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Home My WebLink About16979 CITY OF DIAMOND BAR 1 ----��'-- DEPARTMENT OF COMMUNITY 8c DEVELOPMENT SERVICES ` 21825 E.Copley Drive � (909)8603195 Fax(909)861-3117 PRESS ``'%A�^� BUILDING PERMIT APPLICATION FIRMLY � ¢ DDRIESS �I ��0 D�U � S� �i � i o DATECATION �( ��U`� NUMBER �� #/C � � 3l� � � issuE TYPE �c °r° APN LOT TRACT DATE CONST. GROUP p OWNER p ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT qyy ❑ � APPLICANT TEL. l REAR p �� SIDE/SIDE STAEET RW ❑ CONTRACTOR SIDE p ADDRESS ,�,.�/ � CITY ZIP TEL. PROPOSED USE U d v lS o ARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS u� � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/FaEM O � I HEREBV AFFIqM UNDER PENALTY OF PERNRV THAT I AM E%EMPT FROM THE CONTRACTOq$LI� G0f099/C8fP0lf W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.60USINESSANDPROFESSIONSCODE:ANVCITVOR (n C-� COUNTVVhiICHREWIRESAPEFiMRTOCONSTRUCT,ALTEfl,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� W patio/Deck ' Z TURE,PRIOR TO ITS ISSUANCE,AL50 REWIRES 7HE APPIICANT FOR SUqI PERMIT TO FILE A SIGNED w w STATEMENT 7HAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CMMTER B(COMMENCINO WI7H SECTION 7000)OF DIVISION 3 OF THE BUSINE55 ANO PRO- � PaoUSpe � FESSIONS CODE)OR TMAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEOED E%EMP� C7 TION.ANV VIOLATKKJ OF SECTION 7071.5 BV ANV APPLICANT FOR A PERMIT SU&lECTS THE APPIICANT T0 Z Re-Roof A CIVIL 7ENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(5500�.): � OI.ASOWNEROFTHEPROPERTV,OHMVEMPLOVEESWITHWA6ESASTHEIRSOLECOMPENSATION, � Commerciat Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.704.,BUSI- J � � NESS M1D PROFESSIONS CODE:THE CANTMCTORS LICENSE UW DOES NOT APFLV TO AN OWNER OF j PROPERTV NMO BUfLDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m � OFFEREDFORSALEIF,HOWEVER7}1EBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z TION,THE OWNER�BUILDER WILL HAVE 7HE BURDEN OF PROVINO THAT HE OR SHE�ID NOT BUILD OH � UAPiiOVE FOR 7HE PURPOSE OF SALE). w ❑I,ASOWNEROF7HEPROPERTV,AME%CLUSIVELVCONTRACTINGWITHLICENSEDCONTRACTORS [[ TO CONSTRUCT 7HE PRQIECT(SEC.70W,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U8110l1 ADJ.AREA - W CENSE LAW DOES NOTAPPLV TO AN OWNER OFA PROPERTV WHO BUILDS OFl IMPqOVES THEflEON,AND � NMOCANTRACTSFORSUCHPRQIECTSWITHACON7RACTOR(5)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y 70RS LICENSE UW.). � ❑I AA1 EXEMPT UNDER SEC. B.8 P.C.FOR THIS R N Q � ('� /1w. �� In .l� •� U � DA7E l f1WNFR � Z U � LICENSED CONTRACTORS DECLARATION w � 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � � e(COMMENCWO WITH SECTpN 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND Z XL, MY UCENSE IS IN FULL FORCE AND EFFECT. m LLI � IICENSE CLASS LIC.NO. � U DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � U � I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWING DECURATIONS: Z � _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFOPWOqKERS' _ � COMPENSATqN,AS PROVIDED BY SECTION 3700 OF TME LABOR CODE,FOR THE PERFORMANCE U ' Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS RE-0UIRED BV SECTION ` Q 3700 0F THE LABOR CODE.FOR THE PERFORMANCE OF iHE WORK FOR WHICH THIS PERMIT 15 .� ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER AAE CONSTRUCTION jCARRIER PLAN REVIEW Z POLICV NUMBER ELECTRIC Q � (I}OSSECTqNN�NOTBE00AW_ETmOFTI-EPERMff4SFOqONEMI�OREDD0U11i5(fi00)OqL6S} PLUMBING W Z i CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C} SHPLL NOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECAME SU&IECT TO THE (/� WORKEFS'COMPENSATIONLAWSOFCALIFORNIA,AN�AGPEETHATIFISHWLDOECOME INSPECTIONFEE = SU&IECT TO THE WORNERS'COMPENSATqN PROVISIONS OF SECTION 3700 Of THE LABOR CODE.I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE 0 DATE: APPLICANT: SMIP ...-�e��/:`. Tr � � , � I L. w WARNIN�:FAILURE TO SECURE WOflKERS'COMPENSATKKJ CAVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C .. �� .� ��\ � � ' , J � SU&IECTANEMPLOVERTOCRIMINALPENALTIESPNDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f100,000�.IN ADDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN ' J SECTqN 37oa OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. 1 �C RETENTION FEE: I OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: I � I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT THERE IS ACONSTRUCTION LENDINO AOENCY ��• _ � FOR THE PERFORMANCE OF THE WOPK FOR WHICH THIS PERMIT IS ISSUED(SEC.3aB7,CIV.C.). - � W +�• / � LENDER'S NAME � LENDER'S ADDRE55 � � �[/�\f �V w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES /V�/ - � � I AOREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE L4WS RELATIN�TO BUILDING � O (1 n CONS CTION,AND HEREBV THORIZE REPRESENTATIVES OF THIS COUNTV TO EMER UPON THE 41' 1 ABOV�M NTqNED PROPER7V R INSPECTION PURPoSES. � Z COMMENTS ` � �-��r� I��e,�. � A�A6.t Q I E� � `—=,�! �� . �/,_T� N V �J � SIGNANREO MITfEE . DATE � � RECPT.NO. PAID BY l� VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy �Q�'1`Y �4� 9�9��kl�([1� ��(�i � 9�1�(�I�(��'Q��1 L�[E��➢ P�c�oa �a� e � . � �c�a n - o .� � o o � SET BACK FLOOR JOIST ' FTGS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND i UNDER F�OC>R DUCT GRDUND PLUMBING � UNDER FLC70R CU�IDUIT SLAB GRADE FIREPLACE FOUNDATION TEP11P POWER FIREPLACE BUND BEAM WATER SERVICE MID HT. BOP1D BEAM � ROOF SHEATHING • 8 F7. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PHE-GRADING ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRADING ROUGH PLUNIEING FWiSH GRADING � SHOWERlTUB TEST POO�ELECTRIC EXT. LATHlSIDING � POOL FENCING WALL INSULATiON POOL FINAL CEILING INBULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINA�ENG. SEPTIC TANK LANDSCA�E/tRRIG. SEEP PIT/LL. � ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAI_CONST. FIRE DEPT. FINA� � FINAL HEATING HEALTH DEPT. FINAL F1NAL ELECTRIC DEV. FEES PAID� FINAL PLUMBING ENERGY C�Of�°o c o a _ CUMiVIEiVTS SEPTIC TAPJK SiZE SEEP PIT/U SIZE . ��( _ � � �� . ;� . , � . ,. --- .