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Home My WebLink About16843 _��__ CITY OF DIAMOND BAR - � DEPARTIvIENT OF COMMUNITY&DEVELOPIvIENT SERVICE� , � 21825 E.Copley Drive '� (909)860-3195 Fax(909)861-3117 ,�/ PRESS �`'-.9�^'' BUILDING PERMIT APPLICATION �/ FIRML QJOBSITE //�/� G _L�] j1 f A�7QN� ATE CATION /� o NU 8 R►" / �#lC fll v� ¢ ADDRESS �'Z/ -�U n !J 4V � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER o ADDRES� ZONING SETBACKS Z CITY ZIP TEL. -775-7� FRONT Ryy p � APPLICANT TEL. REAR ❑ �� SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE p ADDRESS � CITY ZIP TEL. PROPOSED USE � w ARCWENG/ �---� � � f z DESIGNER �� ' a ADDRESS NO.DWEL. ,�,�� NO. �� CITY ZIP TEL. UNITS R S BEDROOMS cn ' � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLAFlATION SFR/ADD/REM ' O p I HEREBV AFFIRM UNDER PENALTY OF PERNRV THAT I AM EXEMPT FROM iNE CONTMCTOqS LI- G0109B/C9fPOff W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.SBUSINESSAN�PROFESSIONSCODE:ANVCITYOR (f� U COUNTVWHICHqEWIRESAPERMITTOCONSTRUCT,ALTERIMPROVE.DEMOLISH,ORREPAIRANY57AUC- w TURE,PRIOR TO ITS ISSUANCE,AL50 REWIRES iHE APPLICANT FOR SUCH PERMIT TO FILE A SIQNED w Pgtio/Deck � STATEMENT hiAT HE OR SME IS LICENSED PURSUANT TO iHE PROVISIONS OF THE CONTRACTORS LI- � � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 70D0)OF DIVISION 3 0F THE BUSINESS AND PRO� POOUSPe FESSqNS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALlEOED E%EMP- C7 � TION.MIVVIOLATIONOFSECTION7031.6BVANVAPPLICANTFORAPERMITSU&IECTSTHEAPPUCANTTO Z Re-Roof A GVIL PENALTY OF NOT MORE THAtJ FIVE HUNDRED DOLURS(f500)J: � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrt1R18fCIflI Z WILL DO TFIE WORK,AND THE STRUCTURE IS NOT IMENDED OR OFFERED fOR SALE(SEC.7UN,BUSI- J � NESS AND PROFESSIONS CODE:THE CONTRACTORS UCENSE LAW OOES NOT AFPLV TO AN OWNER OF � PROPERTY WHO BU0.D5 OA IMPROVES THEREON,AND WHO DOES SUCN WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OYM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREOFORS�LEIF,HOWEVERTMEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNERAUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,AS OWNER OF THE PROPERTV,AM E%CLUSIVELV CANTRACTING WITH UCENSED CONTRACTORS [t TO CONSTRUCT 7HE PRQIECT(SEC.70a1,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI- V8IU8�1W1 ADJ.AREA W CENSE UW DOES NOTAPPLV TO/JJ ONMER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � NTpCONTRACTSFORSUCHPRQIECTSWITHACONiRACTOR(S)LICENSEDPURSUANTTOTHECANTRAG QUANTITY DESCRIPTION FEE Y TOAS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 G.C.FOR hIIS REASON � ?� U � DATE OWNER ¢ Z U � LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRM UNDEH PENALTV OF PERJU{iY THAT I AM LICENSED UNDER PROVISIQVS OF CHAPTER U. � D(COMMENCINOWITMSECTION7000�OFDIVISION30FTHEBUSWESSANDPROFESSIONSCODE,AND Z LLI MY LICENSE IS IN FULL FOHCE AND EFFECT. � m � IICENSE CLASS LIC.NO. � V DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION Q , � U � I HEREBV AFFIRM UNDER PENALTY OF PERJURV ONEOF THE FOLLOWWO DECLARATKKJS: � Z �Z _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWOqKERS' a Q COMPENSATION,AS PROVIDED BV SECTION 3�00 OF THE LABOR CODE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUE�. W W � Q _I HAVE M1D WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS RE�UIPED BV SECTION /� � Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR NRiICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION J �p... j CARflIER PLAN REVIEW v v� I Z POLICV NUMBER ELECTRIC � Q 0 (IFOSSE(.'fl[XJNE�NOTBEOOMRFfmOFhfPEM4TISFORONEFiIN�DNEDDp1/3iS(t1ao�OqLESS} PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH h115 PERMIT IS ISSUED,I MECHANICAL ' C�7 SHALL NOT EMPLOY ANV PERSON IN ANV MANNER 50 AS TO BECAME SU&IECT TO THE (/) WORKERS'CAMPENSATION UWS OF CALIFORNIA,AND AGFEE THAT IF 1 SHOULD BECOME INSPECTION FEE SUBJECT TO THE M/ORKERS'CAMPENSATqN PROVISbNS OF SECTION 370o OF THE UBOR S CODE,I SHNI FORTHWITH COMFLV WITH THOSE PROVISIONS. ISSUANCE p DATE: APPLICANT. SMIP /. w ENERGY P/C �I J WARNIN(i:FAILURE TO SECURE WORKERS'COMPENSATION COVERAOE IS UNLAWFUL,AND SHALL 8E J � SU&IECTANEMPLOVERTOCRIMINALPENALTIES/WDCIVILFINESUPTOONEMUNDREDTFKKISAND ENERGYPERMIT ' DOLURS(5700.000),IN hDDITION TO THE COST OF COMPENSATpN,DAMAGES AS PROVIDED FOR IN J SECTION 37oe OF THE LABOFi CODE,INTEREST,AND ATTORNEV'S FEES. ¢ RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: �' p� •�...�_—�-,._ � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDINO AOENCV FORTHE PERFORMANCE OFhIE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30D7,CIV.C.). Z w � LENDEH'S NM/E � LENDER'SADDRE55 w I CEflTIFY THAT I HAVE READ TYi15 APPLICATION AND STATE TFIAT TME ABOVE INFOFMATKKJ IS CAFRECT. TOTAL FE ES � �� . � � � I� � I AGFEE TO CAMPLV WITH ALL GTV AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING � • � � CONSTRUCTION,AND HEREBV AUTHOqIZE REPFESENTATIVES OF THIS CWNTY TO ENTER UPON THE Z ABOVE�MENTIONEO PROPERTV FOR INSPECTION PUPPOSES. COMMENTS � � � �' m PERMI EE AME(PRIN � �� S NAT EOF PERMI DATE �� .`. RECPT.NO. . ' PAID BV VAUDATION � WHITE-0epartment Copy,YELLOW—Finance Copy,PINI(—AssAssor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy � . ' � �� 0�� I��[�C� I`T��I f�3fc��;i�D " � 11 Q - 'p 1� Q��c�o,� .� ,—, U o a DDQ1l�. 0 r ° �S o ' =:� ; 5ET BACK � � FLOOR JOIST . � �ti FTGS/FORPVIS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLO�R DUCT GROUND PLUMBING UNDER FLOOR CU�IDU.IT ' SLAB GRADE FIREPLACE FOUNDATION TEMP POWEFi FIREPLACE SOND BEAM W,4TER SERVICE MID NT. BOND BEAM ROOF SHEATHING 8�'. B�ND BEAM FRAMINGNENTILIATIOfV FINAL BOND BEAM ROOF COVER �. � ' PRE-GRADING ROUGH HEATWG BENCHlNG ROUGH ELECTRIC ROUGH GRADING R�UGH PLUMBING FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC � EXT. LATHISIDING POOL FENCING WALL INSULATIOhI POOL FINAL CEILING INSU�ATI�N OFF SITE IMPS. DRYWAL�tVAILING DEDICATIONS SEWER FINA�ENG. SEPTIC TA(�!K LANDSCAPE/IRRiG. SEEP PIT/L..L. ' ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL F1NAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY ��o Ci��.�'� SEPTIC TANK SIZE SEEP PIT/U SIZE � ° � . �. � [� � ' ' .