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HomeMy WebLinkAbout18119, , . � ,k '` ' CTI'Y OF DIAMOND BAR ` �----��" -- DEPARTMENT OF COMMiJNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive � (909)860-3195 Fax(909)861-3117 � � PRESS �"'������ � BUILDING PERMIT APPLICATION FIRMLY � o DDRESS. 1 (� {/ �/ �+ APPLICATION � ��;�,NUMB R ��I '#/C ��� � � � 1�1��� l��� -DATE o /- ISSUE ^ TYPE OCC r° APN LOT� TRACT [l � �a �+ p OWNER �.R GL�n.p �I/�IP5.��4% DATE CONST.�_ GROUP �_ ADDRESS iL91O ST��C��.G{-� C)RGLE ZONING SETBACKS � ,S� RW ❑ o CITY�(� C.�i/�l�lA ZIP�� TEL. RE�ART ❑ Z APPLICANT TEL. SIDE/SIDESTREE�� IO� i RW ❑ Q CONTRACTOR SIDE +'Gi� ❑ � ADDRESS � CITY ZIP TEL. PROPOSED USE G9���oj�I.0 T�M�R�S • w ARCH/ENG/ , • " z DESIGNER w • ' NO.DWEL. NO. NO. � CDDRESS O ZIP�� TEL.�O�-Ci�I�� UNITS � STORIES � BEDROOMS � cr� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION �,. p� OWNER•BUILDER DECLARATION SFRlADD/REM + O I HEREBY AFFIRM UNDER PENALTV OF PERJURY THAT I AM EXEMPT FROM THE CANTRACTORS LI� G3fe9B/CerpOff W CENSEUWFORTHEFOLLOWINGREASON(SECJ031.5BUSINESSANDPROFESSIONSCODE:ANYCITYOR (n � �' U COUNTYWHICHREOUIRESAPERMIT70CANSTRUC7,AL7ER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W Patio/Deck � Z TURE,PRIOR TO ITS ISSUANCE,ALSO REOUI{iES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED '� w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� w � CENSE LAW(CHAPTER 9(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooVSpa �� FESSIONSCODE)ORTHATHEORSHEISExEMP7THEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� � TION.ANYVIOLATIONOFSECTION7031.SBVANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roaf A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(SSoo).): Z ❑I,ASONRJEROFTHEPROPERTY.ORMVEMPLOYEESWITHWACaESASTHEIR50LECOMPENSATION, � COfilfflBfC18I � WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7044,BU51- J N NESS PND PROFESSIONS CADE:THE CANTRAC70R5 LICENSE LAW DOES NOT APPLV 70 AN OWNER OF = PROPERTY NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER ONRJ EMPLOYEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREDFORSALE.IF,HOWEVER7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALEJ. . w ❑I,AS ON?JER OF THE PROPER7V,AM EXCIUSIVELV CON7RAC71NG WITH LICENSED CONTMCTORS � TO CANSTRUCT THE PROJECT(SEC.70�a,BUSINESS AND PROFESSIONS CODE:TME CONTRACTORS LI- VelUetlOn J.AREA W CENSELAWDOESNOTAPPLYTOANONTJEROFAPROFERTVWHOBUILDSORIMPROVESTHEREON,AND � WHOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y 70RS LICENSE LAW.). � ❑I AM EICEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � U � � DATE OWNER U Z w �Q LICENSED CONTRACTORS DECLARATION W CC I HEREBV AFFIRM UNDER PENALTV OF PERJURY THA71 AM LICENSED UNDER PROVISION CHAPTER Ur � Y(COMMENCING WITH SECTION 7000)OF�IVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE.AND Z `X MV LICENSE IS IN FULL FORCE AND EFFECT. � m � LICENSE CLASS LIC.NO. j • � J V DATE CONTRACTOR a W .. � WORKERS'COMPENSATION DECLARATION � . . � ¢ -- — � I HEREBV AFFIRM UNDER PENALTY OF PERJURV ONE OF THE fOLLOWING DECLARATIONS: � C� a � I HAVE AND WILL MAINTAIN A CER7IFICATE OF CONSENT 70 SELF-INSURE FOR WORNERS' 2 � � CAMPENSATION,ASPROVIDEDBYSECTION37000FTHEUBORCODE.FORTHEPERFORMANCE w OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w _I HAVE AND WILL MAIN7AIN 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.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION .� J _. � CARRIER PLAN REVIEW 0 POLICY NUMBER ELECTRIC Z Q ( �� (iHISSECTIbNNE�NOTBE00MPLEfEDOFTHEPEfU.1f�I5FORONEHUt�DREDDOILARS(f10U)ORLESS). PLUMBING � ` ' 1 Z I CERTIFV THAT INTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL � V^ (.'} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE Q � � WORKERS'CAMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF 1 SMOULD BECOME INSPECTION FEE �� SU&IECT TO THE WORKEFIS'CAMPENSATION PROVISIONS OF SECTION 9700 OF THE LA80R - ! � CADE.ISHALLFORTHWITHCOMPLVWITHTHOSEPROVISIONS. ISSUANCE � �� � SMIP � p DATE: APPLICANT: J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERA�E IS UNUWFUL,AND SHALL BE ENERGY P/C � � SUBJECTANEMPLOVEflTOCRIMINALPENALTIESANDqVILFINESUPTOONEHUNDREDTHOUSAN� ENERGYPERMIT DOILARS(5700.000�,IN ADDITION 707HE COSTOF COMPENSA710N,DAMAGES AS PROVIDED FOR IN � J SEC710N 37oe OF THE LABOR CODE,INTEREST,AND ATfORNEY'S FEES. RETENTION FEE: 2 d CONSTRUCTION LENDING AGENCY PRE-A�T FEE: O • � I HEREBV AFFIRM UNDER PENALTV OF PEFiJURY THAT THERE IS A CONS7RUCTION LENDING AGENCY n- FORTHE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME � � H LENDER'SADDHESS � /_ r . I' � ICERTIFYTHATIHAVEREADTHISAPPUCATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES �W�q�J� ' �y/ �•'1 w I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE ,f��J ^/� ZABOVE-MEN710NED PROPER7V FOR INSPECTION 7URPOSES. COMMENTS� �J� � J � m PER EE (PRINT) /' r � � � � Q ` � � 51 ATURE F PERMITTEE TE = RECPT.NO. C A PAID BY VALIDATION ~ . ITE—De aAment Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEtJ—A icant's Co P PY, PY. PY� PY. PP� PY J � • . C���`� J� �0�6��'i�f� �3t�IF8 , :� ����}C��a���(?� ��C���� , ��.__.� _,_.— v._� , e_ ,. --�--,-� � m a. , � � � . � � , � ����� '� Q i�:��° =�t �� � ` a �� .°[���G� o,� e a J , fl��'Y_ <'�d ° � SET BACK I `�.D� ;_� � FLOOR J�'�IST ----� ---------- �:R'�'TGS/FORMSlSTEEL ✓� � �� FHA RtQMTS f ___��� _ ;__;_...1.._......._--�._.._..---- - ----._..___._ I ---- ELECTRlC GROUND } ' ' j UNC}ER �LOOR DUCl` , _ � ----___._._+ �._..._._ .�__ _... . ____.- ___._. _...__ �:_._._------, GROUND PLUII�BiNG ��/(o�b3 �,--- ' --- -- UNDE�3 �'LOOR CU#��DUiT� ; � ._._.__ � _SLAB GRADE __,,���D�O�,��� � � FiREP!_,�CE FOUNDA-fION ; ____ TEMP POWER �IREF!ACE BOND BEAhJi , - --- WATCR S�FtVICE _ _ ; _ � ______r�MID Hl'. E30ND fiEAM __ _ _ _ ___ - ---- R04F=SHE�iTHING� �a�'�L��?�� . ' � 8 �T' BO�J[7 BEAM � - ----- -, _ _ .___ .�_____ ___� __� ___ _ _ . �RAMIIvvNENTILIATION i FINAL BOND BEA� � . -_---- -- ----- ------------- -- ---- ----_ _ __. �OOF CJ�JER � � PRE-uRADING ; NOUGH NENTlNG BENCHIhlG � ---- --- --- - ROUGH ELECTRIC ,�__ ROU[��! GRADING ___------_______._._� �� _ _.___----- - -�- - - ----- ------- - ROU��i PLUMBING ' j . ' � FINiS�i €�RADINU � _ __�_�.-.. ---,--.--- -__.____ --- -_......_______ __��__ �.___ _...._.. .,' SHOWERJTIJB TEST � ; POOL ELECTRIC _ __ _ FXT. I.r�,TNlSIDING POOL FENCING WALL I(VSIi�TION �- POOL FiI�AL --- i---�--v- -- --' - -_ __ ----- ------- CEILING [N�ULATIO�1 ; � OF�Sf l E IMPS. � � ---__._-- --*-f —__...- --------- -�__� .__. __ .._ _ �----- ---- DHYLVALL NAILIiVG �G��rp�p � I�ECi�'ATIONS SEWER t_. _ � --_ riNAL ENG..-- -- -- -�- SEP'�'IC TANK LANDSCAP�fIRRiG. SEEF PIT/LL ON SITE 1MPS. ---- -------- - - --_____-��------ ___ _....--- - GA�AIF�TEST I � FlNA� ZC�NING '�{ ------ -----.--_—�___.________� .__ -------___.._.--- FI�,4L CONST �� � � � ! �IRE �EPT. FINA� � - - � v`���- - �,� - - FIRAI.H�ATIPJG ZZ � j I HEALTN DEP�. FIN,�� _ __ FiNAL CLEGTRIC �-�3�p�1 � DEV. FEES FAID i - --- -- - --- I - - - - ------• - - L�__�,4_ ll����l/�_"'�Ar'�/_=_v_T�� vi �i__�__.�_i ENEF�uY _��__ ... _�-_ . � -w-�- �� ' , �C�i��¢��o u,� "� „',,.�: �l I -- -------�----1------- -------- -- --^-- -*ti ----- --- ..___...----- \ -- t - - - - - - -- �iUl+a1ViGi��i� � — ------ -- — — — - , � / � — i��G. 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U� � � _ ----- , ----- ---------_ ___ r , , � --.._� — _____ � „ A _----___---- L , . -_-- - ---- , ` •— • , -^^ �F�_ 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 PRESS . "��" BUILDING PER T arrLicATiorr FIRMLY o� JOBSITE Q/�/'� � , APPLIC L/lj NUMB Rd%(S� #/C ADDRESS �� DATE oro ISSUE I� � TYPE � OCC b APN LOT TRA T DATE 7 CONST. V Il � GROUP r3 U� °C OWNER S O � ADDRESS ZONING SETBACKS Z CITY ZIP TEL Z FRONT RW ❑ � APPLICANT TEL. REAR ❑ � SIDE/S�DE STREET RW ❑ � CONTRACTOR � � SIDE ❑ QCDDRESS ZIP TEL. 0 J� PROPOSED USE ` � �A� w ARCWENG/ z DESIGNER w / NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � u� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENALTV OF PE0.IURY THAT I AM EXEMPT FROM THE CONTRAC70R5 LI- G3fe9B/CefPOff W CENSEUWFOR7HEFOLLOWINGREASON(SEC.1o37.58U51NESSANDPROFESSbNSCODE:ANVCITYOR (n U COUNT'NMICHREOUIRESAPERMITTOCONSTRUCT,ALTEfi,IMPROVE,DEMOLISH,ORREPAIRANYSTRUG W Patio/Deck Z TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT_TO THE PROVISIONS OF 7HE CONTRACTORS LI� w � CENSE LAW(CHAPTER 8(COMMENCINO WITH SECTION 7000)OF OIVISION 3 OF TNE BUSINE55 AND PRO- � PooUSpa FESSIONSCODE)ORTHATHEOFSHEISEXEMPTTHENEFROMANDTHEBASISFORTHEALLEGEDEXEMP- C7 � � TION.ANYVIOLATIONOFSECTION7o31.5BYANVAPPLICANTFORAPEHMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500).): ZOI,ASOWNEROFTHEPROPERTY,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOM7ENSATION, � COmRI0ICi81 . - WILL DO THE WORK,ANO THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70��,BU51� J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT A7PLV TO AN OWNER OF � PROPERTV WHO BUILDS OR IMFROVES THEiiEON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PPOVIDED THAT SUCH IMPROVEMEN7S ARE NOT IN7ENDED OR m , QOFFEREDWRSPLE.IF,HOWEVER,7HEBUILDINGOHIMPROVEMENTISSOLDWITHINONEYEAROFCOMFLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FORTHE PURPOSE OF SALE). ❑I,AS OWNER OF THE PROPEHTV.AM E%CLUSIVEIY CON7RACTING WITH LICENSED CANTRACTORS � 70 CONSTRUCT THE PR0.IECT(SEC.7oN,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS LI- V81U8f10l� � ADJ.AREA � W CENSE LAW DOES NOTAPPLV TOAN ONRJER OF A PHOPERTV WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITHACANTRACTOR�S)LICENSEDPURSUANTTOTHECONTRAC- OUANTITY DESCRIPTION . FEE � Y TORS LICENSE LAW.�. � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � ¢ DATE OWNER U Z W � LICENSED CONTFACTORS DECLARATION w � I HEREBV AFFIFiM UNOER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � , d e(COMMENCINGWI7HSECT�70ao)OFDIVISION3OF7HEBUSINESSANDPROFESSIONSCf�,AND Z X MY LICENSE IS IN FULL FO AND EFFECT. .i n( / ' LLI \/y � � CENSE C S LIC.NO. �✓v � . � J V ATE D ONTRACTOR d W � WORK S'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENAL7V OF PERIURY ONE OF THE FOLLOWING DECLARATIONS: Z � _1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF-INSURE FOR WORKERS' _ CAMPENSATION,AS PROVIDEO BY SEC710N 770o OF.7HE IABOR CODE,FOR THE PERFORMANCE W OF THE WORK FOR WHICH THIS PERMI7IS ISSUED. � � w _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BY SECTION Q 370o OF THE LABOR CODE,FOR THE ERFO A CE OF T'�NqRK FOR WHI H THIS PERMI715 �7 �� ISSUED.MV WORKERS'COMP A71�M CE CA IER D O Y MBER ARE: CONSTRUCTION I. /O I . J • l / j �CARRIER � 1� PLAN REVIEW �� 4 9 (� � Zaoucv NUMeER ELECTRIC Q � (rHISSE(,'f10NNE�NOTBENN�PLEfEDOF7HEPEW�1fiI5FORONEMX�DREDDOLLPAS(Stro)ORLESS� PLUMBING �� Z 1 CERTIFY THAT IN THE PERFORMANCE OF THE WOHK FOR WHICH THIS PERMIT IS ISSUED.1 MECHANICAL �� (3 SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE ,�� Uj WORKERS'COMPENSA7ION LAWS OF CALIFOHNIA,ANDAGFEE 7MAT IF I SHOULD BECOME INSPECTION FEE SUBJECT TO THE WOfiKERS'COMGENSATION PROVISIONS OF SECTION 3700 OF THE LABOR � CODE,ISHALLFORTHWITHCOMPLVWITHTHOSEPROVISIONS. ISSUANCE ' � SMIP 3� p DATE: APPLICANT: W J WARNING:FAILURE TO SECURE WORNERS'COMPENSATION COVEFAGE IS UNUWFUL,AND SHALI BE ENERGY P/C '�� � SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT �— OOLLARS(S70o,000),IN ADDITION TO THE COS70F COMPENSATION,DAMAGES AS PROVIDED FOR IN 9 � SECTION 3708 OF THE LABOH CODE,IN7EREST,AND ATTORNEV'S FEES. RETENTION FEE: �^F3 � CONSTRUCTION LENDING AGENCY � PRE-ALT FEE: O � I HEFEBVAFFIfiM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUC710N LENDING AGENCY � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME F_ LENDER'SADDRE55 � ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT. TOTAL FEES �� � S , w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AN�STATE LAWS REUTING TO BUILDING ��- � CANSTRUCTION,ANDHEREB UTHORIZEREPRESENTATIVESOFTHISCOUN7V ENTERUPONTHE � ZABOVE�MEN710NED PROP R INSPECTION PURPO S. COMMENTS � ✓ ` � m PERMITTEE NAME(PRINT) � � � ¢I��� 7 /'!�'. � SIGNATURE OF PERMITTEE DA7E = RECPT.NO. PAID BY VALIDATION ~ WHITE—DepaAment Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENR06—File Copy,GREEN—ApplicanYs Copy (�U�'�( �� ��l��lll�l�l� ��ff� "— , r` 91�S1�1������ f�f����� Oa�pC�C�400a DGQ4G Oa�pLC�40G3 Oa�pCC�400a DQ4C Dfn��pCC�40G3 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 BOND BEAM WATER SERVICE MID HT. B�ND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FIM1IAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC � ROUGH GRADING ROUGH PLUMBING FINISH GFiADING SHOWER�fUB 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. SEE,P PIT/L.L. ON SITE IMPS. GAS AIR TEST ���• � ' FINAL ZONING FINAL CONST. � ;J� . �':% FIRE DEPT. FINAL ' FINAL HEATING �' HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID • FINAL PLUMBING ENERGY �'i �� . :___ - COMMEiVTS`+����0-7 I— `� fM o o�� C�nsoe�� a� 4��ri.,��_ �,"' l� ���� a��� ►� �S� C�r1 �S�ut��o�__ �t3��,o� � ����.i�. �. � �j� p�� 8� �(O MlN� f%ilty_O_l� � �S'c��frt'.fP.riS 4r'� �—c±A�.r+��—� SEPTIC TANK SIZE SEEP PIT/U SIZE a . � c� � � '•-�'-� '"' � 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 PRESS "��', BUILDING PERMIT rr,icATioN FIRMLY N JOBSITE 1� APPLICATION / PERMIT P/C ^ o ADDRESS � I�rl DATE `� � �� NUMBER �c�5�'O# a� ~°� ' � ISSUE � TYPE � / OCC APN LO TRA�,T DATE /3D l�� CONST.