The URL can be used to link to this page

Home My WebLink About17331 (10) CdTY OF llIAMOND BAR �� DEPARTMENT OF CCIMMLJNtTY&DEVELOPMENT SBRVICES ��:i � 21825 E.C.opley Drive (909)860-3(95 Faac(909}8bi-3117 PRESS $UILDING PERMIT APPI.ICATION FIRMLY � JOBSlT£ � �.�'J j\ - -�� APLEICATIOM1I I I , �"� �l_NU BER_t t 1�/t �/C o ADDRESS_=�Q„V _�!_Qt: � RPN LOT TRACT , "`7- �l,t. ISSUE TYPE �—"--�- occ � —�17-�te OmG�s QATE CC}NST_.. C,RaUP p OWNER � ADpRESS �$�Q� g� arman t@ � ZONING SETBACKS z CITY (CVlfl� Z!p 92612rE�. 9497974400 FRONT AW i; � APPLICANT � TEL. REAR �� z ^ SIDE151DE STREET_�_ RW ❑ d CONTRACTpR� SAMC SIDE �7 � ADDRESS � CITY ZIP TEL. PROPOSED USE !" w ARCH/ENG/HOV@ Desi il z DEStGNER w � ' NO.DWEL NO. NO. c� ADDRESS ��-�@W�70Y'�—�-1�f�Y' �P�� CITY N�W�{7Yt._gC�ip 92660T��. 9R976008i 2 �NITS STORiES BEpR�MS cr� DESCRlPTIdN SQ.FT FACTOR PSF ADJ.AREANALUATIdN p� OWNER-BUILDER DECLARATIQN SFRIADDIREM O i HEREBV AFFIftM VNDER PENALTY OF pERJURY THAT 1 AM E%EMPT FflC7M THE CONTRACTpRS Lb G8f898/C3fPOft � CENS&LAWKORTHEFOLLOWINGREASON(SEC.]031.5BU51NESSANJPROFESSION5CODE:ANYCITVOR (n C.� COVMTYrititCHREQUEftE54PERMtTT4CONSTflUCT,AITER.iMPAQVE.DEMOtiSH,ORRE�AiRANYSTRUC- (jf patio/Deck W TURE.PRIOR TO ITS ISSUP.NCE,ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT 70 FIIE A 51GNEp w .�r STATEMENT THAT NE OR 9HE IS UCENSED PURSUPNT TO THE PROVISIONS OF TNE CONTRACTORS 1.1� � � CENSEl.hW�CtiAPTER 9(CAMMENCING W1TN SECTbN�ooa)OF DtV�SiON a bF THE 9VSiNESS AND pR0• POOIISpd FESSR7NSCO�E�ORTHATHEORSHEISENEAAPTTHEREFROMANDTNEBASI5FORTNEALLEGEDEXEMR � � TION.ANYVIOLATIbNaFSECT14NT43t.58YAMYAPA�IGANTFORAPERMRSUBJEGTSFHEAPPtiCANTT6 Z j�e-R66( A CIVII PENA�iY PF FiOT MORE THAN FIVE MVNDRED DOLtAqS�SSao;.): ❑I.AS4WNEROFTHEPROPERTVORMYEMPLOVEESwITHWAGESASTHEIRSQLECpMPEN5ATION, Q � Commercia! Wtll b0 FHE WOitK,hND TNE STflUCTUflE 4S N4T INTENDED Oft 6FFEREb K4R SAIE iSEC.?�d4,BUSi� J � NESS ANO PV10FE5SIONS CODE:TME GONTPACTORS LICENSE lAW DOES NOT APPLV TO AN OWNER OF � ��. PROPERTVYMOBUILD50F',IMVROYESTHEFEON,ANDWHODOE55UCHWOflKHIMSFLFORHERSEIFOR (� THqOUCaM HtS Oft HEft DNRd EMPI.6YEES,PR6VIDE�TNAT SUCH IMPROVE6dENT5AFtE NaT MTENOED OR m � OFFERE�FONSALE.IF,HON'EVERTHEBUILDINGORIMPROVEMEN71SSOlDWITMINONEVEAROFCOMPLE� �„ TION,ME OWNER�9UILDEH WILL HAVE THE BUFiOEN OF PROVING THAT HE OR SHE DIO NOT BUtLQ OR � lMPR6VE FOR THE PUiiP06EOF SALE). W ❑I./SOWNEROFTHEFROPERTV,AMEXCLUSIVELVCONTHACTINtlWITHIICENSEDCONTRACTORS [C TO CONSTRUCT THE PR0.IF:CT{5EC.7Pii,BUSINC5S RNb�ROfE55lONS C4DE:THE CQNiRACTORSIi� �JdItF2ti4ti ADJ.AREA W CENSE tAW OOES NOTApPI_V T4AN OWNER 4F p PflOPERTY WHO BUII.DS OR IMPRpVES TNEREON.ANb " � WHOCqNTAACTSFqRSUCHPq0.1ECt8WITWACONTRACTOR(S)UCENSF.DPURSUANTTOTHECONTRAG- QUANTITY DESCRIPTlON FEE Y TORS UCENSE LAW.J. Q �I AM EXEMPT UNDEFI SEC.�, J ,,,,,_,_ B.8 P.C,FOi1 THIS pEA50N Q ay U _ .,. __.. —.._—.. ¢ ,'�' pATE ...._ OWNER�. .. v � W `—�� l.ICENSED CONTRACTORS DECLARATIOY � CC I HEREBVAFFIRM UNDER PENA4TY OF PERJUHY THAf I AM LIGENSED UNpER PROVISIQNS QF CHAPTER � � 0 t�MMENGiN�}y�7N SECi16N?WD)OF DMSION S C1F THE BUStNESS AND PROFESSK3N5 C�E.AND Z W MY LICENSE IS M FULL FOHCE AND EFFECT. m C a I.tCENSECLASS nf1 !I� �1q LIC.NO. a`7[]��} .._ j ��•J� � pATE,�X�7 3t7 17�1 C4NTftAG70R. [`u�l� __ d W � WORKERS'COMPEN$A710N DECLAP.ATION � a � IHERE6YAFFIRMUNDERPENALTYOFPERJURVONEOFTNEFOLLOWWGDECLAR4TIQN5: Z � Gl . IHAVEANbWILLMAINTAINACERTIFICATEOGCONSENTTOSELF�INSUREFORWOftKERS' _ QCAMPENSATION,AS PRQVit}ED BY SECTI�N 3'IW OF THE 4ABOR COQ£.FOfi TNE PEfiFORMANCE `U ,,,^ OF THF WORK FOP YJHIGH THIS PERMIi IS ISSUE�. � C� W _i HAYE AND W�tl MAINTAIN WOftKERS'COMAENSAT�i�NSURANCE,AS iYEOUiRED BY SECTION � 37DO Of THE LABOP��00E,FOR THE P'eRFO%MANCE OF THE WORK F4fl WHICH THIS PERMIT 15 ISSUEA.MY WORKEFlS'COMPEN5ATION iNSURANC£c4ftPoER ANO POLICY NUMBER ARE: CONSTR�IG�ION a �AAR,Efl Pacific Emp(y�{I11ps.7�CO. " auNaeviEw ^� � POLICVNUMBER_, �4{�q�/1 ,_......—.— ... ELECTRIG '— Q . � (tfasSEcnpNrvEarr�37aE�c�.Er�nc�n+EaEp,a�SroRowEr+urioaEooxisns(Sim}cFliEss�. PLUMB�NG _. ... 4�,5d Z 1 CERTtFY?HAT tN THE AERFOftMANCE ClF THE WOftK FOH WHICH Tki1S PEftMIT i5 tSSUEG,I MECHANICA� , __ (,� 6HALLNOT EMPLqY ANV PERSON IN ANV MANNEF SO AS 70 6ECOME Sl1BJECT TD THE � WOFKERS'GOMPENSATipN LAW5 oG CAUFOPNIA,ANO AGREE 7HAT IF I SFIOULD BECOME INSPECTION FEE � St�JECTTOTHEWORK£RS'CUMFENSATIONPROVISIONSOFSECTK}N31000FTHEtA80R -- �� coDE,I SHALLtFORTHWIT+�H COMPLY W�TH TFqSE PROVISIONS. ISSUANCE p DATE: ��i�—VAPPLICANT: PU It� Homes S��p „ _.__.__ J WARNING FAIL.U{IE?O SECVNE W6PKEft5'CQMPENSATION COVERAGE�S UNtAWFUt,AND SHA�l.BE EIVERGY PIG _,.. ,_�, ,,,_ ,,, W BUBJECTANEMPLOYERTtlCRIMINALPENALTIESANDCIVILFME5UPTOONEHUNDREDTHDUSAND ENERGYPERMIT 40LLARS(f 1 W,o00),IN ADpI1lON TO THE COST OF COMPENSATION.DAMAGES AS PROVIOEb FOR IN � � � _Y.! 5ECi10N3TO90FTHELA00RC�E.iNTEftEST,ANDATTORNFY5FEE5. RETENTIONFEE: � _" d CpNSTRUCTIQN�ENDING AGENGY PRE-AIT FEE: a — - — � IHEFE9VAFFIflMUNDERPENALiYOFPERJUflYTHATTHEREISACON5TRUCTIONLENDINGAGENCV FOR;HE PERFORMANGE[7F-"HE WoitK FOft WHICN TH�S PERM�T IS ISSUfD tSEC,3a47.CIV C.}. Z }"' NOCIe I�UIC@ �. -- — lEN{}Et?'SNAME _.. .. , s F-- IENDER'SA�DHESS_. ...— wI CERTIFV THAT I HAVE READ'�HIS APPI.IGATION AN�STATE THAT THE A80VE INFORMATION 15 CO%PECT Tf7TAL FE ES C C'r n � 1 AGREE TO{{XJMPIT WITH Alt.CRY ANU GWN fY ORDINANCES 4Np STA7E GWS AE(.ATINfi.TQ BUItDING LJ V J V � CONSTFUCTIpN,nND HEFEB"AUiHORIZc'REP9ESENTATNES OF THIS COUNTVTD ENTER UPON TNE � ABOVE�MENTIONEQ YROPER7Y FOR 14SPECTION PUFPOSGS. ��MMENTS d . J _ —. '_. __ '__._�. � PERMITI"EENAME�PRINT�' � _' ' _ G7 �/y SIGNATIIREOFPERMITTEET� �ATE u = RECPT.td0. PAiD 8Y � VRLIpATION ~ WHITE—pepartment Copy,YELLOW—FinenCe Copy,PINK—Assessor Copy. OL ENROD—File Copy,GREEN—AQplicanYs Copy ,; h AR@ � -, i i� ��" "��., "�3 � �� `�'�'� - �` w. �.µ ,m,'��r�;'�.��.r" �fi^w�� _. ., �. . . � , . � . �� ,. �.. 9 . . �. �'° ��' ,� _ �`_ �. ,.. , . . , . . _, .. ..�' .. ..... -. � � . � ', ,��,,��^�� - � �-.� w � y .; �� ,. ; . . . .. ... ... .. .. . . .. . .. .. .. .. � . ,`!:� &a � � � _ : a�asg�' gd " . . .. . . . ... .._ . ._. i ? �i!.'N�?'��'� ti� .�i�sw� r,', .. . .. . _ '.��t �'��,�'��"� ' a� � '- .. ... . . .. . .. . _.... ...... '.. - s• r�,.- ._.. .. _. - �"�. tNPg ..: ... _ . . . . . . y��'+' - a I '. } �. �c a �t i o- �: � . .. . . _ .. . . . .. .. ... . . .�a � t� . . . . . . . _: ,-�,j, g ��a � w ��, ir`�c'� �"'�'�'e�`�� IK"P4H��A�. %. . . .. . . _. .. .. z {j� �, I- �i.��. 3r�4,��i $Yk 1p a " . .. . .. . . . . ^+` v.b t� � � � ��t��" � µ .. . . . ... . . .. . .. . .. . . .... . ... . ... ..... ��. f....... � L��:"� � _ � � -r .. . .... .. .. .. ... ,�3 t� s: 6 w�,G � .� . . x, : �7 �� i-�p �. ��. . ... ... -. .. ._ .. .. � � g s �° . . - � � .. I JOBSITE�, L,r 11 ADDRESS_V C APN LOT TRACT OWNER lt@ omes ADDRESS 18401 Von Karman.Ste ZDT CITY Irvine zip 926121EL. 9497974400 APPLICANT TEL. CONTRACTOR_SAME ADDRESS CITY ZIP TEL. ARCH/ENG/ Hove Desi n 9 DESIGNER ADDRESS effortCenter r. CITY Newport_Bci 92660TEL.9497600812 OWNER-BUILDER DECLARATION I HEREBY AFFIRM UN13ER PENALTY OF PERJURY THAT I AM 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 PERMIT TO CONSTRUCT.ALTER,IMPROVE,DEMOLISH,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 LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)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- TION.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).): ^ I.AS 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 OF 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 COMPLE- TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ^ I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTlNG 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 TO THE CONTRAC- TORS LICENSE LAW.). ^ I AM EXEMPT UNDER SEC. B&RD 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. A 517593 LICENSE CLASS LIC. N0. DATE Exp 9 30 O1 CONTRACTOR Pulte WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 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. 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 WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER Pacific Emp Ins. Co. WO PO I N R 4301187 L CY UMBE (THIS SECTION NEED NJT BE COMPLETED OF THE PERMIT IS FOR ONE HUNDRED DOLLARS($100)OR LESS). 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. Pulte Homes 5-100 P T A PLICANT: DA E 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 3708 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'HE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC. 3097,CIV.C), LENDER'S NAME None(Pulte) LENDER'S ADDRESS 1 CERTIFY THAT I HAVE READ': HIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTlON.AND HEREB"AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMITTEE NAME(PRINT) SIGNATURE OF PERMITTEE DATE CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION PRESS FIRMLY APPLICATION NPERMIT U DATE 9- B UI /C M ER # ISSUE-�-TYPE OCC DATE CONST.GROUP ZONING SETBACKS FRONT RW^ REAR L 1 SIDE/SIDE STREET RW^ SIDE^ PROPOSED USE N0. DWEL. N0. N0. UNITS STORIES BEDROOMS DESCRIPTION S0. FT. FACTOR PSF ADJ.AREAIVALUATION SFR/ADD/REM W Garage/Carport W Patio/Deck L LL Pool/Spa 0 Re-Roof Z 0 Commercial Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J 0 w W (D Z i-n 41.50 a Z U LU CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING 41.50 MECHANICAL INSPECTION FEE ISSUANCE 25. OG SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES 66.50 COMMENTS RECPT. N0. 1 U3 PAID BY VALIDATION WHITE-Department Copy,YELLOW-Finance Copy, PINK-Assessor Copy,�OLtENROD-File Copy,GREEN-Applicant's Copy