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Home My WebLink About16768 ^ �� _ C1TY OF DIAMOND BAR DEPARTMENT OF COIvA�UNITY&DEVELOPMENT SERVICES �,�� 21825 E.Copley Drive '� (909)860-3195 Fax(909)861-3117 �� PRESS ��%A��.w BUILDING PERMIT APPLICATION X O �� FIRMLY I � JOBSITE �J ¢ ADDRESS Z3.��,L •�}''4 b �ZD APPLICATION � � O� PERMIT O� n', f n C o DATE NUMBER_�W 1 lL� � ISSUE 1"� � D f TYPE � OCC APN LOT—�- TRACT DATE � CONST. GROUP p OWNER �� iI/N eT� p ADDRESS � D ZONING SETBACKS z CITY (ldbl�t�b �_ ZIP�cz� TEL. l J� FRONT ` Ryy p � APPLICANT TEL. REAR p �� SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE p o ADDRESS PROPOSED USE �P� �� GO�{ (��/.�'�i� 1�0�' �/� CITY ZIP TEL. � /' w ARCH/ENG/ �—� �7n� �s �h 3r ��b z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION � p� OWNER-BUILDER DECLARATION p SFR/ADD/REM � I HEHEBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM EXEMPT FqOM THE CANTRACTORS U� Gef9 0/Cfl ft W CENSEUWFORTHEFOILOWWOREA50N(SEC.7031.SBUSINESSANDPflOFES510NSCODE:ANYCITYOR (n 9 � C� CWNTVWHICHREWIflESAPERMITTOCONSTRUCT,ALTER,IMPROVE.OEMOLISH,ORREPAIRMIVSTRUC� w Z TURE,PRqR 70 RS ISSUMICE,AL50 RC-0UIRES THE APPLICANT FOH SUCFI PERA11770 FILE A SIGNED w P8ti0/DBCk w STATEMENT THAT HE OR SHE IS LICENSED WRSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� Q� CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION�OF THE BUSINESS AND PRO� � PooUSpa FESSIONS COD�OR THAT HE OR SHE IS E%EMPT THEREFqOM AND THE BASIS FOR THE ALLEGED EXEMP- (� U TION.ANV VIOLATION OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO Z Re-Roof A GVIL PENALTV OF NOT AbRE THAN ffVE HUNDRED DOLURS(f5a0�.): � ❑4��WNEROFTHEPROPERTV,ORMVEMPLOVEESWI7HWAQESASTHEIRSOLECOMPENSATqN, � CORIrtIBfdel Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oad,BU51- J J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPERN NMO BUILDS OR IMPROVES THEHEON.AND M?10 DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGHHISORHEROWNEMPIOYEES,PROVIDEDTHATSUCHIMPROVEMENTSAAENOTINTENDEDOR m Q OFFEREDFORSPLEIF,FIOWEVER,THEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TKKJ,THE OWNERAUILDER WILL HAVE THE BURDEN OF PROVINQ 7}IAT HE OR SHE DID NOT BUILD OR � UA7ROVE FOR THE PURPOSE OF SALE). � w ❑I,AS OWNER OF THE PROPERTV,AM EXCLUSNELV COMRACTING WITH UCENSED CONTRACTORS � TO CANSTRUCT h1E PRQIECT(SEC.7oN,BUSINESS AND PROFESSIONS CODE:iHE CONTRACTOPS LI� Ijp� ADJ.AREA W CENSE UW DOES NOTAPPLY TOAN ONRJER OFA PROPERTV WFIO BUILDS OR IMPROVES THEREON,AND � WFIOCANTRACTSFORSUCH7R0.1ECTSWITHACONTRACTOR�S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION Y TORSLICENSELAWJ. FEE � O I AM EXEMPT UNDEq SEC. B.8 P.C.FOR THIS REASON Q ' � U � E O R 1— Z / U � � LICENSED CONTRACT RS DECLAR TION W � I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTEfl � � e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CADE,AND Z ��x MY LICENSE IS IN NLL FORCE AND EFFECL m � LICENSE CLASS LIC.NO. � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q N I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLAMTIONS; � � Z O _IHAVEANOWILLMAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' _ Q CAMPENSATION,AS PROVIDED BV SECTION 7700 OF THE LABOR CODE.FOH THE PERFOqMANCE U OF TME WOR)(FOR NM111CH THIS PERMIT IS ISSUED. W Q � QW _I HAVEAND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS RC-0UIRED BV SECTION 37000FTHELABORCODE,FORTHEPERFORMANCEOFTHEWORNFORWHICHTHISPEiiM1T15 �0 DU ISSUED.MY WORKERS'CAMPENSATION INSURANCE CARRIER M!D POLICV NUMBER AAE: CONSTRUCTION � J � GRRIER PLAN REVIEW Z roucvNUMeEa ELECTRIC ¢ � (f}pssEcrqMN�No7eECONPlE7IDofnEpEw.Ti1SFOqprEM11�DRE�ppqlqqg(ttm)pqLESS�, PLUMBING W Z I CERTIFV hIAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C.�3 SHAIL NOT EMPLOV ANV PERSON IN ANY MANNER 50 AS TO BECAME SU&IECT TO THE N WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE S SU&IECT TO THE WORKERS'COMPENSATbN PROVISIONS OF SECTION 370o OF THE LABOR CODE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � p DATE: APPLICANT: SMIP W � • J WARNIN�:FAILURE TO SECURE WORKERS'CqMPENSATION COVERAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C J LL SUBJECTANEMPLOVERTOCRIMINFLPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(f700.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN ¢ SECTION 3708 OFTHE LABOR CODE,MTEREST,ANDATTORNEI"S FEES. RETENTION FEE: • OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDINO AGENCV FORTHE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3081,CIV.C.). Z w � LENDER'S NAME F— LENDER'SADDRESS � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES �(/ ` �� w I AGREE TO COMPLV WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELA71N0 TO BUILDING �•� � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � ABOVE-MENTIONED PROPERTV FOR INSPECTION PURP0.SE5. Z COMMENTS � 6 •4v ,.v° L�� m PERMITTEE NAME(P - . Q � � � SI R F PERMI E AT � RECPT.NO. PAID BY VALIDATION � WHITE—DepaAment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy / � t��fJ'�f �f� �O��l�G�9� (ffiQL� �Ir��L�(�(��T0��1 f�l��(�i� 0� U o Do G'Q`� O�G� o � �f� U o Dfl Q 1�'C� 1� U o ' ` 5ET BACK FLOOR JOIST FTGS/FORMS/S7EE� � � FNA REC2MTS � ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBWG UNQER FLOOR CU�IDUlT SLAB GRADE FIREPLACE FOUNQATION � TEMP POWER FIREPLACE BON� BEAM W,4TER SERVICE MID HT. 80ND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILIATfON F►NAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUiVIBING FINISH GRAQING SHOWEt�ffU6 TEST POOL ELECTRIC EXT. LATH/SIDWG POOL FENCING WALL INSULATIOPI � POOL FINAL CEILING IfVSULATIOiV OFF SITE IMPS. DRYWALL NAIUNG DEDICATIONS SEWER FINAL ENG. SEPTIC TAIVK LANDSCAPE/1RRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. F)RE DEPT. FWAL FINAL HEATING HEALTH DEPT. FINAL F1NAL ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY �� C�O� o co. CUf�liViERITS _., . ,..,. :-. _ SEPTIC TAIVK 51ZE . SEEP PIT/U SIZE � Vll [s � .