The URL can be used to link to this page

Home My WebLink About15957 (9) i_ j CITY QF DIAMOND BAR .� If� — -- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ! �1 � als6a�.e�aey t�Ve sffir�zgo �� PRESS ��`�ri��Vw BUII,DING PERMIT APPLICATION "�states° PMan 2 A J L FIRMLY JOBSITE APPLICATION F"" �'� PERMIT �t��`�" � P/C � ADDRESS 71Q Crest Yiew DY. DATE �' FJ � � FIUMBER �'' �.1 # � ISSUE TYPE OCC APN„_,..�pl�eT,�.��:7^�.,OT�A�CT 5Z267 DATE CONST. GROUP �j OWNER � �ITIC �.� � ADbRESS 18401 UCltl Karman ZONING SETBACKS � clrr Ir�iline ZiP��.Z2TEl. �Ug7g7��{}O FRONT �w u _ APP�ICANT S�t112 TEL. REAR ❑ � SIDElSIQE STREET _ RW CJ CONTRAGTOR ��+�- �L[� SIDE C7 p� ADDRESS pRQPOSEQUSE SEWER L.ATERlAL Q Ctrv �'.�Z.,tr7.,�- z��r7.-- T��r/�`�7�t'7� � ARCHlENG/ � f� �j'.f � S�S�(� • pESIGNER ji�`-� NO.DWEL. NO. NO. ADDRESS � _ �_ � UNITS STORIES BEDROOMS = CITY ��;_.__ 21P " TEL. - G� ? � DESCRIPTION SGl.Pl' FACTOR PSF ADJ.AREANALUATION us a OWNER-BUILDER DECLARATIdN SF'{�qpD1FtEM �] I NEREBV AFRRM UNUER PENAI.TY OF PERJLIRY TNAT I AM E%EMPi FR4M THE CANTMCTORS LI� GHf&(j9/Cdfp4n �t,I CENSEIAwWRTkEfOL�OWiNfrREA90N{5EC.Ta3i.beUSlNESSANDPROFESSIONSCQDE:AtdYYCIiYQR (J} COUNTVWMIpiREG/1RE5APERMfTTOCAN$7RUCT,ALTER,�MFROVE,DEMOLISH,OflREPAIRANYSTRUC� W Patio/Deck TURE,PNIOR TO ITS�SSUANCE,ALSD REOUIRES TNE APPUCANT FOF SUCH PERMIT TO FILE A SIGN6D W � 37ATEMENT THAT HE OR SHE IS L10EN5E0 PltRSUtNT T6 7}iE PROVISIONS OF 7NE C�NiRACTORS U� (L poOUS � CENSE lAW(C1iAFTER 9(COMMENCINO WITH SECiION)Mo�OF�IVISION 3 OF THE BVSINBSS AND PRO- P� FESSqNSCOOEjQRTHATHF4RSHEISE%EA/PTTHEREFROAIANDTHEBASISFORTHEALIEGEDEXEMP• (� TION.ANYVIOV..ATMaNaFSEC7iCiN�o3f,68YANYqPPIiCANTFOiiAP[RM�TSU&IECTSTHEAPPLtGANTTO Z RB�HOOf � A CINL VENAI.tt OF NOT MOHE THAN FNE HUNDREO DOLIARS(3500�.): "i � ❑I,ASQWNEROFTNEPHOPFRiY,OFiMYEMPIflYEESWiTNWAGE9A5'SME�flSOLECOMPENSATiON, C� �otttm9tC13I ^^ VALL p0 TNE WORK,AND THE STRUGTURE IS NOT INTENpEO ON OFFEREO FOR SALE(SEC.7044,BUSI� J � NE55 AND PFIOFESSKKIS WOE:THE CONTRAGTORS LICENSE LAW DdES NOT APPLV TO AN OWNER OF � PflQP[H7Y VA1�38UND5 OR IMPROVES THEflEQN,ANQ 4Ni0 OOE5 SUCN Vl(}RK HIMSELF OR FtERSEIF OR ...___ (� iMROUOM HIS OH HER OWN EMPLOVEES.PRCIVIUELI THAT SUCN IMPROVEMENTS ARE NOT INTENOE�OP m � OFFEREDfORSILE.IF,F10YlEVE0.7ME9UIlDWGORIMPROVE4IENTISSOLDWRMINONEYEAROFCAM%.E- � TIDN,THE OWNER�BUILDEH WiIL itAVE T}iE BUADFN OF PROViNG THAT}iE OR SHE CIO N6�BUitD OR � IMPR47VE F8f1 THE PIJRPb5E OF SALE). � ❑I,ASOYMEFtOFTH4:PROPERTY.Al/EXGlUS1YELYCONTRACTiNGWITNLlCENBEOCONTRAGFOflS ro an+sT�cr rri6 pqwEcr tsEc.