�JJ GROUP 3 U °C OWNER � O ADDRESS � S• ZONING SETBACKS Z CITY Z D TEL. Z Z' FRONT RW ❑ � APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ z � CONTRACTO � � SIDE ❑ ADDRESS PROPOSED USE � I�I1�I�C• �C.,�-�tFl7 -- 1�[�-7 , o CITY ZIP a TEL. I� I� w ARCH/ENG/ � r Z DESIGNER + � � � w NO.DWEL. NO. NO. a ADDRESS u� UNITS STORIES BEDROOMS � CITY ZIP TEL. � u� u� - DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENAL7Y OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- Gefa96/CefpOfl W CENSE UW FORTHE FOLLOWING REASON(SEC.7o37.5 BUSINESSPND PROFESSIONS CADE:ANYCITV OR (n U COUN7YWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORqEPAIRANYSTRUC- w iURE,PRIOR TO ITS ISSUANCE,ALSO REOUIPES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � � CENSE UW(CHAP7ER e(COMMENCING WI7H SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PRO- POOVSp2 FESSIONSCADE)ORTHATHEORSHEISEXEMPTTHEREFROMAN�THEBASISFORTHEALLEGEDE7(EMP- (� ' � � TION.ANV VIOLATION OF SECTION 7031.5 8V ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT T0 Z Re-Root A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f5oo).): Q ❑I,ASOWNEROFTHEPROPER7V,ORMVEMPLOYEESWITH.WAGESASTHEIRSOLECOMPENSATION, � COrt1rtIBfC181 . - Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oN,BUSI- J � NE55 AND PROFESSIONS CODE:THE CANTMCTORS LICENSE LAW DOES NO7 APPLV TO AN OWNER OF � PROPERN WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OH � THHOUGH HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m . w OFFEREDWRSALEIFHOWEVER,TiEBUILDINGORIMPROVEMENTISSOLDWI7HINONEYEAROFCOMFLE� � TION,THE OWNER-BUILDE(i WILL HAVE 7HE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). � �= O I,AS OVMER OF 7HE PROPEHTV,AM ExCLUSIVELV CANTRAC7ING WI7H LICENSED CAMRACTOfiS TO CANSTRUCT THE PR0.IECT(SEC.7oa�,BUSINESS AND PROFESSIONS CADE:THE CONTRAC70R5 LI- V01U2t1Of1 `S U � ADJ.AREA � W CENSEUWDOESNO7APPLYTOANOWNEROFAPROPERTVWHOBUILOSOPIMPROVESTHEREON.ANO � WHOCONTRACTSFORSUCHPROJECTSWITHACANTiiACTOR(S)LICENSEDPURSUANT70THECONTRAG QUANTITY DESCRIPTION . FEE . � Y TORS LICENSE LAW.). � ❑I AM EXEMGT UNDEH SEC. B.d P.C.FOR THIS REASON Q � � V � � DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENPLTY OF PERJURY THAT I AM IICENSED UNDER PROVISIONS OF CHAPTER � d 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUS ESS AND PROFESSIONS CO Z X MY UCENSE IS IN FULL FOR�D EFFEC7. � � � � UCENSE CLASS IIC.NO.