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Home My WebLink About13287 (16)E ADDRESS a � ADDRESS APN_ LO OWNERjj i'1� ADDRESS CITY ZIP TEL. APPLICANT TEL.' CONTRACT ILI ADDRESS �(j1llfit F, ARCH/EN! �`� ziftm. Lal. TEL.:3:)j_AT)3' DESIGNER _ ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FORTHE FOLLOWING REASON (SEC.7031.5 BUSINESSAND PROFESSIONS CODE:ANY CITY OR COUNTYWHICH REO'JIRESA PERMITTO CONSTRUCT. ALTER.IMPROVE. DEMOLISH. OR REPAIR ANY STRUC• RF. TUPRIOn TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TD FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER Y (COMMENCING WITH SECTION 7000) OF DIVISION 3 O THE BUSINESS AND PRO. FESSIONS CODE) OR THAT HE OR SHE 15 EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7071.5 BY ANY APPLICANT FOR A PEF.MI T SUBJECTS THE APPLICANT TO A CN:L PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS 1$5001.1: C L AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSAMN, WILL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7Da4, BUSI. NESS AND PROFESSIONS CODE: THE CONTiUCTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND VA 40 DOES SUCH YnRK HIMSELF CR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER, THE BUILDING OR IMPROVEMENT IS SOLD WITHINONE YEAR OF COUPLE. 710N, THE OWNER BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE On SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALEI. C LAS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEG 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS L$ CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AVD V040 CONTRACTS FOR SUCH PROJECTS W TH A CONTRACTOR(S)LICENSEO PURSUANTTO THE CONTRAC- TORS LICENSE LAW.). C 1 AM EXEMPT UNDER SEC. R. A 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 Y (COMMENCING WITH SECTION TOW) OF DIVISION S OF THE BUSINESS AND PPOFESS'ONS CODE, AND MY LICENSE IS IN' LL F CE AND EFFE LICENSE CLASS LIC. NO. DATE , CONTRACTOR- -1 WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF TIE FOLLOWING CECLARA7BONS � I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKER, COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PE RFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REWIRED BY SECTION D700 of THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS AI.CE ISSUED. MY WORKERS'COMPENSA* INSURCARRIER AND POLICY NUMBER ARE _ CARRIER 1 n(Lf_i,� POLICY NUMBER (MS SCCTCN NEEDNOT SE 0.ti pLETED OF TF[ PEURW ISFOR UNE HU`LRCD DOLL/!* 131001 ORLESS). I CERTIFY THAT W THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON W ANY MANNER SO AS 70 BECOME SUBJECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUB IECTTO THE WORKERS' COMPENSATION PROVISIONSOF SECTION 37000F THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL BE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP 70 ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LADOn 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. 3087, CIV. C.). LENDER'S NAME LENDERS ADDRESS 1 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 TIES COUNTY TO ENTER UPON THE ABOVE�M NTIONED PROPE TY FOR 5PEC1,1,0N.,PU.\RPOSES. 5 PErtmirlEE NAME(PRINT 51 NA•DALE i PRESS FIRMLY ION �� (�/ PERMIT /C /✓�1 CITY OF DIAMOND BAR COMMUNITY DEVELOPINIENT DEPARTMENT 21660 E. Copley Drive Suite 190 w ISSUE TYPE OCC (909) 860-3195 Fax (909) 861.3117 ZONING SETBACKS BUILDING PERMIT APPLICATION E ADDRESS a � ADDRESS APN_ LO OWNERjj i'1� ADDRESS CITY ZIP TEL. APPLICANT TEL.' CONTRACT ILI ADDRESS �(j1llfit F, ARCH/EN! �`� ziftm. Lal. TEL.:3:)j_AT)3' DESIGNER _ ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FORTHE FOLLOWING REASON (SEC.7031.5 BUSINESSAND PROFESSIONS CODE:ANY CITY OR COUNTYWHICH REO'JIRESA PERMITTO CONSTRUCT. ALTER.IMPROVE. DEMOLISH. OR REPAIR ANY STRUC• RF. TUPRIOn TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TD FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER Y (COMMENCING WITH