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Home My WebLink About11-1383 - � _��`_ 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)839-7027 E$S "��', BUILDING PERMIT APPLICATION FIRMLY o DDRIESS7�. �� V� . • It�C.') � ' DATECATION r� �'I�I� NU B RI��" 8� #/C ! � T° APN LOT ,/�TRAGT DATE I �I �� ' I I ONST.aL D� GROUP I p OWNER� �I �`Q„��1 e, I �C'�, 0 ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT Ryy p � APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ ¢ � CONTRACTO c> SIDE p � ADDR SS ' � CITY i ZIP��. EL. PROPOSED USE I I " �� w ARCWENG/ 33�3 z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENAL7V OF PERJURV THAT I AM EXEMPT FHOM 7HE CONTRACTORS LI- Gflf89B/C8fF10R W CENSE LAW FOR THE FOLLOWING REASON(SEC.7031.5 BUSINESSAND PROFESSIONS CODE:ANV CITV OR (n U CAUNTVNMICHREOUIRESAPERMI7TOCONS7RUC7,ALTEP,IMPROVE,DEMOIISH,ORREPAIRANYSTRUC- W Patio/Deck w TURE.PRIOR 70 I7S ISSUANCE.�LSO REOUIfiES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED W STATEMENT THAT HE OR SHE IS IICENSED PURSUANT TO THE PROVISIONS OF 7HE CANTRACTORS LI- � CENSE LAW(CHAPTER 8(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPO , Q FESSIONSCADE)OR7HATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� V TION.ANYVIOLATIONOFSECTION7031.5BVANYAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � � A CIVIL PENAL7V OF NO7 MORE THAN FIVE HUNDRED DOLLARS(f5ooj.): �' Z ❑I,ASOWNEROFTHEPROPERT/,ORMVEMPLOVEESWITHWAGESAS7HEIRSOLECOMPENSA710N, � COfflrtlBfCl81 WIIL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70a�,BU51- J � NESS AND PROFESSIONS CADE:THE CANTRACTORS LICENSE LAW DOES NO7 APPLY 70 AN OWNER OF � PROPERTV VAiO BUILDS OR IMPROVES THEREON,AND WMO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER ONM EMPLOYEES,PROVIDED THA7 SUCH IMPROVEMENTS ARE NO7 IN7ENDED OR m w OFFEREDFORSALEJF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPIE- '� 0 TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DIO NOT BUILD OR ' Z IMPROVE FOR THE PURPOSE OF SALE). _ ❑I,ASOWNEROPTHEPROPER7V,AMEXCLUSIVELYCONTRAC7INGWI7HLICENSEDCONTHAC70RS W � TO CONSTRUCT THE PR0.IECT(SEC.70�1,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V01UatlOfl ADJ.AREA W CENSELAWDOESNOTAPPLVTOANONMEROFAPROPER7YWHOBUILDSORIMPROVES7HEREON,AND � ' � WMOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY SCRIPTION FEE - � Y TORSLICENSELAWJ. 0 ❑I AM EXEMP7 UNDER SEC. B.8 P.C.FOR THIS REASON Q � U ti � DATE OWNER F- Z w � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERIURY 7HA7 I AM LICENSED UNDER PROVISIONS OF CHAGTER � � i(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINE55 AND PROFESSIONS CODE,AND Z MY UCENSE IS IN GUL FORCE AND EFFECT. '! ^ �y. ,{ �, In � � UCENSE CLASS � LIC.NO. 1 'V`� � VJ � . W ,DATE��I l.`T7��I_ CONTRACTOR d � WORKERS'COMPENSATION DECLARATION a � I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DECLARATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF-INSUqE FOR WORNERS' a 2 Q COMPENSATION,AS PROVIDED BY SECTION 37000FTHE LABOR CODE,FOR THE 7EFFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w I HAVE AND WILL MAMTAIN WORKERS'CAMPENSA7ION INSURANCE,AS REOUIRED BY SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS / - ISSUED.MY WORKERS'fAMPENSATION INSURANCE CARRIER AND POLICY N MBER ARE: CONSTRUCTION I��Q.d Q j CARRIER LU�� d� �� PLAN REVIEW � POLICY NUMBER '� ELECTRIC Z ' Q � (iHISSECfqNNE�NOTBENMPLEfEDOFiHEPEfUNiISFORONEHUI�DREDDOUNiS(5100)ORLESS). PLUMBING Z I CER7IFYTHAT IN THE PERFORMANCE OF THE WOHK FOR WHICH iHIS PERMIT IS ISSUED.I MECHANICAL C.'} SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJEC7 TO THE Uj WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&IECT TO THE WORKERS'CAMPENSATION PROVISIONS OF SECTION 3700 OF THE IABOR + O � CODE,I SHALL FOR7HWI7H COMPLV WITH THOSE PROVISIONS. ISSUANCE • l � SMIP p DATE: APPLICANT: JENERGY P/C + O WARNINC FAILUFE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL.AND SHALL BE � � SU&IECTANEMPLOVEFiTOCRIMINALPENALTIESANDCIVILFINESl1PTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SEC710N 37oe OF THE LABOR CODE.INTERES7.AND ATTORNEV'S FEES. RETENTION FEE: �� OCONSTRUCTION LENDING AGENCY PRE-ALT FEEy,}�� {M1� � 1 HEREBV AFFIRM UNDER PENALTY OF PE(iJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY �s/�f � O FOR THE PERFORI.IANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). . , Z W � LENDER'S NAME � LENDER'SADDRESS � TOTAL FEES '�«-`�� I CERTIFY TMAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPLV WITH ALL CITY AND COUNTY ORDINANCES AND STATE UWS REUTING TO BUILDING � CONS7RUC710N,AND HEREBY AU7HORIZE REPRESEN7A71VE5 OF THIS COUN7V 70 EN7ER UPON THE � ABOVE�MENTIONED PROPERTY FOR INSPECTION PURPOSES. Z r COMMENTS � �l � 1` � ER EE NAME(PRINT) �� / ' N I A7 RE F PE MITTE DA E �1 = RECPT.N0. PAID BY I VALIDATION ~ WH E—DepaRment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy ci�v o� �u��no�� ,�� Bf�9S(�I�C�'0�� f�fEC�Ft� �,Y`'Oa�pGC�400a =� � � o �'�� :;�,�,�O��C��G3 � Oa�p1��4aC�7a = DQ4C Oa�pC�C�4C5G� SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BQND BEAM WATER SERVICE • MID H'T. BQND 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 DEDICATIONS 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 -,-- ` ---- ------ -_..----------._------...----- � .. ��o � , � COMMENTS ��a� � �� - �� z �.� � SEPTIC TANK SIZE SEEP PIT/U SIZE a e� Q �,��. � � �� - a .