The URL can be used to link to this page

Home My WebLink About17511 (10) CITY OF DIAMQNI7 BAR (�1 �'``'` DEPARTMENT OF Cdl��tvtUNITY&DEVELOPMENT SBRVICES ..I,=� _ 21825 E.Copley Drive PRfSS � (909)860-3195 Faa�(909)861-3117 BUILDING PER14tIT APPLICATION FIRMLY � JOBSITE APPLICATION `� PERMIT ' P/C � ADDRESS �$;� $ ,..CC�/S�a� Rid�e Rd. , pATE ��'�/�NtiMBER l � � I # ISSUE IYPE OCC � APN �4T � TRAGT 4785Q DATE CONST.�._._ GROUP ��j OWNER Diarnond—B�r-West� LL ADDRESS 34�30 Torrance Bt Su 300 ZONING se�acKs W C(Ty TL?YC$tlC� ZIP 5 TEL. • 9 FRQNT _.— RW ❑ � APPLICANT ^ TE�. REAR ❑—_. SIpEiSIDE STREET RW C] � CQNTRACTOR_� �L ��<--�"'k � SIDE l� � ADpRESS/" �[��L . C"T� � PROPOSED USE � G]TY�'`�- sr`..�.13t`-'�`'� ZIP �t'T7�TEL.�C:��lt2`iC�i� w ARCH/ENG/ ' z dESI6NEFi��. ._.,G,�.7�(� � � "' '�_'�_._ T--- N0.DWEL. NQ. NO. Q ADORE S` �.,f I"�' �'� UNITS STORIEB BEdR44M5 � CITY'�� ZI �- �� TEL"�1(�'7� t«��',1�1f.r° � dESCRIPTtON SCt.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATICJN SFFilADDIfiEM O [] I HEREBY AFFIRM UMOEp pENAI.TV OF PERJURV THAT I AM E%EMGT FqqM THE CONI'RAC70R5 LI� G8f8Qe/CefpOlt W CENSEIAWFOR'MEFOL�OWINGREAS�N{SEC.7031.SSUSINEuSANDPROFE5510NSC�DE:ANYGITY6R (f) CJ COUNiYWH�CNHEaUIREE�APERMiTTOCONETRUCT,AL7ER,�MPROVE,DEM04iSMi.ORREFAiRANvSTRVC- W patio/Deck WTURE,PRIOR TO ITS ISSUSNCE,AL54 HEQUIRES THE APPLIGAN7 FOR SUCN PERMIT TO FILE ASIGNE� W � STATEMENT THAT HE OR s'HE IS llCENSm PURSUA»7 TO THE PR4Y15I�S OF THe CONTRACTORS 1,1� � GENSE LAW(CMpPTER 9(COMMENCING WITH SECTION 1000)OF OIVISION 3 pF THE BUSINESS AND PRO- � POOVSPO � FESSIONS CODE)ti1F THAT HE Ofl SHE I5 EXEMPT THEREFROM AND THE BASIS FORTHE ALLEGED E%EMP� � TKNJ.ANYVIO�ATIOM6FSECTiOt370.31.58YAMYAPPUCANTFORAPEflMiT5U8.lECTSTHEAPPUCAN7T0 Z Re-Roof � F CNIL PENALTY OF NO7 NIORE THAN FNE HUNDREU DOLLARS(SSoo).�� f_11,A50WNEROFTHEPRfIPEATY,OflMYEMPtDYEESWITHWAC.ESASTHEIR$QLECOMPENSATION, � Gommarciai � WItl00 TNE WORK,AND iHE STRUCTURE IS NOT�NTENDfD OR OF�EftE�i'OR SALE j9EC.7049,BUS�� J � NESS AND PROFESSIONS�ODE�.THE CONTRACTORS LICENSE lAW DOES NOT APPLY 70 AN OWNER OF � PROPERTYYhi08UIlDS4RlMPftOVESTHEftE4N,ANDWNODOE55UCHWORKHiMSEIFORNERSEt�OR m (r THqC1UGH HIS ORNEP OWN EMPLOYEES,Ffl6VID£P THAT SUCN IMPFOVEMEMS AHE N07'INTENUED OR W� OFFEREDFORSALE.IF,HOINEVER,THEBUILDINGOFIMPRGVEMENTISSGLDWITHINONEYEAROFCOMPLE� � TttNi,THE 4WNEft-BUItOER Will HAVE TNE BUFiDEu QF PROVING T.NAT HE OR SNf DID N6T BU�ID OR = IMPROVE FpR THE PUFPOSE OF SALE), w CJI,A5�WNEROFTHEPROPERTY,AMEXCl.U51VELYCQNiRACTMGWITHLICENSEOCONTRACTORS [= TO CONSTRUCT 7HE PROJECi(SEC.7di4,SUSINESS AND PROFFSSIONS CODE�.THE CONTRACTORS U- V21Ua{ipn ADJ.AREA__,_ W CENSELAWDOESNOTAPPLVTOANOWNEflOFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � WNOCANTflACTSfORSUf:HPAWECTSWITHACONTRACTOR{S)L,ICENSEOPUPSUANTTOTHECQNTRAG QUANTITY DESCRSPTIQN FEE TORS LiCEN$E LAW}. �f ' 1)� � B.8 F.L'.PoR THIS HEASON Q �+'�.�1 �i �� ^"" � Q i�iAM EX@dPS t1tJQERSEC.� . .. U '� — a / �ZL�2'% � �i,r t�'' f ' � DAT6 ._ OWNER w j 4 ' ' VI 1 �J�'ti�.. � UCENSED CONTRACTDRS DEClARA77QN � � W % �../_,.. i Il�''n� i � � i HSfiEBY AFFiFlM UNDER RENAl7Y 4f PEftJUl7Y TMAT f AM UCENSED UNOER PRQViStONS O'r GtSAPTEft � �'y B(CAMMENCING WRH SECTION 7000)O`r DNISION 9 OF THE BVSINESS AND PROFESSIONS COOE,AN� Z � MV IICENSE IS IN FULI FC7RCEAND EFFEGT �/ � � � ��i,�/� l �_•/.� � � LICENSE CLA55.__�� UC.N0._L( J U OATE'___,F„'_TT_ � GONTRACTOR L^'�? 4' W i � WOAKERS'COMPENSATfOM11 DECLAFtATtON --� ¢ � U � i t�REeY AFF{RM UNDEfl PENAI.TY 6F PER.li1RY 4NE flF THE F{3tl4WiNG DECtARATiONS: Z 4 � 1HAYEANOWiL4MAINTAINACERTIFIGA7EOFC4NSENTT0561F-WSUREFOR�"IOPKEPS' Z � CAMPENSAT�oN,AS GR4VI�6D BY SECTiON 3]ob OFTHE IAeOR COO[,FOFl TNE PERFOftMANCE W � OF THE WORK FOF.WNICHTHIS PERMIT IS I55UED. � � (/ W �I HAVE ANp WILL MAINTAIN Wt7RKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q J70A�F THE LA8{1N COOE.FOft THE PERFOFlMANCF O�THE WORK FPA WHICH THIS PERMIT IS — ISSUED.MV WORKFR5' ENSAT�ON INSURANCE ARRIER AN�POL�CV NUMpER ARE�. CONSTRUC.TIOFI _— j cnAaiEa ��.ry� ._�� j�/� P�AN ftEV1EW _...._ � zPOIICVNUMBER_ Y�^��"Cl � l�✓['��,=�!;_�__.. ELECTRIC � �S � (MISSECTICNNEmNJTBE00MPLE7EDOFTHEPEFUNTISWFONEM1NbREDDIXIAAS(btoo)f)RLESS). PLI,IMBING _,_„ W 1 CEATIFV THAT M fHE PERFORMANCE OF THE W(}HK FOR WHICH TYflS PEftMiT IS ISSUED.i �ECHANICAL _,,, —�— Z �} SHAILNOTEMPLOVANVPEi1SONINANYMANNERSOASTO6BCAMESUBJECTTQTHE INSPEC710NFEE � W4liKEftS COMPENSATKKtl IAWS OF CALIfORNtA,ANO RGREE THAT:F!SHOUlO EiEGQME -��- ��J,��/� � SVBJECTTOTHEN/OflNERS'COMPENSATIONPROVISIONSOFSEC710N37000FTHELABOP ISSUANCE . .--(L-�H�s.�— � COfJE,ISHALLFOF'�THWITHCOMPLYWITH""HOSEPROVISIONS. p DATE: _„_ APPI ICANT _,_ .. _ SMIP _ tu ENEit�Y P1C _.,.. .. ..... � WARNING:FAILURETOSECUREWOFKERS'COMPENSATIONGDVEflAGEISUNLAWFUL,AN175MA1.LBE J SUOJECTAN EMPLDYEPTO CRIMINAI.PENALTIES AND CIVIL FINES UP IOONE HUNGRED`HOUSAND __�- e�+ LL MM.tARS(Sy�.WO},IN AD[�IiiON TO TNE GC?S7 Of G4MFENSATION.DAMAGE$AS PROYIOED FOR IN ENERGY PERMIT �, .... -__.__..._ J SECfION 3708 Of 7HE LABOR CODE.INTEREST AND ATTORNEV'S FEES. RETENTION�EE: _._..,. —. � � � CONSTIaUCTiON LEND�NG AGENCY PNEALT FEE: d O CL i HEftEBY AFFiftM UI�EFi PENALLY Of PEft1UFiY TNAT iHCRf t5 A GCHtlS7ftUG7 iON IEN�iNG AGENGY __...._. � FORTHE PERFOflMANC[CFTHE WOIiK FOR WIIIC:N THIS PENMI I IS ISSUE�(SEC.3Q9],CIV.G.). Z tt k � LENDER'S NAME�� - I— LENDER'S AODRESS .._._..... - ......— � � /� c � ICEftTiFYtNATiHAVEREAOTNiSAPPIiCAT1QkANDSTATETHAiTMEABOVeiNFOftMAT10Ni5COflflECT. TQTIt�FEEJ �, W IAGREETOGOM'LYWITH/\LLl:ITYAN�WUN�YQHDINANCE9ANDSTATELAWSRELATINGT08UILDING � GONSTRUGIION,AND HEPF:BVAUTHORIZE REPRESENTATNES QF THIS COUNTY TQ ENTEfl UPOV THE Z A80YE-MENTIONEp PRORCRTY FOR INSPECT46M1!PURPOSES. GOMMENTS ... .... ..�. � __ ��.�.,5 �. +��7kt..�-__. __ _ -.. m PERMI E NAME(PRINT} f f -. - " � w�c.�=� �vl.rc' /7�7�-�•�/—•" �_ - {n NAT RE OF PERlAITTEE� �AT�I l t J s RECPT.NO. PAIO BY _ VALIDATION _ ~ WHITE—DepaRment Copy,Y�Ll4W—Finance Gopy,PIN1C—Assessar C4py.GOLDENRO�File Gopy,GHEEN—ApR��nYs Copy i� � � ' �� 1., � ai� '��a��`� s �r_3:° � , . : � _� �,a .�� k� ��la l-4/ �-� � � . _ �� ,� - , �=-� �i � �; ` A-, � ,�. .�� ,, ; : �� .��; � �, . , . � `�`f i % _ `� :` �.�` h _ � �, _ _ _ � �� ;��s � � � , , � , _ _ _ _ _ _ . _ � ,� . �, s� ,� s. � _ . � g� i ', k i' w Po ' .. . .... ;1�4 ��gx4� 4 ��: .0 -- ... .. . _.. . 