SECTION 7000) OF DIVISION 3 O THE BUSINESS AND PRO. FESSIONS CODE) OR THAT HE OR SHE 15 EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7071.5 BY ANY APPLICANT FOR A PEF.MI T SUBJECTS THE APPLICANT TO A CN:L PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS 1$5001.1: C L AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSAMN, WILL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7Da4, BUSI. NESS AND PROFESSIONS CODE: THE CONTiUCTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND VA 40 DOES SUCH YnRK HIMSELF CR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER, THE BUILDING OR IMPROVEMENT IS SOLD WITHINONE YEAR OF COUPLE. 710N, THE OWNER BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE On SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALEI. C LAS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEG 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS L$ CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AVD V040 CONTRACTS FOR SUCH PROJECTS W TH A CONTRACTOR(S)LICENSEO PURSUANTTO THE CONTRAC- TORS LICENSE LAW.). C 1 AM EXEMPT UNDER SEC. R. A 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 Y (COMMENCING WITH SECTION TOW) OF DIVISION S OF THE BUSINESS AND PPOFESS'ONS CODE, AND MY LICENSE IS IN' LL F CE AND EFFE LICENSE CLASS LIC. NO. DATE , CONTRACTOR- -1 WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF TIE FOLLOWING CECLARA7BONS � I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKER, COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PE RFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REWIRED BY SECTION D700 of THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS AI.CE ISSUED. MY WORKERS'COMPENSA* INSURCARRIER AND POLICY NUMBER ARE _ CARRIER 1 n(Lf_i,� POLICY NUMBER (MS SCCTCN NEEDNOT SE 0.ti pLETED OF TF[ PEURW ISFOR UNE HU`LRCD DOLL/!* 131001 ORLESS). I CERTIFY THAT W THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON W ANY MANNER SO AS 70 BECOME SUBJECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUB IECTTO THE WORKERS' COMPENSATION PROVISIONSOF SECTION 37000F THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL BE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP 70 ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LADOn CODE, INTEREST, AND ATTORNEYS FEES. - - CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3087, CIV. C.). LENDER'S NAME LENDERS ADDRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF TIES COUNTY TO ENTER UPON THE ABOVE�M NTIONED PROPE TY FOR 5PEC1,1,0N.,PU.\RPOSES. 5 PErtmirlEE NAME(PRINT 51 NA•DALE i PRESS FIRMLY ION �� (�/ PERMIT /C /✓�1 DATE— NUMBER / � ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW 0 - REAR 0 SIDE/SIDE STREET RW p SIDE p ••,, ��I n PROPOSED US�� NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM CO Garage/Carport - WPatiODecR . LL PocVSpa 0 Z Re-RDcI C3 Commercial . m Valuation ADJ.AREA OUANTITY DESCRIPTION FEE Q U F- U w w Anzw =D a U Q 2 V W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMOINGt MECHANICAL INSPECTION FEE —{ �£±F2(1 ISSUAN`�1'm CE SMIP CITY OW III gt+(oNID DAR -`— ENERGY P/E;UILD"T T(, E'ID 5 AF h 'Y ENERGY PERMIT RETENTION FEE: - PRE -ALT FEE: 3 � S TOTAL FEES COMMENTS RECF I NO. PAID BY _ VALIDATION _ JM!I tE—Dep anment Copy, V ELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—Fila Copy, GREEN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD l-N$P%CTI0N DATE SET BACK INSPEOTOR INSPECTION 1 FLOOR JOIST,'. DATE FTGS/FORMS/STEEL FHA REOMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION . TEMP POWER sib FIREPLACE BOND BEAM WATER SERVICE ` MID HT. SOND,BEAM ' ROOF SHEATHING 8 IT BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING q 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 FINAL HEATING HEALTH DEPT. FINAL FINAL.ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY r. COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE i