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Home My WebLink About13394 (17)1)1,011J0Il fti C_ a CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY do DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 (909)960-3195 Fax(909)961-3117 \""✓ BUILDING PERMIT APPLICATION . E ADDRESS � ADDRESS APN LOT TRACT _ 5 OWNER Ja21�L_P_*� j ADDRESS !6/ G'A"TlJ.v wj+�a C'OffY 2771 CITY/r &D&1,n Z3.w ZIP 9I TEL. s?6 ! 7ZZZ APPLICANT TEL. CONTRACTOR D O /I t' t ([S14L E=nrrJL /f/fi fi£waF tL/ ADDRESS9 NNF/p��?/ �7 Kcf¢.trli ZIP �?3�r/_ TEL.,sc•9S%37_O ARCKIENG/ DESIGNER L ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION 1 HEREBYUNDER PENALTY OF PERJURY THAT I EXEMPT FROM THE CONTRACTORS L4 THE F 12J CENSE NAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESSMID PROFESSIONS CODE ANY CITY OR- COUNTYIYISCHREOUIRESAPERMRT0CONSTRUCT. ALTER IMPROVE. DEMOLISH, OR REPAIRANYSTRUC. O TURN, PRIOR TO ITB ISSUANCE. ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FLE A SIGNED FrATEMENT THAT HE OR SHE 15 LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- C CENSE LAW (CHAPTER S (COMMENCING WITH SECTION YOM) OF DIVISION 3 OF THE BUSINESS AND PRO. .E17 FESSIONS CODE) ORTFNTHEORSHE ISEXEMPT THEREFROM AND THE BASIS FOR TFEALLEGEDEXEMP- TON. ANY VK"TON OF SECTION 7011.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO ACIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (5500).): O L ASOWNEROF THE PROPERTY, OR MY EMPLOYEES WITH WAGESAS THEIR SOLE COMPENSATION, WILL 00 THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEG 7044, BUST. C NESS AND PROFESSION$ CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY W!O SULDS OR IMPROVES THEREON. AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THOUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SLCH IMPROVEMENTS ARE NOT INTENDED OR L]7 OFFERED FORSALE.IF, HOWEVER, T14EBULDINGOR IMPROVEMENT IS SOLD WITHIN ONEYEAR OF COMR,E- TICN, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BALD OR IMPROVE FOR THE PURP09EOL SAILER LI ORAS OWNER OF THE PROPERTY.AME%CLUSIVELYCONTRACTWG WITH LICENSED CONTRACTORS C TO CONSTRUCT THE PROJECT ISEC. 7041, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U- RI CENSE LAW DOES NOTAPPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON,MIO C YMOCONTRACTS FOR SUCH PROJECTS WITH ACON PACTOR(S) LICENSED PURSUANT TO THE CONTRAG TORS LICENSE LAW.} O 1 AM EXEMPT UNDER SEC. B. 5 P.C. FOR THIS REASON DATE OWNER _ LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER FL 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESSANO PROFESSIONS CODE, AND K MY LICENSE IS W FULL FORCE AND EFFECT. LICENSE C 3 LIC, NO. I( - DATE DATE S i CONTRACTOR 7'b7/Poli fA. rYSC/ WORKERS COMPENSATION DECLARATION A I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 11 v n —� I HAVE AND WILL MAINTAIN ACERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS COMPENSATION, AS PROVIDED BY SECTION 7700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. L II HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE, AS REOUmED BY SECTION 9700 OFTHE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS .,.,M,� ISSUED. MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE i CARRIER ✓� RA!n z�Q POLICY NUMBER masEcTaN NEEDNOTBE ODSYLE WOFTHE PERK 6 FORONE HUNUREDDDLWt51i100N Z 1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WH CH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE n WORKERS' COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATIONS OF BECTON 9700 OF THE LABOR CODE, I (1 RTHWITH COMPLY WI THIO P VISIONS. DATE: ` APPLICANT: WARNING: F LUM TO SECURE WORKERS' COMPENSATION COVERAGE R ONE HUN UI. AND TSHALLOE HOUSAND y SlIB.IECiAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (51 00,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN J SECTION 3700 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. i CONSTRUCTION LENDING AGENCY D 1 I HEREBY AFRRM UNDER PENALTY OF PERJURY ICH THIS PE IS A CONSUED (SEC. LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 19 ISSUED (SEC. 9047, CV. C.). ra LENDERS NAME LENDERS ADDRESS I CERTIFYTHAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATWG TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE j!e ENTIONED PROPERTY FOR INSPECTION PURPOSES. 9 m a � h SMATURE43F PF.RMrrTEEWE PRESS FIRMLY APPLICATVW L�—C� Q' PERMi7�q P/C DATE L �� t l NUMBE # ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ - SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport PatioMedc LL PoOVSpa Z- Re -Roof - - -� Commercial - - 5 m . Valuation ADJ.AREA QUANTITY DESCRIPTION FEE U , LU T:) a rAZ �H N IT l zz VV S W CONSTRUCTION PLAN REVIEW T� CTRL ��i G^V PLUMBING ECHANIC y 5 00 INSPECTION FEE ISSUANCE 5 SMTP ENERGY P/C MAY 0 4 1999 ENERGY PERTIT 11I RETENTION FE T� j;^,_jyf (._.n Aj L -) j1 Ag U PRE -ALT FEE: ' -' -STI) S-A FE -TY TOTAL FEES la d COMMENTS RECPT. NO. PAID BY VALIDATION WHITE—DeDartmem Copy, YELLOW—finance Copy. PINK—Assessor Copy, GOLDENROD—Flle Copy. GREEN—Applicant's Copy ; LANUZjL;AVLIEFiKlU. SET BACK f FLOOR JOIN ON SITE IMPS. FTGSIFORMS/STEEL ? FNA REOMT --- ELECTRIC GROUND i UNDER FLOOR DUCT DEPT FINAL GROUND PLUMBING UNDER FLOOR C;Q .i-),-T,- HEALTH DEPT. FINAL _ SLAB GRADE ( ;FIREPLACE FOUNDATION DEV. FEES PAID TEMP POWER FIREPLACE BOND BEAM --- WATER SERVICE MID HT. BOND BEAM fp; ROOF SHEATHING 8 FT. BDNDaEAM FRMMING.AIENTILIATIONi FINAL BOND BEAM � ROOF COVER ----- � ' PRE -GRADING u i RO' fGH HEATING BENCHING i ROUGH ELECTRIC ROUGH GRADING ( L I ( ROU �H PLUMBING i FINISH GRADING ( V) It,T 1JB TEST POOL ELECTRIC + _X i -H SIDING POOL FENCING � - 101A L- L iNS'jLAT ION I POOL FINAL v - E 73EILINGA IN ULATION ` '_MNP OFF SITE IMPS. D t, LING DEDICATIONS FI T` FINAL ENG. �. , .0 c ; LANUZjL;AVLIEFiKlU. Sr, T 'L. L. ON SITE IMPS. I FINAL ZONING 4`)NST;FIRE DEPT FINAL _ ErtT3.G . i HEALTH DEPT. FINAL _ ELECTRIC G. ,� �' ^--- DEV. FEES PAID PLUMBING ENERGY X-- is tIENTS