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Home My WebLink About18013� CITY OF DIAMOND BAR `��`� ��---��`` — DEPARTMENT OF COTRvIUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS �'�»�� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE � o ADDRESS_�L� � �' ��A ��_ DATEICATION i1 3�'j ��f -NUMBER� #/C O Z" "t Li � �- D TEE / ' �L TMPE OCC APN LOT TRACT p OWNEFi ��'1UIL.IC/N CONST. GROUP p ADDRESS ZZ '�'v .� ZONING SETBACKS �] FRONT qy�/ p Z CITY P TEL. O o APPLICANT TE j� S DE/SIDE STREET RW ❑ � CONTRACTOR SIDE p o C�RESS ZIP TEL. PROPOSED USE � � �� w ARCH/ENG/ � � � �z DESIGNER NO.DWEL. � ADDRE S � N�• � CITY ZIP - TE UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADD/REM � 1 HEREBV AFFlRM UNDER PENAL7Y OF PERNRV THAT I AM E%EMPT FROM THE CONTRACTORS LI� Gel096/C9fPOR W CENSEUWFORTHEFOLLOWINOREASON�SEC.7031.SBUSINESSANDPROFESSqNSCODE:ANYCITYOR (n C-� COUNTVWHICHPEOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUG � w TURE,PRqR TO RS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCN PERMIT TO FILE A SIGNED W Patio/Deck � STATEMENT 7}IAT HE OFi SHE IS LICENSED PURSUANT TO THE PFiOVISIONS OF THE CON7RACTORS LI- LL � CENSE LAW(CHMTER B(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� POOUSPB � FESSIONSCODE)ORTHATHEORSHEISEXEMPTiHEREFROMANDTHEBA51SFOqTHEALLEOEDEXEMP- � TION.ANYVIOLqT10NOFSECTION7031.5BVANVAPPUCANTFORAPERMITSU&lECTSTHEAPPUCANTTO Z Re-Roof A CIVIL PENALTV OF NOT MORE THM!FIVE HUNDRED DOIURS(f500�.): � ❑I,ASONTIEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrt1rtI0fCl01 Z WILL DO 7HE WORK,AND 7HE S7RUCTURE IS NO7 INTENDED OR OFFERED FOR SALE(SEC.7ola,BUSI� J � N NESS AND PROFESSIONS COOE:7HE CONTRACTOF7S LICENSE LAW DOES NOT APPLY TO AN OWNER OF � n / ,v I S�, f �� PROPERTYNTiOBUILD50RIMPROVESTHERE-0N,ANDWHODOESSUC}iWORKHIMSELFORHERSELFOR b V Q iHRIX1GH HIS OR HER OMM EMPLOYEES,PROVIDED THAT SUCM IMPqOVEMENTS ARE NOT INTENOED OR m � OFFEREDFORS�LEIF,FIOWEVERTNEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUIIDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILA OR � IMPROVE FOA THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERTV,AMEXCLUSIVELVCANTRACTINGWITHLICENSEDCONTRACTORS � TO CANSTRUCT THE PR0.IECT(SEC.7oN,BUSINESS AND PROFESSIONS CADE:7HE CONTqACTORS LI- V81118�IOf1 ADJ.AREA W CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPEflTVWHOBUILDSORIMPROVESTHEREON,AND � NTIOCOMRACTSFORSUCHPROJECTSWITHACANTRACTOR(S)UCENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION Y TORS LICENSE LAW.). FEE � ❑I AM F�(EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � 2� U LL" DATE OWNER ¢ Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � p_ 0(COMMENCINO WITH SECTION 7a0o)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X MY LICENSE IS IN FUIL FORCE AND EFFECT. m � LICENSECUISS �i �s�� 43 ��No. �2q88 I � V DATE I I /Zrj I O7 CONTRACTOR I LON �(U(,� � a W � WORKERS'COMPENSATION DECLARATION Q � I HE_R�EBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWINQ DECLARATIONS: Z Z0 v I HAVE AND WILL MAINTAIN A CERTIFlCATE OF CONSENT TO SELF-INSURE FOR WOqNERS' a Q . COMVENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR COOE,FOR THE PERFORMANCE U Q �OF THE WOHI(FOR WHICM THIS PERMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS RE�UIqED BV SECTION Q 3700 OF THE LABOR COOE,FOR THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERAIIT IS J ISSUED.MV WORKERS'CAMPENSATION INSURANCE CARRIER AtJD POLICV NUMBERARE: CONSTRUCTION � CARRIER PLAN REVIEW Z POLICV NUMBER ELECTRIC � Q � (fFASSEC1qNNE�NDTBE00f.1PLETEDOFTHEPERATTISFOqONEF4R.qiEDDq1l�AS(5100)ORLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WOR1C FOR WNICH THIS PERIAIT IS ISSUED,I MECHANICAL C.�} SHALL NOT EM7LOV ANV PEPSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'CAMPENSATION LAWS OF CALIFOfiNIA,AND AOREE THAT IF I SHOULD BECOME INSPECTION FEE SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR OCODE,I SH FORTHWITH COMPLV WITH HOSE PROVISIONS. � ISSUANCE p DA7E: O � ppp�ICANT: �I�N/ �"I`�I SMIP w ENERGY P/C J WARNIN�:FAILURE TO SECURE WORNERS'COMVE ATION CqVERAGE IS UNLAWFUL,AND SHALL BE J � SUBJECT M!EMPLOYEF TO CRIMINAL PENALTIES AND CNIL FMES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(f1oo.000),IN ADDITION TO THE COST OF COMPENSATqN,DAMAOES AS PHOVIDED FOR IN � SECTION37080FTHELABORCOOE,INTEREST.ANDATTORNEI"SFEES. RETENTIONFEE: �� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS ACONSTRUCTION LENDINO AGENCV FOR THE PERFORAIANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.3007,CIV.C.�. Z W � LENDERS NAME ' 1— LENDER'SADDRESS w I C�jiTIFY THAT I HAVE REPD THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL F E ES G`./� .��' ,�j��- )� � I GREE TO CAMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING < <� STRUCTION,AND HEREBY AUTHORIZE REPRESENTATNES OF THIS CW N7V TO ENTER UPON THE Z ABOVE-MEMIONED PROPERTY FOq INSPECTION PURPOSES. ��S { U`�� S�Y�� COMMENTS 1 � Q RMITTEE NAME(P INT) � � � SIONA F ITT E DATE � RECPT.NO. PAID BY ' VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy (�9��T (CD6� �P9�G�(CDf�16� f�l,�ff� ��(P'[�(��T'�cCDb�9 f�i��[�� a `""� ��, � `� � ° `'�✓�4�u u Ll�° Q �L�J� UIJi� p o ,��x ; �, . SET BACK FLOOR JOIST FTGS/FORMSlSTEEL � ' - FHA REQMTS ELECTRIC GROUND UNDER FLOOR QUCT GR�UND PLUP�iBING UNDER FLOOR CU�IDUIT SLAB GRAQE FIRERLACE FC�UNDATION I TEMP POWER FIREPLACE BOND BEAM �— WATER SERVICE MID HT. BOND BEAM � ROOF SHE.ATHWG 8 FT'. BOND BEAM FRAMINGNENTILIATtON FtNAL BOND BEAM ROOF COVER PRE-GFiADING ! ROUGH HEATlNG BENCHING ' � - ROUGH ELECTRIC ROUGH GAADItJG ROUGH PLUfVIBING ! FINISH �RADING � SHOWER/TUB TES7 ^ � POOL ELECTRIC EXT. LATH/SIDING POOL FENCING W,4LL INSULATION POOL FINAI CEILIfVG INSULATION OFF SITE IMPS. DRYWRLL NAILING DEDICATIONS � SEWER FINAL.ENG. SEPTIC TANK LANDSCAPE/IRR�G. SEEP PIT/L.L. � ' ON SITE (MPS. GAS AIR TEST . �1NAL ZONING FlNAL CONST. ' ' �!RE dEPT. FINAL FINAL HEA7ING HEALTH DEPT. FINAL F1NAL ELECTRIC DEV. FEES PAID FINA�PLUMBING ENERGY � _ � � ��o � . . � . GONiNiENTS � � SEPTIC TANK SIZE SEEP PIT/U SIZE a � � � � �� .