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Home My WebLink About14727 � °� ,• . ft ' CITY OF DIAMOND BAB --- DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES �� _ w 21660 E.Copley.Drive Suite 190 °i�.. (909)860-3195 Fax(909)861-3117 — _ � , PRESS � ��`�. BiJILDING PERMIT APPLICATION a FIRMLY o� JOBSITE �G1� �I/Y,��lJ l�N� �"� APPLICATION -- I Q . PERMfT /,��]�I] Pl ADDRESS U DATE <� NUMBERL,_�_�_r_�� # c� ISSUE , 1 NPE OCC � APN LOT TRACT DATE �4 CONST. C,ROUP g OWNER � . �L� a p ADDRESS OS E• C.�'/�� I�' ZONING SETBACKS w CITY ., �� I ZIP g'i 7lcr TEL., , FRONT RW ❑ � APPLICANT �'T TEL.��Z SIDFJSIDE STREET RW ❑ CONTRACTOR SIDE ❑ Q ADDRESS PROPOSED USE S " �� ' �� CITY ZIP TEI. �. $� ��t�• o ARCH/L-N@T = `��-r�� _ � �� _ NO.DWEL. NO. .Z O. ' / ADDRESS 7- UNITS � STORIES BEDROOMS v . � CITY ZIP TEL. Z�• - y . y DESCRIPTION SQ.FT. FACTOR PSF ADJ.A A ¢ OWNER-BUILDER DECLARATION , SFp/qBB/R�k►� ;�J Z O p I HEREBV AFFlRM UI�ER PENAL7V OF PER1UFiY 7HAT I AM E%EAIPT FROM THE CONTiiAC70R5 ll- � GaragelCerport �� J C@lSEUWFOR7HEFOLIOWINOREASON(3EC.7Wi.68USINES3ANOPROFE3SqNSCODEANVGTYOR C� pWr(n'W�{�q[.pUWWESAPERMRTOCONSTRUCT,ALTERIMPROV�DEMOLISH,ORREPAIRANVSTRUG w Z il/HE,PWIXi TO fT3 ISSUANCE.AL90 REW IR£9 THE MPLICANT FOR SUCN PERMIT TO FlLE A 51(iNED Pe�b/D9CIC � �l� STAiEMENT TUT HE OR SHE IS UCENSED%iRSl1ANT 70 TME PROVISIONS OF NE�MW�CTOR3 U- w � CENSE UW(CHAVTER Y(COMMENCWCI WI7H SECTION 7000)OF DMSION J OF i}IE BUSINESS AND PRO- � POOUSpB FES91DN9 CODE�OR THAT HE OR SHE IS IXEAIPT THEREFROM 1ND THE BA518 FOR h1E ILLLE�ED EXEAIP- TION.ANVVIOlA710NOFSECTION7091.6BVANVAPPLICANiFORAPERMITSUBJECTShiEMPLICMlTTO Z Re-Roof � AdVIL PENALTV OF NOT MORE 7HAN FIVE HUNDRED DOIl/�RS(t600).): � � ❑I,ABOhN1EROFTHEVROPEHfV,ORMVEMPLOYEE9WITHWAOESASTHEIRSOLECOMPEN5AT10N, � CORIrtIBfCI9I � � � Wl.L DO THE MIOi1K,AND THE S7RUC7URE IS NOT IHTENDED OR OFFERED FOR S�LLE(SEC.7oal,BUSF J N NE33/J�FfWFE99lONS CODE:THE CONTRACT00.4 LICENSE UW DOES NOT APPLY TO AN OWNER OF � PROVENTV WNO BU6D3 OR G/PROVES THEREON,/W D WHO DOES SUQI WOAK MIMSELF OR HERSELF OR (t Ti4qUGH HIS OR HER OWN EMPLOYEES,PROVIOED THA7 SUCH PIPROVEMENTS ME NO7 PfTENDED OR m - L� OfFER�FOR9ALEIFHOWEVER��LDMUORWPROVEMENTISSOLDWI7MNONEYEMOFCOMPLE- ' ' �'TION,TME OWNER�UILDER WILL F1AVE TY1E&1RDEN OF PROVN/O h1AT HE OR 8HE DID NOT BUILD OR � MPROVE FOR THE PURPQ4E OF SAIE} � F W 04ti^�MNEROF7HEPROVERfV,AMIXCLU3NELYCON7MCTP10WfiHLICENSmCONTRAC70R9 d TO CONSTAUCT 7HE PHO.IECT(SEC.7a4,BUSINESS/WD PROFE9310NS CODE hIE COHTRACTOq3 LI- V81U9IIOf1 J ~ ADJ.AREA � CEN9ElAWDOESNOTAPPLYTOANOWNEROFAPROPEHTVWFpBUROSORIMPROVESTHERE9N./�IdD ; TOR4LICEN9EUW.�g�v�ECfSWI7HAOONTMCfOR(S)UCENSEDPURSUANT70THECONTHAC p�q�ryTy DESCRIPTION FEE . � 0 ❑1 AM D(BAPT UNDER SEC. B.8 P.C.FOR hIIS REASON � ' . '. 3 � LL � ' DA7E _�O OWHER U . � LICENSED CO CTORS DECLARATION � W J � W 1lIEREBYAFF6tl/UNDER PENALTV OF PERAIM 71iAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(COAfMEHC7lW NTfH SECTION 7000)OF DMSION�OF THE BUSINESS AND PROFESSIONS CODE.AND Z � W LICEHSE IS DI RAL FORCE AND EFFECT. m � IICENSE CUSS LIC.NO. j � V DATE CONiRAc70R d W i � WORKERS'COMPENSATION DECLARATION � � 1 HEREBV�FFIRM UNDER PENALTV OF PEiL1URY ONE OFTHE FOLLOWINO DECUMTIONS: Z � � � � _I HAVE AHD WILL MACITAM A CERfIFlCATE OF CONSENT TO 6ELF-INSURE FOR WORNERS' _ COMPEN9A710N,AS