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Home My WebLink About10-1202 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 '��' BUILDING PERMIT APPLICATION FIRMLY � o� JOBSITE q / / � �1 1 DATE CATION NUMBEFj��/�O�#/C ADDRESS O� LD o ISSUE /�, D ��/� CONST.�)P� GROUP °r° APN LOT TRACT DATE p OWNER o ADDRESS F ZONING SETBACKS Z CITY �„�.Q,�� d� ZIP TEL D• 6 FRONT q�/y p o APPLICANT TEL. SIDE/SIDE STREET RW p ¢ � CONTRACTOR C SIDE p ADDRESS 4�/�/� C° � v...�J � CITY ��arw 4>ZIP�,'�%�� TEL. �=�s�6 PROPOSED USE � � � � oARCH/ENG/ � � z DESIGNER w NO.DWEL. N0. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADDIREM I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G3f8 JB/CB�OR W CENSE UW FORTHE FOILOWING REASON(SEC.7o31.5 BUSINESSAND PROFESSIONS CODE:ANY CI7V OR (n U CpUNTYWHICHREOUIRESA7ERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUG � w NRE,VRIOR TO ITS ISSUANCE.AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � S7A7EMENT 7HAT HE OR SHE IS LICENSED PURSUAN7 TO THE PROVISIONS OF 7HE CONTRACTORS LI� � � CENSE LAW(CHAP7ER B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF TNE BUSINESS AND PRO- POOUSPe . 0 FESSIONSCODE)ORTHATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALLEGE�E%EMP- � V TION.ANVVIOUTIONOFSECTION7031.5BVANYAPPLICAN7FORAPERMITSUBJECTS7HEAPPLICANTTO Z Re-Roof �� A CIVIL PENAL7V OF NOT MOFiE THAN FIVE HUNORED DOLLARS(S5o0).): Z ❑I,ASONTJEROFTHEPROPERTY,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COR1rtIBfClel WILL DO THE WORK,AND THE STRUC7URE IS NOT INTENDED OR OFFERED FOR SAIE(SEC.7oal,BUSI- J � NESS AND VROFESSIONS CO�E:THE fAN7RAC70R5 LICENSE UW DOES NO7 APPLY TO AN OWNER OF � PROPERTY NRiO BUILDS OR IMPROVES THEREON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER ONM EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMEN75 ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERTY.AME%CLUSIVELYCONTRACTINGWITHLICENSEDCONTRACTORS Q TO CANSTRUCT THE PRQIECT(SEC.70u,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS LI- V81118IIOf1 ADJ.AREA W CENSE UW DOES NO7APPLV 70AN OWNEH OFAPROPER7V WHO BUILDS OR IMPROVES 7HEREON,AND � NMOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOH(5)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAWJ. � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U ti � DATE OWNER F � W � LICENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PENAL7V OF PERJURV TNAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d B(COMMENCING WITH SECTION 7000)Of DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z MY LICENSE IS IN FULL FORCE AND EFFECT. m 6 �F � � LICENSE CLASS LIC.NO. �� . V DATE �� I Z CONTRACTOR a W � WOAKERS'COMPENSATION DECLARATION Q � � I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DECURATIONS: Z � � . ' � • � _IHAVEANDWIILMAMTAINACERTIFICATEOFCONSEN7TOSELF�INSUREFORWORNERS' _ Q CqMPENSATION,AS PROVIDED BV SEC710N 370o OF 7HE LABOF CODE,FOR THE PERFORMANCE `U Q Of�HE WORK FOR WHICH THIS PERMIT IS ISSUED. � w �I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE OF 7HE WOHK FOR WHICH 7HI5 PERMI715 ///��O ISSUED.MYWORKERS'�PENSA�SURANC=C�RIERAND��iMBERARE: ONSTRU 7 � J � t j CARRIER��l �r'Y� PLAN REVIEW Q POUCVNUMBER ��Jj ��'�9 ELECTRIC � 0 (IHISSEGTqNNE�NOTBECOA4LEfEDOFTHEPERMf�ISFORONEMII�DREDDOILPAS(5100)ORLESS} PLUMBING Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH 7HI5 PERMIT IS ISSUED,1 MECHANICAL �} SHAIL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSA710N lAWS Of CALIFORNIA,AND AGREE THAT IF I SHOULD BECAME INSPECTION FEE � SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR ' � CADE.I SHALL FORTHWITM COMPLV WITH THOSE PROVISIONS. � U C p DATE: APPLICANT: . MIP W J WARNING:F LURE O SECUFE WORKERS'COMPEN ATION COVERAGE IS UNUWFUL.AND SHALL BE ENERGY P/C � SU&lEC7 AN EMPLOYEF 70 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOLIARS(5100.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PHOVIDED FOP IN /� � SECTION 370B OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETENTI . �.�/� � CONSTRUCTION LENDING AGENCY PR ALT FEE: � �� .d � I HEREBY AFFIRM UNDER PENALTV OF PERJURY THAT 7HERE IS A CONSTRUC710N LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3ae7,CIV.C.). Z W � LENDER'S NAME F— LENDER'SADORE55 w� TOTAL FEES `�'/�9 � I CER7IFV 7HAT I HAVE READ THIS APPLICA710N AND STATE THAT THE ABOVE INFORMATION IS fARRECT. � � I AGFEE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOVE-MENTIONED 7qOPERTV FOR INSPECTION 7URPOSES. COMMENTS ' � /� J �. ` f.-f._ �'' �✓ I QJ m PERMITTEE N F�- ) �1 . /� � I � I�I. a (a1Jl/1L�� d•` ��d i � SIGNATURE OF R ITT DATE Z RECPT.NO. PAID BV VALIDATION ~ WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicanfs Copy CB�V C)I� DB�61�C�� A� . INSP�C�DO� IR�COB�� ,�:��'fla��c�400a oca�� :; .o��c�oQ aa��c�400a � �a� = oa��4a� ; SET BACK FLOOR JOIST FTGS/F�RMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR 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 COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC � ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION QFF 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 ��o � COMMENTS '� �n ' ��, 1z�� ——-- - �-`=�7�. � �cov��. `?�'_ /4 �'�� s 9Q��S�t_ _J _/�,�`�� '�� /�/' � / . -r .i�I_VY%�'�_/ •JC..i.��E.✓ �. C.i�� /� ' SEPTIC TANK SIZE SEEP PIT/U SIZE a � c� . : � ` �:�..