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Home My WebLink About12-1052 ��_ CITY OF DIAMOND BAR �� " � DEPARTMENT OF COMMU1vITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702 PRESS ��'9^". BUILDING PERMIT APPLICATION FIRMLY ¢ ADDRESS ��/ ry� � ` APPLICAT�p�I a\ � 1 a PERMITRI�L /J P/C '� o DATE �3( NUMBE D�� \a- 1c��, ISSUE TYPE pCC � APN LOT TRACT DATE ��Z�'�2� CONST. �� GROUP p OWNER p ADDRESS ZONING SEfBACKS I Z CITY }P� TEL. FRONT RW O • p APPLICANT I�y1J� TEL REAR p zd SIDE/SIDE STREET qVy p � CONTRACTOR O� ' �Q � SIDE p o ADDRESS PROPOSED USE_al/JIf��.�-h� -�"''J'� ,�P�t7'� o CITY ZIP 'V TEL w ARCH/ENG/ _ z DESIGNER 1 D C�.f�� 9 Y'�v G a ADDRESS `' �' NO.DWEL. NO. NO. � CITY ' ZIF TEL UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION �OWNER-BUILDER DECIAAATION SFq/ADD/REM o T h�. v.��1 -•�o p I HEREBV AFFlqM UNDER�PENALTY OF PER0.1M THAT I AII E%EMPT FROM THE CONT{UCTORS LI- (`je�gAg/CBfpOf( W CENSEUWFORTHEFOLLOWINOREASON(SEC.7n'i1.68U5ME5SANDPROFES510NSCA0EAN1'p7YOR (n . P _ - � O C-� CIX1NT1'HM1i1Cl1REWIRESAPERAUTTOCONSTRUC7,ALTER,AdPROVE,DEMOIJSH.ORREPAIRANYS7RUG W TURE,PRpR TO RB ISSUANCE,ALSO REWIRES hIE APPLICANT fOR SUCH PERMIT TO FlLE A SIONED w PatidDeck Q�,� •`- G . STATEMENT 7HAT HE OR SHE IS UCENSED PURSUANi TO TNE PROVISIDNS Of THE CONiRAC70R5 LL r' � CENSE UW(pUPTER D(COMMENpNO WITN SECTION 7000)OF DMSION 3 OF THE BUSINE59 AND PRO- V' POOUSPB' �� FESSIONSCOO�OR7YIATMEORSHEISE%EMPT7HEREFROMANDiHEB/515FORTHEALLEOEDE%EMP- (� C �` �� L TION.ANVVpLAT10NOFSEC770N7031.68VANYMPLICAN7f-0qAPERMITSU&lECT9THEMPLICANTTO Z RaRoof ,` ACIVIL�ENALTV OF NOT MORE THAN FIVE HUNDRED DOLLMS(i60D).Y . � ❑4ASOVfNEROFTHEPROPERTV,ORMYEMPLOYEESWIiHl4AGE5ASTHEIH50LECOMPENSATpN, � Q Z WILL DO THE WORIf,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEG.7oN,BU51- J CORIII1BfC13I '� pA \ � � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLY TO AN OWHER OF � O PROPEHfY VYIID BUIL,p$OR IMPROVES TiEREON,AND 1N10 DOES SUCH WORK HIAISELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,VROVIDED h1AT SUq/IMPROVEMEMS ME NOT INTENDED OR m � Q OFFERIDFORSAI.EIF.FION�EVER7MEBlALDPlUORDAPROVEMENTISSp�pW�7�qNONEYEAROFCOMPIE z TION.THE�OWNER-BUILDER WILL HAVE THE BURDEN OF PROV9�(3 THAT-HE OR SHE DID NOT BUILD pq . . . � tMPROVE FOR THE PURP09E OF SALE): ' � � W �4�OwNEROF7HEPROPEATY,AAIEXCLUSNELYCONiRACTW�WRNUCENSEDCONiRACTORS [= TO CONSTRUCi�TME PRQIEGT(SEC.7oN,BUSINES3 A!6]PROFE$$IpNS CODE:THE COHTRACTORS LI- VBIU9II011' (��.qR�� ' L.L� CENSEUWOOESNOTAPVLYTOANOWNEROFAPROPERTVWMDBUILDSORIMPROVESTHEREON,AND � MMOCOMRACTSFORSUCHPfiWECfSWRHACOHfRAC70R�b7LICENSEDPUR&UANTTOTHECONTMF pUANTITY DESCRIP710N � TORS LICENSE LAW.)., FEE � � ❑1 A1d E%EMPT UNDEA SEC. B.8 V.C.FOR THIS REASON Q U � UATE pyMEq � Z U � LICENSED CONTRACTORS DECLARATION � � 1 HEREBYAFFIRAI UNDER PENALTY OF PERWRY THAT IAM LICENSED UNDER PROVISlONS pF qfApTER � �� - � Y(COAIMENCENO WITM SECTqN 7000)OF OIVI510N�OF THE BUSINESS M10 PROFESSIONS CODE,M1D Z �� IAY LICENSE IS pl FULL FORCE AND EFFECT. �l m � UCENSE C S � D _ WC.NO.�✓� C� L/'V (J � � �� . V DATE . CONTRACTOR � a __ . . . LL1 � WORKERS'COMPENSATION DECLARATION ¢ � �� I HEREBY AFFIR►1 UNDER PFNALTV OF PERNFY ONE OF THE FOLLON7NO DECURATIONS: � ' . . . ' CA Z � _I HAVE AND WtLL MNNT/UN A CERTIFICATE OF CONSENT TO SELF•INSURE FOR WORKERS � - I CONPENSATION,AS PROVIDED BY SECTION 37UOOF THE UBOR COOE,FOR THE PERFORMANCE U� OF TNE WORK FOq WHICH THIS pEHMIT 19 ISSUED. W . 0 � � _IFIAVEANDtNLLMAIHTAIN�WOPoCERS'COtdPENSATIONIN3UqANCE,�ASqEWIHEDBV5ECT10N � � � Q 37000FTHELABORCODE,FORTHEPERFORMM�CE�OFTHEWOPo(FORWHK7ITHISVERAUTI3 p ISSUED.MYWORKERSCOM► SA7�qIN5U CECARRIER�AND.POI.ICYMIMBERARE �CONSTRUCTION� . �q(� -1` > CARRIER .Sfif�� r�N� PLAN REVIEW s4-f •�3g � POLICY NUMBER I 1 . . . ELECTFIC SCo •33 o (rwssEcnoror�wree�rIDOFnfa�rswaor+E�oawaslnaoloa�ssl PLUMBING ��. � w Z �CERTIFV THAT M THE PERFOHMANCE OF THE.WORK FOii WHICM T1i13 PERMIT IS ISSUED,1 �ECHANICAL CS SHALL NOT EAIV�OY ANY VERSON W ANY MANNER SOAS TO BECOME SUBJECr TOTHE (q N4RNER5'COMPENSATIONLAWSOFCALIFOqN10.�NDA(iREETHA7�FI5HOULDBECAME INSPECTIONFEE SU9IECTT THEWOFiKERSCOMFENSAT10NPqOVISqNSOFSECT10N37a00FTHEUBOR �� Oi s waTrn�n�couv�v vnn�nasE aov�sarr�s. y// ISSUANCE w oA,�: i�1 �ti AP��,�:._�/�A� J�YI^+�7 SMIP ��O �o � WARNIN(L FALURE TO SECURE WORKERS COMPENSATION COVEMGE IS UNUWFUL,M1D SHALL BE ENERGY P/C .�•�4 " � SU&IECTAN EMPLOVER TO CRIMp1AL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED hpUSAND ENERGY PEAMIT �� , �� DOLURS(f100,ao0),�IN ADDITON TO7HE C0.ST OF COMPENSATqN,DAMAGES AS PROVIDEO FOR IN A� J SECTION 370E OF THE LABOR CADE,WTEREST,AND ATfORNEY$FEES. ' RETENTION FEE: �{p .CI5 � O , CONSTRUCTION�IENDING AGENCY PRE-ALT FEE: � 1 HEREBY AFFIRM UNDER-PENAL7Y OF PERIURV THAT THERE IS ACONSTRUCTION LENDINO A�ENCY SCA� � � Z FOR THE PERFORMANCE OFTHE WORK FOR VlHICH THIS PERMfT IS ISSUED(SEC.3077,qV.C.). W �. LENDER'S NAME . . � F'- LENDER'SADDRESS w ICERTIF/THATIHAVEREADh1tSAPp�ICATIONANDSTATE:iHATTHEABOVEB�FOqMATqNISWqiiECT. TOTAL FEES ��a. \� . . .. ,�� 1 . �� 1 AGREE TO COMPIY WITH ALL CITY AND COUNTY ORDINANCES M1D STATE UWS RELATFq TO BULDINO � CONSTRUCTION,ANDHEREBYAUTHORIZEREPRESENTATNESOFTHISCOUNTY70ENTERUPONTiE " Z ABOVE-MENTIONED VROPER7Y FOR INSPECTION PURPOSES. COMMENTS " � S$t2 r . 