PROVIDm BV 6ECT10N 370o OF 7NE LABOR CODE.FOR 7HE PERFORAIANCE w OF THE WORK FOR WHIQI THIS PERMR IS ISSUED. � � _1 HAVE AND WfLL MAMAPI M/ORKERS COMPENSATION IN9UFiANCE,AS REW IRED BY SECTION Q 970o OF THE LAB01i CODE.FOR THE PERFORMANCE OF hIE WORK FOR WHICH THIS PERMR IS //1 ISSUED.MY WOfU(ER5 COMPQISATION INSURANCE CARRIER M1D POLICV NUMBER ME: CONSTRUCTION / (/ jc.waiea PLAN REVIEW 0 POI.1��NUMBER ELECTRIC � (i�sEcna+NEIDwreEoo�rIDaFnEa�nTswaa+EH�oau�asRiro)aa�ssl PLUMBING Z I CERTIFV THAT P17HE PERFORMANCE OF THE WORK FOR wHlp/THIS PEHAIIT IS ISSUED,I MECHANICAL �� L � (,r} SHALL NOT EMPLOV/V11'PERSON M ANV AIANNER SO AS TO BECOME SUBJEC7 TO TME y WORKERS COMPENSATqN LAWS OF CALIFORNIA,AND AdREE THAT IF I SHOUID BECOME INSPECTION FEE S SU&IECT TO THE WOHKERS'COMPENS�ya PROV IONS OF SECTpN 37ao OF THE LABOR - e.isHuiroAn�vnn�coMv�r rfr� os ovisi� . ISSUANCE � ��Q D APPL�cANT. �SMIP � • � � � ENERGY P/C WARNIN�:FARURE TO SECURE PENSA710N COVEMOE IS UNLAWFUL,AND SHALL BE � SUBJECTMIEMPLOVERTOCRIM TIESANDCMLFINESUPTOONEHUNOREDTHOUSAND ENERGYPERMIT ' DOLLARS(f100.000).IN ADOITION T07HE COST OF COMPENSATION,DAMAOES AS PROVIDEO FOR IN J SECTqN 370E Of hiE LABOR CODE,M7EREST,AND ATfORNEY9 FEES. ' RETENTION FEE: � � OCONSTRUCTION LENDING AGENCY PRF�ALT F�:I�� 1 HEREBV AFFIRM UNDER PENALTV OF VEfi1URV THAT THERE IS�CONSTRUCTION LENDINCi AOENCY V Z FOR THE PERFORMANCE OF THE WORK FOR WNICH THIS PERMIT IS ISSUED(SEC.3077,qV.C.). W QT LENDER'S NAME . � � LENDER'SADDRESS � � I CEHTIFY 7HAT I HAVE REhD T1IS MPLICATION AND STATE THATTIE ABOVE INFORMATION IS CORRECT. TOTAL FEES � ' 3/ I � I A�REE TO COMPLV N7TH�LL CITY AND CWHTY OFDINANCES AND STATE UWS RELA7INO TO BUILDINO �� CONSTRUCTION,M1D HEREBV AUTFIORI2E REPRESENTA71VE5 OF h115 COUNTY 70INTER UPON TFIE � �BOVE�11ENiqNED 7ROPEfiTY FOR INSPECTION PURPOSES. COMM 9 �'�� f`�— c'� � PERM N E(PRI � �� 3-��o I � pF pEqy�TfEE DATE RECPT.NO. PAID BY VALIDAT70N � WHITE—Deparlment Copy,YELLOW—Finence Copy,PINK—AsseasorCopy,(30LDENROD—FlleCopy,GREEN--A�I{cant's Copy ,- CITV O� DB�ii�IOND BAR •�- ' � � If�SPEC'flO�!! REC��i� ° � � ` - � � - o � . . � . SET BACK i � a7 FLOOR J015T . . ;. . � FTGS/FORMS/ST EL � , p FHA REQMTS ' ELECTRIC GROUND ! ' � : UNDER FLOOR DUCT � . �: GROUND PLUNIBING UNDER FLOOR GO'�IDUIT .� ,i ., � �� .- SLABGRADE I"Z=Q� FIREPtsfACE FOUNDATION "��`. w+ - " F'' �'• `-�� TEMP POWER FIREF'LACE�BON13 BEAM WATER SERVICE , ,_ MID HT. BOND BEAM ROOF SHEATHING=.'�- 's•��-�s•=� • '� 8 FT. BOND BEAM FRAMINGNENTIUATION, .� . '_;��.' FWAL BOND BEAM , . • ~- � ROOF:COVER PRE-GRADING :� `. '� ;, .:,�: .:. y;'9, j, ` , ,�,i ' _ . ROUGH HEATING BENCHING � `�- • '� '` '��'`�`�1' i.� ;�,',' , ROUGH ELECTRIC � , ,� .� ' ROUGH GRADING ROt7GH-PLUNIBING � FINISH GRADING SH0INER/TUB TEST =��-:�•: POOL ELECTRlC ESC�'. LATH/SIDING � P�OL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. �RYWALL NAILING DEDICATIONS SEWER FINAL ENG. .SEPTIC TANK ..,_�_ _; ,�;-• LANDSCAPE/IRRIG. � SEEP PITn..,L. " • ` . ON SiTE iMPS. ' - GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HFALTH DEPT. FINAL� ` FINAL ELECTRIC � �i' L-�'`!' DEV. FEES PAID FINAL PLUMBING ENERGY ,k1;,;<. �, {,,,rv . . , _ � - - - ,.�, . • � � � � �.•,;�.�•�. , . ..:��_ �... ._ � _ . __ . •� , �, -,i•;� COMMENTS �'.�..: � - ; .., � �.�, - , . ,1• ,�, : �� , _ _ ,S _ �_! . r � ''' �� • .. . � . - ' � . , SEPTI'C TANK SIZE . SEEP PIT/U SIZE � sr �u t� �+r,��.��,��,.� ' � a� ;��d3a� {�i� .,as¢,��iF t . _ ��`{L, � ��'� � - '- - ' .} x � ��,l�y7 t�,7�,.5� "�, ..�.!4, . . . St`i yj :�# .< ��i �a'��+; �.,�p�,' � e,� . . . "�.� � ��'} � 5.�.� . . ' . . . . =r'�-'�. ,� , .� . • � �`{ �� ' �� r;r� � �� i.' . . � � ' � ' . �-- -_��_ CITY OF DIAMOND BAR DEPARTMENT OF COARvIUMTY&DEVELOPIv1ENT SERVICES 21825 E.Copley Drive ��/�IC�� (909)860-3195 Fa�c(909)861-3117 � F G�"J p �G�� PRESS '�';.9�^� BUILDING PERNIIT APPLICATION L`..��, ( f._, FIRMLY o DDRIESS /�� NI��.� /� �� APPLICATION� / PERMIT P/C [ cJ�G� f�-.ec '� I DATE � b O � NUMBER �� # � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER d p ADDRES / �Q � ZONING SETBACKS FRONT qyy p g CITY '��,� TEL. REAR ❑ APPLICANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ ADDRESS /� � � CITY ZIP TEL. PROPOSED USE �� /'�[ � ��Z oARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY � ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION �7 SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFWADD/REM / O p I HEREBV AFFlRM UNDER PENAITV OF PERIURV TNAT I AM EXEMPT FROM THE CONTRACTORS LI- G8f8gB/CBfPOfI W CENSELAWFORTHEFOLLOWWGREASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANYCITYOR (J� U �p�JrJTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER�PROVE,DEMOLISH.ORREPAIRMlYSTRUC� w w NRE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w P8110/DBCk � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF TME COMRACTORS LI� � CENSE UW(CHAPTER o(COMMENCINO WITH SECTION 7000)OF DIVISION�OF THE BUSINE55 AND PRO� V' POOUSpe O FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEOEDE%EMP- (� V TION.ANV VqLAT10N OF SECTION 7031.6 BV ANV APPUCANT FOR A PERMIT 5U&IECTS THE APPLICANT TO Z Re-Roof A CIVIL 7ENALTV OF NOT MORE THAN FIVE HUNDRED DOLL4R5(f500).): � ❑I,ASOWNEROFTHEPROPER7Y.ORMVEMPLOVEESWITHWAGESASTHEIRSOLECAMPENSATION, � COrt1rtIBfC18I Z WILL DO THE WORI(AND THE STRUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70�a,BUSI- J i � NESS AND PROFESSIONS CODE:TME CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PiiOPERfV WFIO BURDS OR IMPROVES TNERE-0N,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR CC THFi0U4M HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERNEBUILDINOORIMPROVEMENTISSOLDWfTHINONEVEAROFCOMFLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD ON � IMP�VE FOR THE PURPOSE OF SALE). w I.ASONRJEROFTNEPROPERTV,AME%CLUSIVELVCANTRACTINGWITHLICENSEDCONTMCTORS [C TO STRUCT THE PR0.IECT(SEC.7oN,BUSINESS M!D PROFESSIONS CODE:hIE CONTRACTORS LI- V81U8ti0l1 ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN OWNER OF A PROPERTY M?10 BUILDS OR IMPROVES THEREON.AND � WFIOCONTRACTSFORSUCHPROJECTSWI7HACONTRACTOR(S�UCENSEDPURSUANTTOTHECONTqAG QUANTITY DESCRIPTION FEE Y TORS LICENSE LAWJ. � ❑I/UA E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q �� Z u �j/� � �3 ZDATE "'�� `"aJ Zi OWNER � ��. P� � S . � LICENSED CONTRACTORS DECLARATION W � U � � � �� 1 HEHEBV AFFIHM UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCINO WIiH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z �� MV LICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CLASS LIC.NO. � U DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION a N U N I HEREBV AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOILOWINO DECLAMTKKJS: Z � I HAVE M!D WILL MAINTAIN A CERTIFICATE OF CONSEM TO SEIF-INSURE FOR WOqI(ERS' _ QZ COMPENSATqN,AS PROVIDED BY SECTION 37o00F THE LABOR CODE.FOR THE PERFORMANCE U � n OF THE WOR)(FOR WHICH THIS PERMIT IS ISSUED. � '; W e� � _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REWIRED BV SECTION � Q 3700 0F THE L/�BOR CODE.FOR THE PERFORMMICE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION J j CARRIER PLAN REVIEW ZPOUCVNUMBER ELECTRIC ¢ � � � (iHISSE(.'iIONNE�NOTBENMPLETEDOF7FIEPERAYTISFOqIXJEFRA(JREDDOLL/3iS�t100)ORlESS} W Z I CERTIFV THAT IN THE PERFORMANCE OF hIE WORK FOR WHICH THIS PERAIIT IS ISSUED,I MECHANICAL CJ SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECAME SU&IECT TO THE (n WORKERS'COAIPENSATION LAWS OF CALIFORN10.�ND AGREE THAT IF I SHOULD BECOME INSPECTION FEE O SU&lECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTNELABOR � .QO CODE,1 SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE p DATE: APPIICANT: SMIP W J WARNINO:FAILUqE TO SECURE MlORKERS'COMPENSATKKJ CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C 7 J .__ .�.__/ �--...r_ � � SU&IECTANEMPIOYERTOCRIMINPLPENALTIESANDCMLFINESUPTOONEHUNDREDTHOUSAND ENERGYPEAMIT I 1��"�/f^�\ II L J.� DOLLARS(f100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN � SECTqN 3708OF THE IABOR CADE,INTEREST,ANDATTORNEVS FEES. RETENTION FEE: I �p n 1) OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: I tll 11 � _U�t L � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT THERE IS ACONSTRUCTION LENDINO AOENCY I n- FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oe7,CIV.C.). � _ w •cT_ ...l1� . � LENDER'S NAME � " _ � .. . , , �:_.��. '�� LENDER'SADDRESS � ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATqNISCORRECT. TOTAL FEES 6�� ,� p_ I AOREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDINO � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF THIS CWNTV TO ENTER UPON THE Z ABOVE�MENTIONED PqOPERTY FOR INSPECTION PURPOSES. COMMENTS o �_' ��/�� m PERMITTEE N PRI ' Q � � SIO fTTEE DATE � RECPT.NO. � PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy cG@��Y �� l�l�fil�� f��a(� �� 96�sI��'6�� 1�8f��I�� L�.�.�lr��y U VJIJU' � D � << a��"tJ��JU�) � '• } �'° 0 , � D �� Q � :'': SET BACK FLOOR JQIST , FTGS/FORMS/STEEL � FHA REQti�TS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CU�IDUIT ' SLAB GRADE � FIREPLACE FOUNDATION � TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BQtVD BEAM ROOF SHEATHING 8 Ff. B(�ND BEAM FRAMING/VENTILIATI�N FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH NEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUiVIBING FINISH GRADING SHOWERITUB TES7 POOL ELECTRIG EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILIPIG {NSULATION OFF SITE IMPS. � DRYWAL�NAIL�NG DEDICATI�NS SEWER � FINAL ENG. SEPTIC TAt�lK LANDSCAPE/1RRIG. SEEP PITlL.L. QN SlTE lP.9PS.' GAS A1R TEST FINAL ZONING FINAL CONST. _ i , F!RE DEPT. FINAL FINAL HEATItVG HEAI.TH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUP/iBItJG � EN�RGY ��,' ,�:- CUMMENl"S --- - _- - - - . SEPTIC TAiVK SIZE SEEP PIT/U SIZE J� � . �� . . � ,-----�'`— CIT'Y OF DIAMOND BAR . ��r�� DEPARTIv1ENT OF COMMUNTI'1'&DEVELOPMENT SERVICES 21825 E.Copley Drive 01�� ,,„� (909)860-3195 Fax(909)861-3117 ., , ' - r PRESS ��'%��?' BUILDING PERMiT APPLICATION ��"�` FIRMLY } JOBSITE /p�� h!A�,y�� l` ,_ �'/ �N�y APPLICATION /� �" PERMIT P/C I o ADDRESS �� ✓ '�� '�� << DATE � Cf/ !�.l� NUMBER 1�736 # � APN LOT TRACT ISSUE Z TYPE OCC p OWNER �/-//� � M��1G �„�t O DATE � Q CONST. GROUP o ADDRESS 152� D/Ri^o�vD /Gvo � (_,qNC ZONING SETBACKS gCITY L7[N"'""`�0 A-2 ZIP ��Tlr TEL. FRONT RW ❑ APPLICANT TEL. REAR � SIDE/SIDE STREEf RW ❑ � CONTRACT R Q �� ' SIDE ❑ � CITY E(/�� ZIP �� E�.yoy.�99-�6 eq PROPOSED USE LC-�� oARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS cr� � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AFFIRM UNDER PEN/�LTV OF PERIURV THAT 1 AM E%EMPT FROM THE CONTMCTORS LI- G8f990/CO�OfI 2 6 W CENSE UW FOR THE FOLLOWING REASON(SEC.70.71.5 BUSINESSAND PROGESSIONS CODE:ANV CITY OR (n U COUNTVWHICHREOUIRESAPEHMITTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIPANVSTAUC� w n � TURE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck _� STATEMEM THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHAPTER B(COMMENCINO WITM SECTION 7oD0)OF DIVISION 3 OF 7HE BUSINESS AND PR0. � POOVSpO 0 FESSIONSCODE)ORTHATHEOflSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEOEDE%EMP- (� U TION.ANVVIOLATIONOFSECTION7031.68YlWVAPPLICANTFORAPERMITSU&lECTSTHEAPPLICANTTO Z Re-Roof A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOlLARS(f500).): � ❑I,ASOWNEROFTHEPROPERTV,ORAIVEMPLOVEESWITHWAGESASTHEIqSOLECOMPENSATION, 0 COrt1rtIBfCiBI Z WILL 00 THE WOHI(,AND THE STRUCTURE IS NOT INTENDED OR OFFEFiED FOR SALE(SEC.704s,BUSI- J � � NESS AND PROFESSIONS CODE:THE CONTRACTOR9 LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV NhiO BUILDS OR IMPROVES THEREON,AND YA10 DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOYEES,PROVIOED THAT SUCH IMPROVEMENTS AFE NOT INTENDED OR m �, 0 OFFEREDFORSALEIF,HOWEVER711EBUILDINaORIMPROVEMENTIS50LDWIT}IINONEVEAROFCOMPLE- � Z TqN,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVIN�THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPEi7rV,AA/EXQUSIVELVCANTRACTINOWfTHLICENSEDCONTRACTOPS � TO CONSTRUCT THE PHOJECT(SEC.70H,BUSINESS AND PROFESSIONS CODE:THE COMRACTORS LI� V81U8IiOf1 ADJ.AREA W CENSEIAWDOESNOTAPPLYTO/�NOWNEROFAPROPERTVWFIOBUILDSORIMPROVESTHEREON,AND � WFqCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOH(5)LICENSEDPURSUANTTOTHECANTMC� QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM E%EMPT UNDER SEC. B.6 P.C.FOR THIS REASON � � DA7E OWNER �� Z � LICENSED CONTRACTORS DECLARATION H � I HEREBV AFFIRM UNDER PENPLTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �j 'p�_` �C n � B(COMMENCIN(iWITH5ECT10N7000)OFDIVISION30FTHEBUSWESSANDPROFESSIOtJSCADE,AND L W V !� • X MY LICENSE IS IN FULL FORCE AND EFFECT. o C'-Z.o �7397G TJ �4G t$ �.o� � LICENSE CLASS LIC.NO. p . �y V DATE �-�-V 2 CONTRACTOR_U�-�'�'e GS � O r� �� $ �D � WORKERS'COMPENSATION DECLARATION Q t �O O � C_ . �' '��rJ .!�D � U �N I HEREBV AFFlRM UNDER PENALTV OF PERIURV ONE OFTHE FOLLOWING DECLARATIONS: Z �A •. •�� Q FTL � CAMPENSATION,ASPROVID DEBYSECTION�OOOFTMELABOR ICODE.FOHTHEPERFORMANCE U � � �l/ �9'U • (,� OFTHE WORN FOfl WHICH THIS PERMIT IS ISSUED. W � � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION WSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LA80R CODE,f-0R THE PERFORMMICE OF THE WORN FOR NM111CH THIS PEpMR IS ISSUEO.