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Home My WebLink About11-580 CITY OF DIAMOND BAR � �---��`— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES I �:c 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS , '��' BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE APPLICATI N PERMIT :'P/C ADDRESS � DATE � NUMBER � ��# � ISSUE TYPE OCC .- APN LOT TR CT DATE CONST. ROUP p OWNER � ZONING SETBACKS o ADDRES� Z CITY ZIP TEL. FRONT qyy ❑ � APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ ' z a CONTRACTOR SIDE ❑ o CI7Y S IP TEL. , PROPOSED USE �Cl�v r��/ w ARCH/ENG/ � z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� Gdfd9B/C8f(10fI W CENSEUWFORTHEFOLLOWINGREASON(SEC.7o31.5BUSINESSANDPROFESSIONSCODE:ANVCITVOR (n U COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORFEPAIRANYSTRUC- w TURE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOF SUCH PERMIT TO FILE A SIGNED w Patio/Deck STATEMENT THAT HE OR SHE IS IICENSED PURSUAN7 TO THE PROVISIONS OF TNE CON7RAC70P5 LI- � CENSE UW(CHAPTER e(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB � FESSIONS CADE)OP THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALIEGED E7CEMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BYANY APPLICANT fOR A PERMIT SUBJECTS THE APPLICANT T0 Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(5500).�� ZOI,ASOWNEROFTHEPROPERTV,ORMVEMPIOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COmrtIBlClel . WIIL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFEFEO FOR SALE(SEC.70/1,BUSI- J � NESS AND PROFESSIONS CADE:THE CANTRAC70RS IICENSE LAW DOES NOT APPLV 70 AN OWNER OF � PROPER7V WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDEO OR m Q OFFEREDFORSALE.IF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWI7HINONEVEAROFCAMPLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING 7HAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W OI,ASOWNEROFTHEPROPERTV,AME%CLUSIVELVCON7RAC7WGWI7HLICENSEDCONTRACTORS � TO CANSTRUCT THE PROJECT(SEC.7014,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V8111flf1Of1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOANONTJEROFAPROPERTVWHOBUILDSOfiIMPROVES7HEREON,AND � NMOCANTRACTSFORSUCHPfiOJECTSWITHACANTRAC70R(5)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE � Y TORS LICENSE LAW.). � O I AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON Q � U � ¢ DATE OWNER � Z W � LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDEF PROVISIONS OG CHAPTER � _ , d 8(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE Bl1SINESS AND PROFESSIONS CODE,AND Z X AIY UCENSE IS IN FULL FORCE AND EFFECT. lLl / � � LICENSE CLASS� I�_ LIC.N0. � . � J V DATE CONTRACTOR �� a W � WORKERS'COMPENSATION DECLARATION Q � I HEfiEBV AFFIRM UNDER PENALTV OF PERIURY ONE OFTHE FOLLOWING DECURATIONS: Z � I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a Z Q COMPENSATION,AS PROVIDED BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE W Q OF THE WORN FOF WHICH THIS PERMIT IS ISSUED. � w y I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS RE�UIRED BV SECTION Q 3700 OF THE LABOR CODE,PoF THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV W RKERS'COMPENSATION INSURANCE CARRIER AND GOLICY NUMBER AR: CONSTRUCTION Q � CARRIER � PLAN REVIEW Z POIICV NUMBER ELECTRIC ¢ �J/�� (IFiISSECiqNNEmNOTBECOMREfEDOFTHEPERMfTISFORCNEHUI�DPEDDOLLMS(5100)ORLESS) PLUMBING Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.1 MECHANICAL (3 SHALLNOTEMPLOVANVPERSONINANVMANNER50ASTO8ECOMESUBJEC7707HE Uj WORKERS'COMPENSATION LAWS OF CALIF NIA,AND AGREE THAT IF SHOULD BECOME INSPECT�ON FEE = SUBJECTTOTHEWORKERS'COMPENSATI ROVISIONS ECTI 37o00FTHELABOR �� %�,{ CADE,I ALL F RTHWITH COMPLV WIT T SE PROVIS NS ISSUANCE P-�1 � � p DATE: J ��'� � APPUCANT: SMIP J WARNING FAILURE TO SECURE WORNER COMPENS ON COVERAGE IS UNIAWFUL,AND SHALL BE ENERGY P/C � SUBJECTAN EMPLOYER TO CRIMINAL PE ALTIES AN IVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT � DOLLARS(3100,000),IN ADDITION TO TH COST OF C MPENSATION,�AMAGES AS PROVIOED FOR IN /� � SECTION 3708 OF THE LABOR CODE,INT si,nNo nrroaNErs FEEs. RETENTION FEE: .��V O � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � 1 HEREBV AFFIRM UNDEF PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY ' FOR THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). . Z W � LENDER'S NAME H LENDER'SADDRE55 � TOTAL FEES J�p/, /� � I CER7IFY 7HAT I HAVE READ 7HIS APPLICA710N AND STATE THAT THE ABOVE INFORMA710N IS CAFREC7. W I AGREE TO CqMPLV WITH ALL GTV AND COUNTY ORDINANCES AND STATE LAWS REIATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHOflIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � ZABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. Q COMMENTS J � m PERMITTEE NAME(PRINT) ' Q � � SIGNA7UREOFPERMITTEE DATE = RECPT.NO. PAID BY' VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy . C9�V O� D9A�dC�f�� 8�+�$ 9�SI�IEC�'DOY� I��COC�� , ; . . . �, .:, .,_.. _:� � �sr;�aa�p�c�400a oa�� °: oa��c�4oa �. oa��o��- -�� "� aa�� a SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT • � GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING � FINISH GRADING SHOWER/TUB 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 SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL _ FINALHEATING __ _____ __ HEALTH DEPT_FINAL___ ___ _ __ FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING L7�/,�, ENERGY � C�� ' COMMEfVTS ~ SEPTIC TANK SIZE SEEP PIT/U SIZE a � � �y ; -�..µ �