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Home My WebLink About11-1586 1�` _ CITY OF DIAMOND BAR � � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �,;� , 21825 Copley Drive,Diamond Bar,CA 91765 ' (909�)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-70 PRESS '�^', BUILDING PERMIT APPLICATION FIRMLY � JOBSITE yD�f�'e/�so/ �i�, r�o / � � APPLICATION PERMIT p/C o ADDRESS DATE NUMBER1 ' # � ISSUE TYPE /f, OCC APN T ,T DATE + CONST. � N GROUP °C OWNER O � ADDRESS ZONING ETBA KS � FRONT qyy p Z CITY � ZI TEL. - o APPLICANT TEL. REAR p Z SIDE/SIDE STREET RW p � CONTRACTO _ �' SIDE p ADDRES � � � � `A/ � CITY l ZIP �L. � PROPOSED USE ��r w ARCWENG/ �J�O� z DESIGNER w NO.DWEL. NO. NO. n. ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER•BUILDER DECLARATION SFR/ADD/REM � I�� L �!�l�. p I HEREBV AFFIHM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� G8fH90/CBfPOrt W CENSEUWFORTHEFOLLOWINGREASON(SEC.7037.5BUSINESSANDPROFESSIONSCADE:ANVCITVOR (n ZCIXINTVWHICHREOUIRESAPERMITTOCANSTRUC7,ALTER,IMPROVE,DEMOLISH,ORRE7AIRANYS7RUC- W P8�10/DBCk w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICAN7 FOR SUCH PERMI7 70 FILE A SIGNED w � STATEMENT 7HAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CON7RAC70RS LI- � � � CENSE LAW(CHAP7ER B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PRO- POOVSPB � fESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- � V TION.ANY VIOUTION OF SECTION 7037.5 BV ANY APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT T0 Z Re-Roof ' A CIVIL PENALTY OF NO7 MORE THAN FIVE HUNDREO DOLLARS(5500).J: � ❑I,ASOWNEROFTHEPROPER7Y,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrt1rtIBfClal . Z WILL DO 7HE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70��,BUSI- J � NESS AND PROFESSIONS CADE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPER7Y WHO BUILDS OR IMPROVES 7HEREON,AND WHO DOES SUCH WORN HIMSELF OR HERSELF OR 2 TMHOUGH HIS OR HER ONM EMPLOVEES,PHOVIDED 7HA7 SUCH IMPROVEMEN75 ARE NOT INTENDED OR m w OFFEREDFORSALEIF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- 0 TION,THE OWNER-BUILDER WILL HAVE THE BUROEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). _ ❑I,ASOWNEROFTHEPROPER7V,AMEXCLUSIVELYCONTRACTINGWITHLICENSEDCONTRACTORS W Q TO CANS7RUCT THE PR0.IECT(SEC.70�1,BUSINESS ANO PROFESSIONS CODE:THE CONTRACTORS LI- V81U8fI0n ADJ.AREA W CENSE LAW OOES NO7APPLV TO AN OWNER OF A PROPERN WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTRACTSFORSUCHPRQIECTSWITHACANTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U tL � DATE OWNER H � w � LICENSED CONTRACTORS DECLAFiATION W � I HEREBY AFFIRM UNDER PENALN OF PERJURV 7HAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCING WITH SECTION 7000)OF DIVISION 3OF 7HE BUSINESSAND PROFESSIONS CADE,AND Z . XL' MY LICENSE IS IN FULL FOflCE AND EFFECT. m LLI �� UCENSE/Q�LAjSS r LIC.NO. j . V DATE I!/ � CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION a . � I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z ' ' Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CqNSENTTO SELF-INSURE FOR WORNERS' _ ' ¢ COMPENSATION,AS VROVIDED BV SECTION 370o OF 7HE IABOR CODE,FOR THE PERFORMANCE w Q � THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w I HAVE AND WILI MAINTAIN WORKERS'CAMPENSATION INSURANCE.AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS' MPENS ON INSU E CARRIER AND POLICY NUMBERARE: CONSTRUCTION Q � � CARRIER� q A I�f� PLAN REVIEW ZPOUCY NUMBER_, Y / P ELECTRIC Q 0 (1HISSEGTqNNE�NOTBEOJfM.ETEDOFh¢PERMfTISFORONEHUPDF7EDDOLLMS(f100)ORLESS} PLUMBING S/� Z I CERTIFYTHAT IN THE PERFORMANCE OF TNE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (�} SHAIL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATIONlAW50FCAUFORNIA,ANDAGREETHATIF15HOULDBECAME INSPECTIONFEE � SUBJECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE UBOR � CADE,I SH FORTH ITN COMPLY WITH THOSE PROVISIONS. ISSUANCE � �// � � p DATE: • PPLICANP. � SMIP J WARNING FAILURE TO SECURE WORNERS'COMPENSATION COVERAGE IS UNV.WFUL,AND SHALL BE ENERGY P/C � SU&IECT AN EMPLOVER 70 CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT OOlLARS(f100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN I+� � SECTION 3708 OF THE LABOH CODE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE: �✓v a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � I HEREBV AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORN FO{i WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W � LENDER'S NAME � LENDER'SADORE55 w TOTAL FEES ,7� � I CER7IFV THAT I HAVE FEAD THIS APPLICATION AND STATE 7HA7 7HE ABOVE INFORMATION IS CORRECT. � I AGREE TO COMPLY WITH ALL CIN AND COUNTY ORDINANCES AND STATE UWS RELATING TO BUILDING � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OFTHIS COUNTV TO ENTER UPON THE Z ABOVE�MENTIONED PROPERTV FOR INSPECTION PURGOSES. COMMENTS � �� 1�� _ m PERMI7TEE NAME(PRINT) / ' Cn /O / �� SIGNATUFEOFP MI DATE = RECPT.N0. PAID BY � . .�-�'VALIDATION ~ WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanPs Copy C0�'1f �I� ��V�I�� 48� I�Sf�L��V��l �1�C0�� t �a�pr�c�400a oa4� oa�p��4oa oa�p�c�400a . fl�� o��4 �. SET BACK FLO�R JOIST • FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUNQ UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM � WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING ' BENCHING ROUGH ELECTRIC � ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICAT�ONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING � HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID ' ' -- - ----- -.- -----------_....---...._.__..- ----------------------- FINAL PLUMBING ENERGY �� . COMMENTS �C'ev��a.�T'e.V� �W�►.l. tZ.�Zfr�l�p � 1 SEPTIC TANK SIZE SEEP PIT/U SIZE a � Q �