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Home My WebLink About14060 (16)a CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVEL 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 rr BUILDING PERMIT � /APPLICATIONJOBSITE . AD RESS IZ%� W OLV- APN LOT TRACT OWNER S t.L ADDRESS L CITY ZIP TEL(04) (AcG Le). APPLI ANT TEL. CONTRACTOR ADDRESS CITY O ZIP TELI,, 027 AHL;WENG/ 11 DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM/ UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS U• CENSE UW FOR THE FOLLOWING REASON (SEC. 70.71.6 SUSNESS AND PROFESSIONS CODE ANY CTrYOR COUNTY WHICH REOUIRESA PERMRTO CONSTRUCT, ALTER MPROME, DELOUSKOR REPARANY STRUC• - TURE. PRIOR TO ITS ISSUANCE, ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE U LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS U. CENSE UW (CH A PTER F (COLIMENCNO WITH SECTION 7000) OF DIVISION ] OF THE BUSINESS AND PRO. FESSONS CODE) OR TIIAT HE OR SME IS EXEMPT THEREFROM AND THE OAS IS FOR THE ALLEGED EXEMP. TON. ANY VIOLATION OF SECTION 7071.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FINE HUNDRED DOLLARS (1500).), O L AS OWNEROF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEG 7"4. BUSI. NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR MPRDVES THEREON, AND WHO DOES SUCH WORK MIMS ELF OR HE RS ELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFEREDFORSALE IF. HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPILE. TION. THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE 010 NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALEL O L AS OWNER OFTHE PROPERTY, AM EXCLUSNELYCONTRACTNG WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEG 7o44, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI• CENSE UW DOES NOTAPPLYTOAN OWNER OFAPROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITIACONTRACTOR(S) LICENSED PURSUANT TO THE CCINTRAO TOR„ LICENSE LAW.). O 1 AM EXEMPT UNDER SEG B. A D.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER . IOOMMENCINO WITH SECTION 7000) OF DIVISION 7 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS N FULL FORCE AND EFFECT. LICENSE CLASS c 45 LIC. NO. 667 DATE=4 a —I 1CONTRACTOR hL!;r- WORKERT COMPENSATION DECLARATION 2-3I 1 HEREBYAFFIRM UNDER PENALTY OF PERJURY CNF.OF THE FOLLOWING DECLARAT _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELFNNSURE FOR WORKERS' COMPENSATION.AS PF40VIDED BY SECTION 7700 OF THE LABOR CODE, FOR THE PERFORMANCE OF TME WORK FOR WHICRI THIS PERMIT Is ISSUED. 1 HAVE AND WILL MAINTAIN WORKERS COIMPENSATION INSURANCE, AS REQUIRED BY SECTION 5700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. IN WORKERS* COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: _ CARRIER PLXICY NUMBER THIS SECTION NEEDNUT BE OO F IETEDOFTE PERMIT IS FOR ONE HRCnED DOLLARS (STMORLESS), 1 CERTIFY THAT LATHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON N ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATON PROVISIONS OF SECTION 7700 OF THE LABOR CODE, I SHILL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE.q-1 APPLICANT: �1 fi�•�Q[A WARNING: FAILURE TO SECURO WORKERS' COMPENSATION COVERAGE IS UNLAWIFLA_ AND SHALL BE SUBJECT AN EMPLOYER TO CRMNAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (1100,000)• N ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 770@ OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEG 7097• CIV. C.). LENDERS NAME LENDERS ADDRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY NTH ALL CITY AND COUNTY ORDNANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. Ile i 1 C44-0 LIJ PERMITTE NAME f(INT) SIGNATURE OR PERMITT I DATE PRESS FIRMLY APPLICATION / < ERMIT P/ 1ta DATE _ UMBE N 1 ISSUEOCC DATE CONTYP trX P! gFm GROUP ZONING FRONT SETBACKS 0 C T 0 Awl_ ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE 0- P ROPOSED PROPOSED USE I !J S_Fyt&_ O t& W A44, e, 1-4 IJ NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFRIADD/REM to Garage/Carport LU W Patic/Deck - -' -- - - LL Pool/Spa ZRe -Roof cl Commercial fn Valuation ADJ.AREA QUANTITY DESCRIPTION FEE a cc U J w a Z d a U Z Q W - -CONSTRUCTION t1 L O PLAN REVIEW ELECTRIC A PLUMBING —` L MECHANICAL - INSPECTION FEE ISSUANCE A SMIP t ENERGY P/C ^ ENERGY PERMIT T -- •• vuJnt`l: RETENTION FEE: PRE JLT FEE: z5f O:q J `J TOTAL FEES COMMENTS RECPTN PAID BY VALIDATION WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN—Applicant's Copy T ' . F DIAMOND;BAR. ECTION RECORD 'I' �`�;��!►�1-�:•�a;.-.riC��is�•�M►�al��t� �i, 1��.��a��''�'�.�C *' ;BET•BACK i13 ; _ ! j FLOORJOJlT -P !FTGS/FORMS/STEEL FHA REQMTS !ELECTRIC GROUNE]3D;- I,�:� _. UNDER FLOOR DUCT , !GROUND PLUMBING !SLAB GRADE :' ': `: L` ' `" — UNDER FLO R,C PJD .ITil FIREPLAC _ Ff�t1f D%iT ON ry�:<.;��r• fl.. .TEMP POWER — ...._ FIREPLACE BOND BEAM '' -- WATER SERVICE _ .. MID HT. BOND BEMX.,`I i :`: I I :,'Ic I i•, �J :ROOF SHEATHING 1 ;1 t, ` ;:i•.,, : r. ''% l: S FT. BOND BEEtiPW FRANII'N( ,fVENTJLIATlO('.l' i _) - ::,' I .�' y i-1+� t ► FINAL 'tOND WEAM ;ROOF COVER PRE—GRADING ;ROUGH HEATING BENCHING !ROUGH ELECTRIC ROUGH GRADING :ROUGH PLUMBING 7 7 • + 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.PIT/L.L. ON SITE IMPS. !GAS AIR.TEST FINAL ZONING Flf"!a.'CONST. FIRE DEPT. FINAL ;171NAL HEATING A HEALTH DEPT. FINAL ' ,-ltir.L ELECTRIC'-' "' DEV. FEES PAID -_ !P.L. PLUMBING ENERGY `.UOMMENTS IT 1, SEPTIC TANK SIZE SEEP •PITlU SIZE :.