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Home My WebLink About18247r C3 cr 2 0 w z g zd. O C3 L" 0 CnCn N EL O O ZUZ li l �Q v O Z CAD cc W O Z W EL W O Z Qo xd W U Lu N N Im C W tR Cn 7a. W Z C7 1:n S O m J J Dc LL, In_ O Q ICL W H1 L C Q a CITY OF DIAMOND BAR DEPARTMEN7 OF COMMUNrN & DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION ADDRESS 14 A� APN LOT TRACT 260 OWNER L ADDRESS 12.-7(*) CITY1.r ZIP TEL APPLICANT TEL. CONTRACTOR ADDR SS CITY ZIP'125�-j TEL. ARCWENG/ DESIGNER 51 i ADDRESS ' CITY ZIP TEL. -ti3Z) OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- CENSE UW FOR THE FOLLOWING REASON (SEC 7071.5 BUSNESSAND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER. IM°ROVE. DEMOLISH. CR REPMR ANY STRUC. TURE. PRIOR TO ITS RSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUMHT TO THE PROVISIONS OF THE CONTRACTORS Ll - CENSE UW (CHAPTER 9 (COMMENCING WITH SECTION 70001 OF DIVISION 7 OF THE BUSINESS AND PRO- FESSIONS WOE) OR THAT HE OR SHE 15 EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7071.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS IESOO) Y. O L AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS 1HE:R SOLE COMPENSALON, WILL DO THE WORK AND THE STRUCTURE IS NOT VrENDCO OR OFFERED FOR SALE ISEC. 7044, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH SUCH ARE NOT INTENDED OR OFFERED FOR SALE IF,HOW EV ER THE BULDWO OR OAPROVEMENTLS SOLD WITHIN ONE YEAR OF CDMPLE- TION. THE OWNER'BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BURR OR IMPROVE FOR THE PURPOSE OF SALE). O LAS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70N, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE UW DOES NOTAPPLY TOAN OWNER OFA PROPERTY WHO aVIDS OR IMPROVES THEREON. AND WHHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S) LICENS W PURSUANT TOTHE CONTRAC- TORS ONTRAGTORS LICENSE LAW). O IAM EXEMPT UNDER SEC. B. A P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM LICENSED IND ER PROVISIONS OF CHAPTER I (COMMENCING WITH SECTION 7000) OF DIVI5ION 3 O THE BUSINESS AND PROF ESSONS CODE, AND L1Y LICENSE tS N FULL FORCE AND EFFECT. �f LICENSE CUSS LIC. NO. 1 E• Q�y�� DATE `�� CONTRACTOR 44XIIM.,ti7s.l�+yl� r WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELFUNSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 1700 OF THE LABOR CODE. FOR THE PERFORMANCE J` OF THE WORK FOR W4 1CH THIS PERMIT IS ISSUED. I HAVE AND VALL 4MNTAN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BY SECTION • 700 OF THE LIBOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHHICHHTHIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION WSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER �ilrNAt-C3" �-fl at 9 POLICY HUMBER 1 3 1 7 G{ 115-12 (THSSEcnoN NEED NOT BE ODAfirED OFTHE PERMIT b FCRCNNE HUNDRED DOLLARS (5100) OR LESS( 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICHHTHIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON N ANY MANNER SO AS TO BEGONE SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHHOULD BECOME SUBJECT TO THE WORXERS' COMPENSATION PROVISIONS OF SECTION 7700 OF THE LABOR WI CODE.I SHALL FORTHTH COMPLY WITHTHHOSE PROVISIONS. DATE: APPLICANT: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SMALL BE JECrAN EMPLOYE SUBR TO CRIMINAL PENALTIES AND CML FINES UP 10 ONE HUNDRED THOUSAND DOLLARS (f t0o,000), N ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR N SECTION 7709 OF THE LABOR CODE, INTEREST, ANO ATTORNEYS FEES. j CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEFIMI7 IS ISSUED (SEC. 7097, CIV. C.). LENDERS NAME LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION 15 CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATWO 70 BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERM I OF S ATURMI EE DATE WHITE—Department Copy. YELLOW—FPlance Copy, PINK—Assessor COPY, GOLDENROD—File Copy, GREEN—ApplicaRt'I COPY PRESS FIRMLY APPLICATIC4 z O 2 PERMIT L< �y P/C DATE �P NUMBER A) N ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIOE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE On A NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADDIREM U) Garage/Carport U Patio/Dock LL POOUSpa ZRe -Roof / Commorcial 5 CID Valuation ADJ.AREA QUANTITY _j1ESCRIPTION FEE J C��L.rl�l IFF 4 Co CCW6 +� S z Q U Z Q S W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE H SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES COMMENTS RECPT NO. PAID BY VALIDATION '� CITY OF DIAPti/iOND BAR INSPECTION' rRECOtiD _��►��-�=j�Is1��.�►�.+-'_�:�C� SET BACK ~' _iI��VE-��►�.��;t"'��.1.. j _ _ i � :�l�.t-��c�'�f�iil r �'`°I��.c',^�►�+'f��,ci j j�FLCOR JOIST.. FHA REO"ATS I UNDER FLOOR DUCT . I Ut1DE=R FLOOR COr•!DUIT IFIREPLACE FOUNDATION FIREPLACE BOND BEAM FTGS/FORMS/STEEL ELECTRIC GROUND I GROUND PLUMBING_ _ SLAB GRADE I TEMP POWER WATER SERVICE — _ ROOF SHEATHING —_-_ 1 MID HT. BOND BEAM I— -- 1 1 b FT. BOND.BEAM --- I FINAL BOND BEAM — FRAMINGNENTILIATION ROOF COVER I PRE -GRADING_--' ROUGH HEATING BENCHING ROUGH ELECTRIC - ! I� ROUGH GRADING I FINISH GRADING ROUGH PLUMBING _ SHOWER.ITUB TEST - _ _— i tt POOL ELECTRIC EXT. LATH/SIDING I i POOL FENCING WALL INSULATION _ _ I POOL FINAL CEILING INSULATION l_ l i OFF SITE IMPS. DRYWALL NAILING �- _ -- DEDICATIONS SEWER } FINAL ENG. _ SEPTIC TANK 1. LANDSCAPElIRRIG. SEEP PIT/L.L. GAS AIR TEST . — ! f1, ON SITE IMPS. FItlAt. ZOr4RJG FINAL"CONST. ' _ — q;..,..--.... FINAL"HEATING I I — — ' _FIRE DEPT. FINAL HEALTt-I DEPT. FINAL I I DEV: FEELS PAID -I�- — __`•{�� -_— i ---------- _. -- — —._ FINAL ELECTRIC FINAL PLUMBINGENERGY —� COMMENTS--- --- SEPTIC TANK SIZE SEEP PIT/U SIZE — -' T -'- -