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Home My WebLink About11-1455 ��_ 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)839-7027 PRESS � '��', BUILDING PERMIT APPLICATION FIRMLY QJOBSITE � ~O�� DATECATIONiD rj�j !� NUMBER I��1�� #lC �— Q ADDRESS �I� � � � ISSUE �d ` / TYPE OCC APN LOT TRACT DATE lo��F-,� I� CONST. GROUP p OWNER " ADDRESS ZONING SETBACKS 0 Z CITY ZIP TEL. FRONT Ryy p � APPUCANT TEL. REAR p I � SIDE/SIDE STREET RW ❑ ¢ a� CONTRACTOR � 'tf..G f SIDE ❑ ADDRESS i .g- �. p PROPOSED USE o CI7Y l�vsh�qrr�� ZIP.��_ TEL. Gk5/)"�i�- � w ARCH%ENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS I � CITY ZIP TEL. UNITS STORIES BEDROOMS � � cr� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALiV OF PERIURV THA7 I AM E%EMPT fROM 7HE CONTRACTOFiS L�- G8f890/CB1pOR W CENSELAWFORTHEFOLLOWINGREASON(SEC.7037.58USINESSANDPROFESSIONSCODE:ANVCITVOR (n U CAUNTVWHICHREOUIRESAPEHMIiTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANV57RUC� W PeS10/DBCk w TURE,PRqq TO ITS ISSUANCE,ALSO REOUIqES THE APPUCANT FOR SUCH PERMIT TO FILE A SIGNED w i � STATEMENT THAT HE OR SHE IS IICENSED PURSUANT TO THE PROVISIONS OF THE CONTRAC70R5 LI� � � CENSE UW(CHAPTER e(CAMMENCING WITH SEC710N 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� POOVSP3 , Q FESSIONS CADE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR 7HEALLEGED EXEMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BV ANYAPPLICANT FOR A PERMIT SUBJECTS THE APPLICANT T0 Z Re-Roof . A CIVIL PENAL7Y OF NOT MORE THAN FIVE HUNDRED OOLLARS(5500).�: � ❑I,ASOWNEROFTHEPROPER7V,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COfI1fT10fClal Z WIIL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OfFERED FOR SALE(SEC.7ou,BUSI- J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPIV TO AN OWNER OF � PROPERTY NM1iO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER ONM EMPLOYEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m - I � OFFEREDFORSALEIF,HOWEVER,THEBUILDINGORIMPROVEMEN71550LDWITHINONEVEAROFCOMPLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NO7 BUILD OR � IMPROVE FOR THE PUHPOSE OF SALE). ❑I,AS ONMER OF THE PROPERTV,AM E%CLUSIVELV CON7RACTING WITH LICENSED CANTMCTORS � TO CONSTRUCT THE PROJEC7(SEC.7o�d,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V3lllflflOfl vJ ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEHOFAPHOPEP7VWHOBUILDSORIMPROVES7HEREON,AND � WHOCONTRACTSFORSUCHPHOJECTSWITHACONTRACTOR(S�LICENSEDPURSUANTTOTHECONT{UG QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.�. � ❑I AM EXEMPT UNDEH SEC. B.8 P.C.FOR THIS REASON Q � U � ¢ DATE OWNER F' ��OR�1 � W � LICENSED CONTRACTORS DECLARATION w ¢ I 2 I HEREBY AFFIRM UNDER PENALTV OF PERJURY 7HA71 AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(COMMENCWG WITH SECTION 7000)OF DIVISION 9 0f 7HE BUSINE55 AND PROFESSIONS CODE,AND Z ' LLJ MY LICENSE IS IN FULLAFONCE AND EFFECL m � LICENSE CLASS V�G�� LIC.NO. j U DATE ��U� �"I�� CONTRACTOR � �I� d � W � WORKERS'COMPENSATION DECLARATION Q NI HEREBV AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWING DECURATIONS: Z y � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOq WORKERS' a 2 Q CAMPENSATION,AS PflOVIDED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � ' w _I HAVE AND WIIL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REQUIRED BV SECTION Q 37000FTHE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS i �/y��-�_._a � ISSUED.MV WORKERS'CAMPENSATION INSURANCE CARRIER AND FOUCV NUMBER ARE: CONSTRUCTION 1�� , " Q � CARRIER PLAN REVIEW � POLICV NUMBER 7(rl1C��'��n� O)�Z�I ELECTRIC Z Q � ' (fHLSSECTIONNE�NOTBECDFIPLE7EDOFTHEPERMf�ISFORONEMMOfiEDD0UA0.S�St0U)OqLESS� PLUMBING Z I CERTIFV THAT M THE PERFORMANCE OF THE WORK FOq WHICH THIS PERMIT IS ISSUED.I MECHANICAL C7 SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS 70 BEGOME SUBJECT TO THE �/j WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECAME INSPECT�ON FEE = SU&IECTTO THE WOfiKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR 'C� � CODE,I SHALL FORTHWITH COMPIV WITH TMOSE PROVISIONS. ISSUANCE •`�'��• 1 0 � n �`` p OATE: (�_ APPLICANT. v11�� Wn'N� SMIP o�S J WARNING:FAILURETO SEWRE WORKEHS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C � SU&IECTANEMPLOVERTOCHIMINALPENALTIESANDCIVILFINESUPTOONEHUNORE�THOUSAND ENERGYPERMIT DOLLARS(510o,o00J,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,IN7ERE5T,AND ATTORNEv'S FEES. RETENTION FEE: � • � � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: �� -�4� - �O I HEREBY AFFIRM UNDER PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FORTHE PERFORMANCE OFTHE WORK FOR WHICH TMIS PERMIT IS ISSUED(SEC.3097,CIV.C.). W � LENDER'S NAME F- LENDER'S ADDRE55 w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFOR/AATpN IS CARRECT. TOTAL F E ES 1� �� I ACaREE TO COMPLV WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING ' � CANSTRUCTION,AND HEREBV AU7HORIZE REPRESENTATIVES OF THIS COUNN TO ENTER U70N THE Z ABOVE-MEN710NED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � 0 J � t b .�/��1 l7 V+Vv'� ��— m PERMI77E AME(P IR NT) � � � �V�� SI(3kA'�UR ERMITF DATE /�� = RECPT.NO. �OE�1 PAID BY �� T`F� ' VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROa–File Copy,GREEN—ApplicanYs Copy C9�V �f� �8�461�1��9� ��VR I�Sf�[�C�'BO� �I��R� F. � , :Oa�pCC�400a DQ�I�� ` ` Oa�PCC�4Co�a Oa�pCC�400.(�nl"��. DGa4C�;�`` pa�pCC��a ' � : 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 SFiEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING I ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING �1 ;,T_x � POOL FENCING WALL INSULATION / POOL FINAL i CEIIING 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 FINAL ELECTRIC DEV. FEES PAID ---- - - --- . _.._..- ---- -- -- - ---- ----_ FINAL PLUMBING ENERGY C�3��Q� COMMERITS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � �