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Home My WebLink About10-1020 ��_ CITY OF DIAMOND BAR �rX P I R ,� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �, 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 ��OQ"/�O PRESS ��'9^', BUILDING PERMIT APPLICATION FIRMLY I � JOBSITE � / APP�ICATION nPERMIT /O� O p/C � ADDRESS 1 y � DATE /�I��'�'(J NUMBER/ # I � APN LOT TRACT DATE f�-/�1S��C/ ONST. - f f�'/ GROUP p OWNER p ADDRESS ' ONING SETBACKS I z CITY' � l ZIP TEL. �-� •� -� � FRONT qyy � � APPL A TEL REAR � ¢ SIDE/SIDE STREET RW ❑ � CONTRACTOR � SIDE � Q ADDRESS � f q ? 1 ' o � � PROPOSED USE o CITY _�,��_ ZIP �i� TEL.�2 . � wo ARCH/ENG/ �`��r � � � z DESIGNER ' -� " � " a ADDRESS � NO.DWEL. NO. NO. cn - U ITS STORIES BEDROOMS � CITY ZIP . _ /TEL. � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLAR ION � SFR/ADD/REM p 1 HEREBY AFFIRM UNDER PEN�LTY OF PERNRV THAT I AM EXEMPT FPOM THE CONTRACTORS L6 GflfB B/Ce OA LLI CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.5BUSINESSANDPROFESSqNSCADE:PNYCITYOR (n 9 � C-� COUNTYWHICHREOUIRESAPERMfTTOCONSTiiUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANVSTRUC- w W TURE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w P8�I0/DBCK � STATEMENT THAT HE OR SHE IS LICENSED PUqSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE UW(CHAPTER Y(COMMENCWO WITN SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� u' POOUSPB FESStONS CODE)OR THAT HE OR SHE IS EXEMP7 THEREFROM AND THE BASIS FOF 7HE ALLEOED E%EMP• (� TION.ANV VIOLATION OF SECTION 7031.6 BY ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT T0 Z Re-Roaf A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500).): � ❑I,ASOWNEROFTNEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECAM7ENSATION, � COfflfflBfClal Z WILI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFEFED FOR SALE(SEC.70N,BU51� J � NE55 M1D PROFESSIONS CODE THE CONTMCTORS LICENSE LAW DOES NOT APPLV TO AN ONTIER OF j PROPERTY VhlO BUILDS OR IMPROVES THEREON.AND NM110 DOES SUCH WORN HIMSELF OR HERSELF OR � TMRWOH HIS OR HER OVM EMPLOVEES,PROVIDED THAT SUCN IMPROVEMENTS ARE NOT INTENDED OR m � OFFERE�FORSN.EIF,HOWEVERTMEBUILDWOORIMPROVEMENTISSOIDWRMINONEVEAROFCOMPLE� Z TION,TNE OWNER-BUILAER WILL HAVE THE BURDEN OF VROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR 7HE PURP0.5E OF SALE). w ❑I,ASOWNEROFTHEPROPERTV,AM�(CLUSNELVCONTRACTINGWITHLICENSEDCONTRACTORS [C TO CONSTRUCT THE PRQIECT(SEC.7Ma,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS U� V9IUflflOfl ADJ.AREA W CENSE UW DOES NOTAPPLY TO AN OWNER OFA PHOPEHTY WHO BUILDS OR IMPROVES THEREON,AND � W/10CANTRACTSFORSUCHPR0.1ECT9WITHACONTRACTOR(S�LICENSEDPURSUANTTOTHECONTRAG QUANT DESCRIPTION Y 70RS LICENSE UW.j. FEE O ❑I AM E%EMVT UNDER SEC. B.6 P.C.FOR THIS REASON � � �i V . � DA7E OWNER ¢ Z U � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRM UNDER PENALTV OF PERIURY THAT I AM IICENSED UNDER PROVISIONS OF CHAPTEfl � � e(COMMENCW(3 WITH SECTION 7o0o)OF DIVISION 3 0F hIE WSINESS AND PROFE5510NS CADE,AND Z � XL' MY LICENSE IS W FULL FORCE AND EFFE T. m LLI � LICENSE CLASS �IC.NO. � V DATE � ONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � U � I HEREBY AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLIOWING DECLARATqNS: Z Z� _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORNERS' a Q COMPENSATION,AS PqOVIOED BV SECTION 3700 OF THE IAHOR CODE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � w _1 HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSUflANCE.AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORN FOR WHICH h115 PEfUAIT IS Y'�]� ISSUED.MY WORKERS'COMPENSATION INSUFANCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION � � > c�aqiER ' PLAN REVIEW ��( l� � � POLICV NUMBER zd ELECTRIC � (RSSSECTqNNE�ND7BECONPLEfIDOFhEPEPMTISFORpNE{{�y,pq�pp��pp�pqLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOFi WHICH THIS PERMIT IS ISSUED,I MECHANICAL U' SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE [/� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I SHOULD BECOME INSPECTION FEE SU&IECTTO THE WORNERS'COMPENSATKKJ PROVISIONS OF SECTION 37000F THE LABOR �� -~j CODE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE w — G �V DATE: APPLICANE SMIP J WARNINO:FAILURE TO SECURE WORNERS'COMPENSATqN CAVERAGE IS UNLAWFUL,AND SHAILBE ENERGY P/C � J � SUBJECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLAHS(f 700,000),IN�DDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN J SECTION 7708 OF THE LABOR CODE.IN7ERES7,AND A7TORNEvS FEES. w RETENTION FEE: � G O CONSTRUCTION LENDING AGENCY pqF_q T�� I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS A CONSTRUCTION LENDINO AOENCY %j FOR THE PERFORMANCE OF THE WORN FOR WHtCH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W � LENDER'S NAME I'– LENDER'SADDRESS w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT 7HE ABOVE INFORMATION IS CORRECT. TOTAL FE ES '� � � I AOREE TO CAMPIY WIiH ALL CITV AND COUNTY ORDINANCES AND STATE UWS REIATINO TO BUIL�INO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � � J ' � QPERMITTEE NAME ' � � N �..� � ATURE OF PERMfTTEE ATE � � RECPT.NO. S�S pAID BY G G VALIDATION WHITE—Department Copy,YELLOW�inence Copy,PINK—Asaessor Copy,GOLDENROD--File Copy,GREEN—Appllcant's Copy 4"��:��i;:;�' �i;;u,;�`, C07V O� DIAi1�Of�D ��►R ` _ - : �, �o , �'�,,. I�SP�C�'GO� F3�COFtD �,:. ; V,�'ti'+� fi a; , D e o �a�� oa�p�c�op oa�p�4aoa oa4r� o�a��t� �� , oa�p�c�ooa � . SET BACK ' ' �a FLOOR JOIST • FTGS/FORMS/STEEL • FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUNO PLUMBING UNDER FLOOR CONDUIT ' " � SLAB GRADE FIREPLACE FOUNDATION ' TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'L BOND BEAM - ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BEIVCHWG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER�i'UB 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 S►TE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY C��o � COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE - GYl �i7' Q �"