1 � . J � � ¢ PERA/ITTEEN �(Pql i _ � 2 _ . � �G �a3� �,3$ � 5 PERNITTEE A7E � RECPT..NO. PAID BY° VALIDATION WHITE-Depertment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENRO�File'Copy,GREEN—ApplfcanYs Copy CITY QF QlAM4ND BAR � �; . .. iNSPEC�"IC1�1 �ECOR� ,, � . , e �T � .�� .. , � � � , . » PA. ._D. �. � }.. :.�: 3 W..: p i4 1! � :Tr mN F� �"��- � SET BACK I � �LOOR 101ST ` -� . __.._--_l_. ---�.__—.._ _.---- _ FTGSJFORMS/STEEt �^ FHA REQtNTS EI.ECTRIC GROUNO —��-- UNDER F100R DUCT —_ ___� ____. _ GROUNQ PLUMBING tlNDER FLOC}R CONDUlT S�AB GRADE FlREPLACE FOUf�DATiC}N TEMP PC7WER FlREPLACE SQND BEAM WATER SERVICE MID HT.BOND BEAM RC70F SHEATHING 8 FT.BOND BEAM FRAMING/VENTILATION � ^�.,,,�+ FINAL BOND BEAM ROOF COVER � PRE-GRAQING � ----—.___._ .— .------ ROUGH HEATING BENCHING ROUGH ELECTRiC � ,f�,.� — - __ RQUGH GRADING ROUGH PLUMBING FINISH G3�AE}iNG SH{}WEWTUB TEST Pt?t)l ELECTRIC EXT,�ATH/SIC}{NG � PQ4L FENC#NG ..�. �..� VdALL iNSULATI4N PC?QL FENAL CEILING INSULATI4N OFF SffE IMPS. DRYWALI.P�AIL![VG DEDICATIC?NS SEWER ` FINAL ENG. ^ SEPTICTANK �LAND5CApE/IRRIG. � SEEP PIT/L.L. i Ohd SITE IMPS. i GAS AIR TEST J � FINAL 20NING FiNAICO�JST. �, r/ FIRE OEPT.FiNAL FINA�HEATING '1 ' HEALTH DEPT.FINAI �INAL ELECTRIC ' ` ' . � DEV.FEE5 PAID FINAI PLUMBING � � � EldERGY FItUA�PLANING , .. • FINAI ENGWEERING . � �, . � COMMENT5 _,�_'�e. ��sv fo / /� Y"v � \ � _ �r �'�:��t�,��y��f� `. 1�,� �W W� '� '� � ��°�L � { �.�2'a tr.a,�L��__'�,�TS-'�-�-�. ��; , �;� � - ,_�. - t�;--� � � y-__ ____ ` __�� SEPTlC TA�lK 51ZE SEEP PIT(U SIZE �" � II}� '' °�'� �' � _ . � CITY OF DIAMOND BAR � Community and Development Services Department � 21 S 10 E.Copley Drive•Diamond Bar,CA 91765 � '` - Building Inspection Request Hotline �,.�,. .•� (909)839-7027 �Jj69 Building . Planning . Engineering (909)839-7020 (909)839-7030 (909)839-7040 CORRECTION NOTICE ' �-�v�Z a.m. PERMIT NO. �' DATE: TIME: p.m. CONTRACTOR/ OWNER BUILDER ADDRESS(Project S�?P; ' •� � "�' �� '1 A� s 6�T Z �'4.C1ZQ . Q �" Css�p ^r� S 1.d.1J e� (',,,,��`� � 21r N e� �,��,� e� W cJ.c-�t�.a �,�C$r�a S � o� �.. Yec.m , � d � ,gf2.�-.-C�t �- ` ❑PLEASE CONTACT THE UNDERSIGNED ' ❑PLEASE MAKE CORRECTIONS AND CALL FOR REINSPECTION ❑REINSPECTION FEE REQUIRED • a PLEASE MAKE CORRECTIONS AND PROCEED WITH WORK INSPECTOR: (printnarne) SIGNATURE OF INSPECTOR: