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Home My WebLink About17982 (10) ��... CTTI'OF DIAMONi7 BAR � , � � I}EPARTMENT OF COIv4v1UNITY&DEVELQPMENT SERVICES J�� -�� ( 21825 E.Copley Drive (969)860-3 t95 Fa�c(909)861-3117 PRESS � -� BUILDING PERMIT APPLICATiON FIRMLY � JQSSITE �J�y�y� j�,��y+�,('�}J„,,,,f �r^� ' APPLICATION PERMIT P/C � ADDRESS /�"'R..1 � iS.fi,tLC�(,_ A � aAre 5/9/02 NUM�E� 17982 # � issuE �rvP� occ APN . LO RACT DATE COPIST. GROUP p OWNER �'`' ADDRESS ZONING SETBACKS � CITY Z!P EL FRONT RW ❑ � APPLICAN`f � TEL. REAR �'� Z _ SfQE1SlDE STREET RW � � CONTRACTpR, �p�LIAN� I • SIDE �� ADQRESS �' p �1T1,_ � eWdO . PROPQSED USE w ARGH/ENG/ ��" � �' WDESIGNER C;3F#,5942F32 d ADDRESS NQ.DWEL. NO. NO. — UMITS STDRIES BEDROOMS � CiTY ZIP TEI. � DESGRfPTiON SQ.FT. FACTdR PSF ADJ.AREANAIUATION p� OWNER-BUILDER DECLARATION SFR/ADp/REM Q G] i HEREHY AFFlRM UNUER PENALTY OF PERJUFY TNAT i AM E%EMPT FROM THE CONTiiACTpRS LI� � Garage/Carpoh W CENSELAWFORTHEFOLIOWMGREASON�SEG.�o31.5BU31NESSANDpROFE5510NSCODE:ANVCITVOp C.,� COUNTY4VFfiCHNE4UiRESAPEHMiTTOCONSTRUC7,ALTEfi.IMPR6VE.0EMOttSN.�IREPAIRANYSTRUG W PatiolDeck W TURE.PfllOfl TO ITS ISSUANCE,ALSO REQUIRES THE APPUCANT FOp SUCH PERMIT'O FILE A SIGNED W .�,r STATEMENT THAT HE Ofl SHE IS IICENSED PURSUA.YT TQ THF PR�VtSIONS OF 7HE CONTAACTORS ll� � CENSE lAW{CHAPTER 9(COMMENCING WITN SECT�bN T000}OF DMSION a OF THE t3USiNESS ANO PRP �' PflQUSp2 FESSIONSCpDE)ORTHA7HEORSHEISEXE�AP77NEREFpOMANp7HF.BASISFORiHEALLEGEDExEMV� C7 � TION.ANYYIOLATiON�FSFCTION]031.6BYANYAAPIiCANTFORAPEf1NiF5Up.lECtSTHEAPPLtCANTT4J Z Re-Roof � ACNI�PENAI.TYOFNOTMORETHANFIVEHUNDREt3DDLL4RS(3500).1: a ❑I,ASOWNEROFTHEPROPERTY.ORMYEMPLOVEESWITMWAGESASTFiEIR50LECpMPENSATION, � COmme{CIdI . � WILL DQ THE WORK,ANfl iHE STRUCTURE IS NOT lNTENOE�OR OFFEREO FOii SAI.E{SEG 7044,BUSI- _7 N£SS AND PflqFES510N5 CODE:THE GONTRAGTORS LICENSE LAW�OES NOT APPLY TO AN OWNER OF � PROPERTYWI�IOBVILDSORIM7ROVESTHEREON,ANDWNQDOESSUCHWORKHIMSELFORHERSELFOR � CC S»f�6UGti tt�5 oft NER OWN EMPLOYEES,PRO�'10E0 TFiAT SUCH IM?ROYEMENTSARE rt�T IN7ENOED oR � � � OFFEREOFORSALE.IF,HOWEVER,TiEBU1LDMGORIMPROVEMFNTISSoIDWITHINONEYEApoFC4MPLE- �, TIIXJ,THE OWNER�9UILDER WIL4,hAVE THE Bl1R�EN a�PR�VING 7HAT HE OR SHE QID NQT BUfID OR � IMPROVE FOR THE PURPOSf OF SAIEj. W ❑I.ASOWNEROFTHEPROPERTV,AMEKCLUSNELYCONTRACTIN6WITNUCEN9EDCONTRACTOR$ (r TQ CANSTRUCT THE PR0.IECT{SEC.�6ii,8U5lNE^uS AND PftOfESS10N5 GO�E=TME GON7ftACTOftS U� VdIU8Ii0(i ADJ.AREA [Ll CENSE lAW OOES NOT APPi_V TO AN OYMER OF R PROPEflTV NMO BL'ILOS OR IMPFOVES THEREON,AND � WHOCONTRACTSFGRSUCHPRQJECi5WITNAGONTRACTOR(S�LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRlPTION FEE Y TORS UGeNSE LAW_). � J � ❑I AM E%EMPT UN�EFI SEC. ,_ R.R GC.FOR THIS FIEASON Q '-yr _ U � � DATE OWNEft` � Z U W �—�" LlCENSED CONTRACTOR9 DEGLAHATION � � I NEREBV AFFIRM UNDER PENALT V T T I AM I EN E N EF PROVISIONS QF CHAPTER � 8(COMMENCING WlTN SECTiON��Jt��t��lONS CODE.AND Z w MY UCENSE IS IN FULL FORCE ANp EFFEC�.,��ndustry AVe. � Q L�CEN6E CLASS I AI{Pry�J�f� ��,,.,,��' ._ � � 6ATE �.NPlYr��} q�O�� ....__..— 0- .... d�i WC�R!