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Home My WebLink About18151 _ ��_ CITY OF DIAMOND BAR ( �'l�� DEPARTMENT OF COMMUNTI'1'&DEVELOPMENT SERVICES ``�� 21825 E.Copley Drive � (909)860-3195 Fax(909)861-3117 PRESS , ��%��%�� BUILDING PERMIT APPLICATION FIRMLY o ADDRESS � �`� S Pr ' I� DATE CATION/ / /L NUMB R /��/ #/C (9 e 4� ISSUE TypE pCC APN O TRAC DATE CONST. GROUP p OWNER � p ADDRESS ZONING SETBACKS Z CITY ZIP TE FRONT Ryy p � APPLICANT TEI. REAR p �� SIDE/SIDE STREEf RW ❑ CONTRACTOR SIDE ❑ ADDRESS O PROPOSED USE� v � �` S, a O CI7Y ( ZIP 1'� . �y., o ARCH/ENG/ V �� z DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADD/REM � I HEREBY AFFIRM UNDER PENALTV OF PERIURV iHAT I AM E%EMPT FROM THE CONTRACTORS LI� GefB B/C8 OR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCITVOR (n 9 � C-� COUNTVN?11CHREWIRESAPEflMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTqUC- w TURE,PPIOR TO ITS ISSUANCE./�LSO RE�UIRES THE APPLICMIT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUMlT TO THE PqOVI510NS OF THE CONTRACTORS LI� CENSE LAW(CHMTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � PooUSpe � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP� (� U TION.ANY VqLAT10N OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU&lECTS iHE APPLICANT T0 Z Re-Roof A CML PENALTV OF NOT A/ORE TMAN FIVE HUNDRED DOLLARS(f500).): � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECAMPENSATKKJ, 0 CORIrt18fCi81 Z WILL DO THE WORK�ND THE STRUCTURE IS NOT INTENDED OR OFFEFED FOR SALE(SEC.70N,BU51� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE lAW DOES NOT APPLV TO AN OWNER OF � PqOPERTV NRiO BUILDS OR IMPROVES TNEREON,AND WHO DOES SUCH WOfiK HIMSELF OR HERSELF OR CL THROUGH HIS OR HER ONM EM%.OVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTEN�ED OR m � OFFEREDFORSALEIF,HOWEVER711EBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAAOFCOMPLE- Z TION,THE OWNER�BUIIDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOFi THE PURPOSE OF SALE). w ❑4�OWNEROFTHEPROPERTV,AME%CLUSIVELYCANTqACTINGWITHLICENSEDCONTRACTORS � TO CONSTRUCT THE PR0.IECT(SEC.7011,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS U- V01U8I1Of1 O �� ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND � WFIOCONTRACTSFORSUCHPRq1ECTSWITHACANTPACTOR(5)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y TORS LICENSE LAWJ. � ❑I AM E%EMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � ?j U � DATE OWNER � Z U � , LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRAI UNDER PENALTV OF PERIURY THAT I AA/LICENSED UNDER 7ROVISIONS OF CHAPTER � � o(COMMENCWO WITH SECTION 7000)OF DNISION 3 OF THE BUSINESS AND PROFESSIONS COOE,AND Z O MY LICENSE IS IN FULLEO�qyp EFFECT. LIC.NO. Y �� " 7 � LICENSE CLASS � U DATE CONTRACTOR d W � ORKERS'COMPENSATION DECLARATIO Q � U � 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECIARATIONS: Z �Z I HAV D WILL MAINTAIN A CERTIFICATE OF CONSEM TO SE�F-INSURE FOR WORKERS' a Q CO ENSATION,AS PROVIDED BV SECTION 37ao OF THE LABOR CODE,FOR THE PERFORMANCE U THE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSAT INSURANCE,AS RE�UIRED BV SECTION Q 3700 OF THE LABOR E.f-0R THE PE RMAN OF THE WORK FOR WHICH THIS PERMIT IS �� ISSUED.MV WO CO SAT I SU CNFiRIER AND POLICV NUMBERARE: CONSTRUCTION j CARiiIER PLAN REVIEW ZPOLICV NUMBER ELECTRIC Q � (iHISSECiY)NNEIDNOTBENApLEfmpF71E w.rrsFoqp.�M�nr�Enpqlnra�sip��pq�s} PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL ('} SHALL NOT EMPLOV ANY PERSON IN ANV MlWNER SO AS TO BECOME SU&IECT TO THE (/� WORKERS'COMPENSATION LAWS OF CALIFORNIA, AGREE THAT IF I SHOULD BECAME INSPECTION FEE = SU&IECTTOTHEWORKERS'COMPENSATqNPROVI ONSOFSECTI 37000FT ELABOR CODE.1 H ORTHWITHCOMPLVWITHTHOSEP VISIONS. ISSUANCE R p DA7E:-`,�� qPFLICANP. SMIP � SO w ENERGY P/C J WARNINO:FAIL RE O SECURE WORKERS'COMPENSATKKJ COV GE IS UNLAWFUL,AND SHALL BE J � SU&IECTMlEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTFKKISAND ENERGYPERMIT DOLURS(5100.oao�.IN ADDI710N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 37oe OF THE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. OC � RETENTION FEE: ' OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � �Q C� � I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT THERE IS A CANSTRUCTION IENDING AGENCY � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMI7151SSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME 1'— LENDER'SADDRESS w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CORRECT. TOTAL FE ES 1 O 2 � � � 1 AGREE TO CAMPLV WITH ALL CITV AND COUNTV� RDINANCES�VlD STATE UWS RELATINO TO BUILDING � CANSTRUCTION,AND HEREBV AUTHORIZ EPRE ENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE�MEM ED PROPERTY FOR INSPE TION URPOSES. COMMENTS o �� ,,� m PERMITTEE N (PRINn ¢ � � � � SION E PERMI DAT = RECPT.NO. PA1D BY VALIDATION ~ WHITE—Depenment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENRO�File Co GREEN— py. ApplicanPs Copy . � � ��'�1P �� fCD��((if��D6�9� {�@I� �f�l�i�[��"�'0��9 G��c��ff$[� �� ¢ � � � a�� oa��a � �. � .� � �� o ��;. , SET BACK FLOUR JQIST . � . FTGS/FORMS/STEEL FHA REQMTS � ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMBWG UNDER FLOOR CC�MDUIT � SLAB GRADE FIRERLACE FOUNDATION TEMP POWER � FIR�PLACE BOND BEAM � WATER SERVICE � MID HT. BOND BEAM ROOF SHEATHING 7 ��c f��_r.e� 8 Ff B�ND BEAM � FRAMINGNENTILIATlON �^ FiNAL BQND BEAM Fi00F COVER PRE-GRADING ROUGH HEATtNG BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING " SHOWERITUB TEST � P�OL ELECTRIC EXT. �ATH/SIDING PO�L FENCING WALL INSULATION � � POOL FINAL CEILING INSULATION � OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FIPVAL ENG. SEPTIC TANK � LANDSCAPE/ERRIG. SEEP PiT/LL. ON SITE iNiPS. GAS AIR TEST FINAL ZONING FINA�CONST. �lRE DEPT. FINAL F1NAL HEATING HEALTH DEPT. FINAI FINAL ELECTRIC DEV. FEES PAID � � FINAL PLUMBING ENERGY ��a � — — COiVI{ViEPVTS � SEPTIC TANK SIZE i SEEP�PIT/U SIZE � _____ V V . R� _ �- o .