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Home My WebLink About13243 f . � CITY OF DIAMOND BAR � DEPARTMENT OF COMMiJDTITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)86Q3195 Fax(909)861-3117 PRESS ��^'� BUII.DING PERMIT APPLICATION � FIRMLY o DDRESS ZO�� /QIY�Or� B4.r $Idd • DATE'CATION J -�I 1�, `��NUMBEF{�/� #/C ��C� � ISSUE TYPE OCC � APN LOT TRACT DATE CONST. GROUP p OWNER /�r NC S � _ " ADDRESS� �-! T �,7�i'�-I'I�t b�J D /Q-Q ZONING SETBACKS Z CITY I�!/�-�OF-�O ZIP Y�ZLr'TEL S�S- O / R�RT RW p� g APPLICANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOFi�-�� S - _ - SIDE ❑ � ADDRE�S l h� PROPOSED USE CfTY C�L►i O ZIP9��lo TE oARCH/ENG/ �,-, DESIGNER NO.DWEL. NO. NO. � CnDRESS ZIP TEL. UNffS STORIES BEDROOMS � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION . SFFVADD/REM O p I HEREBY AFF1fW UNDER PENALTV OF PERAIRY TFIA7 I AM E%EMPT FROM THE CONTMC70R3 LI- G9f8gB/C9fpOf1 � [31 C@lSEUWFORTHEFOLLOWINORFl..90N(SEC.7o]7.6BUSWESSANDPROFESSIONSCOOE:ANYCITVOR (n <� COUNTVWHK�HREWIRESAPERMITTOCONS7RUCT,AL7ER�PROVE.DEMOUSH.ORREP/URANV57RUG w �Z TURE.PRIOR TO ITS I.,^9UANCE,ALSO RE�UIRES hIE APPl1CANT FOR SUCH PERMR 70 FILE A SIONED W PetlO/DBCk c 9TATEMENT THAT HE OR SHE IS LICENSm WRSUANT TO TiE PROVISIONS OF TME CONiRACTOR3 LI- � 3� CQJSE UW(QUPTER Y(COMMENGNO VATM SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSpB �� fE931ONS CODE)OR 7}UT HE OR SHE 19 E%EMP77HEREFROM AND THE BA515 FOR THE ALLEOED E%EMP- (� �� TION.ANVVqLAT10NOFSECTION70.91.6BYAHVMPIICANTfORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roaf � A CIVIL VENALTY OF NOT MORE iHAN FIVE HUNDRED DOLURS({500).�: � ❑AASOMMEROFTHEPROPERTY,ORMVEMPLOVEE9WITHWAOESASTHEIRSOLECOMPENSATqN, � COrt1rtIBfCI9I � WILL DO THE WORI(MID 7HE STAUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7ou,BUSI- J � NESS A!A PiqFESS10N5 CODE:THE CONTRACTORS LICENSE UW DOES NOT AGPLv TO AN OWNER OF � . PROPERf'(VAiO BU0.D3 OR IMPiqVES THEREON,AND NR10 DOES SUpI WORK HIMSELF OR HERSELF OR � 7HAOUd1 HIS OR HER ONN EMPLO'/EES,PROVI�ED THAT SIX:H IMPROVEMENTB ARE NOT WTENDED OR m w OFFEREDFORSALE15110H�ENER7HEBULDPI�OHMPROVEMEHT1950lDWITMNONEYEAFiOFCOMRE- 0 �'TqN,THE OWNERAUIIDER YALL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FORTHE PURP0.SE OF SALE). � �_ ❑I,ASOWNEROFTHEPROPEHTY.AA1EXClUSNELYCONTRACTINOWITH4CEHSEDCONTRACTOR3 . . TO CONSTRUCT 7HE PqQ1ECT(SEC.70M,BUSINESS AND PROFESSIONS COUE:7HE CONTRACTORS LI- V8111811Of1 qp,�,qqEq W CHtSEUWDOESNOTMPLVTOANOWNEROFAPROPERiYwHOBU1LD90RIMPROVE9TIERC-0N,AND � N'IqCOMAACTSFORSUGiPRQIECTSWITHACOMRACTOR(S)LICENSEDPURSUM1T70THECONTMG qUANTITY DESCRIPTION FEE � TORS LICENSE UW.). � � ❑I AA1 El�A1Pf UNDER SEC. B.a P.C.FOR THIS REASON Q 3 � � ¢ z DATE OWNER � , F LICENSED CONTRACTORS DECLARATION w J � 1 HEREBYAFF7RM UNDER PENALTV OF PERAJRV THAT 1 AM LICENSED UNDER PROVISIONS OF CMAPTER � Y(COMMENCWO WITH SECTION 7000)OF DMSION 3 OF THE BUSINESS AND PROFESSIONS GODE,AND Z I � � AfY LICEHSE IS M FUl f-0RCEMID EFFECT. (�] • S J�� G/�. � � � LICENSE CLASS C�� LIC.NO. / � . , V DATE COIlTRACTOR W a W � WORKERS'COMPENSATION DECLARATION 'n'�-� � �r � 1 HEREBV AFFIRM UNDER PENALTY OF PEiLIURY ONE OF 7HE FOLLOW WO DECLARATIONS: Z � _IHAVEMIDWILLM.VNT/UNACERfIFlCATEOFCONSENTTOSELF-INSUREFOfiWORKERS' a S Q COMPENSATION.AS PROVIDED BV SECTION J7000F THE LABOR CODE,FOR THE PERFORMANCE �� U OF 7HE WORK FOR WHICH THIS PERMI713 ISSUED. W � �HAVE AND WILL MAINTAV!WONCERS'COMPENSATION INSURANCE,AS RC-0UIRED BY SECTION � Q 37o00F 7HE LABOR COOE.FOR THE PERFORAIANCE OF hIE WORK FOR WHICH 7HI5 PEHMR IS = ISSUED.A/Y WOR 'COMPENSA710N IN�JWNCE RIER MID POLICY NUMBER AAE CONSTRUCTION j ��+ � Ca PLAN REVIEW 0ZZ ca�crra►�aea "'� ELECTRIC Q (nassEcfqr+r��t�oreEoo�.�erIDOFnEaEmKrsw�aorrErurnam�t�loR PLUMBING /�� .�� Z I CERTIFY THAT W THE PERFOfUTANCE OF THE WORK FOq WMlpi 7HI5 PERMIT IS ISSUED,I MECHANICAL Y�C1LI1. (,'} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE (q WOAKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I SFiOULD BECOME INSPECTION FEE SU6IECT T0 THE WORKERS'COMGENSATqN PROVISIONS OF SECTION 370o OF THE L.�BOR OCWE,I SHALL PoRTHWITI COMPLY WITH 7HOSE PHON510N5. ISSUANCE �� ,��y n n .T_ p DATE: � APPLICANT: SMIP J WARNINO:FAILURE TO SECURE WORI(ERS'COMPENSATION COVERA(3E IS UNLAWFUL,M!D SH�LL BE ENERGY P/C �CIT�Y(��rti1 �1��I��{�� SUBJEC7 Ml EMPLOVER TO CRIMINN.PENAL71E5 AND CM�FINES UP 700NE MUNDRED 7HOUSANO ENERGY PERMIT ++llA I 1 J�N� .A A(=Tl C,'A FFTV DOLLARS(f100.000),W ADDI710N TO THE COST OF COMPENSATION,DAMAOES hS PROVIDED FOR IN J SECTION J70E OF THE LABOR CODE,INTEREST,/�ND ATTORNE'/'S FEES. � - Q RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I MER�V AFFlHM UNDER PEN/�LTV OF VERIURV THAT TMERE IS ACONSTRUCT/0N LENDMO AGENCV � � FOR THE PERFORMANCE OF THE WORK FOR WHICH TMIS PEfiMIT IS ISSUED(SEC.30Y7,CIV.C.). W � LEHDER'S NAME � LENDER'S ADDRESS � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE TMAT THE ABOVE INFORMATqN IS CORRECT. TOTAL FE ES `�'�� `� � I AOREE 70 COMPLV WITH ALL CfTV AND CWNTY ORDINANCES AND STATE UWS RELATIN(3 70 BUILDINO � � CONSTRUC710N,AND HEREBV AUTFIORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON 7HE � Z MBOVE-MENTIONED PROPERTY FOR INSPECTION PURP0.5E5. COMMENTS � �� m PERMITTEE NAME( � ^/�� Q � N SIONANRE O E DATE . RECPT.NO. PAID BY VALIDATION � WHITE--DepaAment Copy,YELLOW—Flnence Copy.PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN—Applicant's Copy � C11'Y �� 9��1� ��a0� 1�9S�EtC��l fi�fEC�9�� `��lr'L��UU� � a ; _�� 0 � '' � 3 ,;�' G 0 �. � '`�3r � � � �� o SET BACK FLOOR JOIST �_ , � <:: , � ., ,.. � �r. 'l� FTGS/FORMS/STEEL FNA RE�MTS � "' ' � `� � '"'"" ELECTRIC GROUND UNDER FLOOR QUCT = , .�,-,------—— GROUND PLUMBING UNDER FLOOR CU�i4� UIT.:�;'� ' , .. . SLAB GRADE �� FIREPLA�� FOUNRATION , °; ,� .,�� , :.: ,. .; t TEMP POWER FIREPLAGE BOND BEAM WATER SERVICE MID HT. BOND BEAM : . :.,.�..-„ `, � ROOF SHEATHING 8 F�. BO D �A�' '��' '•'r; -''''� ' -��.'? j' + `=.' . FRAMING/VENTILIATION FINAL BOND BEAIN•��'` �' ` � ROOF COVER PRE-GRADING ROUGH NcAT1NG BENCHING ROUGH ELECTRIC ROUGH GRADING ROLiGF-4 PLUMBING FINISH GRADWG SH�WERJTUB TEST POOL ELECTRIC EXT. LATH/SIDWG POOL FENCING WALL INSULATION POOL FINAL CEiLING INSULATION OFF SITE IMPS. DRYWALL NAfUNG DEDfC,4TtONS ��'�� FiNAL ENG. � �� SE�'TIC TANK LANDSCAPE/lRRIG. �SEEP p1T/L.L. ON SlTE IMPS. G;�.S Hlr�i�ST FINAL ZONING ,�__.____ Fl�+,��I�NST, FIRE DEPT. FINAL Flt�:•.��NEATING HEALTH DEPT. FINAL � `��t;v.�.'_�L�CTRIC - � DEV. FEES PAID � R------ .",._PLUMBING ; >> .. . ,. �; � ENERGY -- , _ .. . ... ,.,.:, :. , �_. � � , o• '� �� .`�''. " �...__� t_�- . , _,.a ,_ r�;,Lr�a.y •..l _ � � �G�difViE�TS� S�E��2�, i�" l �Z- _� _.� . i.�,: ,4`� /_ ... �. .o,. '��' r _ �. �i a.^ir�. .�; � . . • . � � � i SEPTIC TANK SIZE � SEEP PIT/U S(ZE � � � � F �� ' - � , ; ��. , � � � � t�=��"�._°' � ...� -,-!.; ,, , � � � � � � � � � � _ . i i