�� � ��� j . � � J V DATE CONTHACTOR a W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIHM UNDER PENALTV OF VERJUFY ONE OF THE fOLLOWING DECLAflATIONS: Z � _I HAVE AND WILL MAIN7AIN A CER7IFICA7E OF CONSEN7 70 SELF�INSURE FOR WORNERS' 2 CAMPENSATION,AS P{70VIDED BY SECTION 370o OF TME LABOR CODE,FOR THE PERFORMANCE `U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � W _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION I RANCE,AS REQUIRED BV SECTION Q 370o OF THE LABOR CODE.FOR THE PERFORMANCE T WORN FOR HICH THIS PEfiMI71S ^ �d ISSUED.MY WORNERS'COMP NSAT4 S qANC ARRIER ND O V NUMBERARE: CONSTRUCTION A� ��7l I"� ¢ F � CARRIER � PLAN REVIEW �3O ZPOLICV NUMBER ELECTRIC Q 0 (RiISSECiIONNE�NOTBECOMRFfEDOFTI�PEPMffISFORONEFN1�DfiEDDCILARS(5100)ORLESS� PLUMBING Z I CEfiTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMI715 ISSUED.1 MECHANICAL �}' SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECAME SUBJECT TO 7HE Uj WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULO BECOME INSPECTION FEE = SUBJECT TO7HE WORKERS'COMPENSATION PROVISIONS OF SECTION 37o00F THE LABOR QI � ,� CODE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE d[ � SMIP S '� p DATE: APPLICANT: J WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHAILBE ENERGY P/C � SU&IECTANEMPLOVERTOCRIMINAIPENALTIESANDCIVILFWESUPTOONEHUNOREDTHOUSAND ENERGYPERMIT DOLLARS(5100,000).IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PHOVIDED FOR IN y J SECTION 3708 OF THE LABOR CODE.IN7ERE57,AND A770RNEY5 FEES. RETENTION FEE: O�S� 2 O CONSTRUCTION LENDING AGENCY 2S q/✓!Q/Z PRE-ALT FEE: �-��7•.� � IHEREBVAFFIRMUND PENALTVOFP RJURYTHAT7HEREISACONS7RU TIONLEN INGAGENCY FOR THE PERFORMA E O THE 0{iK OR WHICH THIS PER IS ISSUE (SEC.30 ,GV. Z T LENDER'SNAME �O � � / nNyti �''�. �� i ry< r f=;:,- F- LENDER'SADORESS � w ICERTIFYTHATIHAVER@�DTHISAPPLICA710NANDSTATETHATTHEA VEINFORMATIONISCARFECL TOTAL FEES I�1'����N��.� ��L,�.S, ✓�`r'• �� � I AGREE TO COMPLY WlyyAlL ITY AND COUNTY ORDINANCES ND E LAWS REUTING TO BUILDING '-` / CANSTRUCTION,AN iS�iEB UTHORIZE EPRESENTATIVE FT OUNNT/TERUPONTHE �/'� � ZABOVE-MENTIONED R�PE FO T N PURPOS , �jw �j,) O . ` COMMENTS �'h't"eG' a �FS/�Id�i�- Q `�N _ m PERMITfEE NM/E(PRINT) ' ' �J/7 O S E /LNJ�. ' �SG � y S '. ' N p� I'loc3 � SIGNATUREOFPERMI7TEE DA7E = RECPT.N0. Y �QJ(LIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GO ENFiOD—File Copy,GREEN—Applicant's Copy �153 ✓ �p5 � �C��'V �fF ��r�sdiii�f�l� [��I� . � --. „�' DI�Sf�[���D�f� f�L���l�� �a�pCC�400a DGJ4C� Oa�p�C�40a Oa�pC�C�400a DGQ4C� DL��3L�CU4C��I.. . . 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 BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHIN(a 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 IANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST ! -� FINAL ZONING FINAL CONST. Z����; FIRE DEPT. FINAL FINAL HEATING ' � HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY �1?Of�oO�C.�,�=:_.:� _ ._,. COfViMENTS —��'«����i;�(�c!_�l���'L�s-k'_:��l,///� �, .j�',�'� ���-�r l -,) �`,j~ �i�%"�.i '�\ ',�^�/ ��� �r- �� ,i��� �' �� G!/u:/.% I�c. /I/� � �� " ;'; �Y... �J Z�/�7 �ri�_s"�-s"r�� / ���%v� ��.����'��` � _ -.. . . '���r,-/�?-� ��r� � . ���� ��--��������� ���� , � T-�%l -- - - � t � 0�7L" % ' � �,,r�%'� �- =% _ . � _��``- —�=�'� �;.� ,, /�' r ' �i� �.-... .�-- ; �_�Y_ ��� �"/L�/ly� � _ly/�--�v_��'_l !_-G_Ll�,� �� �`" / ---�y� t �� �%.�" �"�-� _ J� _�.�%� �.���� SEPTIC TANK SIZE SEEP PIT/U SIZE a � � � - - � 1� � CITY OF DIAMOND BAR - DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �,.w . Zis2s E.coPi�y n�►�e - PRESS (909)860-3195 Fax(909)861-3117 '""'� BUILDING PERMIT APPLICATION . FIRMLY , N JOBSITE APPLICATION � �.I C;rU� PERMIT X P/C o ADDRESS DATE I NUMBER o" # O�r � ISSUE TYPE OCC .