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Home My WebLink About11-557 ��_ CITY OF DIAMOND BAR ✓ � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �j 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PIRESS �'��'� BUILDING PERMIT APPLICATION FIRMLY N JOBSITE '�Q �j�Q`��n� �� _�� APPLICATION � PERMIT p/C o ADDRESS O / l�� DATE NUMBER # `r APN LOT TRACT ISSUE � O // TYPE OCC DATE CONST. GROUP °C OWNER R, CC-�S O p ADDR S C� DUY' ZONING SETBACKS Z CITY �i� 1 CJLGI� ZIP TEL7 .� FRONT RW p � APPLICANT TEL. „ O REAR ❑ � SIDE/SIDE STREET RW ❑ i ¢ CONTRACTOR � T e� SIDE ❑ � ADDRE S IZ � N L- I °C PROPOSED USE I � CITY / Q. ZI - TEL. .7 w ARCWENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADD/REM I HEREBV AFFIRAI LINDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CONTRACTORS U- G3f8g0/C2fPOR W CENSEUWFORTHEFOLLOWINOREASON(SEC.7037.SBUSINESSANDPROFESSIONSCODE:ANYCITYOR (n U COUN7VWHICHREOUIRESAPERMITTOCANSTRUCT,A�TEfi.IMPROVE,DEMOLISH,ORREPAIRANV57RUC� � W TURE.PRIOR TO ITS ISSUANCE.ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUAN7 TO THE PROVISIONS OF 7HE CONTRACTORS LI� � � CENSE LAW(CHAPTER e(COMMENCING WITH SECTION 7ooa)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSPe , � FESSIONS CADE)OR 7HA7 HE OP SHE IS EXEMPTTHEREFROM AND THE BASIS FOR 7HE ALLEGED E7(EMP- (� V 710N.M1V VIOLATION OF SECTION 7031.5 BV ANY APPLICAN7 FOR A PERMIT SU&IECTS 7HE APPLICANT TO Z Re-Roof I A CIVIL PENAL7Y OF NO7 MORE THAN FIVE HUNDRED DOLLARS(fsoo).): � ❑I,ASOWNEROFTHEPROPER7V,ORMVEMPIOYEESWITHWAGESASTHEIR50LECOMPENSAT10N, � COfI1rtIBfClel �� Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFEPED FOR SALE(SEC.7ou,BUSI- ,_I 'I � NESS A/JD PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NO7 APPLV TO AN OWNER OF � � PROPERTV NhiO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THA7 SUCH IMPROVEMENTS ARE NOT IN7ENDED OR m w OFFEREDFORSALE.IFHOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWI7HINONEVEAROFCqM7LE� � TION,THE OWNER�BUIL�ER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOq 7NE PURPOSE OF SALE). � _ ❑I,ASONRJEROFTHEPROPERTY.AME%CLUSIVELYCONTRACTINGWITHLICENSEDCAMMC70R5 W Q TO CONSTRUCT THE PR0.IECT(SEC.70�t,BUSINE55 AND PROFESSIONS CODE:THE CONTqACTOFiS LI� VBIUdIlOf1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOANONMEROFAPROPER7YWHOBUILDSORIMPROVESTHEREON,AND � WHOCANTRACTSFORSUCHPRQIECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). QO I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U LL � DATE OWNER v Z W �Q LICENSED CONTRACTORS DECLARATION W 2 t HEREBY AFFIRM UNOER PENALTV OF PERJURV 7HAT I AM LICENSED UNDER PROVISIONS Of CHAPTER � O C� /� �^ � B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CODE,AND Z � �i(�.J AIY IICENSE IS IN FULL FORCE AND EFFECT. � LICENSE C SS ��✓ LIC.NO. ✓I Z�� /' � � V DATE CONTRACTOR / 1 a W � WOFKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIflM UNDER PENALTV OF PERJl1RV ONE OF THE FOLLOWING DECLARATIONS: Z Z I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SE�F-INSURE FOR WORKERS' a _ Q COMPENSA710N,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR THE PEHFORMANCE U Q OF THE WORK FOil WHICH THIS 7ERMIT IS ISSUED. � w �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV`WORKERS'COM,P/�ENSATIO INSURANCE CAHRI`ER AND POLICV NUMBERARE: CONSTRUCTION ¢ CAqRIER I� �\ U..C� �x/'�V1�iC.n�`'-- PLAN REVIEW � �� Z POUCYNUMBER ELECTRIC ` ¢ �'�7."'f� 0 (iHU^SECiIONNE�NOTBE00MR.EfEDOFTHEPEPoMISFORONEMN�DREDDOUARS�S100)ORLESS} PLUMBING �'T^ W Z I CEFiTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL U' SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORNERS'COMPENSA710N LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � � SUBJECT TO THE WORKERS'COMFENSATION PROVISIONS OF SECTION 37000F THE LABOR ''']� � CADE I nSHA,LL ORTHWITH COMPLV WIj H�THOSE PROVISIONS. ISSUANCE � y �� L�- ��l�� v��l� SMIP p DATE: APPLICANT: J WARNWG FAILUHE TO SECURE WORNEF7S'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJECTANEMPLOVERTOCRIMINALPENALTIESANOCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLL4R5(Stoo,000�,IN ADDITION TO THE COST OF COMPENSA710N,DAMAGES AS PROVIOED FOR IN l^ � SECTION 3708 OF THE LABOR CODE,IN7ERE5T,AND ATTORNEV'S FEES. FETENTION FEE: �-v N OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � t HEREBV AFFIRM UNDER PENAL7Y OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOF THE PERFORMANCE OF THE WORK FOR wHICH 7HI5 PERMI7IS ISSUED(SEC.3oB7,CIV.C.). . Z W � LENDER'S NAME H LENDER'SADDPESS � TOTAL FEES ?�� I CERTIFV THAT I HAVE READ THIS APPLICA710N AND STATE THAT THE ABOVE INFORMATION IS CARRECT. w I AGREE TO COMPLV WI7H ALL CITV AND COUN7V ORDINANCES AND STA7E IAWS REUTING 70 BUILDING � CANSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTEF UGON THE � ABOVE�MENTIONED PROPERTY FOq INSPECTION PURPOSES. Z COMMENTS � � ��P��1 C�- ��(�� m PERMI EE NAM (P � - � ( p � � SIGNA OF qMITTEE TE 2 RECPT.NO. PAID BY VALIDATION � ~ WHITE—DepaAment Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOIDENROD--File Copy,GREEN—Appticant's Copy Co�V C�� D9AiV�01�� BA� IY�S�I�CTB0�9 �IECOR� �° �1��0��}:'�;,�� j o. � � � � • . �.s' �*` f. .... ..�;' i,' :��s �.s��i��n. �. SET BACK FLOQR JOIST FTGS/FORMS/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 I'OOL EL'ECTRIC 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 FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING �__i � �( __ __ ENERGY _ _____________ _ � � -�— �)=f4-v."v `�" �..(�_^'/+��4 x �"Y�f�',MW COMMEiVTS SEPTIC TANK SIZE SEEP PIT/U SIZE �,�� a� � � ��_�� ,� r�. = � � �W � ; . �a •y3 f r t� ��':� � lY�� x