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Home My WebLink About13-974 CITY OF DIAMOND BAR `—�"�' ^�� -- DEPARTMENT OF COMMUNIT`Y&DEVELOPMENT SERVICES � � I 21810 Copley Drive,Diamond Bar,CA 91765 � (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 ESS �'��'. BUILDING PERMIT APPLICATION FIRMLY I } JOBSITE .l /�.� j� APPLICATION PERMIT » Q�� p/C � ADDRESS D /T� �/� DATE �f' r� NUMBER� ��`� Ii � , ISSUE TYPE APN LOT TRACT DATE � CONST. GROUP p OWNER T ,�( SLYY�4�� p ADDRESS�JCI�Yl.t� ZONING SETBACKS Z CITY ZIP TEL. FRONT q�/y p o APPLICANT TEL. SIDE/SIDE STREET RW ❑ z � CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE li.��L`' � CITY ZIP TEL w ARCWENG/ z DESIGNER • w NO.DWEL. NO. NO. � ' a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCAIPTION SQ.FT. FACTOR PSF ADJ.AREANALUA710N Q. OWNER-BUILDER DECLARATION SFR/ADD/REM O _. 1 HEREBY AFFlRM UNDER PENALTY OF 7ERIURY THAT I AM E%EM7T FROM THE CONTRACTORS LI- GafdJO/CBIpOR W CENSEUWFORTHEFOILOWINGREA50N(SEC.7o31.5BU51NESSANDPROFE5510N5CODE:ANYG7YOH (n U CpUNfyWHICHREOUIHESAPERMITTOCONSTRl1CT,ALTER,IMPROVE,DEA/OLISH,OHRE7AIRANYSTHUG w NRE,PRIOR TO RS ISSUANCE,AL50 REWIfiES hiE APPLICANT WR SUCH PERMIT TO FILE A SIGNED W Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSEO PURSUAHT TO THE PflOYI510NS OF THE CANTPACTORS LI- � � � CENSE UW(CFUPTER B(COMMENCING WITH SECTION 7000)OF DIVISION 9 OF THE BUSINESS AND PRO� POOUSp3 � FESSIONSCOD�ORTHATHEORSHEISFJ(EMPTTHEFiEFROMANDTHEBA515FORTHEALLEGEDE7(EMP- (� V TION.ANYVIOLATIONOFSECTION7o31.5BYANYAPPUCANTFORAPERMITSU&IECTSTHEA�PUCANTTO Z RB-R001 .A CIVIL PEN�LTY OF NOT MOHE TNNJ FIVE HUNDRED�OLLAHS(i5oo).): Z ❑I,ASOVMEROFTHEPPOPERTY,OfiMYEMPLOVEESWITNWAGESASTHEIR50LECOMPENSATION, � COf11ffIBfCIaI - WILL 00 THE WORKµD THE STRUCTUFE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oai,BU51- J � NESS ANO GROFESSIONS CD�E:THE CONTMCTORS UCENSE UW OOES NOT APVLV TO AN OWNEq OF � VROFEHTY NTiO BUILOS OR IMVROVES iHEREON,AND WHO DOES SUCH WOHK HIMSELF OR HEqSELF OR Q iHROUGHHI50RHEROWNEMPLOYEES,PROVIDED7HATSUCHIMPROVEIAENTSARENOTINTENDEDOq m Q OFFEREDFORSALEIF,HOWEVERTMEBULLDWGORIMPROVEMEHiISSOLDWTIINONEYEAROFCOM7LE- I, Z TION,THE OWNER-BUILDER N1LL HAVE THE BUR�EN OF PROVING THAT HE OR SHE DID NO7 BUILD ON � � IMPROVE FOR THE PURPOSE OF SALE�. w ❑I,ASONRlEROF7HEPROPERiY,AME%CLUSIVELYCAMRACTINaWfTTiLICENSEDCOHTRACTORS [[ TO CONSTRUCT THE PRQIEGT(SEC.70N.BUSINE55 ANO PROFESSIONS GODE:iHE CONTMCTORS LI- V8IU8IlOf1 ADJ.AREA W CENSE UW DOES NOTMPIYTOAN OWNER OFA PROPERTY WHO BUILDS Oq IMPROVES THEREON,AND � WHOCOMRACTSFORSUCi1FRQ1ECf5WIh1ACONTRACTOR�S)LICFNSEDPURSUANiTOTHECONTRAG QUANTITY DESCRIPTION FEE � II Y TORS LICENSE UW.). [[ J � ❑I AM EI(EMPT UNDER SEC. B.d P.G FOR THIS REASON Q � U � � . DAT OWNER F— Z - �U OLICENSED CONTRACTORS DECLARATION w �C 1 HEREBY AFFIRM UNDER PENALTY OF PERIURV 7HAT IAM LICENSED UN�ER VROVISIONS OF CHAGTER � d o(COMMENCINO