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Home My WebLink About11937 (5) ---�'�=+� CTTY OF DIAMOND BAR COMM[3NTTY DEVfiLOPMENT DEPARTMENT C 21660 E.Copley Drive Suite 19D jj (909)86a319S Fax(909)861-3117 g��f�� vv , �'°"',� BUILDING PERMIT APPLICATIGN f 1°�r '� FIRMLY � JOBSfTE �-28�- ��/�� /�.�� APPLICATIQf� !J PERMIT l o ADbRESS --' � DATE �~�'"�� NUMBER ` P/C�� ' # `� APN LOT � TRACT �� DA EE CONST. GROUP p OWSJER �l.sg/d�r�N'J�� i��'r`9'— T " ADDRESS �' � �t�i�i' '� ZONING SETBACKS ry Z CIN �l'' ��TGS ZIP �is"'�S TEL � 1L��c`��' -a FRON7 _ /� RW ❑ � APPLICANT TEL. REAR �� z �j SIDE/SIDE STREET !S RW � a CONTRACTOR 6/�Z11 ?�C G SIDE _. /"27 � Q ADDRESS � PROPOSED USE .�� C1TY ZiP TEL. w ARCHlENG! � w DESiGNER �� NO.DWEI.. NO. � NO. �..T a ADDRE5S UNITS I STORIES BEDROOMS � � CITY P TEL c� v� DESCRIPTfOfd SQ.FT. FACTOR PSF ADJ.AREAJVALUATION OWNER-BI:IIDER DECLAAATION SFR/ADD/FlEM � o . /�/ 5 f� I HEREBY AFFIRM UNDEfl PENALTY OF PERJURY THAT I AM E%EMPT FqOM THE CANTMCTOfl4 ll- f W CENSEIAWFORTHEFOLLOWINGRFhSON{SECJo31.66USINESSANDPROFE5510N5CODEANYCIIYOR Garege/Carport � U �' U WUJ7yW�iIqiREOU�AESAPERMITTOCONSTRUCT,ALTEk,ItaPROVE,DEMOLISH,ORREVAIqpNVSTFUG � � TURE,PRIOR TO li:ISSUANCE,q�gp REQUIRES THE APPLICANT FOR SUCH PERMIT TO flLE A SIGNED w atiolDeck '�'~3 � STATEMENT THAT HE OH SHE IS UCENSED PUpSUANT TO 7HE PROVISIOTIS OF SHE CONiMCTORS�F � CFNSELAW(CNAPTERB(CJJA�MENCINQWITHSECTION70DOJOFDIVISION3OFTHEBUSINES3ANDPRO- � POOUSpe FESSbNSCODE�ORTHATHEOFSHEISEXEMPTTHFREFRpMANDTHEBASISFORTHEALLEOEDEXEMP- (� UTION.ANYVIOLATIONOFSECTION703150VANVAPPLICWJTFORAPERMITSU9JECTSRIEAPPUCANLTO Z Re-Root ACiVlLPENALTY OF NOT MORE TFIAN FIV�HUNDRED DOLlAftS�55W)): � D6ASOWNEROFTHEPflOPEflTY.ORMYEMPLOYEE5WI7HWAGESASTHEIP50LECOMPEN5AT10N, � COttlme(Clal WILL DO THE WOAK�D TNE STRUCTURE 15 NOT INTENOED OR OFFEREA FOR SALE(SEC.7oN,BUSI- J � NE55 AN�PliOFES510N5 CO�E:THE CONTRACTOFS LICE7.75E l0.W OOES NOT AV7LY TO AN OWNEft OF � PROPER7Y WH00UILDS OR IMPHOVES THEREON,AND WHO DOES SUCN WORKNIMSELF OP HERSELF OR [[ THRDUGHHI30RHEROWNEMPLOYEES,PROVIDEDiNATSUCNIMPROVEMENTSARENOTiNTENDEDOR m QOFFEREDWRSALEIF,HDWEVER7NEBUILDINGORIMPNOVEN6NTISSOLDWITNINONEVEAqOFCOMP�E- � TION,THE OWNER•BIIILDER WILL HAVE 7XE BURDEN OF PqOVINO THAT HE OR SNE 010 NOT BUILD OR = IMPROVEFORTNEPl1RPOSEOFSALE) W OI,ASOWNEqOFTHEPROPERTY,AMEXCLUSIVELYGONTRAC7INGWITHLICENSEDC0�7TRACTOR3 [[ TO CANSTRUCT'IHE PANECi(SE0.to<9,BUSINESS AND PR�FESSIONS COD@ THE CONTpACTORS LI- V21Ud�ion L ADJ.AREA W C[d.IgELAWDOESNOTAPPLVTOANOWNEROFAPqOPERTVWHOBUILOSORIMPROYE5TF1EqfON,AND FWHOCbNTRACT5FON5UCHPP0.IECTSWITHACONTPACTOR(S�LICENSEDPUPSUANTTOTHECONTRAG QUANTITY DESCRIPTION Y TOAS ULENSELAW). FEE � O I AM EXEMP7 UNDER SEC. 8.E P.C.FOR iHIS REASON Q � U _ ti � OATE oWNER V Z W � LICENSED CONTRACTORS DECLARATION W � 1 HER�V AFFIRM UNDEH PENALTV OF PERAURY THAT I AM LICENSED UNDER PROVISIONS Of CHAPTER � (L 9(COMMENCWGWITHSECTtON7ao0)OF'ONISION30FTHEB4SINESSANDPROFESSIONSCODE,AND Z `X MV LIGENSE IS IN FIILL FORCE ANO EFFEC7 3 3 fj! m fl IICENSE C/L�ASS T�� UC N0. � � � WDATE h ~" "� !