The URL can be used to link to this page

Home My WebLink About11-1538 . ____ / / �F,�,� CITY OF DIAMOND BAR ' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � �` 21825 Copley Drive,Diamond Bar,CA 91765 I (909)839-7020 Fax(909)861 3117 Building Inspection Hotline(909)839-7027 PRESS �'^"� BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE ,1� APPUCATION PERMIT J p/C ADDRESS 2�05 S ��A�U^i�p ��, � ��g DATE " I t1 � NUMBERI I 153� #�4Z��- IS��jB � APN LOT TRACT DATE 2� TMPE �C p OWNER {v CONST.�� GROUP p ADDRESS bMdt� ZONING SETBACKS FRONT z CITY ZIP TEL. RW ❑ o APPLICANT TEL. �ZL � � S DE/SIDE STREET qyy ❑ � CONTRACTOR SIDE � ADDRESS � CITY D ZIP TEL. � PROPOSED USE o ARCH/ENG/ z DESIGNER � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFlRM UNDER PENALTV OF PERIUFV THAT I AM EXEMPT FROA1 THE CONTRACTORS LI- GHfBgB/CBfPOA W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.SBUSWESSANDPROFESSIONSCODE:ANYCITVOR (n U COUNTYNhiICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� W patio/Deck W NRE,PRqR TO RS ISSUNlCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w � STATEMENT 7HAT HE OR SHE IS LICENSED WRSUANT TO THE PHOVISIONS OF THE CANTRACTOiiS ll� � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� � POOUSpB , � FESSIONS COD�OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THEALLEOED E%EMP• � TqN.ANV VIOLATqN OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPUCANT TO Z Re-Root A CML PENALTV OF NOT MORE 7HAN FIVE HUNDRED DOLLARS(5500)J: � ❑I.ASONTIEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOA/PENSATION, 0 COlf1f1161C181 Z WILL DO THE WORN,AND 7HE S7RUC7URE IS NOT IN7ENDED OR OFFERED FOR SALE(SEC.7ou,BU51- J � � NESS AND PqOFE5510N5 CODE:THE CONTRACTORS IJCENSE LAW DOES NOT APPLV TO AN OWNER OF � PR07ERTV Vh10 BUILOS OR IMPROVES h1EREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w THRWOHHISORHEROWNEMPLOYEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m Q OFFEREDFORSALEIF,HOWEVE{�THEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z TIOH.THE OWNER-BUILDER WILL HAVE THE BURDEN OF PqOVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SAL�. W ❑I.AS ONRJER OF THE PROPERTV,AM E%CLUSIVE�V CqNTMCTINO WITH LICENSED CONTRACTORS Q TO CONSTRUCT THE PROJECT(SEC.7oN,BUSINE55 ANO PROFESSIONS CADE:THE CONTRACTORS LI� V8Il19NOf1 ADJ.AREA W CENSELAWDOESNOTAPPLVTOANOWNEROFAPROVERTYWHOBUILDSORIMPROVESTHEREON,AND � MAiOCONTRACTSFORSUCHPRQIECTSWITHACONTMCTOR(5)LICENSEDPURSUANTTOTHECONTfUC- QUANTITY DESCRIPTION Y TORS IICENSE UW.j. FEE � ❑I AM E%EM7T UNDER SEC. g.8 P.C.FOR THIS REASON Q � ?� U � DATE OWNER ~ Z U .J � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSEO UNDER PROVISKKJS OF CHAPTER d Y(COMMENCIMO WITH SECTION)000)OF DIVISION J OF 7HE BUSINESS AN P FESSION�CAqE,AND ' X AIV LICENSE IS IN FULL FORCE AND EFFECT. �r'T p lll ( ` � LICENSE CLASS � LIC.NO. V DATE CONTRACTOR �W 'j�Q/�f� WOFKERS'COMPENSATION DECLARATION�� '' '� "- f ¢ � 1 HEREBV AFFIRM UNDER VENALlY OF PERIURV ONE OF THE FOLIOWING DECURATIONS: Z � N � _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' a COMPENSATION,AS PFOVIDED BY SECTION 3700 OF THE LABOR CADE,FOR THE 7ERFORMANCE U Q �04 THE WORK FOR WHICH THIS 7ERMIT IS ISSUED. W � � ��_1 HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REWIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMMICE OF hIE WORK FOR WHICH THIS PERMIT IS -�� ISSUED.IAV WOR S' MP NSATKKJ INSURANC C RIERAND POLICV NUMBERARE: CONSTRUCTION p�S3, jCARRIER PLAN REVIEW o�� • Y.�S Z POLICV NUMBER� —� ELECTRIC Q ti p fi1-M1SSEC�IONNE�NOTBEOOMPIETEDOFTIEFEW.IT�SFORCNEMX�DR�DJUNiS�S70o)OqLESS} PLUMBING W �Z I CERTIFY 71iAT IN THE PERFOpMlWCE OF THE WORK FOP WHICH THIS PE MIT IS ISSUED,1 MECHANICAL U' SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECOME ECT TO TH ' (/� WORKEFS'COMPENSATqNLAW50fCALIFORNIA,ANDAOREETH SHOULDB INSPECTIONFEE SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFS 37o00F p , -�j CODE, FOR7HWITHCOMPLVWITHTHpSEPROVIS ISSUANCE � O � �� p DATE: � Z qPPLICANT: ' SMIP � ENERGY P/C u�`. S 1 � WARNINO:FAILURE TO SECURE WORK CAMPENSAT CAVERAOE IS UNLAWF L,AND SHALL BE � SU6IECTANEMPLOVERTOCFIMWALPENALTIESAN VILFINESUPTOONEHUND EDTMOUSAND ENERGYPERMIT �S• �� DOLLARS(5100.000).IN ADDITION TO TNE COST OF MPENSATION,DAMAQES AS PROVIDED FOR IN w SECTION 3708 OF THE LABOR CODE,INTEREST, ATTORNEV'S FEES. RETENTION fEE: t �� O CONSTRUCTION LENDING AGENCY P E•A T FEE: � 1 HEREBV AFFIFiM UNDER PENALTV OF PERJURV THAT THEFiE IS A CONSTRUCTION LENDINO AGENCV �� . O O FOR THE PERFORMANCE OF THE WORN FOF WHICH THIS PERMfT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NMIE F— LENDER'SADDRESS � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL F E ES ��, �� w I AOREE TO CAMPLV WITH ALL CITY AND CAUNTV ORDINANCES AND STATE LAWS FEI.ATWO TO BUILDINO � � CONSTRUCTION,AND HEREBV AUTHORI2E REPRESENTATNES OF THIS COUNTY TO ENTER UPON THE - Z ABOVE-A/ENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS ' 0 � � � m RMITTEE N E(PRI � ¢ � Z �Plc ��Q� ,(�sq � � 7URE DA — � RECPT.NO. AID BY - VALIDATION WHITE—Department Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy T CI�V �� DI�►fViO(�D BAR I�SP�C�'OOh� ��CORD , � �� oa�pr�c�400a o �� oa�p��Q oa�a�c�4o�a : . o �.�. `_ �nr�� m : SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAI BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING r BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER�UB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALLNAILING 13� I 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 PAID FINAL PLUMBING ENERGY �� COMMENTS � �c C►' - �� e � . �� 3� ► z � r— SEPTIC TANK SIZE SEEP PIT/U SIZE � a � � `:_� . a� ,,��