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Home My WebLink About18219 �X(J� `�'�( CITY OF DIAMOND BAR ^---��` -- DEPARTIv�NT OF COMMUNTI'Y&DEVELOPIv1ENT SERVICES 21825 E.Copley Drive - (909)860-3195 Fa�c(909)861-3117 PRESS �"%9�� BUILDING PERNIIT APPLICATION FIRMLY a� JOBSITE APPLICATION �l /� PERMIT �i P/C ADDRESS � DATE��T�l/�— NUMBER D Zi # Q� -2� � ISSUE TYpE pCC APN LOT TRA T DATE CONST. GROUP p OWNER p ADDRESS ' ZONING SETBACKS z CITY ZIP�� TEL. FRONT R�ry p o_ APPLICA TEL. SIDE/SIDE STREET RW ❑ � CONTRACT R SIDE p ADDRE S �, p � CITY ZIP TEL. � PROPOSED USE Y� L��OV S f C'�G� o ARCH/ENG/ z DESIGNER i w NO.DWEL. NO. NO. a ADDRESS � CITY IP TEL. UNITS STORIES BEDROOMS cn � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLAFATION SFR/ADD/REM O Q I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT 1 AM E%EMPT FROM THE CONTRACTORS LI� G0f8g8/CBfpOh W CENSEIAWFORTHEFOLLOWWOqEA50N(SEC.7031.SBUSMESSANDPROFESSIONSCODE:ANYCITVOR (n U �pUN7yWryICHRE-0UIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREFAIRANYSTRUG W w NRE.PRIOR TO ITS ISSUANCE,AL50 REW IRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W Patio/Deck � STATEMENT THAT ME OR SHE IS LICENSED WRSUANT TO THE PROVISIONS OF iHE CONTMCTORS LI� � � CENSE LAW(CHAPTER B(COA/MENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS M1D PRO- POOUSPB � FESSIONSCODE)ORTHATHEORSHEISE%EMPT7HEREFROMANDTHEBASISFORTHEALLEOEDEXEMP- (� U TION.ANV VqLAT10N OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU&lECTS THE APPUCANT TO Z Re-Roof A CNIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLLAAS(SSOD).): � ❑I,ASONRJEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATqN, Q Z WILL DO THE WORK,AND THE STRUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.704a,BU51� J COrt1rtI0fCi81 � � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF ` ) 'j PROPEHTVWHOBUILDSORIMPROVESTNEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR � �pN {��J� w THROU6HHISORHERONMEMPLOVEES,PROVIDEDiHATSUCMIMPROVEMENTSAqENOTINTENDEDOR m � OFFEREDFORS�LEIF,HOWEVERn7EBUILDINGORIMPROVEMENTISSOIDWITHINONEYEAROFCOMPLE� Z TION,THE OWNER-BUILUER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OH. � IMPROVE FOF THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPEflTV,AME%CLUSIVELVCANTRACTINOWITHI.ICENSEDCOMRACTOFS � TO CONSTAUCT TME PROJECT(SEC.7041,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� ValUB�lOf1 Q� '� ADJ.AREA W CENSEUWDOESNOTAPPLYTOAfJONRJEROFAPROPERTVWHOBUILOSORIMPFOVESTHEFEON,AND � WFIOCONTfiACT5FOR5Up1PRQIECTSWITHACONTMCTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y TOFS LICENSE LAW.