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Home My WebLink About12-309 (6) CITY OF DIAMOND BAR / �-"---��'-- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � �� I 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 � PRESS , �'"^'� BUILDING PERMIT APPLICATION FVRMLY o� JOBSITE �2�� p�a�� APPLICATION I i/�/�NUMBER ��/ p/C ADDRESS DATE J I � ISSUE �9 �7 � �NPE OCC APN 10T TRACT DATE ,��/ / CONST. �v� GROUP p OWNER � \I��S 11 Mott� " ADDRESS �— ZONING SETBACKS 0 z CITY ZIP TEL. �' FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW ❑ z ¢ CONTRAC R SIDE ❑ ADDRESS � � CI 1 ZIP TEL. PROPOSED USE I o ARC NG/ z DESIGNER w NO.DWEL. NO. NO. n. ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDEF PENALTY OF PERJURV THA71 AM EXEMPT FROM THE CONTRACTORS LI� GefBJB/C8fp01f W CENSELAWFORTHEFOLLOWINGHEASON(SEC.7031.SBUSINESSANDPROFESSIONSCADE:ANVCITVOR (n U COUNT'WHICHREOUIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,OR{7EPAIRANYSTRUC- � w NRE,PRIOR TO ITS ISSUANCE.AL50 RE�UIRES THE APPLICANT FOR SUCH PERMIT 70 FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CAN7RAC70R5 LI- � � CENSE LAW(CHAPTER e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSPe Q FESSIONS CADE)OR THAT HE OR SHE IS ExEMP7 THEREFROM AN�THE BA515 FOR THE ALIE�ED E%EMP- (� - V TION.ANV VIOUTION OF SECTION 7031.5 BV ANV APPLICAN7 FOR A PERMIT SU&1EC75 THE APPLICANT TO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(f500).): Z ❑I,ASOWNEROFTHEPROPERTV,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, � COrt1rtIBfCldl WILL DO 7HE WORK,AND THE STRUCTURE IS NOT IN7ENDED OR OFFERED FOR SALE(SEC.70I1,BUSI- J � NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTV NhiO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPqOVEMENTS ARE NO7INTENDED OR m w OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWI7HINONEYEAROFCAMPLE- � TION,h1E OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINCa THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). _ ❑I,AS OVMER OF THE PROPERTV,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS W Q TO CONSTHUCT THE PRQIECT(SEC.70N,BUSINESS ANO PROFESSIONS CADE:THE CONTRACTORS LI- V01U8�i0� ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPHOPERTVWHOBUILDSORIMPROVESTHEREON,AND � WHOCANTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S)LICENSEDPURSUA/JTTOTHECANTRAC- OUANTIN DESCRIPTION FEE Y TORS LICENSE LAW.). �� ❑I AM E%EMP7 UNDER SEC. B.8 P.C.FOR THIS REASON Q U � � DATE OWNER F 0 W � LICENSED CONTRACTORS OECLARATION w � 1 HEHEBV AFFIfiM UNDER PENALTV OF PERJURY TNAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � a e(COMMENCING WITH SECTION 7000)OF DIVISION 3 Of 7HE BUSINESS AND PROFESSIONS CODE,AND Z X MY LICENSE IS IN FULL FORCE AN FFECT. � � m LLI � � LICENSE CLAS6 � LIC.NO. � S( � V DATE CONTRACTOR � d W � WORKERS'COMPENSATION DECLARATION a � I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWING DECURATIONS: Z Z _I HAVE AND WILL MAIN7AIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOR WORKERS' _ Q COMPENSATION,AS PFOVIDED BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w �I HAVEAND WILLMAIN7AIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SEC710N Q 370a OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMI7IS O ISSUED.MV WOR 'CAM SA71 INSURAN E CARRIER AND POLICV NUMBER ARE: CONSTRUCTION /�/i� Q � cqaaiEa_ PLANREVIEW ZPOUCVNUMBER ELECTRIC Q � (IHISSECiKXJNEmNOTBE07MREfEDOFTHEPEWMISWRONEHUI�DREDDIXIARS(5100)ORLESS} PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOP WHICH THIS PERMIT IS ISSUED,I MECHANICAL (,�J SHAIL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECAME SUBJECT TO THE � WORNERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECAME INSPECTIONFEE //ID = SUBJECTTO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 37o00F THE LABOR CADE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � SMIP _�S p DATE: APPLICANT. J WARNING:FAILUFE TO SECURE WORKEf75'COMPENSATION COVERAGE IS UNLAWFUL,AND SHAIL BE ENERGY P/C � SUBJECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLAHS(5700,000J,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN �f � SECTION 37ae OF THE UBOR CODE,INTEHEST,AND ATfORNEV'S FEES. flETENTION FEE: L� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER GENALTY OF FERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY /f�� / ///�� FOR THE PERFORMANCE OF THE WOfiK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.), �r' � � � Z W � LENDER'S NAME F— LENDER'SADDRESS ,� TOTAL FEES ,3S � I CERTIFY THAT I HAVE READ THIS AFPLICATION AND STATE THA7 THE ABOVE INFORMATION IS CARRECT. � I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE UWS FEUTING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTYTO ENTER UPON THE Z ABOVE-MEN710NED PROPERTV FOR INSPECTION PURPOSES. � COMMENTS J � m PERMITTEE NAME(PRINT) � � Q � � SIGNATURE OF PERMITTEE DATE = RECPT.NO. PAID BV VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy CG�V O� DIAUVV�6�� A� Ei��[�C�90h� �L�CO�� . o��p�c��ooa o ��:�:-:� ,oa��a :: aa�p�c�oo�� o�� oa��c�a� SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOQR CONDUIT SLAB GRADE FIREPLACE FOUNDATIQN TEMP POWEH FIREPLACE BOND BEAM WATER SERVICE MID H'L BOND BEAM ROOF SHEATHING '�S � _i� � ' ' � 8 FT. BOND BEAM FRAMINGNENTILATION � FINAL BOND BEAM ROOF COVER i PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMB.ING 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 PITlL.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAIQ FINAL PLUMBING I ENERGY -- -- --- ----- -----�--__---------- -- -- ;L __ _ C�i't �0�' . COMMEfVTS — -3-��d�, - --- -- SEPTIC TANK SIZE SEEP PIT/U SIZE GY1 � � . -,` �� a .