- APN LOT TRACT DATE CONST. GROUP °C OWNER O p ADDRESS ZONING SETBACKS Z CITY L. FRONT RW ❑ � APPLIC TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE p � ADDRESS � CITY ZIP TEL. PROPOSED USE w ARCH/ENG/ iz DESIGNER � - NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY i y T . � • cn DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER D CLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENPLTY OF PERIURY THAT 1 AM EXEMPT FROM THE CANTRACTORS LI- G9fHgB/CBfPOfI W CENSEUWFORTHEf-0ILOWINOREASON(SEC.7o31.58USINESSANDPROFESSIONSCODE:ANYCITYOq (n U CIXINTVWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYS7AUG W PatidDeck NRE,PRIOR TO ITS�SSUANCE,AL50 REOUIRES THE APPLICANT fOR SUCH PERMIT TO FILE A SIGNED W STATEMENT THAT HE OR SHE IS LICENSED PURSU/�M TO TNE PROVISIONS OF 7HE CONTRACTORS LI� w � CENSE lAW(CHAPTER e(COMMENCINO WITH SECTION 7a00)OF DIVISION 3 OF THE BUSINE55 AND PRO- � POOUSPO FESSIONS CODE)OR 7HAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALIEGED EXEMP� � TION.ANVVIOUTIONOFSECTION7031.5BYANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Raof A CIVIL PENALTV OF NOT MORE TMAN FIVE HUNDRED DOLURS(i500).�: . Z ❑I,ASOVMEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESAS7HEIRSOLECAMPENSATION, � COrtIRIBfCl81 . � VALL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70��,BUSI- J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � � VROPEHTY NM1IO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WOHK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED hIAT SUCH IM7ROVEMENTS ARE NOT INTENDED OR m � OFFEREDFORSALEIF,HOWEVER711EBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- � Z TpN,THE OWNER-BUIIDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERfY,AMEXCLU5IVELYCANTMCTINOWITH�ICENSEDCOHTRACTORS Q TO CONSTRUCT THE PRQIECT(SEC.7o1a,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI� VelU2tlOf1 ADJ.AREA W CENSEUWDOESNOTAVPLYTOANONRJEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � WHOCONTMCTSFORSUCH7RQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE � Y TORS LICENSE LAW.). ¢ ❑I AM EXEMpT UNDER SEC. 8.a P.C.FOR THIS REASON Q � V , � � �ATE ONMER � � W � LICENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV 7HA7 I AM LICENSED UNDER 7ROVISIONS OF CHAPTER � . d Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINE55 AND PFOFESSIONS CA E,AND Z � X MY LICENSE IS IN FULL FORCE AND EFFECL I LlJ � � LICENSE CLASS LIC.NO. � . � J I V DATE CONTMCTOR- �- W � ORKERS'COMPENSATION DECLARATION Q � U � I HENEBV AFFIRM UNDER PENALTY OF PE0.IURY ONE OFTHE FOLLOWING DECURATIONS: Z ' � O _I HAVE AND WILL MAINTAIN A CERT�FICATE OF CONSENT 70 SELF-INSURE fOR WORKERS' _ � Z COMPENSAiION,AS PHOVIDED BV SECTION 370o OF TME IABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOfi WMICH THIS PERMIT IS ISSUED. � 0 W I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION YC• Q 9700 OF THE UBOR CODE,FOR THE PERWRMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS �'1 Y�`�a ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION �1 � ��� j c�aaiea PLAN REVIEW �� �. �./ Z POLICY NUMBEH ELECTRIC Q • � (ITUSSECTIONNE�NDTBEOOA6lFfmOF7HEPERMfTISFORONEM1PDRmDOLLARS(f10U)ORIESS} PLUMBING W Z I CERTIFV THAT IN THE PERFOHMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL ('} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSA710NLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECAME INSPECTIONFEE j SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR ISSUANCE ,�\A J COOE.1 SHALL FORTHWITH CAMPLY Wlhl THOSE PROVISIONS. 