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBEHAAE: CONSTRUCTION � CARRIER PLAN REVIEW 0 POIICV NUMBER ELECTRIC � (iHISSECf10NNE�NO7BEOq.1PLEfmOFThEPERMTISFORONEMII�DREDpq.WLSK100)OR�ESS� PLUMBING I .�� (' 'S�� w . �. Z I CERTIFV THAT IN iHE PERFORMANCE OF THE WOR1C FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL I , �� CJ SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECAME SU&IECT TO TME /� � WORKERS'COMPENSATIONLAWSOFCAUFORNIA,ANDAGREETHATIFISHWLDBECAME INSPECTIONFEE I 11 7 I = SU&IECT TO THE WORKERS'COMPENSATpN PROVISIONS OF SECTION 37ao OF THE LABOR �� L I CODE,ISHALLFORTHWITHCOMPLVWITHTHOSEPROVISIONS. ISSUANCE I 0 ) p DATE: �7'G�_V Z APPLICANT: �� t- �� SMIP ��I1'. I —w-� ENERGYP/C �'"'�'�-'--�-------__ � J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION CqVERAGE IS UNLAWFUL,AND SHALLBE �y SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCNILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT � DOLLARS(S1oo.o00),IN ADDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN J SECTbN 3�oB OF THE LABOH CODE.INTEREST,AND ATTORNEV'S FEES. ¢ RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: Q I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING A�ENCY � FOR THE PERFORMANCE OF THE WORK FOR WHICN THIS PERMIT IS ISSUED(SEC.70G�,CIV.C.�. Z W � LENDER'S NAME F'- LENDER'SADDRESS , w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE iHAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES �"�.�0 Z �/� d I AGREE TO COMPLV WITH AlL qTY AND CAUNTY ORDINANCES AND STATE LAWS RELATMG TO BUIL�ING 1 v � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTV fOR INSPECTION PURPOSES. COMMENTS � � -�-�� gc..a�e �-F tJ�sf QPERMITTEE NAM (PRINT) ' �, �� - l,J�..,E— 3-�-�z � � SIGNATUREOFPERMITTEE DATE /, = RECPT.NO. PAID BYV VALIDATION ~ WHITE—De artment Co YELLOW--Finance Co PINK—Assessor Co GOLOENROD—File Co GREEN— IicanYs Co P PY. PY, PY, PY, APP PY �La��lf �� 116-U��d'iti� �bSl� l � . DE�Ia�'91f"`�l�.o tl §�Itl ��o�U"7Y� t � � D�,t�:s� e � o a �[�-�o�f`i�] ,DD G'Q5�. n ° � ,U� ' , SET BACK . FLOOR JQIST � FTGS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CUMQUIT SLAB GRAQE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. B�ND BEAM ROOF SHEATHING 8 FT. E3Q�D BEAM ' FRAMING/VENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING ' ROUGH HEATING BEt�CHlNG ROUGH ELECTRIC • ROUGH GRADING ROUGH PLUfVIBING FINISH GRADING SHOWER/TUB TEST i POOL ELECTRIC EXT. LATH/SIDWG POOL FENCING � WALL INSULATiOPI POC?L FINAL CEILING INBULATION � OFF SITE IMPS. � � DRYWALL NAILIh1G DEDICATIONS • SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON S17E IMPS. �� GAS AIR TEST FINAL Z�NING FINAL C(�NST.. ' , F�RE JEPT. FINA� FINAL NEATIRIG HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY C�G�I O� o � o CONiMIE�TS SEPTIC TANK SIZE SEEP PIT/U SIZE � , . � � � . . _ �� `` CITY OF DIAMOND BAR �-� DEPARTMENT OF COMM[JNITY 8c DEVELOPMENT SERVICES �� w 21660 E.Copley Drive Suite 190 r , (909)860-3195 Fax(909)861-3117 PRE$S �^�'� BUII.DING PERMTI'APPLICATION .. FIRMLY o� JOBSITE � (� rf� ��//, /�� DATE CATION l 5 � NUMBER ��/� #/C ADDFiESS 7 � . /�ni;�_ � ISSUE TYPE OCC APN LOT �Z+ TR T DATE CONST. GROUP � OWNER �` ADDRESS - - ZONING SETBACKS � w CITY P �i'l'y TEL�Z�o �/L 7Z FRONT RW ❑ � APPUCANT r��s TEL. SIDE/SIDE STREET RW O � CONTRACTOR SIDE ❑ p� ADDR S / !