(ERS'C6MRENS�AY#U�N D��ARATI{.)N Q = U � INERE9YAFFIRMUNOERPENALTYOFPERJUPYONEOFi4EF01_I�WINGDECLARATIQNS: � � Q — � �_I HAVE AND WILL MAIN7AIN A CERTIFICATE OF CONSENT TO SELF-IN5l1RE FOR WOqKERS' _ COMPENSATION,AS P30V1DED 8Y SEGTION 3I446F TME GABOft COOE,F�R THE PERF6RMANCE W OF TNE WOflK FOfl W HICH TMIS PERMIT IS ISSUED. � � W I HAVE ANQ Wtll MA!NTAIN WQAKEFS'C�MP£MSATIQN INSURANCE,A9 ftEQU�RED 9Y SECT�ON Q 3]DO OFTHE LABOR=00E,FOR THE PERFD MANC[OF THE W4RK FpR WHICM TH19 PEPMIT IS f55UED.MY Ft5' SAT i RANCE cRRftIEft AND PpUCY NUMBEP AftE: CONSTRUCTION �„ ,_,.__,,. _,_ Q }, caqaieR ._ PLAN REVIEW _ � aoucvuuMaeR_ ELECTRIC _ ¢ � (7H�'iSECT}�NtdEEONJTBEmNJ'L.Ef�OFTHEPEiif.�9TtSFQRIXJEHUM1DREODaLLAF15tL106}OftIESS). PLUMBING _..�_.,...._. W i CERIIFY iHhT 14 TI-E PEAFOflMANCE CF TME WORK FOfl WHICM TMS QEftMiT IS ISSUEQ.i MECHANfCA� Z („� SHALLNOTEMPLOY,4NYPERSQNINANYMANNER30ASi06ECOMESI)BJECTTOTHE � WORKERS'COMPENSATI9N LAWS OF CALIFQNNIA,AND AGREE TMAT IF I SHOULD BECOME INSPECTION FEE _,_ SUBJEGT Ttl THE WCRKEF?5'GOA-0PENSATION PftOVI5F4NS OF$ECTION 3790 QF THF LA80R � `c P ,II I ITH COMPLV WI T O E PR VI51 5 +` ISSUANCE Q ` ��L��j SMIP �- �j OATE:i�p1��J��AFPLiCRNT: -- - � —��— J � ENERC�Y P1G J WAftN1NG.�AiIUAE TO SeG4J�4E YtOAKERS'C4MFENSATION L17VtftAGE I6 UNI.AWFU(„AND SHAL�BE ��—"' �— � SUBJECTAN EMPLOVEfi Tp GFIMINAL PENALTIES AND CIVIL FINES UP Tq ONE HUNDRED THDl15AND ENERGY PERMIT OOLLAflS Sf 1qo.aoa),IN AOUIl10N TD THE COST OF COMPENSATION,DAMAGES AS PROVIOEb FC1R IN --- � ..�.1 SECTION 37a8 OF THE 1A60P CApE.IMEREST AND ATTORNE!"S FEES. RETENTION FEE: � _...�..._�.� _..___ d CQNSTRUGTION CENDING AGENCY pRE-A�T FEE: .__ O �- IHEREBYAFFIFMVNDERPEPlALI'VOFPERJURYTHA`THEREISACONSTAUCTIONLEN�INGAGENCY d- FOR TME PERfORMANCE OF tHE WIXtK FOR WHFCN THIS P£ftMiT IS ISSU'eD(SEC.3�97.CIV.CJ. - Z LLl �___._._ ,Sy tGN6Efl'S NAME _.... .. ......__._... � __— F� LEN�ER'SADDRESS ._ � ICER1'If�VTHATINAVEREAD�HISAPPIIGATIONANp5TAiETHATTNEABOVEINKORMATIONISCO%RECT TQTALFEES �� f�� AC�ftEET�GpMPLYWITHRIs_CtTYtYDGOUNTYORD�NANCE5AN65TAT[LAWSRE(.ATIN^uTOBUtt.DiNG � CONSTRUCTI4')N,AfJU HEREtl'/AUTHORIZE REPRESFNTATNES OF THIS COUNTY TO ENTE{i UPON'WE � A60VE.MENTI NEO PP�Y GO-R INSPECTIo�URPosES. COMMENTS_ t 1 1�¢a !w ( h A . ._........_.....��.� � N� l��r�� 1/ 1!'/i _ — _._� V v.. �.J��-�r � _ m RM'TEE E(PRI � � ^S -- ._- � � 5 GNATURE OF PEflMITTEE ^ DATE �i � ^ ^ = RECPT.�O. AIDBY ,��}4$ VA�IDA7ION �� ~ WHI7E—pepartmem Copy,YELLOW—Finance Copy,PINK—Assessar Copy.GOLDENF06—File Copy,GREEN—Appliaant's Copy �i i; �� §�*� �'� ��'`�" � � F�.. _ $i � ` ,, , . i � ia �i��, �ii��„� n� . �,, , G — � , � s� a� "a afl�' -'v�;8.,i'��i°�ix, ,- , ., � ' . c ! �� : _ . . . _- .... . .. 1. �. �; ,� .. . .;. � •.�r � , �� - _ _ _ _ , � - ; � , , � . . ,�a� . � � � , � - � ' ��.�a��$��'��°�� a��"��. �a�i� � a I�; �;� �� F �" , �� t�i��,€ �re,n��it '�6��+�� a`- '�. �� '��'�� ly� �q�'��.� � .. . . .. . �',-��."��5 �'�'��, � �[� � � ' .. _ ... .. . . .. . . . . ..._ .. ... _. ._ . _._ ... -- — ._ � ., �r `�Y^� ��"�F°�l§ � s�iq+hs,i �� `� a;�� e�.��s��: ... . . . . .. .. . ._. .. .. « �r ? �a �� ,� � ��, � t �� s� �� n a��+�@�'��aa�� s* '�'�='' � ��p° � !� �',- � i �e � - u��qw�,� a�y�.,;, � a : . ... .. .... . . . . . . .... ...... . . .. . ... . ... . � t� � ��..,s �i, �. . . ... ... ... ... . . . .... . ... , , au _' .,� iM r i,.�„ .�. '.. .: y�, : F ' ` � . .. .. . .. - , :"'�� »m — _ _ — _,".; _: � _.. n. _ _. _ .C&1wKd A-w JOBSITE j �jj„Cre v ADDRESS-"'��J �� APN LO RACT OWNER%I Ky ADDRESS Ift/-AI 1, CITY ZIP EL._41 "fly APPLICANT TEL. CONTRACTOR APPLIANCE i STALLERSINU. ADDRESS industry 3823 CITY ewoo. C Vl )z F 51 ARCH/ENG/(562)986- DESIGNER C36 #594282 ADDRESS CITY ZIP TEL. 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 B (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($500).): ^ I,AS OWNER OF THE PROPERTY OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044,BUSI- NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF. HOWEVER,THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE- TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ^ I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTlNG WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044, BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S)LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). ^ I AM EXEMPT UNDEFI SEC. B. &P.C. FOR THIS REASON DATE OWNER LICENSEDCO NTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALT E Y T T AM ),I�EN$Ep�LN QER N JJ 0 R FIND: 0 9(COMMENCING WITH SECT ON"I �p NS CODE,AND MY LICENSE IS IN FULL FORCE AND EF-FECCff. 3823 Industry Ave. LICENSE CLASS I ake ,GA 90712 wo cc n �f DATE I,py pY Ey)i98 a55 9 Q 3 WORK RS'COMPEF ATIUSt 1 DECL R N E A ATIO I HEREBY 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 HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFO MA CE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY R FIS' M SATIO IN RANCE CARRIER AND POLICY NUMBER ARE: CARRIER POLICY NUMBER (THIS SECTION NEED NDT BE COMPLETED OF THE PERMIT IS FOR ONE HUNDRED DOLLARS(E100)OR LESS). I CERTIFY THAT IN TI-E 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 WCRKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR C I I ITH COMPLY WI THOSE PR VI5 1 q-/T: /_ Y p DATE:APPLICANT: L ,'!�v�Ci 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 ADDD ION 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 WHICH THIS PERMIT IS ISSUED(SEC. 3097,CIV.C.). LENDER'S NAME LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREOF AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE.MENTI �NED PR ERTY R IN ECTION PURPOSES. W atob RMLTTEE I17 E(PRI )w t/\7 SIGNATURE OF PERMITTEE DATE CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION PRESS FIRMLY APPLICATION 5/9/02 PERMIT 17982 P/C NUMBER # ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ^ REAR ^ SIDE/SIDE STREET RW ^ SIDE ^ PROPOSED USE N0. DWEL. N0. N0. UNITS STORIES BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ.AREA/VALUATION SFR/ADD/REM Garage/Carport W Patio/Deck IL PooVSpa 0 Re-Roof Z Commercial M Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J U I- U W W 0 It Z \U1 vxi LI W C ONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES COMMENTS RECPT. N0.AID BY 9448 VALIDATION CC WHITE-Department Copy,YELLOW-Finance Copy, PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-Applicant's Copy