�cu,eus�t�sss,vm pne�ssians a7oe THe conTwcmRs u� Valua[ion ADJ.AREA�..,,_,,... W CENSEUWDOESNOTAPpLV7tlANOWNENQFAPROPEflTVWI'IOBUiI.p50RIMPqpVESTNEflEQN,AND �� - NM1qCOttTMGTSFOFiSUCNAPOJECTSWiTtiACONTRACTOR{S}4��ENSEOPUflSUAMTOTNEC%?MTftAG QUANT3TY DESCRIPTIDN FEE �� TORS I,ICENSE LAW.). � J O 4M1 EXEAiF7 UNDEH SEC._ _�._.....__ $,E FC.F4R THiS REAS{}4 U _� _ --."__ � _ � DATE ...OWNER..._—�.__..��__. -.... V �+ �. W _... � �ICENSED CONTRACTORS DECfiARATiQN -� ._ W 'KC t.L IHEREOYtFFiFAttX9DERPEtiN.TYOfPEfiU4JRY7tlATltMUGENSEDUNDEftFROViSiUNSQFCktAPTER �. � Y�COMMENCINCi W�TH SEG�'ION 7UOoJ OF OIVI510N 90FTH€BUSINESSAND PROFFSSIONS CODE,AN0 Z X MY IICENSE IS IN FULL FQPCE D EFFEC7. t1J � � � LICEN5E 5S f LIC.NO.�� "' J V DATE__Cl��` � GONTRACTO ._(��_�.. C�!'G:�� a (JJ — � JdORKERS'COMPENSAT104 DECi_ARATION -� Q � i HER AFFIRM tR7DER PENAL7Y OF PEFUURY OtVE OF THE FOtIOW WG DECIARATIONS� U N Z C� . i NME ANO Will MAtNTAl4 h CEHTIflGATE QF CON5ENT TO SEIF-INSUflE FOA 4YOftKERS' S �� `COMPENSAiIUN,AS PNOVIDFU 9Y SECTION 3�0o C.�F TME LF,BOH GOOE,FOR THE PERFOflMANCF: 'U � OF THE WURK FOR WHiCH THIS PEFMIT IS 15SUED. � � I HAVEANb WILL 1XAINTAIN W4RKER9'WM7ENSATI4N INSVRANC£,AS REOUIRED BYSFG710N � 37o00i TH�LAH4R COpE,F4ft THE FERf�RMANCE 4f 7HE WOA.K fRft WN3GMTHtS FERM{T IS -- �� ISSUED.MY�v,�q/q,�c�Efl5'COMPEN@AT16N INSURANCE C RIER AND POUC�Y N�LIM/BE,R�+AP.E: CONSTRUCTION � c,�aa�Ffl-�C�'Ci ' . ' �� /'�-�/...µ.7�{--�'� PtANREV3EW � POLICYNUMBER�I��7��-�tE�� -}-�-�--.-- ELECT(�IC _ .... . —. d / " � �ncssFcrvwr�Evr�oT�EooMa.srEooFn�a�warr�swaori�iawnEo�a.ia�s(t�oo�an�Essa PLUMBING _ .....�... -.,._ ._._..� � I CEIiTIFY THAT IN T4E PERFORMANCE OF THE Ntt?RK FbH WHICH THIS PEHMIT IS�SSUED.I MECFIANICAL � .,_.__, .._ -- (;} SMM.L NOT EMP�OY ANY PEftSl7N IN ANV MANNEH 50 AS 70 BECOME SUBJECT TO THe yy wos�aERs•wraWsnsnr�uws ac cu�FoaNu,nr;o aGflEe TwT if i sraw�o eE��aE 1N9PECTtON FEE .._ ..._.... _�.7_,�-� SU&IECT Tp THE NMJRHERS'COMPENSATII7N PPOYISiONS OF SECTION 3700 0F iNE U80F �(�✓) = COpE,ISHALLFOFlrl4WITHCOMPLYWITHTNOSEPftOYISIONS ISSUANCE _ rJ �✓�]/p SMIP � OATE��,�C__. APPLIGANT: U�� ._"�_.. -"-- '—' �- � ENERGY PtC � WARNINO:FAiLURETO SECURE WOFiKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALLBE -"" ""'i"-��--- LL 5U&lECTANEMPLOYEflTUCRIMINALPENAlT1ESANOCIVILFINE9UPT00NENUNDREDTHOUSAND ENERGYPEf�MlT _... _ — ppt{,hfl$(3/W.IXq).iN A6D%T10N T4 TFiE GOST OF CdA1PENSATK3N.DAMAGES AS PR6V76E0 FOR IN � $ECTIC7N3�pBOF7HELABORCfJDE,INTEREST.ANpATT6qNEV'SFEFS. (�E,TENTIONFEE: ___._ ._ � CONSTRUC710N LENp1NG AGENGY PRE-ALT FEE; � �. � IHEREBYAFflfBAUNDERPfNhI.TYOFPER.lUflY ATTHEflEiSACONSTAtfCT�ONtENO1NGAGENCY „ .._.... FOR THE PEPFORMANCE Of�iHE WORN FOR W H THIS PERMIT IS ISSUE EC.3q97,CIV C. � 4ENpEflSNAME`._�L.=L- �' �-�-_____��-----+�� / -._ ."_. �_ H LENDER'S An6FESS___..,_ /� � IGEfiTiFYTtiATIHAYEftEACt7rpSAPPIIGATk'N7ANOSTA7ETHATTHEA�VE7NFQflMATtON�SCORftECT. TQTA'iL F��S � t � 1 AGREE TO COMPL�WI7N ALL CITV AND COUNTV OROINANCES AND 57ATE IAWS RElATING TO 9UILOINr � CANSTRUCTION,AND HEREBY AUTHORRE REPRF£ENTATNES OF THIS COUNTYTO ENTEA 11PON TNE � REOYE-i.iENT16N6DPROFERNFORiNSPECT" F'URPOSES. CCIMMENTS ... � aT.�.�.�L-L u"r�-f' m � — . _ PERMITTEE NAME(PRIM) Y � fy (✓' � � ��M � .r.. ._i s/ L � SIGNAT ��F P£M1�T i E � - ppTE RECPL N0. _ PAID BY ' ��` VALIDATION_, F�=- WHITE-Depariment Copy,YEtLOW-f�stu:e Gopy,PINK-Assessw Gopy.GOLDENROG?-Fiie Copy,GF?EEN-ApplicanYs Copy �e�.�"� �� '°��:`�a"�,,��";i^:.�`�� .�.'��'� ��'f�'��'�,"��°� �"��''�,r�#`°.��..:u _ �; � e� � � .„�,..e � . . � „ �=�u,��'..4 e. � , a . n � � ` � ,�r��- ' � � " ` Y, 'oR ..... . m"`?ym e �t . . . . . . .. . . . . . . ... __ .1 a-y- .. ^t { �,,..... _ ' �"i.�3� f '�. . .. . .. .._._ __ _...... - ' .�.� . . ".- <$ �' . . �, a.. i �. l. ". - :.e ` .3 . �.. - ..,�.., . . ,_ , .__.. ,. _._ _ '___ - -� . ._ ... .. _ , . . ... .._. ._. _._ , .. ..... , _ , . .., -" � ,A ° .. �., . �, . ... r .�:. , � _ � .. _ . , , i . , , x � . _ ._ . . �_ ,,. , . . _ . ' � C2 j� a ' .�- � ' .. , �.' . . .. .. . . . .... . ... � _. . .. ,_, ._.. ... . . ,.. F�.} � : , ,:�ti �.�� . ...._.. . � � .. _., s-r i .. .. ._ ...._ "_. �_,� ,.. r�j.,j �, '. .._. . .. __ —... _� r� r dP t . .... .. ... . . . . ... . ... _.. .... � . � _� � � � ,.-.a,�,� ��%G.",. kr3_4�>m�'.��&�-�,F..n.'�...... .. ._ ._.._ .. . . . .. ...,.. ........._...._..... .-... . � . .. .._..... . . . _.. ... _.... . � _.__�... ..,.. .__ _... _.._ ..... .._. .... ... ... . ..... _ .. .. . . .. .. .. . . . .. ......_._.....__ ... ..._ .._.. .. ._..._ _... - ..__.._ ..._.. _.... . .._ ...... . .._. ... _. ..._._ _..... .. .... ..._..... .. . ._.. .......__.__.__.... . _. .... . ...._. .._... _... .. '.. . .. ...._ __.. _ ._... . . . . . � .. .,._.. ..... . . ......_. ... ._ .... .. .. . _. _... . . _.._.._...._..._.._... _ , �. . ... _.. ..... .. .... .._.. .. _ ....... . ._ ... . .... .. ..... . .. . ... . . . .. ...__.._._ ........ .. ....... ; .. _...... ..._. _.... ...._ ..... . ...... ..... .. . . ��. .._.� ......._ _... .._. ..... ....... ._... . ..... ..... ._.. , r y : .. .. ... .. .. _. ... .... . . ... . . . . .. ... . r� �! , a�� K� �k+�� T✓v�n , t��„��>,�NK . � ' � �"�� ,�� ' _ : ,�� ;�`��"�� _ _ ; ��_��"`�u��.� � �� _ _ _ �,E �� j��' , ui �� : � n � r dE ,� � � k �� ,�+�� '��e��° y � �� u�� ' �� s��^��b��'i� — "a x a a f,� �:r s�� §.�,` . .. .. .. . . .. ... . . '�#�::�t�'��*� ��e s� y� x�s� :�,�+� ... .__. ... _ . .. ... .. a i�.� � �g s�-� �° a ,+ 6 a ��r ��,�� .�.r�.�„,�� .. .��,�A�»�, ,3,�:�� _ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION "Estates"Plan 2 A/L PRESS FIRMLY JOBSITE iew Dr. re s t ADDRESS 710 C V 22 77 APN TRACT 52267 ER Palte MCorp OWNER ADDRESS 18401 Von Karman CITY Irvine zip 92612TEL. 9497974400 APPLICANT-Same TEL. CONTRACTOR U I L2 ADDRESS K�IPW CITY Z�'/i/lr�ZIP ! Z TEL9�'1 -7 17'/ ARCH/ENG/ S DESIGNER ADDRESS CITY ZIP � TEL.0 7 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. TKKJ.ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500).): DI,AS OWNER OF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL 00 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). ^ I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTlNG 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.). ^ I AM EXEMPT UNDER SEC. B. $ 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 D EFFECT. LICE14 SASS C D ONTRALTO I,(,-, DATE U/ WORKERS'COMPENSATION DECLARATION I HER AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' COMPENSATION.AS PROVIDED BY SECTlON 37x0 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 RRAANDD POLICY NUMBER ARE, ISSUED. MY ERS'COMPENSATION IIN�SSURRAANCCEE C EL CARRIER � i RRII� f J POLICY NUMBER�_i//�•�--_ 11�I�! '•t"/rV I (THIS SECTION NEED NOT BE COMPLETED OF THE PSWAY IS FOR ONE F&INDRED COLLARS($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//�L.APPLICANT:v-I 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 3708 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 W HHTTHIS PERMIT IS ISSUED SC. 3097„CIV C. /�//maY/"-.�-� LENDER'S NAME-//J�y LENDER'S ADDRESS I CERTIFY THAT 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 RELATING TO BUILDING CONSTRUCTION.AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE PROPERTY FOR INSPECT N PURPOSES. ABOVE-ME NTIONEED E PERMITTEE NAME(PRINT) / SIGNAT OF PERMITTE DATE 'RE APPLICATION,PERMIT P/C DATE NUMBER# ISSUE TYPE OCC DATE CONST.GROUP ZONING SETBACKS FRONT RW^ REAR^ L SIDE/SIDE STREET RW^ SIDE^ PROPOSED USE SEWER LATERIAL N0. DWEL. N0. N0. UNITS STORIES BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ.AREA/VALUATION SFR/ADD/REM U) Garage/Carport w Patio/Deck LL Pool/Spa 0 Re-Roof Z d Commercial 5 Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J U Cc U W W (D 41.50 Z 03 Q U Z W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES COMMENTS RECPT N0. PAID BY VALIDATION WHITE-Department Copy,YELLOW--finance Copy,PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-Applicant's Copy