The URL can be used to link to this page

Home My WebLink About16158 ;--.. /. ''\ ` 1�` CITY OF DIAMOND BAR ,�� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � � 21660 E.Copley Drive Suite 190 � � (909)86Q3195 Fa�c(909)861-3117 PR ESS '�^°� � BUILDING PERMTT APPLICATION C�'" � ��',� �C� FIRMLY QJOBSITE r �/7 /',�.' ( F DATE �`'��J� 'J� NUMBER lj I S� � �� ' '�� ¢ ADDRESS Vc`-'l� Li\ s'-�� \ (-�'�,� ` �'/ APPLICATION PERMIT p/C � � � ISSUE TYPE OCC APN L TRACT CZZ- � _ DATE CONST. GROUP p OWNER " ADDRESS r%+'1' {-�t1�It�11� ZONING SETBACKS � ��/�, RW ❑ Z CITI��U`b" - ZIP , TE .'��V�=t-t �i`"��' FRONT g APPUCANT TEL. U REAR � � SIDE/SIDE STREET RW ❑ CONTRACTOR �1 -� SIDE � ADDR S r U ' \ v�s:,.•v' � CITY '(. ZI ' T6C` L�PROPOSED USE oARCWENG/ � � DESIGNER � � NO.DWEL. NO. NO. ADDRESS a. � CITY � ZI E , � � . TS STORIES _BEDROOMS � N DESCRIPTION 50.FT. FACTOR PSF ADJ.AREANA UATION Q OWNER-BUILDER DECLARATION SFRlADD/REM " O �� I HEREBY AFFIRM UNDER PENALTY OF PERNRY THAT I M1 EXEMVT FROM THE CANTRACTORS LI- G818g0/CdfpOft /' W CENSEUWWRiHEFOLLOWINGREASON�5EC.7031.58USINESSANDPROFE5S10N5CODE:ANYCITVOR (f� C.) COUNTYWHICHREWIRESAPERMITTOCONSTRUCT,AL7EH.IMPROVE.UEAAOLISH,ORREPAIRANVSTRUC. W pa�i0/DBCk W NRE.PRIDR TO ITS ISSUANCE.ALSO REOUIHES THE APPLICANT FOR SUCH PERAl1T TO FILE A SIGNED w � SUTEMENT TMAT HE OR SHE IS LICENSED PU0.5UANT 70 THE PROVISIONS OF THE CON7RACTORS U- � CENSE UW(CHA7TER B(COMMENCINO WITH SECTION]000)OF DIVISION 3 OF THE BUSMESS ANO PRO- LL POOUSPO FESSpNSCODE)ORTHATHEORSHEISE%EMPTTHEREFROMANOTHEBASISFORTHEALLEGEDE%EMP� (� TION.ANVVIOU710NOFSECTION7031.5BYANVAPPUCANTFOPAPEflMITSU&lECTSTHEAPPLIGANTTO Z Re-Roof � ACIVIL VENALTY OF NOT MORE THAN FIVE HUNOflED DOLURS(f500�.)' � ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPIOYEESWITHWAGESASTHEIRSOLECOMPENSATpN, 0 C01TIR10fClel NALL DO THE WORK,AN�TME STRUCTURE i5 NOT INTENDED OR OFFERED FOR SALE(SEC.7014.BUSI- J � NESS AND PROFESSIONS CODE:7HE CANTMCTORS LICENSE lAW DOES NOT APPLY Tp AN OWNER OF '� PROPERTYW/10BUILDSORIMPROVESTHEREON.ANDWHODOFSSUCHWORKHiMSELFOAHERSELFOR � ' � � iHRDU(3fIMI50RHEROWNEMPLOYEES,PROVIDEDTHATSIICHIMPROVEMENTSARENOTINTENDEDOR m . � Q OFFEREDFORSALE.IF,HDWEVERTMEBUILDINGORIMVROVEMENTISSOIDWITHINONEYEAROFCOMPLE- Z TIDN,THE ONMER-BUILDER WILL HAVE TNE BUROEN OF PROVING TNAT HE Ofl SHE DI�NOT 6UILD OR � IMPROVE FORTHE PURPOSE OF SALE�. W ❑I,AS OWNER Of iHE Pfl0?ERTY,AM EXCLUSIVELY CONTPACTING WITH LICENSED CONTRACTOqS � TO CONSTRUCTTHE PRQIECT(SEC.7oN.BUSINE55 AND PFiOFEuSIONS GODE:TME GONiRACTORS LI- V8Ill8llOf1 ADJ.AREA W CENSEUWDOESNOTAPPIYTOMlOWNEROFAPROPERT7WH09UILOSORIMPROVESTNEREON,AND � � — � N77000NTMCTSFOHSUCMPRQIEGTSWiTHACONTMCTOR(SjLICFNSEDPURSUANTTOTHECANTRAG QUANTITY DESCFiIPTION FEE Y roRs ucErvsE uw.). �— O ❑I AM EXEMPT UNDER SEC.___ _______8.6 P.C.FOR THIS REASON Q 1 3 � . �'i' DATE OWNEF � 1— Z __— — U � C_.' � LICENSED CONTqACTORS DECLARATION � - A � l, I MEREBY AFFIRM UNDEFl PENALTY OF PERJURY I'HAT 1 AM LICENSED UNDER PROVISIONS OF CHA?TER � 9(COMMENCIN(3 WITH SECTKKJ 7000)OF DIVISION 3 DF THE BUSINESS AND PROFESSIONS COOE,AND Z C,� `L; MV LICENSE IS IN FULL FORCEAND EFFECi. m � � � � UCENSEGLASS A _ ��.No. 517593 � ' ~ DATE 9/3/01 CONTRACTOR_ PU I te omes a � � U — ------ W o, O � WORKF_RS'COMPENSATION DECL4RATION Q ( r C � I HENE Y AFFIRM 11NDER PENALTV Of VE0.IURV ONE OF THE FOI.LOWING DECiAqATION$: U ' v� �/�P. Z �_ � � �Q(LIHAVEANDWILLMAINTAINAGEflTiFICATEOFGONSENTTOSELF-INSUREFORWOHKERS' ¢ /� _ Q COMPENSATION.AS PROVI�ED BV SECTION 3�Dc OF THE 1A80R CO�E,FOR?HE PERFOflMANCE U v� O OF THE WORK FOP WHICH THIS PERMIT IS ISSUE�. � � r . W I HAVE AND WILL MAINTNN WORNERS'WMPENSATION INSURANCE,AS RF�UIRED BY SECTION � (� ,/ Q31000F TNE LAtlOR COOE,FOfl THE PERFORMANCE OF THE WOFK FOR WHICM TH�S PERMIT IS �,�I��``��( � � ��`. � ISSUED.MY WORKER5 COMPENSATION INSUiiANGF GAPRIER AND POLILY Nl1MBER AflE: CONSTRUCTION I ) j CARRIER_P ,^''�fip�.E�� ee I nS_Co_. PLAN REVIEW Z POLIGY Nl1MBER___�7_.}��LL_y A _ ELECTRIC �• � �J�. Q �0 R�sct.nnrar��nNOTSEca.wtEiE�oFn�cEw.n'�swaoriE�ur��ooat.utslsiao�ofalEssa PLUMBING I�•J � „�� w \ `� Z I CERTIFY THNT IN THE PERFUFMANCE OF THE�JOHK FOR WHICH THIS PERMIT IS ISSUED,I MECHANIGAL — , �J{ . i e�� ` i L) SHIILLNOTEMPLOYANVPERSONINANYAlANNERSOASTOBECOMESU&IECTTOTHE / (n WOflKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHAUL�BECOME INSPECTIONFEE ��/ SUBIECT TO THE WOHKERS'COMPENSA710N PROVISIONS OF SECTION 3�0o OF THE LABOR 1 pCOOE,I SHALL F01lTHWITH COMPLY WIiH THOSE PROVISKKJS. ISSUANCE I yr ��,� � p DATE:_S � O�qppLICANT: PUIte HOme'S_ SMIP 3�-� Ul� �l 1 �'J WAqNING FAILURE TO SECURE WORNERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL BE ENERGY P/C J _— —__ �`� � SU&IECTANEMPIOVERTOCRIMINALPENALTIESMI�qVILFMESUPTOONEHUNDREDTFIouSAND ENERGYPERMIT �� 'rl )�_ � OOLLARS�f 10U.000),IN A�UITION TO THE COST OF(:OAIPENSATION,DAMAGES AS PROVIOED FOR IN J SECTpN 3)oB OF THE LA90R CODE,INTEREST,AND ATTORNEYS FEES. � OC RETENTION FEE: OGONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBY AFFIRM UNDER PENALTY OF FERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY ( FORTME PERFORMANCE OFTHE WORK FOR WHiCH iHIS PERMIT IS ISSUED(SEC.3o9],CIV G�. � W � � LENDER'SNAME None jPulte Home CDr�� _ ___ H LENDER'SADDRE55 y� � TOTAL FEES -�.TC �j�� ` ' � I CERTIFY THAT I HqYE R'cAD THIS APPIICATION AND STATETHAT THEABOVE INFORMATION IS CARRECT / yn w 1 AGREE TO CAMPLV WITH ALI.CITY AND COUNTY ORDINANCESAND STATE LAWS REUTING TO BUILDING � u �F� � � d � CONSTFUCTION,ANDHEREBVAUTHOqIZEREGRESENTATIVESDFTHISCOUNTVTOENTERUPONTHE Z ABOYE�MENTIONE�PROPERTV f0 INSPECTION PURPo5E5. COMMENTS � � O . (^ I � �nc�l�� J m PFRMITT E NAME(P .) ¢ _/j�-G'� -- � _ � SI UREOFPERMITT ORTF — '}c� S RECPT.NO. PAID BY VALIDATION L�__ F WNITE—De anment Co YELLOW--Finance Go PINK—Assessor Copy.GOLDENROD—File Co GREEN— P PY� VY. PY. ApPlicanYs CoPY �n�M�� ` ��.�£�� :�� "=`�� =�_��a ��: - � � �� . ��Fr• _. .�, .� � � �n �, q� z. � � � �� .�a� , . �� ,�� ` � • � �� a � � �'�'`�� '",� � � „�, . � . . �..-.�� 's` _ �,: � �� ,.--,. 'i' , , , � � � ,, „ , � �� ` � - �v_ ._._ ,. � _. � ; , e, . . �" Q ` F . � � , _,,.� . ., _ ._. � s ��. � , , � ,, . ___ _. .J � �l _ _ _ _ , _. � �� . '.. i�. j �i . n � . . _.. . _ p ._ .._.. . . . __. .._. ...... ....... . ...... ..... .. .. �=~t�--1 T..�----- � ��. _ _ _� _ , � � �, � �.� �,,� �,.,.�-�� _ � ,:: . ��. „ � � � __ r . _ �� _ _ __ _ � � ,�� . �..._ � . _ , , _.. ,_. _ _ _ _ _ �-- - _ . _ �y1�. �, , .. .�,� .. . _ . , n , � �!-� '-� _ _ _� � _ _... _. � . . � b � _ _ _ , ��, . s. , �}.,.Q � � - _ � __ _. _ w .. __. �_ . _ �, � �: __ _. _ _ � � , � �� _� �_ . _ . �. #p t lI ---_ � _ . �f - — . . ;: � ... � 1.. . __-�----- ,��,,�� _ �. _ _ _ _ _ _ E _ . _ _ _- . - - - _ _ _ �-c�_�-��. _ - _ �_ _ � _.. _ �_. _ __ _ � _. _ _ �. . �� _ _ _ _ . �.,_. . _ _ � ��waa.L... �-�,2.—c7�. ,G�'=---�—�,. _ _ _.._ _ __ .� ,: ... . +� =a .. _. ...._ _. . .... .. . .- . - . _ _... _ ... .,s .,.,� kE aY, ,�'�`,�s»`:_��.�i�k�'�`e��"��sR., ...- — ....... ....... ...._.. .... .. _.... ........ . . .._.. _.,. .__. ... ...... ....... .. . .... ... . _. . , ... ....... __. . ...._.. ...... _ . ... ... ... ......., ._. .... .._. _ _.. ..... � ...... .__. .... ... _.... ...... _._ .... . .. ..._. ._..... .. . ..... ...... ......_ ... ... . . ..... ...... .. .... . ....._ ...... ..._... __... .__.., ..._.. ....... . _... . � , . ..... . . ..... ..._. .._. . . ..... . ..... . . .. .... . . .._... . ...... ......_ _..... ..._. .._. _... _ ,......._ _.... . . .._.. ._..._ ..... _.._.._. .. _. � , . ._ ._ _._. . _.._. _.. ... _.._ ... _. . . .._.. ...... ._.. ..._. ._._. .._. _ ._. ,.. .... . . .._.... ... ... .._.. .. . ._ . ,... ... _...._ ..._.. ...... _ . ..._... .,.,. . . .... ..... . . ..... ...._ ._._. . _.._. ... .... ...._ . ...... , . . . . ... ...._.. .. ..._ _ ...... ... ... � ��",*.�.e2� �� g��o�� yy�� _ _ _ _ _ � ��. � , � �, � �� '�a�y �� `„ _ �' '�� '�°� �"�� "s , � '� �i* 1 �,��, � `�".�° 5`�r��N:�.�,��. , n"�, :"� _ _ ,__ . ... ._. __. __ ., __ ... ... .._ .... ... .. .. . 4�€'�a"�+,�,3��+�*'��+' �' �.,� ��: � �P�� ;``� „ a�r�,�, '( �Q� _ __ _ __ _ _ b� ��°#,�"��5 ��i� . s+.� ' �>y��i�� 't }h'�q�,6i ��'�� , ,, � . . .. ._ ._. ..... .. . ... . .. .. ��a c�iz� �,�W:��c��z� � ' � � � _ _ _ _ _ ��."�ryc'� ��`�`' ��,rv� "`�. .�s ; �.., .� .. .