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Home My WebLink About15963 ��, CITY OF DIAMOND BAIt � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES '",�� 21660 E.Copley Drive Suice 190 � (909)860-3195 Fax(909)861-3117 PRESS ��' BUILDING PERMIT APPLICATION "Estates" Plan 2AR FIRMLY � JOBSITE APPLICATION � �� PERMIT \ �- � P/C o ADDRESS /�5� Crestview �"�j'� � ��. DATE NUMBEF J ^`J # � APN LOT 3O TRACT SZZG7 ISSUE TYPE OGC � DATE CONST. GROUP p OWNEq �U�t2 O�COt"p " ADDRESS �f«0� VOtI Karman ZONING SETBACKS � cirr I rvine� ziP 92612rE�. 9497974400 REORT Rw o � APPIICANT _ TEL. SIDE/SIDE STREET RW ❑ CONTRACTOR (/I o ��-� Ch�1- . SIDE ❑____ � ADDRESS � PROPOSED USE 5 EW E R LAT E RA L o CITY �-�!/1/�V� ZIP z--TEL L � ARCWENG/ L � � �f- �S r� z DESIGNER�� NO.DWEL. NO. NO. � CDDRESS�� Z�P TEL�� -��t UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNEF-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFlRM UNDER PENALTY OF PEHJURY THAT I AM EXEMPT FR�M THE CONTRACTORS LI- G8�899/CBfpOfl W CENSEIAWf-0RTHEFIXI_OWINGHEASON�SEC.7031.SBUSINESSANDNROFESSIONSCOOE:ANYGITVOfl (n � COUNTYNMICHREWIRESAPEHMRTOCONSTRUCT,ALTER,IMPROVE,�EM10lI5H2ORREPAIRANYSTRUC- W Pallo/DeGk IURE.PRIOR TD ITS ISSUANCF.ALS�REOUIq�S THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNE� W � STATEAIENT THAT NE OR SNE IS LICENSEO M1RSl1ANT TO THE PRDVISIONS OF THE CONTRACTORS LI- � CENSEUW(CHAPTER9:;COMMENCMGWITHSECTION7WU)OFDIYISION30FTHEBUSINESSANDPRO- � PooUSDa FESSqN&QODE)ORTMA(HEORSHEISEXEMPTTNEREFROMANDTHEBASISFORTHEALLEGEDEXEMV- � TION.ANYVIOUTIONOF:iECTION7091,5BYANYAPPLICANTFORAP[RMITSU6JECTSTHEAPPLICANTTO Z Re-Root F ACMLPEN�LTVDFNOTMORETHANFIVEHVNDREDDOLLARS(f5C0).): � ❑I,hSONNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGE5A5THEIF50LEGOMPENSATION, � CORIff10fCIdI WILL DO THE WORK,AN�THE STRUCTUHE IS NOT INTENDED OP OFFEREO FOR SALE(SEC.70M,9U51- J N NESS AN�PROFESSIONS CODE:THE CONTRRCTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPEHiY W}IO BUILDS OR IMPROVES THEREON,AND MMO DOES SUCH WORK HIMSELF OR HERSELF Ofl 2 THROIXiH HIS OR HER OSVN EMVLOYEES,PROVIOED THAT SUCH MPROVEMENTS AflE NOT INTENDED OR m �}1 OFFERED FOR SALE IF,HOWFVER TME&JIL�ING OR IMPROVEIAFM IS SOIL WITHIN ONE VEAR OF CAMPLE- zTqN,THE OWNFR�BUILOER WILL HAVE THE BUROEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVEWRTHEaURWJ5EOF5ALE). w ❑I,ASOVMEROFT�.IEPROPERTV,MAEXCLUSNELVWNTfUCTINGWRHLICENSEDCON7RACTORS � 70 CONSTflVCT THE PR<1/EGT�SEG.IOH,BUSINF55 AFiD PROFES310N5 CODE THE CONi'RACTORS U- V81U8I10l1 ADJ.AREA W CEN3EUWDOESNOT�PPLVTOIWOWNEROFAPROPERTYWHOBUILDSCRIMPROYESTHEREON,AND - � VAIOWNTRACTSFORSUqiPHQ1ECTSWIiHACOfJTRAGTOR�S)LICENSEDPURSUPNTIOTMEGONTRAF pUANTITY DESCRIPTION FEE Y TORS UCENSE UW.�. Q � O ❑I AM EXEIAPTUN6ER SEC. _B.8 P.C.FOR THIS PFASON Q 3 � � � DATE OWNER ._ _ _ V Z — W � LICENSED CONTRACTpRS DECLARATION W � IHEREBYAFFIRMUNDERPENALTYOFPERIURVTHATIAMLICENSEDUNDERPROVISIUNSOFCHAPTER � d G(COMI.�NCINO WI7H SFCTION 7000)OF DIVIS!pN 3 OF THE BUSINESS AND PROFe551CN5 COD'e,AND z ._ X W LICENSE IS IN FULL FI�RCE AN EFFECT Lll � � ''� � � UCENSE CLASS_,_ LIC.NO.� � �r-y� /y V DATE��1�"L!_�. CONTRACTOR_ - � d W � INORKEFiS'GOMPENSATION DECLARATION Q � U � INERE AFFIRMUNUEFPENALTVOFPERIURVONEOFTH`cfOLLOWINGDECLARATqNS: Z Q 0 INAVEANDWILIMhINTAINAGERTIFICATEOFfANSENTTOSELF-INSUFEFOFWORKERS' _ � COMPENSITION,AS PROViDED 6V SECTION 3'I�o OF THE LABOR COOE,FOR THE PEfiFORMANCE `U OF hlE WORK FOR WHIf.H T411S VERAIIT IS ISSUED. � � � I HAVEAND WILLMAIMNN WORKERS'COMPENSATION INSVFANCE,AS HEQUIfiED BV SGCTIOY Q 37000F TME LABOR CODF,FOR TNE PERFORMANCE OF TMF WOflN FOR WHICY THIS PEflM1T IS ISSUED.MY '�KERS'COMPENSATIpN�INSUSANC RFIER AND POLICY NUMBER��ARE: ' CONSTRUCTION j c�aaiEa��✓_L��/��- PLAN REVIEW Z aouCVNUr.�eEa...�Il�� /� ��Q�� ELECTRIC d J � (iNi55EC1X]NNEI�hOF8E00A�PLEfEDOFTFEPF.PoNTISFOFlONEFAN�REDDOLLPRS(f100)ORLESS). PLUMBING __ W z I CERTIFV TNAT IN THE PERFORMPNCE OF TNE WQRK FOR WHICH THIS PERMIT IS ISSUE�,I MECHANICAL C,'}� SHALL NOT F.MPI OY ANV PERSON W ANY MANNER SO AS TO BECAME SUBJECT TO iHE � WORKERS'CdA�%ENSATION LAWS OF CALIFORNIA,AND AGREF.THA'(IF 1 SHOl1LD BECOME INSPEGTION FEE _,__ � SU&IECT TO THI:WORKERS'COIAVENSATION 7R0'JISIONS OF$ECTION 3]OOOF THF.LABOR ',I� � �E,�SIIALL�J�WITHCOMPLVWITHTj��FlO�NS., / M�� ISSUANCE �SIY��°1 ODATE: /— � APPUCAN7: r %T N"� SMIP _ w ENERGY P/C J WI.RNING:FAILURE TO 5ECURE WOPNERS'CAMPENSATION CAVERAGE IS 11NLAWFUL,AND SHALL BE LL SUBJECTANEMPLOVERTOCRIMINALPENAlTIESANDCIVILFINESUVTOCNEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(5100.000).IN P,DDITION 70 THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION3]OBOFTNEU\BOF'b�E,INTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: _ � .____._--__._.-__.___._____._. --_- d CONSTRUCTION LENDING AGENCY pRE-ALT FEE O � I HEREBV AFFIRM UNOER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV d FOR THE PERFORMANCL'OF THE WORK FOP WHICH THIS PERAl1T IS ISSUED�SEC.3PB�,CIV.C.). � LENDER'SNAME��V N'�F H LENDER'SA�OflE55_ � I CERTIFY THAT I HAVE FEAD THIS APPLICATION AND STATE THA7 THE ABOVE MFORMATION IS CARRECT. TOTAL F E ES �� ' ' W 1 AOREE TO COMPLV WI1N ALL CI1Y AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING � CANSTRUCTION,AND HGREBY AUTHOR2E REPR[SLNTATNES OF THIS COUNiV TO ENiER UPON THE ZABOVE-MENTIDNED PRC�FERTY FOR INSPEC ION PURPOSES. COMMENTS � I�/,��/✓�_�_��r J __�rfC=L._- . � m PERMITTEENNME(PFINT) � ��_��a� �.--/l �-C�I : � SIGN EOFPERIAITI"EE OATE .,, = RECPT.NO. _ PAID BY �L VALIDATION_. . _ - — ~ WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—ApplicanYs Copy ' �r�� 7'!� �w.s� ��. 3 4 �.��y'��w' �.�t"'�S�w ��.,�� .�'�.P,, � �� 5�� .�t � �� r a �i��;'`� < .... . . . . ., . . . ... .. . . . ....... .. .. ..... . _. _ ',. -. F" - �,,. . , , _. . ,,.� e .�. ..< , ', t t - . �� .,s: '�. , . __ ... ... ..__.. ._._ _..�.. _ _.._ ._ _. _ , ... ...... _._ ..__ _...... ... ._ . .. . . __. , . .._. ..... .._.. . . __ _ .._— --_ ..... ....._ __. . __. ._.. �� ... ',. �ri',:. . _ .._ .___ . ..... __ ..._ ........ . . � , .._.. __ . .. _. .. ._.. ._. ._ . _ , .. -t �:`d� � ��. . .. �. __.. .. ,..._ ....._ .,.. , .. . . . , .....' _ '.__ . ... . .. -,. :_ ' ",..... ;� .. ,.: � ..�„ .. . .. .. ,_... .. .. .._. .._.... .......... . ..... , .._.__ , _..._.. ._._ ...... ... ..._.... .. , .. .. . _ '"E� ; ' .. .. . .. . . .. ..... _._ --- _... .___ _ ._ _. .__. _ . .__ _ .._... .. ._ _ ... : . �,.` ' ' ,,,�, ._ .... ... . ,. . . .-�_>, .. .._.. �. . . .. .:.. ,. � .� . . _ � . ._ ... . . . ... �7.�4�Cr� f�-� ��%�� ` � � � _ _ _ _ _ _ _ _ __ _ __ _ _ _ _ _ . . ...... .... .. . .. ...... _. _... . ... �.p �. 3 Y ..'Ei3}� 2 �' .. ... .... .... . ... .. { �� 5 F �. a o . _ _ _ _ ,.",;P...�..'�a�'z�� m.��n^��u,��t4�� _ _ _ _ _ _ _ _ _ _ _.... _ _ _ __ _ _ _ __ _ _ _ _ . _ _ _ __ ___ _ _ _ _ _ � ; _ _ ^� � ��;'�'��°� n�`� � ' � �� ''�i�� p:�c�ti ��, _ � � � s� _ '� �� , ,�� _ ��,��"�� _ ��`��`�� i �� ti w�� : _ _ � 9 � �} �t��a3 .,.�ti��' � � _. _. „ ..,.. .... .. .._ .... .. . .. . ... . �. � =�� 'm�-a�s '� . wa�� n ,t�� f��= � � 4 T� `��}�"aaSN�fi ��N � _. .. ... . _ .. .. .... ... . . ... .._ .. "r��W p,,.t��.1 v�'� 3� :�� 3 erc` . �''�MIPo-S� ,�'�e��' h .. .... .. ..... ... .... .. .. ... .... .... ..... ... ... �"AN, :s ��`�!`!�'�t4bd mr�" _°�r�� s..,,.�_��,��4� °�',.v�, . . . . .. . . . . . . . .. . . . �. DIA IIIJD 14 1;.11 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 2AR r PRESS FIRMLY JOBSITE 750C i t res v ew ADDRESS APN LOT 30 TRACT 52267 OWNER Pulte I Corp ADDRESS 1E1401 Von Karman CITY Irvine ZIP 92612TEL. 9497974400 APPLICANT TEL. 55 me CONTRACTOR vI <.-I ADDRESS CITY/�ZIP Z--TEL. ARCWENG/ Lf-Sr� ADDRESS CITY ZIP-TELg 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 REQUIRES A PERMITTO 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 a ;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 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500).): ^ 1,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). ^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 T 0 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 Y(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND FORCEFFECT. MY LICENSE IS IN FULL EA LIC NO LICENSE CLASS 7 DATE CONTRACTOR 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 SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. ,I Li 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'IKERS"COMPENSATION INSURANC RRIER AND POLICY NUMBER ARE: CARRIER POLICY NUMBER (THIS SECTION NEID NOT BE OCMPLEFED OF THE PERMIT IS FOR ONE HIX-ORED 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'COMP=ENSATION LAWS OF CALIFORNIA.AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR P COMPLY WITH PROVISIONS. CODE,I SHALL FORTHWITH A DATE:/-�APPLICALICANT: 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($100,000),IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE. INTEREST,AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC. 3097,CIV.C.). LENDER'S NAME_j'II LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPEC ION PURPOSES r INT) PERMITTEE NAME(PRINT) SIGN E OF PERMITTEE DATE APPLICATION PERMIT P/C DATE NUMBER-- "� # ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ^ REAR ^ SIDE/SIDE STREET RW ^ SIDE ^ PROPOSED USE SEWER LATERA L N0. DWEL. N0. N0. UNITS STORIES BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ.AREANALUATION SFR/ADD/REM U) Garage/Carport W Patio/Deck LL PooVSpa CJ Re-Roof Z 0 Commercial 5 Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J U U w W 0 Z DO a ) U Z Q U L CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING J MECHANICAL INSPECTION FEE ISSUANCE S$_'r SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES L I( COMMENTS RECPT. N0. PAID BY I VALIDATION WHITE-Department Copy,YELLOW-Finance Copy, PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-Applicant's Copy