3�. e.- y '. .. .... . ... . ..... ...... .. .. .. .. . .... ._.. ... �. . tj.,' �N� b �• � , . .. i.- � �' � .� . . k = , . ..... _.. . . ..... .._. .. .. .... . � ,, ia ; � . . ... . . .... .. .. .... �'. �i ' �ii�� 5 . � ,� �-�,�� '��, .�:-R ='�. .._.. .. . _ ... .. � � : _ m �� . ... .. . . ... ._ . . . . . .. .. . .... .. . .. ._ � t �in:° >.. ,. �a5 �E :�-�� i!� � . .._ ._. ... .. . . .... .. .. .... . . .... _ ... . . . ... . ..... ..... .. �S a_ ;�a ��€ — ._. , .. , ,, �li g i1 s .:: '��. = N S � f ' e .�: I � � � ' . .. ... .. . . , ,. . 1my.m`c,e�•�" � �� ._.. .. . .._ .. . . . . . . . . .. ... ... . . . _.._ ..._. ...... -. CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS-2811-8. Crystal Ridge Rd. APN LOT B TRACT 47850 OWNER Diamond Bar West, ADDRESS 34130 Torrance BI Su 300 Torrance 90503 9 CITY ZIP TEL. • APPLICANT TEL. CONTRACTOR ft_'f L,LL"'R ADDRESS_4L;,2_-7,\S C T CITY):?IMM+ZIP CII-7-1 TEL.;M:-210�-t( ARCH/ENG/ DESIGNER ADDRE S tr io'T/. CITY)ZIP�t' 3 TEL-0 S IW 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 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 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500).): ^I,AS OWNER OF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044,BUSI- NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF, HOWEVER,THE BUILDING OR IMPROVEMENT IS SOLD W ITHIN ONE YEAR OF COMPLE- TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ^I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON.AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S)LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). ^I AM EXEMPT UNDER SEC. B. B P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND MY LICENSE IS IN FULL FORCE AND EFFECT Gry LICENSE CLASS LIC. NO j q [._Z DATE CONTRACTOR L$ WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: -1 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 FOF WHICH THIS PERMIT IS ISSUED. V 1 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 WO R ATION INSURANCE ARRIER AND POLICY NUMBER ARE: CARRIER T?k POLICY NUMBER_Z7 Cl (THIS SECTION NEED NOT BE COMPLETED OF THE PERMIT IS FOR ONE HUNDRED DO-I AR.S($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 FOF'THWITH COMPLY WITH THOSE PROVISIONS. DATE:APPLICANT: 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. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE CF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC. 3097,CIV.C.). LENDER'S NAME LENDER'S ADDRESS 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 ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. 11yKtL5 L,vrsc)h«i PERMI E NAME(PRINT) / �( NAT RE OF PERMITTEE'DATE/ �T WHITE-Department Copy,YELLOW-Finance Copy, PIN PRESS FIRMLY APPLICATION I{ PERMIT I /C DATE v 1 �/ V N UMBER# 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.AREANALUATION SFR/ADD/REM 6731 U) Garage/Carport 1270 W Patio/Deck L'- Pool/Spa 0 Z Re-Roof Commercial Valuation ADJ.AREA QUANTITY DESCRIPTION FEE A.V, E / Zur"i Si,A, k4o? LU CD Z ED D a Z U w CONSTRUCTION PLAN REVIEW ELECTRIC v PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES COMMENTS RECPT N0. }PAID BY VALIDATION