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Home My WebLink About16786 (10)� C1TY OF DIAMOND BAR — ` � �� --��~-- DEPARTMENT OF COMMUNITY 8c DEVELOPIv�NT SERVICES 21825 E.Copley Drive PRESS � '" (909)860-3195 Fax(909)861-311'I �� I '":.,;�`w BUILDING PERNIIT APPLICATION FIRMLY � JOBSITE '/ APPLICATION � I Z O NUMBERI � #/C I o ADDRESS I7'�0 �/O�� DATE � ISSUE D TYPE OCC APN�LOT� TRACT DATE CONST. GROUP p OWNER "' ADDRESS .SG7Ly QI/ O ZONING SETBACKS o FRONT F1�N ❑ Z CITY ZIP .�BO T TEL. _ - - -� REAR ❑ o APPLICANT TEL. SIDE/SIDE STREET RW � � CONTRACTOR � SIDE ❑ � ADDRESS PROPOSED USE � � � � O � � CITY Z1P TEL. w ARCWENG/ /J �� t�r�� z DESIGNER L'1u�� NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFWADD/REM O I HEREBV AFFIRM UNDER PENALTV OF PERIUFV THAT I MI E%EMPT FROM THE GONTRACTORS LI� G8f0Q0/COfPOR W CENSE U�W FORTHE FOLLOW WQ REASON(SEC.7031.6 BUSINESS ANO PROFESSIONS CODE:ANV CITV OR (n U COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,N.TER,IMPROVE.DEMOLISH,ORREPAIRANYSTRUC� w patio/Deck wTURE,PRIOR TO ITS ISSUMlCE,AL50 RE-0UIRES THE MPLICMlT FOR SUCH PERMIT TO FILE A SIONED � STATEMENT T1iAT HE OA SHE IS LICENSED PURSUANT TO TNE PROVISIONS OF THE CONTMCTORS LI� LL PQQUSP2 � CENSE UW(CHAP7ER e(COMMENCINO WITM SEGTION 7000)OF DNISION 3 OF THE BUSINE55 AND PRO- � � FESSIONSCOD�OiiTHATHEOFlSHEISE%EMPTTHEREFROMANDTHEBASISFORiHEALLEGEDE%EMP� V TION.ANYVIOLATIONOFSECTION7031.SBVANVAPPUCANTFORAPERMITSU&IECTS7HEAPPLICANTTO Z Re-Rool � A CML PENALTY OF NOT MORE THAN FNE HUNDRED DOLLARS(f50D).): l p ❑I,ASOWNEROFTNEPROPERTY,ORMYEMPLOVEESWITHWAOESASTHEIRSOLECAMPENSATION, � COR1If1BfC181 Z WILL DO TME WORI(,AND THE S7RUCTURE IS NOT IMENDED OR OFFEFiED FOR SALE(SEC.7ou,BU51- J � NESS AND PFOFESSIONS CODE:THE CONTHACTORS LICENSE UW OOES NOT AFPLV TO AN OWNER OF � PROPERTVNM1IOBUILASORIMPROVESTHEREON,ANDWHODOESSUCHWOFKH7MSELFORHERSELFOR m � THROUGH HIS OR HER OVM EMPLOYEES,PROVIDED THAT SUCM IMPROVEMEMS ARE NOT WTENDED OR w OFFEAEDFORS/�LEIF,FIOWEVERNEBUILOINOOHIMPROVEMENTISSOIDWITMINONE�EAROFCOM7LE- � TION,THE OWNER�BUIIDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). � _ �LASOWNEROFTNEPROPEHfY,/JAE%CLUSIYELYCONTR�CTINOWITHUCENSEDCOMPACTORS w TO CONSTRUCT THE PROJECT(SEC.7011,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U8t1Of1 ADJ.AREA � CENSE LAW DOES NOTAPPLV TO AN OWNER OFA PROPERTV WIIO BUILDS OR IMPROVES THEREON,AND WFqCONTMCT5FOR5UCHPAQIECTSWITNACANTAACTOR�S)LICENSEDPURSUANTTOTMECONTMG QUANTITY DESCRIPTION FEE Y TORS UCENSE LAW.). J " •(/�c,� O I AA1 E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � ¢ E1z 1�m LL DATE OWNER ~ /F �/ ,/N A��a Z W �� Q LICENSED CONTRACTORS DECLARATION i j uj � 2 i I HEREBY AfFIRM UNDER PENAL7Y OF PERIUFY THAT 1 AM LICENSED UNDER PqO�IS10N5 OF CHAPTER �r � p� Y(COMMENCIN(1 WITH SECTION 7000)OF DINSION 3 OF THE BUSINE55 AND PROFESSIONS CODE.AND � "�� ' � X MY UCENSE l5 IN FULL FORCE AND EFFECT.� LLI /n/ � LICENSE CLASS "rf'��B UC.NO. � � � � VDATE �I•C-'O� GONTRACTOR C a w ff - Ud,�lrS � WORKERS'COMPENSATION DECIARATION � — g" ,��,(rF � I HEREBV AFFlRM UNDER PENALTV OF 7ERIURV ONE OF hIE FOLLOWINO DEIX.ARATIONS: Z `� �`�� C� Q CJ _I HAVE AND WILL MAIN7AIN A CERTIFICATE OF CqNSENT TO SELF-INSURE FOR N9RKER5' 2 a� .