�[__ CONTRACTOA �` � d � WORKERS'COMPENSATION DECLARATION � � � �i f � y i HEREBV AFFIRM UNDER PENALTY OF PENUR�ONE OF THE FOLLOW WO DECIARATION � Z Q � „_,_IHAVEANDW�LLIAAINTAINACERTIFICATEOFCONSENTTOSELF•INSUREFOH'NORKERS' _ COMPENSATION,ASPpOVIDEDBYSECTION3]ooOFTHELA80ACO�E,FORiHEPERWRMANCE U Q OFTHEWORKFOHWHSCf�THISPERMITI515SUE0, � � �W I MAVE ANO WILL MAIMAIN WOFKERS'COMPEN5ATION MSUAANCE,AS AEDUIRED BY SECTION ryryry 4 37UOOFTH£LABORCODF,FO%THEPERFOflMANGEOFTHEWORKFORWHICHTHISPEHM1T15 �/SQ�r �� ISSUFA.MY WO K 51'COMPE T��ION/WSURANCE CAflR1ERAND PO�ICY NUMBERARE: CONSTRUCTION �l / � CARRIEH ��7 GI r101 _ PLAN REVIEW � ,�q � Z POUCVNUMeEf1_/�',f��{�T�"`, �-�—' ^ � ELECTRIC � �•d'� Q �,c*Q 4 (iFi15SECf10NNE�NOT8ED7MR�mOFiFEPEfiMffSFnRQVE1MDFWOd1MSryt0�0ALES5� PLUMBING I Q W ICERTIFYTHATINTNEPERWFih1ANCEOFTHEWORKGORWH�CHTMSVERMITISI55UED.i MEGHANICAL ��•�x Z [� SHALL NOT EMPLOY AtlY PEPSON IN ANY MANNER SOAS TO BECOME SUBJECT TOTHE � WORKER5COMPENSAi1oNLAWSOFCNIWRNU.A1JDnGREE7HATIFISHOULDeECOME INSPECTIONFEE = SUB,IECT TO THE WORKERS'COMPENSATION PqpVI5pN5 OF SECTION 370o OFTHE IABOfl CODE,I SHALL FORTNWITH COMPLY WITH THOSE PROVISIONS _ �SSUP.NCE �' o / �f��2J26�(/ r�i9C.��iL. sM�P ll'77..9a1 • " p DATE:�_� APPL7CAM: T � WqRNIN6:FAILURE TO SECURE WORKEFS'COA�iPENSATION CAVERAGE IS UNIAwFUL,ANO SHALL BE ENERGY P/C•'�' � SU&IECTANENPIOYERTOCRIMINALPENALT�ESANDCIVILFWESUPTOONEHUNDHEDTHOU50.ND ENERGYPERMIT 4 DOLURS(f laD.aDo).IN PDDITION TO THE COST OF COMPENSATION,D1JMC3E5 AS PROVIDED FOR IN � SEGTqN 37oe OF THE LABOR CODE,WTEFEST,ANO ATYOPNEY'S FEES • � RETENTION FEE: ` [ � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � O � 1 HEREOY AFFIRM UlAER PENA�n'OF PERIURY TNATTHERE�5 ACANSTRUCTIDN LENDINCa ACENCY � FORTHE PERFOFMANCE OF hIE WOPK FOR WHNN THIS PERMIT I5155UED�SEC.3Wi.CIY C�. Z W � LEN�ER'S NAME 1� LENUER'SADDHE55 ' � ICERTIFVIHATINAVEREADTHfSAPPLICATI�NANOSTATETHATTHEABOVEINFORMATIONISCARRECL TOTAL��ES �� ,Ly, (`7�• L W IAGREE70GOMPLYWIT}IALLCITYAN�COUNTVORDINANCESANDSTATELAWSRELA71NG108UI�DINO J" 6 CONSTRUCTION,AND HEREBY AUTHORI2E REPHESENTATIVES OF T1iV5 CWHTY TO ENTER UPON THE �y z ABOVE-MENTIONEDPROPERTYFORINSPECTIONFURPOSES. COMMENTS �� t� � m ��:��... � P ITI'EE NAME(PRIM� „ � � TUREOFV MI ;' — DATE = RECPT.NO. �' PAID BY VALIpATION ~" WHITE—De anment Co YELLOW—Financa Cop,P{NK—Assessw Co GQLDENROD—Fde Co GREEN—A I�canPs Co P PY. Y PY• PY, PP PY �Bl�( �1� [?IAc,tE�i`�� 6�fi i Ei�.�'s��T�C?