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Home My WebLink About10-991 i , ` �` CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �w , 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702 PRESS ��'��' BUILDING PERMIT APPLICATION FIRMLY Q DDRIESS �� I � C.D 1 a S�r� ��S � . APPLICATION PERMIT p/C I p DATE NUMBER�� # � ISSUE TYPE OCC APN LOT TRACT DATE �O� O CONST. GROUP p OWNER �- 1-a S a o ADDRESS �I C.�I � 1� • ZONING SETBACKS Z CITY I�1�lOY1Ll F� ZIPC1�-7cPs TEL. -S(D(�S(q ci FRONT RW ❑ � APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTO B Kt� eXl SIDE ❑ o ADDRESS • � _ • PROPOSED USE � CITY �iR.YI �1 YM10.Z ZIP�Z�jTEL. -q w 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 p� OWNER-BUILDER DECLARATION SFR/ADDlREM O I HEREBV AFFIRM UNDER PENALTV OF PERIURV THA71 AM E%EMPT FROM 7HE CONTRACTORS LI- G2f8gB/C81f10R W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSAN�PROFESSIONSCODE:ANVCITYOR (n U CIXINTVWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC� W patio/Deck Z TURE.PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNED W STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CAN7RAC70F5 LI- w � CENSE UW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� � POOVS(10 , 0 FESStONSCODE)ORTHATHEORSHEISEXEMP77HEREFROMANDTHEBASISFOR7HEALLEGEDEXEMP- (� V TION.ANV VIOLATtON OF SECTION 7071.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof A CIVIL PENAL7Y OF NOT MORE THAN FIVE HUNDRED DOLLARS(S5a0).�: Z ❑I,ASONMEROFTHEPROPER7V,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � CORIrtIBfCi31 . - WILI DO THE WORK,AND THE STHUCTUHE IS NOT INTENDED OR OFFERED FOR SALE(SEC.701l,BUSI- J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � 7ROPERTV WHO BUILDS OR IMPROVES THEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGHHISORHEROWNEMPLOYEES,PROVIDEDTHA7SUCHIMPROVEMENTSARENOTIN7ENDEDOR m Q OFFEREDFORSALEIF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILO OH � IMPROVE FOR THE PURPOSE OF SALE). W O I,AS ONMER OF THE PROPEHTV,AM E%CLUSNELV CON7RAC71NG WI7H UCENSED CONTRAC70RS � TO CONSTRUCT THE PfiOJECT(SEC.70��,BUSINESS AND PROFESSIONS CODE:THE CONTRAC70RS LI- V81UeilOfl ADJ.AREA W CENSE UW DOES NO7APPLV TO AN ONTJER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � WHOCANTRACTSFORSUCHPROJECTSWI7HACON7RACTOR(S)LICENSEDPURSUANTTOTHECONTRAG OUANTITY DESCRIPTION . FEE � 70R5 LICENSE UW.). 0 O I AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON Q � FGI rad e.� � LL ¢ �V PJW �7 1 'I'Zi(�'�� DATE OWNER U , �l �� 1 _ O W �� LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PEN�LTV OF PERJURV THAT 1 AM LICENSED UNDER PROVISIONS OF CHA7TER � �7 n�„p `71 N �/ � i(COMMENCING WITH SECTION 7000)OF DIVISION 9 OF THE BUSINESS AND PROFESSIONS CODE,AND Z 4 �'«.�_. !�\ �� MV LICENSE IS IN FULL FOFiCE A/N�D EFFECT. m � LJ!�"$) �7 LIC.NO. ./✓ I / � �' I�� UCENSE C S ✓ � I �i� Q� �e , V DATE ��V� S �( CONTRACTOR a 'v ��/ W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENAL7V OF PERJURY ONE OF THE FOLLOWING OECLAFiATIONS: Z z _IHAVEANDWILLMAINTAINACERTIFICATEOFCANSEN7705ELF�INSUREFORWORKERS' _ Q CAMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE �U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � Qw �I HAVE AND WILL MAIN7AIN WORKERS'COMPENSATION INSURANCE,AS REDUIRED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMI7IS ISSUED.MV WORKE S'COMPENSPT N INSURANCE"�c/,�R,�RIEQR A.N,,D,P�O/LIC�V NUMBER ARE: CONSTRUCTION ¢ CARRIER ��rn� 1� /� �/1 �`��"�1�� I Y�S • PLAN REVIEW ` �'7 ZPOLICVNUMBER X��'O �!7JD ELECTRI /, I / ¢ �3R G� � (fHLSSECiIONNE�NOTBE001.1PI.EfEDOFTHEPERAYfISFORONEFNI�DHEDDOILARSR��)�LESS} PLUMB W Z I CEATIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL C7 SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJEC7 TO THE � WORNERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECAME INSPECTION FEE � SUBJECTTO7HE WORNEfiS'COMPENSATION PROVISIONS OF SECTION 37ooOF THE UBOR � CADE.ISHALLFORTHWITHCOMPLVWITHTH EPROVI� ISSUANCE � p DATE: �O��O APPLICANT. �� .SMIP J WARNING FAILURE TO SECURE WORKEFS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES AIJD CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(S10o,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN /�'� � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: `.� �+ d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIFM UNDEfi PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z w � LENDER'S NAME H LENDER'SADDRESS � TOTAL FEES �Q 3 Q � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. W I AGREE TO CAMPLV WITH ALL CITYlWD CAUNN ORDINANCES AND STATE UWS REI.ATING TO BUILDINO d � CANSTRUCTION,AND HEREBY AU7HOFiIZE REPRESENTATIVES OF THIS COUNN TO ENTER UPON THE � Z ABOVE-MENTIONED PR07ERTY FOR INSPECTION PURPOSES. COMMENTS - � Y vi.an d.e _ m PERMITTEE NAME(PRI T) - � � ��y��O N SIGNATUREOFPER E DA7E = RECPT.NO. �o PAID BY I VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy � c��f �IF ��t�V�i�lfi9� [��f� ' � . .. � - ��f�f��I� I�[�c��f�� _ Oa�pf�(�400a DQ4C� , Da�pC��40a Oa�pI�C�400a DQ4l� Oa�pC�C�4C�;G� ;s SET BACK FLOOR JOIST . FTGS/FORMS/STEEL FHA REQMTS. ELECTRIC GROUND UNDER FLOQR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT ' SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. 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 SHOWER/TUB TEST �2 n POOL ELECTRIC EXT. LATH/SIDING � � POOL FENCING WAL�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 FINAL ELECTRIC _ � � DEV_FEES PAID FINAL PLUMBING ENERGY C�'U�o � — -- COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � �