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Home My WebLink About13-267 ��_ 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� 27 PRESS '"^' BUILDING PERMIT APPLICATION FIRMLY � DDRESS r �� DATE� o.Zv �� NUMBEfl� ZT'� #/C � ISSUE TYPE OCC APN ,L�T� TRACT DATE CONST. GROUP p OWNER � ` o ADDRE S � Q,J� lI �j ZONING SETBACKS z CITY ' � �P TEL : "� a FRONT q�y p � APPLICAN �J . � . TEL. - 1 ' REAR p Z SIDE/SIDE STREET RW ❑ ¢ CONTRACTS� . � SIDE ❑ ADDRE 'V � CITY ZIP TEL. � PROPOSED USE o ARCH/ENG/ iz DESIGNER NO.DWEL. a ADDRESS � NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION i p� OWNER-BUILDER DECLARATION SFR/ADD/REM O Q I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G818g0/CBfPOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANYCINOii (n U CpUNryWHICHRE0UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC� w 7URE,PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck � S7ATEMENT hiAT HE OR SHE IS LICENSED PURSUANT TO THE PHOVISIONS OF THE CON7RACTOPS LI- � � CENSE UW(CHAPTER B(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINE55 AND PRO� POOVSPB , 0 FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANOTHEBASISFOR7HEALLEGEDE%EMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PEflMIT SUBJECTS THE APPLICANT TO Z Re-Roof A CIVIL PENALTV OF NOT MO{iE THAN FIVE HUNDRED DOLURS(3500).): � ❑I,ASOVMEROFTHEPROPERTY,OHMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � Commercial Z WILL DO THE WORK,AND THE STRUCTURE IS NO7 INTENDED OH OFFERED FOR SALE(SEC.701/,BUSI� J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND NMO DOES SUCH WORN HIMSELF OR HERSELF OR WTHROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALE.IF,HOWEVER,7HEBUILDIN�ORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING 7HAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PUHPOSE OF SPLE). W ❑I,AS OVJNER OF THE PROPERTY,AM E%CLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTOqS Q TO CONSiRUCT THE GRQIECT(SEC,7oI1,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V81U0110f1 ADJ.AREA W CENSE LAW DOES NOTAPPLV 70AN OWNER OF A PROPERTY WNO BUILDS OR IMPROVES THEREON,AND � NM1iOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR�S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.j. � ❑I AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON Q ?� U � � DATE OWNER H � w � LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIFM UNDER PENALTV OF PERJURV 7HAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � B(COMMENCING WITH SECTION 7000)OF DIVISION 9 0F THE BUSWESS AND PROFESSIONS CO�E.AND Z XL� MY LICENSE IS IN FULL F��CE AND EFFEC7. o � �:> > � '"/� � � UCENSE CLA LIC.NO. � V DATE CONTRACT a W � WORKERS'COMPENSAT�ON DEC ARATION Q � I HEREBY AFFIRM UNDER PENAL7V OF PERJURY ONE OF THE FOLLOWING DECLAiiATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' ¢ � 2 ¢ CAMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U Q O WORK FOR WHICH THIS PERMIT IS ISSUED. � w I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOF WHICH 7HI5 PERMIT IS ISSUED.MV WOR 'COMPENSA71 I URANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION ¢ i'�r,./�'� > cnaaieq _ _ - PLAN REVIEW Z POLICY NUMBE �� ,' �� ELECTRIC Q 0 (IHISSEC�IONNEmNOTBEOJNPLE�EDOFTHEPEMYTISFORONEHUFDREDDOLLARS(5100)ORLESS). PLUMBING Z I CERTIFVTHAT IN THE PERFORMANCE OF 7HE WORN FOR WHICH THIS PERAIIT IS ISSUED.I MECHANICAL (.�} SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS 70 BECOME SUBJECT TO THE (/� WORK RS' OMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE = SU&1 CT THE WORKERS'COMPE PROVISIONS OF SECTION 97o00F THE UBOR — O CA ,I A FORTH�.�ITHCOMP WITHTH s%aovisioNs. ISSUANCE p DATEI 'APPLIC SMIP J WAR G:F URE TO SECURE WORNEfiS' NSATION COVEPAGE IS UNLAWFUL.AND SH BE� ENERGY P/C � SU CTAN MPLOVERTOCRIMINALPE SANDCNILFINESUPTOONEHUNDREDTH 5 D ENERGYPERMIT '� DOLLARS(5700,000),IN ADDITION TO TH 5T OF COMPENSATION,DAMAGES AS PROVIDE F IN J SECTION 37oe OF 7HE LABOR CODE,IN RE57,AND ATTORNEV'S FEES. � p� RETENTION FEE: OCONSTRUCTION LENDING AGENCY PpE-ALT FEE: � 1 HEREBV AFFIRM UNDER PENALTY OF PERJURY 7HAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. Z W � LENDER'S NAME F— LENDEH'SADDRESS w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES � � I AGREE TO COMPLV WITH ALL GTV AND COUNTV ORDINANCES AND STATE LAWS i7EUTING TO BUILDING � CANSTRUCT ON,AND HEREBY AUTHORIZE FEPRESENTATIVES OF THIS COUNTY TO ENTEN UPON THE Z ABOVE-MEN IONED PROFERTV FOR INSPECTION PLRPOSES. COMMENTS ' � � � � — � ¢ PERMITTEE IN7) � . / �' / ��a//.. / � SIG U OFP RMI EE DA —�-T Z RECPT.NO. � � PAID BY VALIDATION ~ WHITE—DepaAme Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy I CI�V �� DGQ►61��D�D �Q►R Bi�S6�f�C��0�9 �I�C�9�� ,Y, _ _ _ � . . �, `Oa�3pC(�400a DC14C� '� ��1�pC��r'Oa Oa�pC�C�400a DQ4C� ��I��CC�4bG1 'X 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'L BOND BEAM ROOF SHEATHING � 8 FT. BOND BEAM FRAMINGNENTILATION � ; FINAL BOND BEAM ROOF COVER � PRE-GRAQING ROUGH HEATING j BENCHING ROUGH ELECTRIC i ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST � POOL ELECTRIC EXT.LATH/SIDING � POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION I 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. i FIRE DEPT. FINAL FINAL HEATING � HEALTH DEPT. FINAL - - ---._-_ _.___.----- - ------- --------------- ----------------------- FINAL ELECTRiC DEV. FEES PAID FINAL PLUMBING ENERGY -- C�i C�O�� -------- ---- COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � �