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Home My WebLink About15140 (29)r v w p� S U) rn w Q Opp (zW� W �4 G N 5Q O Z W Q SW 1-- LL W O 1— U E0 en ZO Q 0 G O Z7 Q W Z E,7 U3 S O J W O Zd W M W 93- F F 0 CO, `Q Cn en CITY OF DIAMONI] R DEPARTMENT OF OMMUN Y 8: DEVELOPMENT SERVICE 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 PRESS BUILDING PERMIT APPLICATION �� FIRMLY JOBSITE ADDRESS APN L _ ACT OWNER . D L ADDIS SS 'It 'yj CITY ZIP TEL 1 APPLICANT D TEL. CONTRACTOR ADDRESS CITY ZIP TEL ARCWENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT INA EXEMPT FROM THE CONTRACTORS U. DENSE LAW FOR THE FOLLOWING REASON (SEC- 7031 b BUSINESSAND PROFESSIONS CODE. ANY CITYOR COUNrYYMICHREOUIRES A PERMTTTOCONSTFUCT,ALTER IMPROVE, OEMOLISH,OR REPAIR ANY STRUC- TURE. PWOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS U. DENSE LAW (CHAPTER 0 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRC- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEUP- TION. A1JY VKXJLTKW OF SECTION 7031.5 BYANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HLJNDR ED DOLLARS iss00) ): O L AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WALL DO THE WORK. MID THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI. ND NESS APROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY INIHO BULDS 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 ff.THE -HOWEVERBLMDINO OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OFCOMPLE. TION, THE OWNER4"LOER WALL HAVE THE BURDEN OF PROVNO THAT HE OR SHE DID NOT BUILD OR I.IPROVE FOR THE PURPOSE OF SALE). O L AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70M, BUSINESS AND PROFESSIONS CODE, THE CONTRACTORS LI- CENSE LAW DOES NOTAPPLYTOAN OWNER OF APROPERTYYHO BUILDS OR IMPROVES THEREON, AND VOID CONTRACTS FOR SUCH PROJECTS WITHA CONTRACTORS) LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW). O 1 AM EXEMPT UNDER SEC. B. a PC. FOR THIS PEASON DATE :.� OWNER ) � LICENSED CONTRACTORS DECLARATION I HEREBYAFFIRM LNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER 0 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AA'D PRDFESSKONS CODE, AND MY LICENSE IS N FULL FORCE AND EFFECT. LICENSE CLASS LIC. NO. DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJU7Y ONE OF THE FOLLOWING OECLARATKMIS. _I HAVE AND WALL MAINTAJN A CERTIFICATE OF CONSENT TO SELF-INsURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR COVE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. _'HAVE AND WALL MAINTAIN WORKERS COMPENSATION INSURANCE, AS REQUIRED BY SECTKXJ 3100 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER ' POLICY NUMBER um sEC11CN NEED NOT BE COAfLETiD OFnE PEPo.R is FOR ONE HLIN7Rm oaiAR5 (1+00)OR LESS) 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 SHALL NOT EMPLOY ANY PERSON IN ANY 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 PROVISIONS OF SECTION 3700 OF THE LABOR CODE I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE APPLICANT. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (0100.000), N ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 7705 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CN C.). LENDERS NAME LENOERSADDRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CRY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BULDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-ME�(N'TT04EED PROPERTY FOR INSPECTKJN PURRR\POS ES. • i..,,.A le,5 YI 0 , PERMITT E(PRI \ / w - SIGNATU MOFPERTTEE gAFE PPLICATIONOU PERMIT f q D P/C DATE NUMBE l g ISSUE („ 00 TYPE OCC DATE �u �J CONST. GROUP ZONING SETBACKS FRONT RW 0 REAR 0 SIDEISIDE STREET RW O L-1 SIDE p PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFR/ADDIREM Garage/Carport WPatio/Deck LI- POOVSpa 0 Z Re -Roof Commercial m Valuation V ADJ.AREA QUANTITY D SCRIPTION FEE _J Q U, FL- U W UJ L7 � m t J d U Z Q S ' W .2 CONSTRUCTION ' PIAN REVIEW T ELECTRIC _ PLUMBING MECHANICAL INSPECTION FEE ISSUANCE • i SMIP ENERGY P/C 1 j_,, ENERGY PERMIT �� 9 i/ I W1 RETENTION FEE: PRE -ALT FEE: 1.1 V1NL JI IL, -� LJ I _1 1 t v,3 I-,.: LJ 0, ,1-- 1 1 TOTAL FEES 4 C COMMENTS v"� RECPT. NO. PAID BY VALIDATION WHITE --Department Copy. YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN—Applicant's Copy CITY OF DIAMOND BAR -COr INISPECTIONT RE --D SET BACK, FL"O-OR JOIST FTGS,'FOR%lSJGT EEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND Fl- U,"BIND j SLAD GRADE j UNCER FLOOR CODNDUIT FIREPLACE FOUNDATION /1¢__ �b I TEMP POWER FIREPLACE BOND fja \VATER SERVICE rvl;D HT. BOND BEANI ROOF SHEATHING 8 FT, BOND BEAM FRAt,li,'-�Gr'VENTILI,I\TlOrI I FINAL BOND BEAM' ROOF COVI-:R PRE -GRADING R' DUSH H E AT 1 N'—:i BENCH114G ROUGH ELECTRIC ROUGH GRADING FINISH GRADING 7P SHOWEH.rftUB TEST POOL ELECTRIC EXT. LATHI/SIDINIG POOL FENCING. YVALL INSULATIOI,., POOL FINAL CEILING INSULATION OFF SITE UPS. DRYWALL NAILI'JG DEDICATIONS -- SEWE, i FINAL ENG. SEPTIC TA N", LANDSCAPE/I RR I G. STEP PiTIL-L. 20� ON SITE RAPS. GAS AIR TEST—F7 FINf,L ZONING FIRE DEPT FINtL FINN CONST, T, IN HEALTH DEPT. FINAL F'tJ,^.L ELECTRIC DEV, FEES P,-`dD EI,iEnm' _--. �� I � ___.—.—___—_�__–_ i - 1. �` _ i .1: -_ - -.--- — _ 001,AIMENTS o oo SEPTIC TAN"-, SIZE SEEP PIT/Ul SIZE