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Home My WebLink About14946 (17)CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 W (909)860-3195 Fax(909)961-3117 BU LLDING PE A13PLICATION PRESS FIRMLY APPLICATION JOBSITE 'dam o ADDRESS TE_ (� (J NUMBER / k APN LOT TRACT ISSUE OWNER 1 5, p ADDRESS - - CITY C' ZIP TEL 01) CONST. GROUP APPLICANT TEL. ZONING SETBACKS CONTRACTORJI e ADDRESS " _L g REAR CITY ZIP ]9 j._ TEL. teg&-lYtAW El ARCWENG/ SIDE/SIDE STREET RW DESIGNER ADDRESS CITY ZIP TEL 7 PROPOSED USE CC OWNER -BUILDER DECLARATION O NO. DWEL. p 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS Li - CENSE LAW FOR THEFOLLOWNG REASON (SEC. 7031.5 BUSINESS AND PROFESSKNS SX)DE ANY CITY OR STORIES COUNfI' WNK31 REOUIRESA PERMrTTO CONSTRUCT.ALTER, IMPROVE. DEMOLISH, OR REPAIR ANY STRUO TURF, PRIOR TO ITS ISSUANCE. ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FLE A SIGNED DESCRIPTION STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON"ACTORB U. ADJ. AREAIVALUATION CENSE LAW (CHAPTERS (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO- SFRIADDIREM FESSIONS CODE) ORTHAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOS THE ALLEGED EXEMP- T'ION. ANY VIOLATIONOF SECTION 7081.5 BY ANYAPPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO C0 ACIVILPENALTY OFMOTMORE THAN FIVE HUNDRED DOLLARSX)* ❑ I,AS OWNEROFTHE PROPERTY, ORMY EMPLOYEES WITH WAGESAS THEIR SOLE COMPENSATION, WILL DO THE WIND( AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE ISEC. 7D44, SUSI. NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO SURDS OR IMPROVES THEREON, AND VASO DOES SUCH WORK HIMSELFOR HERSELF OR 2 THROUON HIS OR HER OWN EMPLOYEES PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF. HOWEVER. THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE- TION. THE OWNER -GUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE ON NOT BUILD OR -Root IMPROVE FOR THE PURPOSE CF SALE} ❑ 1, AS OWNER OF THE PROPERLY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 71144, BUSINESS AND PROFESSIONS CODE: THE CONT RACTORS Li. CENSE LAW DOES NOTAPPIY TOAN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WLgOaNTRACT3 FOR SUCH PROJECTS WITHACONTRACTOR(S) LICENSED PLJRSUANTT13TIAE CONTRAC. TORS LICENSE LAW.). ❑ 1 AM EXEMPT UNDER SEC,S. L P.C. FOR THIS REASON Y.. DATE OVNER LICENSED CONTRACTORS DECLARATION - - sst[[[ I HEREBYAFFIPM UNDER PENALTY OF PERJURY THAI IAM LICENSED UNDER PROM IIONS OF CHAPTER IN B(COMMENCG WITH SECTION 7000) OF DIVISION3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. 0 3L ' LICENSECL'ASS ' LIC. NO. - DATE - 6Z r�� .CONTRACT IT WORKERS' COMPENSATION DECLARAT '1 1 CfD 4 EBYAFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLDWI 'G DEC TKN d_ FEE - (HAVE AND WILL MANTANACERTIFICATE OF CONSENT TO SELFINSURE FOR h RS' a COMPENSATION. AS PROVIDE. BY SECTION 37DO OF THE LABOR CODE, FORTH ERFORMANCE OFTHE WORK FOR WHIN THIS PERMIT IS ISSUED. p I HAVE AND WILL MAINTAIN WORKERS COMPENSATION INSURANCE• AS REOUIRED SECTION O 37000E THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH IS PERMIT IS �j ISSUED. MY WORK S' CCo MPENSATDN INSURANCE CARRIER AND POLICY N BER ARE: ` CARRIER Log - POLICY NUMBER I Q (fHLi sECfK1NNNE ®NOT BE CA.iTETEDOFhf PERMIT fn ON �Isjss W Z N= 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PECD SHALL NOT EMPLOY ANY PERSON N ANY MANNER SO AS TO BECOME SUBJ IJP WORKERS' COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF I SHOULD BE COME LU TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR SSUBJECT TH COLIPLYwITH THo P ER )HAl1. a pDATE: 11 APPLICANT - - 1 c 7 WAFNING: FARIIR TO SECURE WOFBCERS' COMPENSATKN COVERAGE IS UNLAWFUL, AND SHALL SE SUSJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND Y DOLLARS (111 W,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN �1 [FICHECONSTRUCTION SECMN 3708 OF THE LABOR CODE, INTEREST AND ATTORNEYS FEES. LENDING AGENCY O ryC I HEREBYAFFIRM LNDER PFINALTYOF PERJURY THAT THERE 15 A CONSTRUCTION LENDING AGENCY u• FCR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. W97, CIV. C.). LUZ LENDER'S NAME t LENDER'S ADDRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I 1 AGREE 7O COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING L CONSTRUCTION, AN HERESY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSESfil . _ I C� I�Y•V A /� _' / ox e - m PERMRTEE E(P \\ Cn '%ILL -_ en SIGNATURE OF PEAMITTEE OAXE PRESS FIRMLY APPLICATION PERMIT MOD P/C TE_ (� (J NUMBER / k ISSUE 1 TYPE OCC DATE 01) CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE p PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFRIADDIREM C0 Garage/Carpon WPatio/Dock U- Poet/Spa ZRe -Root Commercial m Valuation - ADJ.AREA QUANTITY DESCRIPTION FEE a U it U W LU % q CT. m�� 1 c 7 a 3f J Q � UzWOFR 3 r C� I�Y•V W P : & LA)RUCTION EVIEW RIC PLUMBING MECHANICAL PA TTE - - INSPECTION FEE ISSU i SMTP MAY_1 1 2000 ENERGY P/C CfTY ENERGY PERMIT OF DUMOND BAR RETENTION FEE: PRE -ALT FEE: - TOTAL FEES COMMENTS - - - RECPT.. NO. PAID BY - VALIDATION WRITE—Department Copy, YELLOW --Finance Copy, F INK:—Assessor Copy, GOLDENROD—File Copy, G EN --Applicant's Copy r - CITY OF DIAMOND BAR INSPECTION RECORD SET BACK �' �,i. , FLOOR JOiS7:' , FTGS/FORMS/STEEL ) ; FHA REQMTS ELECTRIC GROUND `-� UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT `. SLAB GRADE FIREPLACE'tOUNDATION - TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BON&bEAM r ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING I FINISH GRADING SHOWER17UB TEST f r POOL ELECTRIC EXT. LATH/SIDING ( POOL FENCING WALL INSULATION 1 POOL FINAL CEILING INSULATION OFF SITE IMPS. 1 DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. F ; ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. - I FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FVJAL.E(_'ECTRIG .. F t ' DEV. FEES PAID r.WAL PLUMBING 2 ENERGY ' 00NfMEIVTS ;. I \ SEPTIC TANK SIZE SEEP PIT/U SIZE