WITH SECTION 7000)OF DIVISION 70F 7HE BUSINESS AND PROFESSIONS ODDE,AND Z. X M'/UCENSE IS iN NLl FORCE AND EFFECT. lll CO � t�UCENSE CLASS LIC.NO. j U DATE CONTFiACTOR d W " �. � WORKEAS'COMPENSATION DECLARATION � J � � 1 NEREBY AFFIRM UNDER PENAL7V OF VERJURY ONE OF 7HE FOLLOWING DECLARATIONS: Z � � _1 HAVE AND WILL MNMNN A CERTIFICA7E OF CANSENT TO SELF-INSURE FOR WORKER5 = ' COMPENSATION,AS PROVIOED BY SECTION 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE W Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � ' ' w _I HAVE AND WILL MAIHfAIN WORKERS'COMPENSA710N INSUMNCE AS REOUIRED BY SECTION � Q �70o OF THE LABOR CODE,FOF�THE PERFORMANCE OF THE WORI(FOR WHICM THIS FERMIT IS ISSUED.MV WORKEAS COMPEr]SATION MSURlWCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION ' J � j CARRIER PLAN REVIEW �Z PouCYNUMBER ELECTRIC � � Q � (fHLS6ECf10NNFIDNDTBEOpJFLEfIDOFTHEPETi4TfSFORONEMJH)REDOOLIARS(5100)ORLESSI PLUMBING W .- Z 1 CEHTIFY iHAT IN THE PERFOflMANCE OF THE MlORK FOR WMICH THIS 7ERA11T IS ISSUED,1 MECHANICAL (.'} SFULL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECAME SU&IECT TO THE � WORKERS'COMPENSATION UWS Of CALIFOqNI/�AND AGREE THAT IF I SHOULD BECAME INSPECTION FEE � = SUBJECT TO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR � �7 CODE,1 SHALL FORTMMTH COAIPLV WITH 7HOSE PROVISIONS. ISSUANCE � f� � SMIP p DATE: APPLICANE J WARNINO:FAIWRETO SECURE WOR)(ERS'CAMPENSATION COVEMGE IS UNUWFUL,ANO SHALL BE ENERGY P/C � SU&IECT AN EMPLOYER TO CHIMINAL PENALTIES ANO C1VIL FlNES UP TO ONE HUNORED 7Y%]USANU ENERGY PERMIT DOLURS(f100,000),W ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN •O� ¢ SECTION 37oe OF TiE LABOR COOE,WTEPEST,AND AITORNEV'S FEES. � RETENTION FEE: G., �O � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFIRMUNDERPENALTYOFPERIURYTHAT7HERE�SACANSTRULTIONLENDWOAGENCY FOR 7HE PERFORMANCE OF THE WORK FOR WHICH hi15 PERMIT IS ISSUED�SEC.3097,CIV.G.). Z W � LENDER'S NAME F— LENDER'SADDRESS � ICERTIFYTHATIHAVEREADTHISMPUCATIONANDSTATETMATTHEABOVEINFORMATIONISCARAECT. TOTAL FEES � � �rS/ � W I AGREE TO COMPLY N7TH ALL CI7Y Ml�CAUNTV ORDINANCES AN�STATE UWS REUTIN(i TO BUILDiNG � CONSTRUCTION,AND HEFEBY AUTHOHIZE REPRESENTATNES OF THIS CWNTY TO ENTER UVON iHE � ABOVE-MENTIONED 7ROPERTY FOR INSPECTION PURP0.SES. � � � Z COMMENTS � k. � ,t�,�j? ' Q PE P 7 �, ' N � sieru mee DATE �� ' � � VALIDATION = RECPL NO. �I,�9�, PAID BY ~ WHITE—De rtment Co YELLOW—Finance Co PINK—Assessor Co GOLDENfi D'-fi1 ' ' ;GFEEM— Pa PY. PY. PY. � 4� _ ApplicanCs Copy � � r : `I, ��ti"'+ 'r �}.�' . � � ��a"i'�rf �� R�,6l��$� �:`-��.,�� .. , .��. ��;��=��;`�'B�",a"�� .� �-{i Y....,-'- �._;'r'r� "'y?"h .0�w.�,�r"`.. .��',,.y"�,""'"`3.`I`��,°.'y"��...:�-.� .,L4 c—Z:�ir,�—h�.�.,,"a��_'y F y,.-,..�..`._ f A.:ra.t��,as�yrp, i�"��"'-`5-.f s�.-�s� �� :.�;�:G�� *•��a�e�u.� :g t� .4t?��"C7 �Jr.'.,Fi I�,'t h� i�l!�,`:1# .�C�i�� :j �[S'"�{��Y� ^`�'�"��-!r o�i-�.