�. � �I AM E%EMPT UNDEF SEC. B.8 P.C.FOR THIS REASON Q � � �� DATE ON?JER � Z U �Q LICENSED CONTRACTORS DECLARATION W 2 I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � d e(COMMENCINO WITH SECTqN 7000)OF DNISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND Z �X AIV LICENSE IS IN FULL FORC AND EFFECT. � LICENSE CLASS LIC.NO. / � U DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLA ION Q � U � I HEREBY AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWINQ DECLARATIONS: Z �Z I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKEFiS' ¢ Q = COMPENSATION,AS PROVIDEO BV SECTION 37aa OF THE LABOR CODE,FOR THE VERFORMANCE �U OFTHE WOfiK FOR WHICH THIS PERMIT IS ISSUED. � � ' Qw I HAVE M1D WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION 370o OF THE LABOR CqDE,F R THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS �'� �C/� ISSUED.MV W09(E SATIO 5 ANC C RR AND POLICV NUMBEF ARE: CONSTRUCTION _ / J j CARRIER PLAN REVIEW D ^� `�TT�_'A'7�� Z roLICV NUMBER ELECTRIC �, ��.S u ¢ � (i}{�SSECiKXJNE�NOT8EN1aREfIDOFhiEPEipMISFOqONEFiIN�OREDDOLLARS(t1C0)ORLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL ' C.�} SHALL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIq M!D AGREE THAT IF I SHOULO BECAME INSPECTION FEE = SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSE N37000FTHELABOR •D�^ CODE.I SHALL FORTHWITH COMPLY WITH T'Hj E PRO 5. ISSUANCE �� p DA7E:y��1�PLICANT: ��+�[� SMIP � D w ENERGY P/C J WAANINO:FAILURE TO SECURE WOR)(ERS'COMP SATION CAVERAGE IS U UL,AND SHALL BE J � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCNILFINESUPTOONEHUNDREDTHWSAND ENERGYPERMIT DOLURS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN J SECTION 3)oB OF THE LABOR CODE,INTEREST,AND AT70RNEY'S FEES. .� Q" w RETENTION FEE: t� O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENAL7V OF PERJURV THAT THERE IS A CANSTRUCTION LENDING AGENCV n- FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.C.). Z W � LENDER'S NAME � LENDER'SADORESS w I CERTIFV THAT I HAVE READ THIS APPLICATIONAND STATE THAT THEABOVE INFORMATION IS CARRECT. TOTAL FEES� ��p� � i � I AGREE TO CqMPLV WITH ALl CfTY AND CWNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CONSTRUCTION,ANDHEREBVAUTHORIZEREPRESENTATIVESOFTHISCWNTVTOENTERUPONTHE � �A\ �� f �O Z ABOVE-MENTqNED PROPERTV FOF INSPECTION PURPOSES. ME� B � . O� m PERMI E N INT) (� ._ S Z,.., � U E PE EE DA = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy �D��Y �(F ��1G�l�f��9 (�/�1L� �fi��ff�[�C��'9�[!9 �3f�C��IRi� °`,DG�� a �IQU� -6 OG:I�� :; = [� U o ��] � ' 1� OG'� � ' SET BACK FLOOR JOIST � FTGS/FORMS/STEEL � FHA REQMTS ' ELECTRIC GRUUND 11NDER FLO�R DUCT � GROUND PLUMBING UNDER FLOOR CUf�DUlT ' • SLAB GRADE FIREi'LAGE FOUNDATION � TEMP POWER FIREPLACE BOIVD BEAM WATER SERVICE W MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM` _ _ _ � • FRAMINGNENTILIATtON FINAL BOND BEAM ' ROOF COVER pRE-GRADING ROUGH HEATiNG BENCNING ROUGH ELECTRIC ROUGH GRADING ROUG1-I PLUNIBING FINISH uRADING SHOWER/TUB TES7 POOL ELECTRIC EXT. LATH/SIDIIVG POOL FENCING WALL INBULATION POOL FINAL CEl�ING INSULATIOfV OFF SITE IMPS. DRYWALL(VAILItVG DEDICATIONS SEWER FINAL ENG. SEPTIC TAfUK . ~ LANDSCAPE/IRRIG. SEEP PiT/L.L. QN SITE IMPS. - GAS AIR TEST FINAL ZONlNG FINAL COPJST. � . �lRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY 6 �C�.,�&�.o �.;�?.y. .:y�� I�JIJ� COi��liENTS SEPTIC TA�lK SIZE SEEP PIT/U SIZE � , e ,;�° � � � - , .