1, p DATE: APPLICANT: SM�P ���+� . J WMNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNUWFUL.AND SHU.L BE ENERGY P/C �—y SUBJECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 7HOUSAND ENERGY PERMIT DOLLARS(5700.000).IN ADDI710N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 Of THE LABOR CODE,INTEHEST,AND ATfORNEV'S FEES. RETENTION FEE: V Q d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBY AFFIRM UNDER PENALTY OF PERIUHV THA7 7HERE IS A CANSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.9087,CIV.C.). Z W � LENDER'S NAME F_- LENDER'SMDRE55 � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT 7HE ABOVE INFORMATION IS CARREC7. TOTAL FE ES 1� � W I AGREE TO CAMPLY WITH ALL CfTV AND CAUNTV ORDINANCES AND STATE IAWS REUTING 70 BUILDING � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNN TO ENTER UPON THE � ZABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � 0 J � m PE EE NAME IN7) / ¢ •�� �� � SIG TUREO PERMITTEE DAT � = RECPT.NO. PAID BY VALIDATION ~ WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—ApplicanPs Copy /, ;�: .. , . _ . . . ., ���I'�f �(� ��Glf�il�6�� f��ll� o����c�uo�� ����c�� ' ° �� DQ� � ° � a � OG� � � �e;�DQ4L ° a � �� SET BACK , FLOOR JOiST, ' FTGS/FORMSISTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUGT • - • GROUND PLUMBING UNDER FLOOR CU�IDUIT' • SLAB GRADE FIREP.LACE FOUNDATION � � �� TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID NT. BUND BEAM ROOF SHEATHING S FT. BOND BEAM FRAMIIVGNENTILIATION FINAL BOND BEAM • ' ROOF COVER PRE-GRADING ' ' � ' - • ROUGH HEATING BENCHING • � � � ' � � � ROUGH ELECTRIC ROUGW GRADING ' ROUGH PLUIVIBING FINISH GRADING SHOWER/TUB TEST' POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WAL�Ih1SULATiON . POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAII.ING � ' DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/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 PLUMSING ENERGY � �,.QO c�o . . COfVr�/iENTS SEPTIC TANK SIZE SEEP PfT/U SIZE � � �� � ; . . � . _�..__.____ - - - - - �,�.____..___._�.�_ _ ..,..�z. ��� . :�- ; ,� , . , , ' � `" � 3 , i' R � f ; 1 - . ; _ �� - � � ; ; �J �, ! � � � � � o � � � � � c� � o �r, A � co " w �� � ti i � � o � � � � ; ._ � Q � � � � ; U °° .° � � Q v o � ; I � O E � -�p U L N � �� 'N o c � c4 i � ') `-'= L � � CO N ( , � � � � � 0 � � � � � � � �- (n U O � C � �i c- f� � � � j � :a ,�, � oo � O >� � ..Q 1 i • � V � O � > � LL � ; � ti � � N _ � m o _ � i � } � cEo z v�i a � ` �� � -� � � O = � � � � ! � � Z d U U � E N � �t i. p � � � .0 L U> � U � i � ,�'�6� r , � � "_' (4 i a Q J (Cf � i Mo o� V Q a�i cn � � � � ( 1. � � �� �rT- � � � a� � � ti�� P�7 �' � � ""' u�i � z � t F"°� � °' a�i � � m > I � F - �+ � � i O ` ` ` � � n, '� v� o � �y � c I. _ 1�1 m °' � ° � � .� i � ;.,r..� � > a> c� � c � � i � i � w U � � (n � � � }, �.. 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