+a� �v,�,��-,R, S �'3yL' i.7 r.r��I Q" 1 xL''•'.f-:'i�p W i�S '- �s.y ii��' .i ��,.� ..��y • f:�, �iL��7�� 'F��r�ti1�4 E x� n�� K r,rr'h3'�� !�'`� �`�a�Fr-��A�,,�V.. l �'x3ti�.ryr��'F�s�'1.�s. t��r��-KiTtayfi�x4-r' �t ��-�g, ��1, ,.C�� .. ..< <+.... �=�,:a..,.a a ��7 � LL ti�� . .LT�M. ,..d''��- u u� �•. _..�......Y.�...��.. v.:.,,�.,_�-.,.'�i�.- •-a'f.:". �'� �� _ �_ _ _..�.., _._ ��.,i'�. �3i� ��:�.'-'�n. . _�_��s:s.�i--�r �'�^ _.u�,..�... - ..,-...:,.....�.�.4,,: ....;;.,�-.f..�_.;�._��_��_-.,.. �ET br��f; � � ' �rLUORlOIST --- ------ - ` ----- - ____.....---� _._-- - --_!- --- __---._—_ - -..._..— --� ;-- -..__ __..__..._ . _...__-- ---a=-- -----_ � --------- fTG��r Ohi��I�;STEEL �_ ---._ ___--f_.._ i �FHF RE�MTS � -�------ --- -- --- ---_. _ � .._-- ---.._�_.___------ - ----- -- ----—_ ----- ---------- r L[,..TRIC GRGUPJQ ' � � '�JPJDER f!U�)R DI;CI j i --------------------___�_..__------�----------..-----------j �----------------------�-- —1------ GRGUP;D FLUi�1BING ! �_______ _ j �JNDER FLi�OR CONUUfT � � --r----- �----� �--------- -----� SLL�3 GR;�,DF ---------- j--------.__� I ;FIP,EPLACE FOU�vD;�TION i I i--------- - — -�EN1P PG,�?�ER ^ I � j FIREPLFlCE EOtvi;BE,a�t�l � _� �VATtR�ERVICE — � - —�-- --- j �MllD HT.BOf��D E�EAM---�— r_ ROOF SHE�I�HING _ ~ _�_ _� j 8 FT.BOND BEAM FRf�M�hJG!VEh1TILATI0t�1 � � _� j FINAL BOND BEANI_ ___ _ ___ —----------------�---------------------—---- ROOF COVER � , �PRE_GHADING _____ _ ____ _ _ _------ ------------._ _---�------------ ___._....------._...-- -- ROUGH HEATING � � i BENCh`IhJG ROUGH ELECTRIC � I I ROUGH GRADIi�!G ROUGI�PLUfviE31P!G � i FINISH GRADING SHO�A/ER�'TU6TEST � I . I PGOL ELECTRIC EXT.LATH!SIDIfJG � i ;POOL FENCING �VALL INSULATION i T— �POOL FINAL CEILING I�dStJLATION �� OFF SITE IMRS. QRYVVALL NAILING � i �dEDICA,TI0N5 -------------------------------------------- --------- r- ------ - - -------------- _SE4�lER ----------------�------- I FINAL ENG_------- SEPTICTANK �LANDSCAPE/IRRIC,__ _ _ _ __ SEEP Pll:!L.L. _ _�_ 0�!SITE IMPS. — GAS AIR T[ST i � ;FIPJAL ZONING FINAL CQNST. --� � I FIRE DEPT,FINAL �- FINAL HEATING �HEALTH DEPT.FINAL FiNAL ELECTRIC � j DEV.FEES PAID FIiVFlL PLUMBING _�_ _ �ENERGY FINAL PLANING } � -- -- —. -- - -- ---- _._ _ F�NAL ENGINEERING �� - 9..' :. . --- __. -----�---�_--- ----- --- _ .--- ---- --- - � 4 � �;��.. .� .: COMMENTS ------- --------- --- ---------- —� ----------_._---------- ------------- S � i� - -----------� ----- - —�- ----------------- ---------- ----------- _------------- -- ---------- --------— --------------- ---------- --- — SEPTICTANK SIZE SEEP PIT/U SIZE - -- � � ' ------ ---------------- - -- - - '__��- � „u_ _ - ,� �- ` --- ------------------ -- -------- ----- _ �� ,� -�,`=�' . -: �� -- ----- --— — --- - — --- — .3 _ - - :�� - = ---- --- ----------------- — -_�. _ - _ _ . _ � ��:�'. - - -------------- ----- — '_�- - - - _ �_�� - . ti -