> p e PROPOSED USE o CITY ZIP �/ /f9 TE / �u ARCWENG/ • � DESIGNEFi NO.DWEL. NO. NO. ADDHESS UNITS STORIES BEDROOMS � � CITY ZIP TEL. N v� DESCRIPTION SQ.FT: FACTOR PSF ADJ.AREANALUATION . Q OWNER-BUILDER DECLARATION SFR/Ap0/REM ' O � I HEREBY AFFIfM UNDER PENALT'OF PERJUFiV THAT I MI E%EMPT FHOM THE COPITRACTORS LI� GHfBQB/CBfPOR CENSEUWFORTHEFOLLOWINORFASON(SEC.7071.6BUSPIESSANDPROFESSION9CODE:ANVCfTYOR (n COUMVNMICMREOUIRESAPERAIRTOCONSTAUCT,ALTEqIMPROVE,DEMOLISH.ORREPAIRANY57AUG W Pef10/DBdc NRE,PRqR TO 1T9 133UANCE,ALSO REWUiES THE APPLICANT FOR SUpi PERMIT TO FlLE A S10NED w BTATEMENT THAT HE OR SHE IS LICENSED WRSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� C CENSE UW(CHAPTER 0(COMMENCMO WI7N SECTION 70D0)OF DrvI510N a OF THE BUSINE55 AND PRO- LL POOUSpO }� FESSIONSCOO�OR7HATHEORSHEISEXEMPT7HEREFROMMlDTHEOASISFOR7HEALLEOEDEXEMP- C7 �.� TION.ANYVqLATqNOFSECT10N7031.6BYANYAPPLICMlTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � A CML PENAL7Y OF NOT MORE h1M!FIVE HUNDRED DOLURS(i600).): � ❑I,/�40NRlEHOFTHEPHOPERTV.ORMYEMP�OVEESWITHWAOESASTHEIR$OLECOMPENSA710N, � �mmercial � - � WILL DO 7HE WORK MID TiE STRUCTURE IS NOT IHTENDED OR OFFERED FOR SALE(SEC.7ou,BUSI- J N NE95 AHD PROFESSIONS COOE hIE COHTRACTORS LICENSE Uw DOES NOT A7PLv TO AN OWNER OF � � � PfqPEHTY WVIO BUqDS OR IAI7ROVES THEREON,/WD WHO DOES SUpI WORK HIMSELF OR HERSELF OR � - ' � TWqU4H NIS OR HER ONT!EAIPLOYEE3,PROVIDED T/IA7 SUpi W PROVEMENTS ARE NOT INTEN�ED ON m OFFERm FOR SALE IF,HOWEVER 7ME BULOPI(i OR W PFOVEMBfT IS SOLD WfTHW ONE YEAR OF COM7LE Z �•710N,THE OWNER-BUILDER WILL HAVE 7HE BURDEN OF PROVINO 7HAT HE OR SHE DID NO7 BUILD OR � WPROVE FOR 7HE PURPOSE OF SALE). � OI,A90MMEROF7HEPROPERTV,AMIXCLUSIVELYCONTRACTINONATHLICENSEDCONTRAC70R5 . TO CONSTHUC7 THE PRO.IEC7(SEC.70N,BUSINESS AND PROFESSIONS CODE THE COHTMCTORS U- V811101I0I1 ADJ.AREA CEH9E lAW DOES NOTAPPIV TOAN OWNER OFA PROPERTY NM110 BUILDS OR IMPROVES THERC-0N,AND � N11000HTRACf9FORSUd1PROJECTSWIhIACOHTR�CTOR(5)LICENSEDPURSUNfTTOTHECONT{UG pUANTITY DESCRIPTION� - �FEE . T00.S LICENSE UW.). � ❑I AM EXEAIPT UNDER SEC. B.6 P.C.FOR THIS REASON J 8 Q 3 � o � vu DATE ON7JER � Av �2 J , . � LICENSED CONTRACTORS DECLAAATION W `-z ��S- . ' � 1 NEREBY AFFlRM UNDER PENALTY OF 7ERIURY THAT I AM LICENSED UNDER PROVISIONS OF CNAP7ER Z � ` � i � Y(COMMENCWO WITH SEC710N 7000)OF DMSION J OF THE BUSINESS AND PROFESSIONS CODE,AND MY LICENSE IS W OqCE AND EFFECT. m � � 1 � uc�se cuss 1� uc.No. la 77 � -�'� � J DATE CONTRACTOR d / .s _ 1 � WORKERS'COMPENSATION DECIARATION � � � Ki � I HEREBV AFFIRM UNDER PEIULTV OF PE0.AJRV ONE oF THE FOLLOWIN6 DECLAAATIONS: Z , 1 � ��( l' K.. � _1 HAVE ANO Wlll MAMTNN A CEHTIFlCATE OF CONSEM TO SELF-INSURE FOR VlORKERS' _ �-+�,�f� - - ��j. Q COMPENSATION.AS PROVmED BV SECTION 37ao OF TNE L/iBOR CODE,FOR THE PERFORMANCE `U ✓ l � OF THE WORK FOR NM1IKYi THIS PEH),IIT IS ISSUEO. � � � � � f _I HAVE AND WILL MAWTAVI WORKERS COMPENSATIDN INSURANCE,AS REWIRED BY SECTION � Q 37000F THE LABOR COOE,FOR THE PERFORIAANCE OF THE WORN FOR WHICH 7HI5 PERMIT IS � . ISSUED.MV WOfil�(ERJ�S'/COMPE1NSATION INSUFiANCE CAFRIER AND icv NurneEa aae: CONSTRUCTION � CARRIER—dT�/�}�'L�� /'!/Y� � PLANREVIEW \ Z ��R � �'��C�� ELECTRIC Q 0 (nassecipNr�Ho7sEao�i�ocnfaEw�rsroaor��oalu�s�Sim�OR�ssl PLUMBIN^G _ - Z I CERTIf'Y hIAT M THE PERFORMANCE OF hIE WORK FOR WIiICH h115 PEHA/1T IS ISSUED,I MECHANICAL (,� SHALL HOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECOME SU&IECT TO THE � NORKERS'COMPENSATION LAWS OF CALIFORNIA AND AOREE THAT IF I SHOUID BECOME INSPECTION FEE `�+�� .++ S SU&IECT TO THE MfORKEfiS'COMPENSA710N PHOVISIONS OF SECTION J7oa Of THE LJ�BOR e cooe,i swLL�wan+v�nni coMv�r vnn+nase vRoviswNs. ISSUANCE . �� 7 r. � ,_ � 1�� p DA7E: ��s d APRICANT�' ��y�� SMIP W � � WARNINO:FAILUHE TO SECURE WORKERS'COMPENSA710N COVERAOE IS UNLAWFUL,AND SH�LL BE ENERGY P/C h' n � LL SU&IECT AN EMPIOVER TO CRIAIINAL PENALTIES ANO CNIL FWES UP TO ONE HUNDRED TMOUSAND C r 1 C� V DOLUflS(i100,00D).M ADD1710N TO THE COST OF COMPENSATION,DAMAQES AS PROVIDED FOR IN ENERGY PERMIT��}+�� /� ^�7�n � SECTION J7a0 OF THE U1BOR CODE,INTEREST,AND ATfORNEY5 FEES. ' RETENTION FEE'1 .[ ` 'F 1 1I A�l /I V�/(�AR ' OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:BuTT�TT�f(; A T�TTI C A�'+FT� � I HEREBV AFFlRM UNDER PENALN OF PERIUHY THA77HERE IS A CONSTRUCTION LENDINO AGENCY ' � �� FOR THE PERFORMANCE OF hIE WORK FOR WHICH THIS PERMR IS ISSUED(SEC.30D7,qV.C.�. � , , Z W � LENDER'S NMIE �'r' ' ' � LENDER'SADORESS � TOTALFEES ' � I CERTIFY 7HAT I HAVE RF1D THIS MPLICATION AND STATE TTMT THE ABOVE WFORMATqN IS CORRECT. ' � w I A6REE TO COMPLV YJITH ALL CfTY AND COUNTV ORDINANCES MID STATE UWS REUTINO TO BUILDINO d � CONSTRUCTION,M1D HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE ' ' ' Z PBOVEMENTIONFA PROPER7V f-0R INSPECTION PURPOSES. COMMENTS ' ' _ ,l✓�,�z,�s� ,�.��vD,� m PERMI (PRIHn . . , � � - / ,^c�.�-� �7- /d^ O� , y H3S NATUREOFPEgpn 7TEE DATE � / RECPT.NO. PAID BY VALIDATION ' WHITE--0epertmenl Copy.YELLOW�inence Copy.PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—ApplicanYs Copy , �BYY OF C)��4il�0(�ID B�►ff�i ` • � � `'� I�SPECYICD� F;ECOR� � �. .. D C _ n e a� '.. � . � � ... ". '�. T • t .�.....� ,bS. � � �rc. � - d at- ' � � � d t p��' o � ` . � SET BACK ' ' � FLOOR JOIST FTGS/FORMSISYEEL - FHA REG�MTS ' ' � � ELECTRIC GROUNd UNDER FLOOR DUCT . GROUND PWMBING UNDER FLOOR CU�IDUIT • - ' SLAB GRApE FIREPLP.,CE FOUNDATION' � �. � TEMP P01NER I FIREPLACE BOND BEAM WATER SERVICE MIQ HT. BOND BE/,M - ROOF SHEATHING � 8 FT. BOND BEAM FRAMINGlVENTILIATIQN ' , �`-c31 FIN.AL BOND BEAM ROOF COVER — PRE-GRADING ROUGH HEATING �'�( r NCNING � ROUGN ELECTRIC � -U1 ROUGH GRADING ROU.GH�PLU1vIBING ,3- �' FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT. LATHlSIDIiVG ' POOL FENCING i� WALL INSULATI�N � POOL FINAL CEILING INSULATION �� ` QFF SITE IMPS. pRYWAIL NAILING . j'•!'3 -v DEDICATIONS SEVVER � FINAL ENG. + SEPTfC TANK LAPJDSCAPE/IRRIG. SEEP PIT/4.L.. ON SITE IMPS. GAS AIR TES`f Z_� . FINAL ZONING - FINAL CONST. . • FlRE DEPT. FINAL �INAL HERTING . ' s HEALTH DEPT. FINAL FINAL ELECTRIC �� Z • DEV. FEES PAID FINAL PLUtdIBiNG • - • - � ENERGY �� . , , , , � �. . . --- - - -- _ _ . . _ � � • � ,'_, . . ---_ Ct�t�/lNIENTS . � 2 + . .� ��al �• f�'u'2 � � a � _2 � r^ . � mC _R--� d�- �,�a� �� . ' �� 1� � a� ,-.y'� ��__5-�� `7� � bL-�"F..�'\ SEPTIC TP�NK SIZE SEEP.PIT/U SIZE � �� . ,,� •;��-�;, �,��. . �, r��,� r .. � �i � � ' �M�a�:. �k R!��x�� . � > �� }y�� P i �<�� '�Fi.'�"£�� C��..y�� . '° ��,,�� " ' � �� ,- �.� ��,��'�s��ka*`��f�z q,,��'�'�`'t� ��.i,G .yfl- d ,;&,� 7 �-ti:`� sx, `l� .. �p'�fi�''�t.��S'k°t?.�'�,b�� `�di.�6+2 . . i}�, j t V�,. . � ,,.. . � ��r�r � L� �'� iA�� . . I . . � ' . �..