The URL can be used to link to this page

Home My WebLink About19078r 0 i� Crz O ED z O 0 z m O 1n w z w Z3 w Cr O O U Z W 0 O v O Z N Q W Ca Z W Cc N cc 2 LL z O Cc ULJ d X W co co LLJ ¢ 4 0 Z O w Z Cn H C> O 0 w W d O cc CL LU Ir S H Ir IZ Ci Z 0 J co D61J1111D HIR i CITY OF DIAMOND BAR � I d� �� It F y DEPARTMENIT OF COMMUNITY & DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS_ 900-932 N. Diamond Bar APN LOT TRACT OWNER ADDRESS lei CITY ►a c� Z TEL APPLICANT TEL CONTRACTOR• ADDRESS L1—� h i.[ CITY 1 G7 ZIP R�X��J TEL( %( i _ ARCH/ENG/ DESIGNER -T R M /� ADDRESS CITY ZIP _ TEL. _ OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.S BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REGUIRESAPF..RMITTO CONSTRUCT, ALTER, IMPROVE. DEMOLISH, OR REPAIRANY STRUG' TUBE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 70 ) OF DIVISION 3 OF THE BUSINESS AND PRO. FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION T031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSW)): ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEFS WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE ;SEC. 7044, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOE'S NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. R HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE. TION, THE OWNER BUILDER WILL HAVE THE BURDEN OF PROVING `.HAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ❑ I. AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC, 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO aUl1. DS OR IMPROVES THEREON, AND WHOCONTRACTS FORSUCH PROJECTS WITH A CONTRACTOR(S) I ICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW) El I AM EXEMPT UNDER SEC. B. A P,C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT p LICENSE CLASS ��i _ LIC. N. / DATE_ 4,- i O Z CONTRACTOR[[,�// / WORKERS' COMPENSATION DEL't AadKr'4 I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _ I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF4NSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION IN URANCE [CI�RRIER AND POLICY NUMBER ARE:. CARRIER S /�, 'L _ L �+c%`' POLICY NUMBER (THIS SECTION NEED NOT BE COMPILE OF THE PERMIT IS FOR ONE HUNDRED DrOUARS ($100) OR LESS). 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED, 1 SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SOAS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVIS CODE I SH ALI FORTHWITH COMPLY WITH TRIOS n DATE. ,-� d� APPLICAN - WARNING: FAILURE TO SECURE Eg PENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRI AL LTIES AND CIVIL FINFS UP TO ONE HUNDRED THOUSAND DOLLARS I$I W.000). IN ADDITI E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370A OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE 15 ACONSTRLICTION LENDING AGENCY FOR THE PERFORMANCE OF THE: WORK FOR WHICH THIS PERMIT IS ISSI IED (SEC. 3a9.7, CIV C.). LENDEH'S NAME LENDER'SADnRESS CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PURPOSES. CO PERMI EE N T ¢ 1/ T RM �/ DATE PRESS FIRMLY APPLICATION 10/16/02 PERMIT P/C 02-421 DATE NUMBER # ISSUE TYPE OCC DATE CONST GROUP ZONING SETBACKS FRONT RW 7 REAR ❑ SIDE/SIDE STREET RW L] _ SIDE ❑ PROPOSED USE 9340 SF of TI from fire damage NO. DWEL. NO, NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport WPatio/Deck LL PooUSpa ZRe -Root Commercial 1p Valuation 206,47 ! _ nn ADJ.AREA QUANTITY DESCRIPTION FEE: J q U a U w J W C3 Z on J 0. Q U_ Z Q x W 1,301.80 CONSTRUCTION 1106.53 PLAN REVIEW 250.00 ELECTRIC 250.00 PLUMBING 100.00 MECHANICAL INSPECTION FEE ISSUANCE 4 43.34 SMIP ENERGY PIC 110.65 _ ENERGY PERMIT 130.1818 RETENTION FEE; PRE-ALT FEE: 1 817.18 TOTAL FEES COMMENTS .1 1 RECPT NO. PAID BY VALIDATION r WHITE—De artment Copy, YELI-OW—Finance Copy, PINK —Assessor Copy, GOLDENROD —File CoPY, GREEN —Applicant's Copy CITY OF DIAMOND BAR DEPARTME?—TT OF COI—M7IUNTfY & DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS- 900-932 N. Diamond Bar APN LOT TRACT OWNER ADDRESS A—Q CITY —N — •Z P TEL. APPLICANT i' b— TEL. CONTRACTOR-- -Cl" —y< i ADDRESS " C1,F, 'h ,ft .."/ CITY (p.-L t., :,: c7 ZIP ""X7 TEL( 7/' ")S' "3 "0 ARCH/EKG/ (3'/4)G S... YiI"U/ DESIGNER "T R M /} ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM E%EMPT FROM THE CONTRACTORS LI- CENSELAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE: ANV CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE. DEMOLISH, OR REPAIR ANY STRUC— TORE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO FESSIONS CODE) OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION.ANV VK)IATION OF SECTION 7031.5 BY ANV APPLICANT PoR A PERMIT SUBJECTS'fHE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (f 500).): ^ I, AS OWNER OF THE PROPER TY, OR M V EMPLOYEES W ITH WAGES AS T HEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE !SEC. 7044, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOc'S NO — APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE— TK)N, THE OWNER —BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ^ I. AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING W ITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO dUII.DS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITHACONTRACTOR(SII ICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW). ^ I AM EXEMPT UNDER SEC. B. 8 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PP,OFESSiONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT G LICENSE CLASS LIC. NO. / DATE- ",.-_I I TIO.Z CONTRACTOR WORKERS' COMPENSATION DECt7—CATTSt—'— ' -• ' n 5 r. I HEREBY AFFIRM VNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECORATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF4NSURE FOR WORKERS' A COMPENSATION, AS PROVIDED BV SECTION 37000E THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. __ 1 HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BV SECTION 1700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. MV WORKERS' COMPENSATION IN ORANGE C RIER AND POLICY NUMBER ARE: CARRIER S C.. r r+ ' POLICY NUMBER _ (THIS SECTION NEED NOT BE COMPLETED OF THE PEFMfT IS FOF ONE HUNDRED 00I1AR5 (5100) OR LESS). 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVIS CODE, I SHALL FORTHWITH COMPLY WITH THOS a d2 APP T ICAN DA E: L WARNING: FAILURE TO SECURE E PENSATION COVERAGE IS UNOWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRI AL LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLORS (f 100,000), IN AODITI E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE: WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. ]09], CIV C.). LENDER'S NAME LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CI7V AND COUNTY ORDINANCES AND STATE OWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE —MENTION ED PROPERTY FOR INSPECTION PURPOSES. C f J PERMI EE NA T TRH/DATE/ 0 0 LL 0 LL 0 w 0 0 z m 0 F- Q Z N Y 2 LL Z 0 d X W F-- U rn _N Z Q W Q 0 Z W Z 0 Y J W d 0 d Z W S W Z m Q (13 Silly a — PRESS FIRMLY - —/ WHITE -Department Copy, YELL -OW -Finance Copy, PINK -Assessor Copy, GOLDENROD -File Copy, GREEN -Applicants Copy 141 9-16--415 , 'rV&r=P 3" d3 15 looll