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Home My WebLink About18027 (10) cir�o�D�orm B� ��'h`'` DEPARTMENT OF COMMtINi7`Y&DEVELOFMENT SERVICES I� 21825 E.Cogley Drive ��04}s�a�rss F��409�s�l-3117 PRESS ""%�w*" BUILT3ING PERMIT APPLICATICMN FiRMLY � JOBSITE � ^► ` _ � ( � APPIfCATtON ��.. ��(\'��RMIT �/'!�/C � ADQRESS 1tJ ^-��Y_.. \.!� DATE U MF3ER� o" # o� ��y� ISSUE TYPE K?CC APN LOT THACT_, DATE CONST. GRQUP p OWNER Puite Hames " ApDRE5S 18401 Von Karman Ste 240 zar�iN� sETaacscs � cETv _J.�Yi.O�._— zi� 92612rEG. 9497974400 FRor�r Rw o p APPLICANT � TEL. REAR [� n - SIDEISIDE STREET RW O � CdNTRACTOR_ SAME _ _ SIDE G] � ADDRESS � ClTY ZtP TEL. PROPOSED 4JSE ��+.+ ARCHlENG! z DESIGNER HOVE3 D(.'St tl NO.dWEL. NO. NO. a AdDRESS '�—� G'W OY' @►1 er f". UNITS STORIES BEbRQQMS � CITY �2Wp��t"t C ZIP L. �Z � I DESCRIPTION SQ.FT. FACTOR PSF ADJ,AREANAL�ATION O4WNER-BUILDER DECLARAT�ON gFi41ADp1REM 1 HEftEBY AFftRM UNDEIi PENAETY pF FEp.�RY THA7 i AM EkEMFT FRt)M THE CONTRACTORS Li- (jy(y98/GdfP01t W CENSELAWFOqTHEFOLLOWWGREASON(SEC_To31.58USINES$ANDPROFESSIONSCODE:ANYCI7YOR (� � COUNTVWHIGHRE�UIRESACERMITTOCONSTRUCT,AL7ER.IMPROVE,bEMOUSH,ORREPAIHANY5TRUC� W pytI0ID8Ck W TURE.PR1L)R TO ITS ISSUANCE,ALSO REaVIRES THE APPLCANT FOR SUCH PERMIT 70 FIIE A SIGNEO .� STA7EMENT TNAT NE 4R 5HE i5 LIGENSED PUilSUAN7 TO THE PROVlSM5N5 OF TNE CONTRACTORS ti� � CENSE lAW(CHAPTER 9{GOMMENCING WITN SECTION tooR�QF OIVISIQN 3 OG THE BUSINE55 AN�PRO- �'1' POOUSPB Q FESSIpNSCODE�oRTHATHEORSHEISEXEMPiTHEREFROMANDIHEBA5I5FOR74fEALI.EGEDEXEMP- � TFON.ANYVIOCATIONOFSECTIONT037.59VANYAPpLiCAMFORAPF.flMiTSUBJECTSTNEAPPLICpNTTO Z Re-Roof � A CIVl4 PENAL,TY QF N07 MORE 7HAN fiVE HllNDRED O(XtARS(25a6�.}�. Q LII,ASOWNE%OFTHf:PROPEATY,ORMYEMPL9YGESWlTHWAGESAS7HEIfl501ECOMPENSATNJN. � Commercia� ,--r,4 WILtDU iHE WOFUC.AND THE STRUCtURE IS NO7IN7ENpE6 oR oFFERED FOR SALE(SEC.7oad,BUSI. ,! NESS AM1R)PROFESSiONS COOE:TH[GON'RACTORS�ICENSE lAW DOES NOT APPLY TO AN O�JNER oF N PROPEATYWHQBUIfDSOPib1Pft�VES7HEREON,ANUWHp00ESSt�liWpRKHIMSEIFOiiHERSEtG"oq � [[ THROUGH HIS Op HEROWN EMPIOYEES,PRqVIOED TNAT 5�GH IMPROVFAdEN7SAAE AO7 WT[NtlEDQH � W pFFEREDGOpSALE.iF,HON/EVER,THEtlUILDING4RIMPROVEIAENTISS(1LDWI7HINONEYEAROFCOMi'LE- 0 T10N,THE OWNEA$UI6DEF;N1ItL HAVE iHE BUFiDfN OF PROVMG T1�IAT HE Op&HE DID NOT 9UILD OF � IMPROYE FOq TNE PUftPO:�E OF SALE}. � ❑I,AS OWNEN OF TNE:PROPERTY,AM E%CLUSNELV COMTPACTINp WITH LICENSEU CCINTRACTtlRS W TO CANSI'RVCi THE PROJFCT(9EC.70aa,BUSINESS AN�PROFFSSIONS CO�E THE CpN7RACTORS L4 . � Valuation ._.._, _ ApJ.AREA W CENSELAWDOESNOTAPP�_YTOAt�64lNEROFAPFtOPERTYWHOeUitDSbRiMPRpVESTMEREON.AND F WFIpCONTRACTSFOf75UCHPHOJECT5WITHACONTRACTOR{SjUGEMSEDPU£iSUANTTOT3{ECANTRAG QUANT�TY DESCRIPTION FEE x TORSUCENSELAW). � �I AM EXEMPT UNDEfS$EC.,_ 8.a P.C.FOA THIS REASON Q � .�._—._ .� .— � _ � u' DATE_... _ 4WNER�. ..._._.. � a LIt;ENSED CONTRACTORS DECLAAATiON � ¢ CC I NEREBY AFFIRM UNOEA PENALTY OF PEAJURY THAT t AM UCENSeD UNDER PROViSiONS�F CHAR7ER � .L. q. 9�COMMENCINGWITHSEC7iON7oo0)OFOIVISIONJOFIHGBUSINESSANDPRO�ESSI�NSCODE.AN6 z V MY�iCENSE 5�N FULL f=ORCEAND EFFECT � � UCENSE CiASS n ...,._L(C.Nq._,._�`�1 t�3 3 ._, � � qATE Exp 9/�3Q 01 CONTRACTQR._,� u..�� - W _.. � WORKERS'COMPENSATION DECLARATION Q � � � IHEREBYAF�IRMUhAERAENAITYOFPERJURYONEOFTHEF6LLOWWG�ECURATIONS � Z G? I HAYE AN�WILL MAINTAINA CEFTIFICATE Of CONSENT TOSELFlNSUHE fOft YlORKERS' 2 � COMPENSATION.AS PROVIDED 6V 9EC710N 3�oU OF THE LABOR CODE,F6R 1HE PERFORMANCE tU .._. OF THE W�RK FOR W'HICN THIS PE%Mli IS ISSUED. � � W _4 HAYE AND WILL MAINTAIN WORKER9'COMIPENSATION INSURANCE,AS ftE9UiREU BV SECTION Q 3]q0 pF THE LABOR CODF.FOR THE PERFORMANGE OF THE WOPK Foft WHlCH THiS FERMlTlS d ISSUE0.MY WOPKER">'COMPENSATION INSURANGE CARRIEftAND POLICY NUMBERAftE' CONSTRUCTION ,,, y, cnaaiEa p�CIfIC Emp! �C1S. r.Q. PI.ANREVIEW � POIICV NUMBER_._ . ELECTRIC Q t� 1 � {i}USS€cttoNNEERNeTaL�7EcorTi�FH�AitswRorvePNRDaEDtXJu.Pasib'�ro70AI.ESS7. PLUMBING ..-- ._�!� W Z" I CERTIFV TNAT IN THE:PERFpRMANCE OF THE WOFKFOR WHICHTNIS PEFiMIT IS ISSUF�,1 MECHANICAL ,,,_ — �} SHALL NpT EMPLOV A4Y PEflSON IN ANV MANNEF SOAS TO BECOME 5UBIECT TO T4E � WORlSERS'CQMPENSATtONlAW50FGALiF6RNIA.ANOAGREFTHATiFiSHOUi.OBECOME �NSPECTIONFEE _ _,_„ , � SUOJECT TO THE WOFIKERS'GOMPEN5ATK)N PROVI510NS QF SECTIDN 4]OOOF TNE LA60fl �—'�-"N'� � Co�E,I SMAIL FORiH'NITH COMPLV WITHTHOSE PpOVISIONS. �SSUANCE ��/° a Pulte Homes SMIP Cy DATE'...__. .,_ APPLICANT. _, ..._. .._. - " — W ENERGY P/C J WRpNING:FAILUftE TO 5ECl1AE WORKEfiS'COMPENSATION COVEAAGE IS U411AWFUl,At7D SHAtL 0E ' "— � SU&IECTANEMPLOVERTOCFIIMINAI.P[NALTIESANbCIVILFWESUVTOONEHUNDREDTHOUSANp ENERGYPERMtT DOICARS�Sion,0007.�N AADITItNt TOTHE CC551 OF CAMPENSATION,�AMAGES AS PROVIf1ED FOR In �— "" � SECT70N 37a6 UF THE lABOfl S:40E,i�'TEREST,AND ATTORNEV'S FEES. RETENTION FEE: . ._ � CONSTRUGTION IENDING AGENGY PRE•ALT FEE: .—..�. a � IHEAE6YAFFiRMUtYDEAPEWFITVOFPERJURYTHATTHERE�SACONSTRUCT�ONLENDINGAGENCY , n- FqR TME PERF-0ftMPNGE DFTt4t WORI(FOR WHICN TH15 P£RM�T IS ISSUED ISEG.3DST,GIY,G). W t�[� }ef � LENtlER'SNAME �OI�G iPU�IG�.i. ._..._..._. � ..._ F— LENOEfl'SADDRESS._ _ ... — � i CERTIFY FHAT i HAY=riEAD TNlS APPUC:Ri16N A�YD STATE T1tAT'NE ABOVE iNF6RMAT�ON IS COPRECT TOTAL F EES � y _ �� w I AGREE TO Cf7M4lY W}TM ALL G{TY ANQ COUNTY 4flDINANCES AND STATE IAWS REIATiNG TO BU��ING �•�' � CONuTRUGTION,ANO hEREOV/1U7HpRIZt REPAESENTATNES OF THI$COVN'Y TO EWTEft UPON THc ZABOVE�MENTItiNEDPROPEPTYFORINSPEGTIONPURPO5E5. COMMENT$ „_.,_ . � J ..� ._..�.�..�.��... ..� � ...._. . ...�_..._._. . ' � m PEFMIREE NAME(PRINT) _..._ . ----.-- — Q � � ._.� .�� .. T.. ..._... ' � � SIGNATUftEOfPE.RMiTTEE DAT6 _ � ��_ � RECFT,NQ. PAItT BY VA�I6ATION �� '"` WNlTE--0epartment Copy.YELt..OW—Finanoe Copy,PiNK—Assessor Copy,GOLDENflOD---Fi�e Copy,GREEN—ApplicanYs Copy .'6 e 4_ " ^��,aa? ., . .��`��'�p �,.s "� �.s-��Y� "�"'� iM. ... .... .. . ... .. .... 4 m ._ .. .. _ . . ... . .. . .. . .. � .�°y � �.� ay' ', ..... —._ . , .� - ... . ... ._ ... ... . , � ,- 5 �r p -' -- � �: . : y �� . _... ._.... . ._. . �� `" ��:� �� 4 �• . . . . . . . . .. .. .. . . ... ... ... ... a �� , �a' §�� '� .... . -. - . �"i� ��u°�� r��°��*�.s'" _ _ � � M .�„ „ ; i �,y TI 1 =.� :.` ,a � . . ... .... .. . ._. ...... . . ��. k ' i r{ :� 19L o . . . . .. . ... . .... . .... S 16 ; j F 4� � ..4 �: .. . . _ . ... . .. � . � k�.k� Y;a r€'�, r=jj i `�: �� . . . ... . .. .... . ._ (� ..t' r_ , : `^� .. . .. . . 4 j .-1 � � i ,�'2 .�.. , . .. . .. . . ��. i . � "{:.a i ... . ._. .... ._ . . _... .. .. ... _. .. n: � t i �..;,:��' .��, .. . . ... . — . •ax.'�. , : ... ....... — . i r : � � ��.. .. . . 1 ,� .� �. . ... .. . —. . . � . �u. s. .,i� _... . .... .. . _ <' .� .F �Y ..�, . . .. _ .._.._. ( >,. " �c '� . .. . _ .. „_ � ...�.. . -- � I(L. III I ADDRESS ADDRESS • APN LOT TRACT OWNER Pulte Homes ADDRESS 18401 Von Karman Ste 200 CITY Irvine zIP 92612rEL 9497974400 APPLICANT !TEL. CONTRACTOR-SAME ADDRESS CITY ZIP TEL. ARCH/ENG/ DESIGNER Hove Design ADDRESS X40 N@W Or Center Dr. CITY Newport C ZIP 9266*L.9497600812 OWNER-BUILDER DECLARATION I HEREBY AFFIRM UNDER 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 ANYAPPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500).): D 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 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 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). D 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 ACONTRACTOR(S) LICENSED PURSUANTTO THE CONTRAC- TORS LICENSE LAW.). 0 I AM EXEMPT UNDEFI SEC. B. &P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBYAFFIRM 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 517593 A LICENSE CLASS LIC. NO DATE Ex t)9/3 0 0 1 CONTRACTOR Pu Ite 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: fic Empl Ins.Ca. CARRIER Paci POLICYNUMBER• •OKL130I• UIPt (THIS SECTION NEEDNCT BE OUMPLEl'ED 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 SUBJEGT TO THE WOFIKERS'COMPENSATION PROVISIONS OF SEGTION 3700 OF THE LABOR CODE,I SHALL FORTH'NITH COMPLY WITH THOSE PROVISIONS. Pulte Homes DATE:APPLICANT: WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE SUBJECT AN EMPLOYER TO CFIIMINAL 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. CONSTRUCTION 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 None(Pulte) LENDER'S ADDRESS CERTIFY THAT I HAVE READ TI-IS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT AGREE TO 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. PERM(TTEE NAME(PRINT) SIGNATURE OF PERMITTEE DATE EI Cr 0 0 w w 13- U) CO CO C� Er 0 in W W QE 0 LL 0 LI W 0 U W CI) W Q W U C/J 0 0 w J J LL U w d 0 Cr a W tr W O1- 0 J co co C/) C/) 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 f NU B r 1/C M R 1�V DATE 0 ISSUE TYPE OCC DATE CONST.GROUP ZONING SETBACKS FRONT RW^ REAR^ SIDE/SIDE STREET RW^ SIDE^ PROPOSED USE N0. DWEL. N0. N0. UNITS STORIES BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ.AREA/VALUATION SFR/ADD/REM W Garage/Carport LLI Patio/Deck LU LL Pool/Spa 0 Re-Roof Z Commercial 5 CO Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J U W W Z CL U Z CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING 4 Imo' MECHANICAL INSPECTION FEE �� ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES COMMENTS RECPT. N0. -PAID BY VALIDATION WHITE-Department Copy,YELLOW-Finance Copy, PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-Applicant's Copy