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Home My WebLink About11-1507 ��_ CITY OF DIAMOND BAR - �� / � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � V �_w 21825 Copley Drive,Diamond Bar,CA 91765 � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-'7 � P�iESS � '��'� BUILDING PERMIT APPLICATION � FIRMLY o� JOBSITE ' APPLICATION ,.n PERMIT /C ADDRESS DATE_ L �-�7-�� NUMBER�� ISSUE TYPE OCC APN LOT� TRACT DATE � p OWNER ml 1`� 1(7)1 S CONST. L� � GROUP o ADDRESS Sow: ZONING SETBACKS Z CITY • b 1��1 TE . - FRONT RW ❑ � APPLICANT TE� - REAR p � SIDE/SIDE STREET RW ❑ ¢ � CONTRACTOR � `� 'P�. SIDE p � ADDRESS PROPOSED USE � CITY ZIP T . � - � w ARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFFVADD/REM O p I HEREBV AFFIRM UNDER PENAL7V OF PERJURV THAT I AM EXEMP7 FROM 7HE CONTRAC70RS LI� Gdfe9B/CBfpOA W CENSELAWFORTHEFOLLOWINGREASON(SEC.7o31.5BU51NESSANDPROFESSIONSCADE:ANYCITVOR (n U COUN7VNMICHREOUIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORfiEPAIRANVSTRUG � w 7URE,PRIOR TO ITS ISSUANCE.AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck � STATEMENT 7HA7 HE OR SHE IS LICENSED PURSUAN7 70 7HE PROVISIONS OF 7HE CONTMCTORS LI� � CENSE UW(CHAPTER B(COMMENCING WITH SECTION 7a00)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSp2 � FESSIONSCODE)ORTHATHEORSHEISE%EMPT7HEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� C7 V TION.ANV VIOUTION OF SECTION 7031.5 BV ANY APPIICANT FOR A PERMIT SU&lECTS THE APP�ICANT T0 Z Re-Roof �, A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(SSao).): Z ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrt1ff18fClel WILL DO THE WORK,AND THE STRUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oa�,BUSI- J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNEF OF � PROPERN WHO BUILDS OR IMPROVES THEREON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR Q 7HROUGH HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMEN75 ARE NOT INTENDED OR m w OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMEMISSOLDWITHINONEYEAROFCAMPLE- � TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). _ ❑I,ASOWNEROFTHEPROPER7V,AMEXCLUSIVELYCqNTRAC7INGWITHLICENSEDCONTRACTORS W Q TO CONS7RUCT THE PR0.IECT(SEC.7041,BUSINESS AND PROFESSIONS CADE:THE CONTRACTOfiS LI- V81UflfI0f1 ADJ.AREA W CENSElAW00E5NO7APPLVTOANONMEROFAPROPERTYWHOBUILDSORIMPROVE57HEREON,AND � WHOCANTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION . FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.Q FOR THIS REASON Q � � U � � DATE OWNER H 0 W � LICENSED CONTRACTORS DECLAfiATION w � � 1 HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER d B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS ANO PROFESSIONS CADE,AND Z l X AIV LICENSE IS IN FULL FORCE AND EFFEC7. m LLI ��Z O DA ENSE Cl,ASS_ `�� LIC.NO. j " C� , �I'l%�v CONTRA R d ` W � WORKERS'COMPENSATI N�D � r� Q � I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE� OWING DECURATIONS: Z � _I HAVE AND WILL MAIN7AIN A CER7IFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ COMPENSATION,AS PROVIDED BY SECTION 370o OF 7HE LABOH CODE,FOFl THE PERFOFMANCE U Q OF THE WORK FOR WHICH THIS PEFMIT IS ISSUED. � I w �I HAVE AND WILL MAINTAIN WORKERS'COMPENSA710N INSURANCE,AS REOUIRED BV SECTION Q3700 OF THE LABOR CODE,FOR THE PERWRMANCE OF THE WORN FOR WHICH THIS PERMIT IS I ISSUED.MV WOR F,`RS'COMP SATION INSUCq��NCr CAR ER AND POLICY NUMBER ARE: CONSTRUCTION j CARRIER �TIZ�II� V .I.Gl�� PLAN REVIEW I� � POLICYNUMBER_�g�I.�D � ELECTRIC Z Q �� (fHISSEC�qNNE�ND7BE07MPLEfEDOFTHEPEW.IRISFORONEMN�OREDDOILAHS(5100)ORLESS� PLUMBING S( � Z I CERTIFV THAT M THE PERFORMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUED.1 MECHANICAL (,'} SHAIL NO7 EMPIOY ANY PERSON IN ANY MANNER SO AS T BECOME SUBJEC7 70 7HE (n WORKERS'COMPENSATION 1AW50F CALIFORNIA.AN R T IP I SHOULD BECOME INSPECTION FEE = SU&lEC7 TO THE WORKERS'COMPENSATION PRO F SEC71 37o00F THE CADE,ISHALLFORTHWITHCOMPLVWITH7H0 SIONS. ISSUANCE �l� I G � ��-a3- t SMIP p D APPLICANT: J WARNING:FAILURE TO SECURE WOflK SAT IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IEC7AN EMPLOYER 70 CRI L IVIL FINES UP TOONE HUNORED 7HOUSAND ENERGY PERMIT DOLLARS(5700.000).IN ADDITI�O THE' CAMPENSATION,DAMAGES AS PROVIDED FOR IN �/9 � SECTION 3708 OF THE LABOR CODE,MTEREST,AND ATTORNEV'S FEES. RETENTION FEE: ��V OCONSTRUCTION LENDING AGENCY PAE-ALT FEE: � I HEFEBV AFFIRM UNDER PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFOfiMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. W � LENDER'S NAME F— LENDER'SADDRESS � TOTAL FEES �� 7-3 � I CERTIFY THAT I HAVE FiEAD THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. � w I AGREE TO COMPLV WITH ALl CITY AND fAUN7Y ORDINANCES AND STATE UWS REU7ING TO BUILDING � CqNS7RUCTION,ANDHEREBVAUTHORIZEREPRESEN7A71VE50F7HISCOUN7V70EN7ERUPONTHE � ABOVEYMENTI D PROPERTV F PECTION P RP S. Z COMMENTS � 0 � m PE TTEENAME � � Q � � �� SIGNA7U . E DATE = RECPT.NO. ��• PAID BY VALIDATION ~�� WHITE—DepaAment Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENR00—File Copy,GREEN—Applicant's Copy . , . . . . . < . . . . �B�V O(F �8�6V�OV�9D ��a�8 I��I��1T�� f�[��ORD „ � . ,, r� �� t oa�p��400a o �4� oa�p�c�4oa oa�p��4oaa �� .,. �oa��c��. SET BACK FLO�Fi JOIST FTGS/FORMS/STEE� FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT ' GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM I ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER�fUB TEST POOL ELECTRIC � EXT. LATH/SIDING POOL FENCING i WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPElIRRIG SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. . � Jy FIRE DEPT. FINAL FINAL HEATING _ �/ HEALTH DEPT. FINAL -------- ----- -- ----------- --._._._..---------- =-- ----..-------------..._._----- FINAL ELECTRIC � DEV. FEES PAID FINAL P�UMBING t ?,_ � �� ENERGY � _ ��o � �� , _ - ------ COMMEIVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a — - -- e� � - �