHISS[CTONNE�NOTBEOOMPLEiIDOF7FgPEF7HTISFORpNEFiIN.DqEpppUpRS(f�pp�pq�ESS� PLUMBING W Z I CERTIFY hIAT IN THE PERFORMANCE Of THE WOR1C FOR WHICM THIS PERAl1T IS ISSUED,I MECHANICAL CS SHALL NOT EMPLOV ANV PERSON IN ANV MANNER$O AS TO BECAME SU&IECT TO THE (n WORKERS'CAMPENSATION LAWS OF CALIFORNIA AND AQREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&IECTTOTHEWOHKERS'COMPENSATIONPROVISIONSOFSECTION37ooOFTHELABOR I CODE,I SHALL FORTHWITH COMPLY WITH THOSE PFOVISIONS. ISSUANCE � p DATE: APPLICANT: SMIP W J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � J � SUaIECTAN EMPLOVEil TO CRIMINAL PENALTIES AIJD CML FINES UP TOONE HUNDRED TFKKISAND ENERGY PERMIT DOLLARS(f100,o00),IN ADDITION TO THE COST OF COMPENSATqN,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. w RETENTION FEE: O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AOENCY � FOR THE PEqFOFMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDEfYS NAME F— LENDER'SADDRE55 w I CERTIFV THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE WFORMATqN IS CARRECT. TOTAL FE ES �'/ei/,' d I AGREE TO CAMPLV WITH ALL CIT'AND COUNTY ORDINANCES AND STATE UWS REI.ATINO TO BUILDINO ✓' � CONSTRUCTION,AND/IEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE�MEMIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � �� m PERMITT E( INn � � . Q UJ � SIGNATUFEOFPERMI DA E � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Flnar�ce Copy,PINK—Aasassor Copy,(30LDENRO�File Copy,GREEN—Applicant's Copy CITV O� DG,�►(�liON� BAR II�S��C�BO� RECORD �°;OG1�pUC�4QOG�1 ��Q� ��'�� OG]�PG�G3' ; O�I�pC�(��0�] . DQ4C, O�I�PC�C�Ot�: �.' SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLO�R DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF C�VER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGN GRADING FiOUGH PLUMBING 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 DEV. FEES PAID FINAL PLUMBING ENERGY C��.� COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a �m a ��; � � �. � a�._ �F_-� ��-� ��