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Home My WebLink About10-1167 I . . ��,_ 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)839-7 PRESS '°�'� BUILDING PERMIT APPLICATION FIRMLY N JOBSITE APPLICATION PERMIT� // p/C o ADDRESS � ��Z- �Q R'R,.D/�I'LaG � DATE _ NUMB�� ISSUE �j� /�� ` TYPE � �/ OCC APN LOT TRACT DATE � � CONST. �•� p OWNER GEf/N�/�lb G/'7�i4y�,lL3r GROUP p ADDRESS Z'i-o02. GE�DAlLQ�L � ZONING SETBACKS Z cirv i'�RHo.uQ /�/�IP TEL. �JT1 Z`�I�7 FRONT RW O � APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ z � CONTRACTOR E�wO /�'//j- SIDE p ADDRESS �6I/S" P�"��- � E• � CITY �-�/1-�� ZIP�3�'dZ TEL.�,JS�D� •z�L PROPOSED USE o ARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNEA-BUILDER DECLARATION � SFR/ADD/REM I HEHEBV AFFIRM UNDER PENALTY OF PERJURY THAT I AM E%EMPT FROM THE CONTHACTORS LI- G8l0gB/C2fPOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7o31.58U51NESSANDPROFESS10NSCODE:ANVCITYOq (� U COUN7YWH�CHREOUIRESAPERMITTOCANSTRUCT,ALTEH.IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� w TURE,PRIOR TO ITS ISSUANCE,AL50 REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STA7EMENT THAT HE OR SHE IS LICENSE�PURSUAN7 TO THE PROVISIONS OF THE CANTRACTORS LI� � � CENSE UW(CHAPTER e(CAMMENCING WITH SECTION 700a)OF DIVISION 3 OF THE BUSINESS AND PRO� POOUSP3 � FESSIONS CADE)OR THAT FIE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED E%EMP- (� V TION.ANY VIOLATION OF SECTION 7031.5 BY ANV APPLICAN7 FOR A PERMIT SUBJECTS 7HE APPLICANT T0 Z Re-Roof � A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLURS(i500).): 0 ❑�,ASONMEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � Commercial Z WILI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70I�,BUSI- J � NESS AND PROFESSIONS CADE:THE CANTRACTORS LICENSE LAW DOES NOT APPLY 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 EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT IN7ENDED OR m OOFFEREDFORSALE.IF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWI7HINONEVEAROFCOMPLE� Z TION,THE OWNER�BUIL�ER WILL HAVE THE BURDEN OF PROVING 7HAT HE OR SHE DID NO7 BUILD OR � IMPpOVE FOR THE FURPOSE OF SALE). W ❑I,ASOWNEROFTHEPROPEFiTV,AMEXCLU5IVELYCON7RAC71NGWITHLICENSEDCAMRAC70RS ([ 70 CONS7RUCT THE PRQIECT(SEC.7a�,BUSINESS AND PROFESSIONS CODE:THE CON7RAC70R5 LI� V81U8flOn ADJ.AREA W CENSE UW DOES NO7APPLY 70 AN ONRJER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � NMOCONTRACTSFORSUCHFRQIECTSWITHACONTRAC70R(S�LICENSEDPURSUAN770THECANTRAG pUANTITY DESCRIPTION FEE Y TORS LICENSE UWJ. � � J Q ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOFi THIS REASON Q � U � � DATE OWNEH U / Z W � LICENSED CONTRACTORS DECLARATION W � I HEHEBV AFFIRM UNDER PENALN OF PERJURY THAT I AM LICENSED UNDEH PROVISIONS OF CHAPTER � � B(COMMENCINGWITHSECTION7oao)OFDIVISION90F7HEBUSINESSANDPROFESSIONSCODE,AND X MY LICENSE IS IN FULL FORCE AND EFFECT. L1J m / Tk �.1EA ��I�- h+,e" � � � LICENSE CLASS� � LIC.NO. �� , V DATE L � I J CONTRACTOR a W � i�' Gt,!'�.E � WORKERS'COMPENSATION DECLARATION ¢ � I HEREBV AFFIRM UNDER PENALTV OF PEiiJURV ONE OF THE FOLLOWING DECURATIONS: Z � _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSEN7TOSELF-INSUREFORWORKERS' ¢ 2 �MPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE,FOH THE PERFORMANCE U Q FTHE WORK FOR WHICH THIS PERMIT IS ISSUEO. � � I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIHED BY SECTION Q 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INS ANCE CARRIER AND POLICV NUMBERARE: CONSTRUCTION Q � CARRIER�� PLAN REVIEW Z POLICY NUMBER Lt/ Q �' �'� ELECTRI � � Q � (iHISSEC?qNNE�NOTBECOMR.EfEDOF7FIEPEHAYTISFORONEHUI�DREDDOUAAS(5100)ORLESS� ING �� W . Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I ME ANICAL C7 SHALL NOT EMPLOV ANV PERSON IN ANV MANNEF SO AS TO BECOME SUBJECT TO THE � WOHKERS'COMPENSATION LAWS OF CA�IFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHElABOR � ` � CADE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. � p DATE:' �.�9/v APPLICANT: SMIP J WARNING FAILURE 70 SECURE WORKERS'COMPENSA710N CO AGE IS UNLAWF ,AND SHAIL BE ENERGY P/C � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5700,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN / J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. E � • a CONSTRUCTION LENDING AGENCY , � , p _�E� O ' � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT7HERE IS ACONSTRUC710N LENDING AGENCV � FOR THE PERf-0RMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7097,CIV.C.). Z W � LENDER'S NAME F— LENDER'SADORESS � TOTAL FEES ��.�'-/ � I CER7IFV 7HAT I HAVE READ THIS APPLICA710N AND STA7E THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPLV WITH ALL CITY AND CAUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CANS7HUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUN7V TO ENTER UPON THE � ABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. Z COMMENTS � J ,rQ Q9t� �i9�i�'Z- � m PERMI77EE NAME(PiilNn � ¢ ' �' �I'` 'f � SIGNAT�PERM E � . DA7E � /b � _ � RECPT.NO. PAID BY � VALIDATION ~ WHITE—Department Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROa–File Copy,GREEN—Applicant's opy C61�'V �(F DG�6V�01�� ,AC� . . IY�S(�I��UOi� ��CO�D F "F � oa�p��400a ac��c� oa�r��c�4oa oa�p�c�4�a� � '��a��;�. ��a��i� �� F;, SET BACK FLOOR 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 SHOWERlTUB TEST POOL ELECTRIC 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 FINA�ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY ��o � COMMEi�TS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � �