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Home My WebLink About10-1214 '��_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �""^' BUILDING PERMIT APPLICATION FIRMLY � JOBSITE '�+�''�6 CRc��C2�kT�Z /�/ � APPLICATION PERMIT /C o ADDRESS �Z�/ DATE NUMBER p o ISSUE TypE °^ APN LOT TRACT DATE�� O OCC p OWNER 1/Y'�i2U(/� Si �%1� '�ri. CONST. GROUP p ADDRESS �it� ZONING SETBACKS Z CITY � ZIP�'�^ TEL.� 1'S�O FRONT qyy p o APPLICANT TEL. SIDE/SIDE STREET RW ❑ z � CONTRACTOR 'C�L.I�I ' l: SIDE p Q ADDRESS � �. I•� t "' L o CITY �P7JYL.�-��'1IC_ ZIP��j._ TEL��Ef3_ '� PROPOSEDUSE 1 � � Gy� w ARCH/ENG/ L z DESIGNER � w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFIRM UNDER PENAL7V OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G2fe90/C2Ip0lf W CENSEUWFOR7HEFOLLOWINGREASON(SEC.7o31.5BU51NE5SANDPROFESSIONSCADE:ANVCITYOR (n ZCAUNTYWHICHRE�UIRESAPERMITTOCONSTRUCT,ALTER,IMPfiOVE,DEMOLISH,ORREPAIPANYS7qUC- W Patio/Deck w TURE,PRIOR TO ITS ISSUANCE,/�LSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CONTRACTORS LI� � � CENSE LAW(CHAP7ER B(CAMMENCING WITH SECTION 7000)OF DIVISION 3 Of THE BUSINESS AND PRO- POOUSPe FESSIONSCODE)OR7HATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALIEGEDE%EMP- (� � TION.ANYVIOLATIONOFSECTION7o37.5BVANYAPPLICANTFORAPEHMITSU&lECTSTHEAPPLICANTTO Z Re-Roof /�/{ � A CIVIL PENAL7V OF NO7 MORE THAN FIVE HUNDRED DOLLARS(f5ao).): W Z ❑I,ASONRJEROFTHEPROPER7Y,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COmfflBfCi21 WILI DO 7HE WORK,AND THE STHUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.701l,BUSI- J N NESS AND PROFESSIONS CADE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV WHO BUILOS OR IMPROVES THEREON,AND WHO OOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m Q OFFEREDPoRSALEIF,HOWEVER,THEBUILDINC,ORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THA7 HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W ❑I,ASOWNEROFTHEPROPERTY.AME%ClU51VELYCANTRACTINGWITHLICENSEDCONTRACTORS Q TO CANSTRUCT THE PR0.IECT(SEC.70N,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U8i1Of1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANONTJEROFAPROPERTVWHOBUILDSORIMPHOVESTHEREON,AND � NM1IOCANTRAC75FORSUCHPRQIEC7SWITHACONTRACIOH(S)LICENSEDPURSUANTTOTHECON7RAC- QUANTITY DESCRIPTION FEE Y 70R5 LICENSE LAW.). � O I MI EXEMPT UNDER SEC. 8.8 P.C.FOR THIS FEASON Q � U LL DATE OWNER � � w � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d D(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z X MV UCENSE IS IN FULL FORCE AND EFFECL � m , 11J (//y' � � UCENSE CLASS � LIC.NO. Ta O � V DATE � CONTRACTOR��(� d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBYAFFIRM UNDER PENALTV OF VERIURV ONE OFTHE FOLLOWING DECLARATIONS: Z I � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORNERS' _ Q COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE UBOR CADE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERAl1T IS ISSUED. � I w I HAVE AND WILL MAINTAIN WORKEflS'CAMPENSATION INSURANCE,AS REOUIRED BY SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS /� (%/ ' ^ � ISSUED.MY WORKER' MPENS ION INS NCE CAR ER AND POLICY NUMBERARE: CONSTRU ION i Q O�-Iv � � CARRIER ��'��•� P � ZPOLICYNUMBER��I��L�T��1 ELECTRIC � Q . 0 (iHISSECf10NNE�NOTBECOA4LEfEDOFTiEPEPMfTISFORONEHUI�DREDOCIlARSK10D)ORLESS} PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUEO,I MECHANICAL (.'} SHALL NOT EMPLOV ANV PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE Uj WORKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE = SUBJECT TO THE WORKERS'COMPENSA710N PROVISIONS OF SECTION 3700 OF THE LABOR CADE,I SHALL FORTHWITM COMPLV WITH T V SIONS. SSU � �P ,� 9 p DATE:�—� APPLICANT: J WARNING FAILURE TO SECURE WORKERS'CAMPENS ON COVERAGE IS UNIAWFUL.AND SHALL BE ENERGY P/C � SU&IEC7ANEMPLOYER70CRIMINALPENALTIESANDCIVILFINESUP700NENUNDREDTHOUSAND ENERGYPERMIT DOLLARS(S10o,000�,IN ADDITION TO THE COST OF COMPENSA710N,DAMAGES AS PROVIDED FOR IN n � SEC710N 37oe OF 7HE LABOR CODE,INTEREST,AND ATTORNEv'S FEES. TENTIO E' �C,•O D � CONSTRUCTION LENDING AGENCY PR ALT FEE: O � � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THATTHEFE IS ACONSTRUCTION LENDING AGENCV �' "�� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.�. /� . Z W � LENDER'S NAME F- LENDER'SADDRE55 � TOTAL FEES o�3O� / � 1 CER7IFY THAT I HAVE READ 7HI5 APPLICA710N AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE 70 COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE Uw5 REU7ING TO BUILDING � CANSTRUCTION,AND HEREBY AUTHORIZE REPFiESENTATIVES OF THIS COUNTV TO ENTER UPON THE ZABOVE�MENTIONED PROPEF7Y FOR INSPECTION PURPOSES. � /� COMMENTS � �. `�V 6� �r m PERMI77EE N (P � � a L- �b � � SIGNATURE OF RMI DA7E = RECPT.NO. BY VALIDATION ~ WHITE—Department Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy C@�V Of� D9�4�Vd0�� AB� ,' Ift�S�I�CTEON ��COR� - - : � � � � �- vK� � . .4. /\�y+ r ) R.` S D��7 � �.,• , .�. . � � � � . D � � � • ��vF+ � ��.': }} �� . . � �- - . , - ,.:� ..Vi- r:f. ".�. . '[ - .. .4��- ` a.:. " �;r .. ''�i�•. . SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRAOE FIREPLACE FOUNDATI�N TEMP POWER ' FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING B 1 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER ' PRE-GRADING ROUGH HEATING BENCHWG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FIN15H GRADING SHOWER�i'UB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. ' FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY �� ;� � ��", COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE .� w ,-1 �,A Y{d[.. �� a �. �� k'�� '� : (� .'Y x_:� .,a ,�� C,�.l �,'�,,.�'��r.�zX :