�6 i�E��fiC� , I ,� ' • � � �. I � R � � d a � R � � �' � � II ET BACK ' FLQGt�JaIST , i I FGS/FQRMSISTEEL' FHA(�EQMTS • LECTRtC C�ROUND UI�DER FLOOR DUCT • � Ft(�Uf�d PLUMBtNG ,��r�z S UNDER FLOOR CO�ti1Ul7 � k.AB GFtADE 0 � S� FIREPLACE FOUNDATION I . , i EMP F{JtN�R FIREPLACE BONR BEAM ''• • � � j JFVTER SERVtGE MIQ NT. BOND BERM IOG�F SFlEATti{t1G • f7 8 FT. BOi�IQ BEAM RP,fVEIhlCzNENTIL1ATiON FfNP,L B(�ND BEAM t00F COVER PRE-CRADING �Ol`!GH HEATft�G BEtVCHitVG �OUGH ELECT,RIG � ROtiGH GRADII�G �OUGN PLUMBING - FINISH CRADING ;�Qy��Ug�'��g "POQL ELECTRfG :XT.LRTN/S(DENG POUL FENCtNG NALL iNSULATION - ' P(�OL Fft�Al. .EfLl��G lhISULATION OFF SITE INIPS. �RYVlrALL NAILIRIG dEDtCATIUNS 3EV`dEFt F!tVAL EiVG. 3EPT4C TAl�tC LANDSCAPE/1RRIG. �EEA PiT/L.L. �;' "' ��, �N SITE IMPS. .�AS AER TESi' �� a� �-'" ' -•K-�"'� FIf�RL ZONfNG FiNAL CONSI'. - � FiRE DEPT.FtNAL FlNAL HEATING NEALTH DEPT.FINAL FtfVA�ELECTRIC ' DEV. FEES PAIQ • F4NAL PLUMBlt�lG I ENERGY • .� 1 ' � ` � , � I r m � � � . � '' Ct��r1fVlE�lTS ZI � �_� � '�. g �� ,.� �- � � � _� . , �� f� o �' �' ' , • +�� • . . � �� , � , .-� . �, , ^ �, ', � � L . , , . .. �•, �: , x,� .... ; . . � , - ' S SEPT6C TRNK S!ZE . t�" "� �' " 3 2 SEEP PIT/t1 Slr_�= � ' �.�`� _,,.,?`�;,-ry....»,. �' _�� .. � � � .�.,., ...,,... . ., � S ` ', _� � �' � . � � f � �f _ '� " �.'.F'f� � CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21660 E. Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION / PRESS ADDRESS-_:-' owitv.,/vi OW APN LOT ,S- TRACT,.....<-//6 OWNER 17:4/eOAM/1.06- 1----Th':a-- i/Z14:-YgAt— r ADDRESS ;""xIg4IS — CITY 71,ii-'S-A17-6 ZIP zz,_s TEL.9257,66...7-7121 APPLICANT TEL. CONTRACTOR #4e7241ii rif e- ADDRESS 4 CITY ZIP TEL ARCH/ENG/ DESIGNER /1 ADDRESS CITY P TEL OWNER-BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AAA EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE ANY CITY OR COUNTY WHICH REQUIRES A PERMITTO CONSTRUCT,ALTER,IMPROVE,DEMOUSH,OR REPAIR ANY STRUC- TURE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW(CHAPTERS(COMMENCING WITH SECTlON 70Do)OF DIVISION 3 OF THE BUSINESS AND PRO- FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- noN.ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500)): 0 LAS OWNER OF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044,BUSI- NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW 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 IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF,HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COUPLE MN,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE) 0 I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044, BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S)LICENSED PURSUANT TOTHE CONTRAC- TORS LICENSE LAW). DI AM EXEMPT UNDER SEC. B.&P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND MY LICENSE IS IN FULL FORCE AND EFFECT LICENSE CLASS LIC NO 7373 ./7e ..g DATE 8-,/y-7 7 CONTRACTOR 4e 11'- WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONZ--L3 1 I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, ti. I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY W03K 5'COMPE TIZSURANCE CARRIER AND POLICY NUMBER ARE CARRIER,..5 a ei POLICY NUMBER ;AZIFLOMINIIINIFMISii (THIS SECTION NEED NOISE COMPLETED OF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100)ORLESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT To THE WORKERS COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME . SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS DATE: 7-1175/- APPLICANT: 416/0/215#/4316/71(C.--. WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES • . CONSTRUCTlON LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC. 3097,CIV C). LENDER'S NAME LENDEFrS ADDRESS L I CERTIFY THAT I HAVE READ THIs APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. ' I AGREE 70 COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING To BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. .........03IMPRE-CNAME(PRINT) >---5/G91,6TURE OF P MLITTEE------,__ DATE) APPLICA DATE TIC4 ,.... -5--'---- PERMIT X 9, 3/pie a/ip. NUMBER" # /E2-� 610 ISSUE DATE TYPE OCC CONST. GROUP FRONT SEfBACKS ZONING REAR SIDE 70 RW 0 PI - ID .2S SIDE/SIDE STREET 03- RW o /0 0 PROPOSED USE N0. DWEL. .......c.Pg UNITS / N0. STORIES -Z-• BEDROOMS 7 DESCRIPTION SQ. FT. FACTOR PSF ADJ.AREANALUATION SFFt/ADD/REM 9 e. ..9 -5-7f, Garage/Carport 2 BM VP-.. 0 11-1 atio/Deck .--- 3.r (..5 Pool/Spa Z Re-Roof E J Commercial 5 En Valuation 3/Y Vb',I, ADJ.AREA QUANTITY DESCRIPTION FEE -t < 0 X I- C.) LLI -J U.I C../ Z 33 M D -I 0- -I 1 < 0 2 a I 0 CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE 2615,c-o ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: — PRE-ALT FEE: 1711.iff3 Z3p.av /OO. ,D /69,OC. /77.94/ 00. era IC 7.2 12 A., . 1114111111! ,F,.! .,,,lippliy 411211M MILap "mIF-Alw. .aro TOTAL ---- COMMENTS :AO v AV I 111 w FEES SI,rli- 'I.., RECPT. N0. "110 PAID BY NNW VALIDATION', 111,44. WHITE-Department Copy. YELLOW-Finance Copy, PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD \s- 'INSPECTION,: DATE ',INgPE SPECT! .11. ATE INSPECTOR'. ET BACK - FLOOR JOIST I-GS/FORMS/STEEL FHA REQMTS • • LECTRIC GROUND UNDER FLOOR DUCT • , . ,ROUND PLUMBING 'S. 7,st ,e, UNDER FLOOR CONDUIT . LAB GRADE 07i. M /-,C/ . FIREPLACE FOUNDATION FIREPLACE BOND BEAM '." . E P POWER !ATER SERVICE MID HT. BOND BEAM 100F SHEATHING A/7h.7 8 FT. BOND BEAM "RAMINGNENTILIATION FINAL BOND BEAM IOOF COVER PRE-GRADING IOUGH HEATING BENCHING lOUGH ELECTRIC .. ROUGH GRADING IOUGH PLUMBING - . - FINISH GRADING " POOL ELECTRIC ;HO ERTI-UB TEST EXT. LATH/SIDING POOL FENCING rti ALL INSULATION r i POOL FINAL EILING INSULATION OFF SITE IMPS. 3RYWALL NAILING T DEDICATIONS SEWER FINAL ENG. SEPTIC TANK ' LANDSCAPEARRIG. SEEP PIT/L.L. ---;;---- , ON SITE IMPS. 3AS AIR TEST hizka. i.e,:e---(6.. _ FINAL ZONING FIRE DEPT. FINAL FINAL CONST. FINAL HEATING t_ /SiIIS HEALTH DEPT. FINAL FINAL ELECTRIC • v. 7 FINAL PLUMBING •,:r� ^ .._ COMMENTS f- Arroldr-0-- ti ...e....l --/7, , , ;: EZZ_f_A2Cd2/eV/r ,,,0100"Ilar. ,.... . •4 ?M , ....7 . ..e.:- .411......_ • • 1 - //7 ,.•, • --7--- • �� • • • � , , A ialliffireglairMair - ,r,dar 1 - -a • / ./ ...,, .... . - ...... s --------------- �r diD 43')171/ SEEP PIT/U SIZE