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Home My WebLink About16408 _ _1�� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS ��'" BUILDING PERMTT APPLICATION FIRMLY o� JOBSITE J /� ,,��o,,¢y� APPLICATION �/G�/� ,+ PERMIT P/C ADDRESS ! �({ �G� � - l�/�� DATE_ �/' //�/ NUMBER�� # c� ISSUE TYPE OCC � APN LOT TR CT DATE CONST. GROUP p OWNER ''� " ADDRE ZONING SETBACKS z CITY � � � 9�7/�yEL. FRONT RW ❑ g APPLICANT TEL. REAR p � SIDE/SIDE STREET RW O CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE � U � CITY ZIP TEL. o ARCH/ENG/ � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFlRM UNDER PENALTV OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- GefB[JBICefpoR W CENSELAWWRTHEFOLLOWINGREASON(SEC.7o31.5BUSINESSANDPROFESSIONSCA�E:ANVCITYOR (n U COUNTYWHICHRE-0UIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORREPAIRANVSTRUG W Patio/Deck TURE,PRIOR TO ITS ISSUANCE,AL50 REOUIfiES THE APPLICANT FOR SUCH PEFMIT TO FI�E A SIGNED W STATEMEM THAT HE OR SHE IS LICENSED PUi35UANT TO THE PROVISIONS OF THE CONTRACTORS LI- W � CENSE UW(CMAPTER 0(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT TNEREFROM ANO THE BASIS FOR THE ALLEOED E%EMP- TION.ANY VIOLATION OF SECTION 7031.5 BV ANYAPPI.ICANT FOR A PERMIT 5U8JECTS THE APPLICANT T0 Z Re-Roof � ACIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLLARS(S5a0).): � ❑I,ASOWNEROFTHEPROPERTV,ORMYEMPLOYEESWITHWAGESASTHEIFSOLECOMPENSATION, � Commercial - MALL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.701a,BUSI- J � NESS AND VROFESSIONS COOE:THE CONTRACTOFS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PqOPERTY NM1IO BUILDS OR IMPROVES THEREON,AND MMO DOES SUCH WORK HIMSELF OR HERSELF OR Q THiqUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUq1 IMPROVEMENTS ARE NO7INTENDED OR m Q ,OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE- Z TION,THE OWMER-BUILDER WILL HAVE THE BURDEN OF PROYING THAT HE OR SHE DID NOT BUILD OR � IMP(�VE FOR THE PURPOSE OF SALE). W ❑I.ASOWNEROFTNEPfiOPEHTY.AMEXCLUSNELYCAMRACTINGWITHUCENSEDCONTRACTORS � TO CONSTRUCT THE PRQIECT(SEC.7011,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V8IU8110f1 ADJ.AREA W CENSElAW00E5NOTAPP�YTOANONMEROFAPROPERTYWHOBUILDSORIMPROVE57HEREON,AND � WFIOCONTMCTSFORSUCHPH0.IECTSWITHACONTRACTOR(S)LICEN SUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE � Y TORS LICENSE UW.). � ❑i AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � 3 � � � DATE O ER i � U z W � IICENSED CON� TORS EC ATION w � I HEREBY AFFIRM UNDER PENALTY OF PERJURV TMA7 I AM LICENSED UN�ER PROVISIONS OF CHAPTER � d a(COMMENCINO WITH SECTION 7000)OF OIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X. MY LICENSE IS IN FZ1LL FORCE AND EFFECT. m L1J � UCENSE CLASS LIC.NO, j V DATE CONTRACTOR d W � WORKERS'COMPENSATiON DECLARATION Q � I HEREBY AFFIRM UNDER PENALTV OF PER)URV ONE OF THE FOLLOWING DECLAMTIONS: Z . � _I HAVE AND WILL MAIN7AIN A CERTIFICA7E OF CONSENT TO SELF-INSUPE fOR WORKERS' Q 2 Q COMPENSATION,AS PROVIDED BY SEC710N 370o OF THE IABOR CODE,FOR THE PEAFORMANCE 'U OF THE WORK FOR WHICH THIS PERMIT IS ISSUEO. � � _I HAVE ANO WILL MAINTAIN WORKERS'COMPENSATION INSUMNCE,AS REOUIRED BV SECTION / Q 37000F THE LABOR CODE,FOR THE PER WRMANCE OF THE WORK FOR WHICN THIS PERMIT IS S�' ISSUED.MY WORKERS'COMPENSATION INSURANCE CARflIER AND POLICY NUMBER ARE: CONSTRUCTION � � cpqqiEq � PLAN REVIEW t Z aoucvNUMeea — ELECTRIC ¢ I � (IF9SSECf1DNNE�NOT8E00�+�LEfIDOFhIEPERMTISFORCNEFAADREDDq1Aii5(f100)ORLESS� PLUMBING w q ' Z I CERTIFV THAT IN THE PERFORMANCE OF TNE WOHK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL . i � RKE STCOMPENSAIONLAWSOfCALIF RNIqANDAGREET A'TEFI�SHOULDBECOME INSPECTIONFEE � � SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR ^� -�j CADE,1 SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE �,J�J � SMIP -- - p DATE: APPLICANT: J WARNING:FAILURE TO SECURE WORKERS'CAMPENSATION COVERAGE IS UNLAWFUI,AND SHALL BE ENERGY P/C � SU&IECTANEMPIOYERTOCRIMINALPENALTIESAN�CIVILfINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DO�URS(i100,000).IN AODITION 70 THE COST OF COMPENSATION,DAMAGES AS PROVI�EO FOR IN � SECTION 3loe OF iHE LABOR COOE,INTEREST,AND ATTORNEI"S FEES. RETENTION FEE: a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PENURV THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH TMIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. Z W � LENOER'S NAME !— LENDER'S ADDfiE55 � TOTAL FEES � � I CERTIFV TNAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORAIATION IS CORRECT. w 1 AGREE TO COMPIV N7TH ALL CITV AND CAUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING � � CONSTRUCTION,AN MEREBY AUTHORIZE REPRESENTATIVES OF THIS CAUNTV TO ENTER UPON THE � ABOVE-MENTIONED OPERTV FOR I PEC ON PUR SES. Z COMMENTS � J � L � m PE MITT�E N FI Q � N SION UR I�, AT � RECPT.N PAID BY VALIDATION WHITE—Depertment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy � � . ' 7 . . � .. . . . . . . . . .. .. . .. . . �� Y �� W��YV� �W� �uVV.�� 0�� Q� 0�� QU� ��n SET BACK FLOOR JOIST � FTGS/FORMSJSTEEL FHA REOMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CUi�IDUIT � SLAB GRADE FIREPLACE F(�UNQATION ' _� TEMP POWER FIREPLACE BOfVD BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHIiVG ' 8 Ff. 80ND BEAM FRAMINGNENTILIATION OS-Z!-•a( FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGN HEATIfVG BENCHIIVG ROUGH ELECTAIC ROUGH GRADING ROUGH PLUMBIiVG FINISH GRADING SHOWERITUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILIP�G IiVSULATIOM OFF SITE IMPS. I DRYWAL.L NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK I.ANDSCAPE/IRRIG. SEEP PlT(�.L. ON SITE IMPS. GAS AIR TEST FINAL ZOiVING FINP,L CONST. ��Z�-tJ� : FIRE DEPT. FINAL FINAL NEATING HEALTH DEPT. FIiVAL l=1NAL ELECTRIC DEV. FEES PAID ' � f=;i�lA�PLUMBIIVG ENERGY i..... 1 �(�(�� . ..-_� I�ISW U ��o �__ V1.JIVIIHI�Itl 1 S � . t ; �..�. SEPTIC TAN{4 SIZE SEEP PIT/U SIZE � � � �'