��'� Q COMPENSATION,AS PROVIDED BY SECTION 3]OOOF THE UBOR CODE,FOH THE PERFORMANCE U OF TNE WOi1X FOR WHICH THIS PERMIT IS�SSUED. � � /�,E `i�f� � �� w ✓I HAVE ANO WILL MN�MAIN WORNERS'COM7ENSATION INSURANCE.AS REOU�RED BV SECTION Q 37000F7HELABORCODE,FORTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS ISSUED.MV WORI S'CAMPENSATION INSURANCE CARRIER ANO POLICY NUMBER ARE: CONSTRUCTION � CARRIER_ �0�� PLAN REVIEW 0 vaicvN�••��^ � �7 � � ELECTRIC ' Z Q PLUMBING � (fF65SECIlONNE�NOT8E001.WlEfEDOFhEPEP1NTISfORONEFUFDRED0011/Ji5K10010R1E5S1 w MECHANICAL Z I CERTIFY hiAT IN THE PERFORMANCE OF THE N�OFlK FOR WHICH 1HIS PERMIT IS ISSUED,I , (,�} SHALLNOTEMPLOYAN'/PERSONWANYMANNERSOASTOBECAMESU&IECTTOTHE INSPECTIONFEE � WORKERS'COMPENSATION LAWS OF CALiFORNI AGREE THAT IF I SHWLD BECOME � SU&IECTTOTHEWORKEqS'COMPENSATKKJP OVI SOFSEC �7aoOFTHEIABOF ISSUANCE � CODE,I SHALL FORTHWITH COMPLV WITH SE P NS. O SMIP p DATE: Z�Zw/ APPLICANT: J ENERGV P/C J WAqNING FAIIURE TO SECURE N'ORKEAS'CO E ATION CO E IS UNU L.AND SHALL BE � SUBJECTAN EMPLOVER TO CRIMWAL PENAL D CML FIN V TOONE H NDRED THOUSAND ENERGY PERMI � J DOLLAFS(f 100.000),IN/�DDITION TO THE C F COMPENSAi N,OAMAOES AS PROVIDED FOR IN - �i�;- � _ _ � SECTION 3]OB OF THE LABOR CODE,MTER sT,�o nrrotwers FEEs. RETENTION FEE: "' , w CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � , O � I HEREBV AFGIRM UNDER PENALTV OF PERIURV THAT TNERE IS A CONSTRUCTION LENDING AOENCV �- FOR THE PERFORMANCE OF TME WOR1(FOR WHICH THIS PERMIT IS 1SSUED(SEC.3oW,CIV.C.). ' W � LENDER'S NAME � - _ F_- LENDERSPDORE55 wI CERTIFY THAT I HAVE HEAD TNIS APPLICATION ANO STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES I O � I AGREE TO GOMPLY WITH ALL CfTV AND CqUNTY ORDINANCES M1D STATE LAMS RELATING TO BUILDING � CONSTRUCTlON,AND HEHEBV AUTHOFIZE NEPRESENTATIVES OF THIS COUMV TO ENTER UPON THE Z A80VE-MENTIONED PROPERTY FO N ECTION PURPOSES. COMMENTS � �� m PERMIT7EE NAM RIN7) � '/2r�� Sf6NATUREOFP Ee DATE RECPT.NO. PAID BY LIDATION � 2 ~ � WHITE—Department Copy,YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENROO—File Copy,GREEN—Applicant's Copy / \ (�9��`( �6� ��G�9� �/�1f� ��i�l�C��'8�� f��C�I�iH� � ��u�U�1 DD L�� 'OG�`^��rU� �pCC�rLl� � " D �`t� Of�1 �° O ' ��,:. P �u:.: SET BACK FLOOR JOIS i ' FTGS/FORMS/S7EEL � _ j_ FHA REC�MTS � ELECTRIC GROUND UNDEH FLOOR DUCT � GRQUPID PLUMBING UNDER FLOOR CUMDUIT SLAB GRADE i4 FIREPLACE FOUNDATiON TEP/IP POWER FfREPL.ACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 �. BONQ BEAM FRAP/IINGNENTILlATIOIV FfNAL BOND BEAM ROOF COVER PRE-GRADING � ROUGH HEA7'ING BENCHING ROUGH ELECTRlC � ROUGH GRADING R�UCaH PLUIVIBING � FINISH GRADINC � SHOWER/TUB TEST POOL ELECTRIC E7C7. LATH/�IDlNG POOL FEN�ING WALL fi�SULATION POOL FINA� � CEILING il�lBU�ATION � OFF SITE IMPS. DRYWALL NAILINCi DEDICATtONS SEWER FINAL ENG. SEPTIC TAiVK LANDSC,4PE/IRRIG. SEEP PIT/L.L. ON SITE 1MPS. , GAS AIR TEST FlNAL ZONING FINA�CONST. `� FIRE DEPT. FWA� FINAL HE,4TING � HEALTH DEPT. FINAL � FINAL ELECTRIC • DEV. FEES PAID FINAL PLUMBING, . ENERGY . . , �, , , G ,_____—_._ �_�_,_ a. ...,.,��_�. .... �- • '_ : _ C��/I�� iedu.!7Z S'��L �� 5—� SEPTIC TANK SIZE SEEP PIT/U SIZE � h (Y� --- � � � �, - � � � � �_ � � � � ��°� � I