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Home My WebLink About12-823 - - �;�„` _ CITY OF DIAMOND B�t' � � , _ _ � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ' 21825 Copley Drive,Diamond Bar,CA 91765 ;..:�; . (909)839-7020 Fax(909)861-3117 13uilding Inspection Hotline(909)839-7027 � PRESS �'"^'� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE �3� � r� �y�� • ��j '/�/ PERMIT )Z�� P/C APPLICATIO � o ADDRESS � � DATE (/D NUMBER� # °r APN OT• TRACT �SSUE �fj TYPE J OCC DATE d CONST.�I� GROUP p OWNER l � s �,Q�' ra o ADDRESS . Ir� GL(1 • ZONING SETBACKS � Z CITY,DIaM ZIP�t� TEL. IO � �j FRONT Ryy p o APPLICANT TEL. REAR p Z SIDEJSIDE STREET RW ❑ Q CONTRACTOR �-1 S S f' _S I�) SIDE ❑ ADDRESS Z � � CITY Y1�11I ZIP EL. PROPOSED USE C• Ct.� �f 1 w ARCH/ENG/ �z DESIGNER NO.DWEL. �-r� NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIfiM UNDEH PENAL7V OF PERJURV THAT I AA1 E%EMPT FROM 7HE CANTRACTORS LI- GOfegB/C2fpOR W CENSEUWFOR7HEFOLLOWINGREASON(SEC.7037.SBUSINESSANDPROFESSIONSCODE:ANVCITYOfi (n U COUNNWHICHREOUIRESAPERMIT70CANSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANVS7RUC� W patio/Deck w TUFiE,PRIOR TO ITS ISSUANCE.ALSO RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT THAT HE OR SHE IS LICENSED 7URSUANT TO THE PROVISIONS OF THE CAN7RAC70RS�I- � � CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� POOVSPO � FESSIONS CADE)OR THAT HE OR SHE IS EXEMPTTHEREfROM AND THE BASIS FOR THEALLEGED EXEMP- (� V TION.ANY VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMI7 SUBJEC7S THE APPLICAN7 70 Z Re-Roof F, A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLURS(i5o0).): Q ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTNEIRSOLECOMPENSATION, � COrt1f110fCifll Z WIIL DO THE WORK,AND THE STRUCTURE IS NO7 INTENDED OH OFFERED FOR SALE(SEC.7a�,BUSI- J � NE55 AND PROFESSIONS CADE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY 70 AN OWNER OF � PROPERTV NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSEIF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7HA7 SUCH IMPROVEMENTS AHE NO71N7ENDED OR m w OFFEREDf-0RSALEIF,HOWEVEF�THEBUILDINGORIIAPROVEMENTISSOLDWI7HINONEYEAROFCAMPIE� 0 TION,THE OWNER-BUILDEFi WILL HAVE THE BURDEN OF PROVING 7HA7 HE OR SHE DID NOT BUItD OR Z IMPqOVE FOH THE PURPOSE OF SALE). ' Q_ ❑I,AS OWNER OF THE PROPER7V,AM EXCLUSIVELV CONTRACTING WI7H LICENSED COMRAC70RS TO CANSTRUCT THE PRQIECT(SEC.701a,BUSINESS AND PROFESSIONS CODE:THE CON7RAC70R5 LI� V81U8�1Of1 � ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN ONTJER OF A PROPERN WHO BUILDS Ofl IMPROVES THEREON,AND � WHOCONTRACTSFORSUCHPRQIECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECONTMG pUANTITY DESCRIPTION FEE Y 70RS LICENSE LAW.J. � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON J � Q � DATE > OWNER � u�f�' ��*b�` 1 O W V"1 �l �N. �Q LICENSED CONTRACTORS DECLARATION w 2 I HEREBY AFFIRM UNDER PENALTV OF PERJURV THA7 I AM LICENSED UNDER PROVISIONS OF CHAPTER � d B(COMMENCING WITH SECTION 7000)OF DIVISION 3 0f THE BU5INESS AND PROFESSIONS CODE,AND Z X AIV LICENSE IS IN FULL FOFCE AND EFFECT. � LICENSE CLASS Y IIC.NO. ��/" � I�-/' � � V DATE�I Z� CONTRACTOR' �" d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWING DECUfiATIONS: Z Z I NAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a 2 ¢ COMPENSATION,AS PROVI�ED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � W �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BV SECTION �',,j/�� ,��) � Q 37000FTHE LABOR CODE,FOR THE PERFORMANCE OF THE WOflN FOR WHICH THIS PERMIT IS !�� ✓ "V y SD. ISSUED.MY WO RS'CAMPENSATION INSURANCE CARRIER AND VOLICV NUMBER RE: CONSTRUCTION �' �r�sfi ri�fi o-naR. I nS �o ' �`7�. � CAHRIER � PLAN REVIEW . Z POIICVNUMBER �J�P�7��000 �JIIZI ELECTRIC � '� � ¢ -� � 0 (IHISSECiIONNE�NOTBECDMREfEDOFTHEPEW.1f�ISFORONEMADRED00LLPAS�SID7)ORLESS� PLUMBING Z I CERTIFV THAT IN 7HE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL U' SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECOME SUBJEC7 70 7HE � WORNERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SUBJECT TO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 37o00F TNE UBOR � CADE,1 SHALL FORTHWITH COMPLY WITH T OSE PROVISIONS. ISSUANCE O DATE: � a-'� G�. APPLICANT. � ' AI�1 � SMIP wWARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHAL� ENERGY P/C �y SU&IECTANEMPLOVERTOCRIMINALPENAlT1ESANDpVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5100,000),IN ADDI710N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTOHNEV'S FEES. RETENTION FEE: OCONSTqUCTION LENDING AGENCY PRE,;,(�LT FE� ;Q Q I HEfiEBYAFFIRM UNDER PENALTY OF PERJURV 7HAT THERE IS ACONSTRUCTION LENDING AGENCY ��) a- FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED�SEC.3097,CIV.C.). �' � . Z W � LENDER'S NAME H LENDER'SADDRESS � TOTAL FEES �-67,� � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. w I AGREE TO CAMPLV WITH ALL CITV AND COUNTY ORDINANCES AND STATE UWS PEUTING TO BUILDING d � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UVON THE Z ABOVE-MENT NED VROPERTV FOR INSPECTION uaaosEs. COMMENTS � J � m PERMITTE RINT) j � - ¢ `y ?� 2 � � SIGNATUREOFP RMITTEE DA7E � = RECPT.N0. PAID BY VALIDATION ~ WHITE—De artment Co YELLOW—Finance Co PINK—Assessor Copy,GOLD�NROD—File Co GR N— s/ �„ / P PY� PY� �I � �� PY, �1,`I O V CoPy 7 0� cf COTY C�F DVAVi��6�lID��A� B�Sf�f��0� f�[��OR� �— -< Da�pCC�400a o �4L� �}: �G��pCC��r'Oa :. ` O�I�pCC�40C�a OLa4C Oa�pCC��OG3�. SET BACK I FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND I UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONQIJIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HL BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC � - � .'Z'�!"''��"`• ROUGH GRADING ROUGH 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 I FINAI ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING = __+ ��,� HEALTH DEPT. FINAL FINAL ELECTRIC _��, DEV. FEES PAID FINAL PLUMBING ENERGY ----------._---- - -----_..---- ------1- C��o � COMMEfVTS � _ SEPTIC TANK SIZE SEEP PIT/U SIZE a -- c� Q �