�o.wa .,; ULVIIIJO II,IR JOBSITE � w ADDRESS A APN L TRACT eZZ- OWNER �� ADDRESS r2'1 �1'V•Ir.4 CIrf(U,V ZIP TE G7 APPLICANT TEL. o) CONTRACTOR ADDR S U\v� CITY ZI Tf ARCWENG/ DESIGNER ADDRESS a4 CITY Vic ZI E-/ OWNER-BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE:ANY CITY OR COUNTY WHICH REQUIRESA PERMIT TO CONSTRUCT,ALTER. IMPROVE, DEMOLISH,OR REPAIR ANY STRUC- TURE,PRIOR TO ITS ISSUANCE.ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION.ANY VIOLATION OF SECTION 7031.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500).): D I.AS OWNER OF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044. BUSI- NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH 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-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). D I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044, BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S)LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). D I AM EXEMPT UNDER SEC. B. It 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 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND MY LICENSE IS IN FULL FORCE AND EFFECT. 517593 A LICENSE CLASS LIC. N0. DATE 913/O1 CONTRACTOR Pu I to Homes WORKERS'COMPENSATION DECLARATION IY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORK ERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: K CARRIER-[ ifI Employee Ins.Co. 'I POLICY NUMBER fl[ i.LRC4A (THIS SECTION NEED NOT BE COMPLETED OF THE PER W IS FOR ONE HUNDRED DOLLARS($100)OR LESS) I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE.I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: 5 1 OlAPPLICANT: Pu I to Homes WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3709 OF THE LABOR CODE. INTEREST,AND ATTORNEY'S FEES. CONSTRUCTlON LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC. 3097.CIV.C.). LENDER'S NAME None(Pulte Home Corp) LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FO INSPECTION PURPOSES. ) PERMI� RO 9/ SI LIRE OF PERMIT T DATE WHITE-Department Copy,YELLOW-Finance Copy, PIN CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 860-3195 861-3117 BUILDING PPLI BUILDING NG PERMIT APPLICATION PRESS FIRMLY APPLICATION PERMIT 0 P/C DATE NUMBER�1 # +J J ISSUE TYPE OCC DATE CONST, GROUP ZONING SETBACKS FRONT RW LI REAR SIDE/SIDE STREET RW^ SIDE ^ G PROPOSED USE N0. DWEL. N0. N0. TS STORIES BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ.AREA/VALUATION SFR/ADD/REM -2 AL _ �� In Garage/Carport W Patio/Deck LL Pool/Spa 0 Z Re-Roof Commercial - J M Valuation ADJ.AREA QUANTITY DESCRIPTION FEE Q ,1 U CIE LU L 0 tr G Z III. Q W CONSTRUCTION PLAN REVIEW ELECTRIC 0 •�- AID . PLUMBING _I I •J 4j MECHANICAL INSPECTION FEE ISSUANCE (Jr) SMIP ENERGY P/C ENERGY PERMIT 7C�- RETENTION FEE: c PRE-ALT FEE: VI 1 I 9 e\ TOTAL FEES _ TC ff I FFB 2 COMMENTS V RECPT N0. PAID BY VALIDATION 1