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Home My WebLink About11-1575 ��_ CITY OF DIAMOND BAR C��r'��jD � DEPARTMENT OF CONIl�IUNITY&DEVELOPMENT SERVICES .. 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �'9"'. BUII.DING PERMIT APPLICATLON FIRMLY JOBSITE �� r � Q ADDRESS_ LD -�'�,� l l�) �✓L.� APPLICATION q 1 �/ �2� PERMIT /I�-/S�C"'p/C o DATE ��r NUMBER�� J � °r APN � LOT TRACT DA EE �I I I I "t �� CONST�"��.6qp p p OWNER /1/ L p ADD S�S�/ 7.v ZONING SEfBACKS Z CITY �1Oh� ZIP TEL90 ��p/ FRONT qyy p . � APPLICANT TEL. REAR p �� SIDE/SIDE STREET RW ❑ CONTHACTOR SIDE p o ADDRESS CITY • ZIP TEL PROPOSED USE_�X� ��,�/1r� t �� S �S oARCWENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � C�T, Z�P TEL UNITS STORIES BEDROOMS � � DESCAIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBV AFFlRM UNDER PEN�LTV OF PERAIPV 7HAT I MI E%EMPT FROM THE CONTRACTORS U- GOfHCJO/C8(pOff W CEIJSELAWFORiNEFOLLOWW6REASON(SEC.7m1.6BU5WE5SANDPROfESSION5CO0EANYClTYOq (� U CIXIMYMM1iK)1REOIJIRESAPERAOTTOCANSTqUCT.A�7ERWPROVE.�EMOUSH.ORREPAIRANY9TRUC W w TURE.PRIOR TO RS ISSUANCE,ALSO REOUIRES THE APPLICMtf FOR SUCH PERMR TO FlLE A SIQNED W PadO/Dedt � STATEMENT THAT NE OR SNE IS IICENSED PURSUANT TO THE�ROVISION$OF THE COHTMCTOR3 LL � CENSE UW(CHAPTER Y(COMMENpNG WITH SECTION 7000)OF DMSION 7 OF THE BUS WESS ANO PR6 V' POOVSpB � FESSIDNSCODE�ORTHATHEORSHEISEXEMPTTNEFlEFROMAND7HEB/915FORTHEALLE6EDE%EMV• (!� V 710N.AM'VIOLAT�tJ OF 5ECT10N 7W1.6 BV ANv AYttICMlT FOR A PERMIT SUBIECTS 7HE APPLICMI7 T0 Z Rg-ROOf A CIVIL VOJAL7Y OF NOT MORE TMAN FIVE MUNORED DOLLARS(1500).r � ❑4ASOWNEROFTHEPROPERTV.OHMVEMPLOVEESWfTH14AGESA4TNEIRSOLECOMPENSATION, � CpmmBfClal Z WILL 00 THE WORI(,ANO THE STqUCTURE L4 NOT INTFNDED OR OFFEAED FOR SALE(SEC.7aa,,BUSF J � � NE53 AND FROFESSIONS CODE THE CONTMCTORS LICFNSE�UW DOES NO7 AFPLY TO AN OWNER OF ? � PqOPEHTY W/i0 BUILDS OR IMPROVES iHEREON,AND WHO DOES SUCM WOqK H W SELF OR HERSELF OR w THROUGHWSORHEROWNEMVLOVEES,Pi10VIDEDTHATSUCHWPROVEAIENTSARENOTPlTENDEDOR m Q OFFERmFORSALEIF,MOWEVEqTHEBURDWOORW7ROVEMENTt55p�pWlJHINONEYEAROFCON7lE- z TION.THE OWNER-BUIIDER WILL HAVE THE BUROEN OF PROVINO T{AT HE OR SHE DID NOT 9UILD OR � IMPROVE FOR 7HE PURPQSE OF SALE�. uJ ❑4�40WNEH OFTHE PROPERTY,AM EXClUSNELY CONfRACTINo WRH LICENSED COIlTRACTOfiS [C TO CONSTRUCT 7}�E PRQIECT(SEC.70a�,BUSINE55 AND PROFESSlONS CODE:7HE CONTMCttIRS Ll- V81UdtI0l1 AQI.AREA W CENSE lAW DOES NOTAPRY TOAN ONMER OFA PROPER7Y HT10 BUILDS OR IMPROVES THEREON,ANp � MMDCONTAACTSFOHSUGiPRQIECfSWITHACOMRACTOR(S)LICENSE07URSUMlTTOTHECONTRAG pUANTiTY DESCRIP'fION ioas ucENse uw.>. FEE � � ❑I AA1 DfEMPT UNDER SEC. B.a P.C.FOH THIS REASON � . � U � o�rE owne � Z U O W � LICENSED CO CTORS DECIARATION -� � w I HEREBY AFFIRAI UMDER PENALTY OF VERIURY THAT I AM LICENSED UNDER PROVISION$OF CHAPTER � � Y(COMMENCWO WfTH SECTION 7000)OF DMSION]OF THE BUSINESS AND PROFESSIONS COOE,AND Z ', �� MY LICENSE IS w GUIL FORCE AND EFFECT. m � UCENSE CLASS LIC.NO. � . (,~j �� CONTRACTOR a. W � WORKERS'COMPENSATION DECLARATION Q � U � I HEREBYAFFIRM UNDER PENALN OF PERJURY ONE OF THE f-0IIOWWG DECWiAT10N5: z � _I MAVE AND WILL MIUNTAIN A CERTIFlCATE OF CqNSF�l17 TO SELF-WSURE FOR WDfiKERS' _ • Q CONFEMSATION,A,4 PROVIDED BY SECTIOH 3]OOOF TNE LABOR C00�Fpq 7HE pERFpqMANCE U OF THE WOH1(FOR WHldi THIS PERMIT IS ISSUED. W � � w _I HAVE AND WILL MNNTAIN WORKEAS'COM7EJISATION INSUqANCE,0.5 qE0U1RED BY SECTION ///ppp Q J7000F THE 1A60R CODE,FOR THE PERFORMMlCE Of 7ME WOW(FOR WMpi iWS PEfiNR IS �-{�, `� � LSSUED.MY WOPo(EAS'COMPQd5A7pN INSUHANCE CAAq1ER MID POLICY NUMBER ARE: CONSTRUCTION � �� jGRAIER PLAN FiEVIEW 0 POLICY NUMBER Zd ELECTRIC p (�s�cno�+r�IDraTe�oo�t�rIDo�n�v��awaa+Er��oavsulsimla+iFss1 PLUMBING w Z 1 CERTIFY THAT W TNE PEAFOHMANCE OF THE WOPoC FOR WHICN THLS PERAIIT IS ISSUEO,1 MECHANICAL � U' SHALL NOT EMPLOY MfY PERSON W ANY NMINER 50 AS 70 BECOME SU&tECT TO 7HE (,/) WORNERS'COMPENSATION LAWS OF GLIFOqNi/�M!D AGHEE THAT IF I SViOUID BECOME INSPECTION FEE � SUBJECTTO7HEWORKERS'COMPENSATK)NPROVISqN3OFSECTION�7a0OFTHELABOR " ,� �— � ,_ cooe.i sH�u wRr�mn�couv�v Hnn�n+osE vaov�sior+s. ISSUANCE � � i�—n,�— p DATE APPL�ICANi: �SMIP �, i� W . ._ J WARNWO:FAIWRETOSEWREWORKERS'CAMPENSATIONCOVEMGEISUNUWFUL,ANDSHAILBE ENERGYP/C � J � SUBJECT AN EMPLOVEH TO CRIMW�L PENALTIES ANO CM�FlNES UP TO ONE HUNDRED 7NOUSANO �EROY PERMIT DOLLAAS(f1a0,000�,W ADDITON TOTHE COST OF COMPENSATqN,DAMA(iE5 AS PROVIDED FOR IN J 6ECTpN 370!OF 7HE LABOR CODE,V7TEAEST,AND ATTORNEY'$FEES. � .(. � w . RETENTION FEE: r s�•-' � - O CONSTRUCTION LENDING AGENCY PRE-ALT FEE � I HER�Y AFFlAM UNDER PENALTY OF PERRIRY THAT THERE IS ACANSTRUCTION LENDWO AOQiCY Z FOR T71E PERFORM/WCE OF THE WORI(FOR WH1CH 7HI5 PERMIT IS ISSUED(SEG 3ov7,pY.G} W � LENDER'^NAME . F— LENDERSAODRESS � I CERTIFY THAT I HAVE READ THI9 APPLICATION AND STATE THAT 7HEABOVE PIFORAIATION IS CORAECT. TOTAL FEES g�['jr�� I AGREE TO COMPLY VATH ALL CfTV AND COUNTV ORDWANCES AND STATE UWS RELATINO TO BULLDlN(i � CONSTRUCTION,ANDHEFEBYAUf}IORIZEREPRESENTATIVESOF7HISCOUDfiY70EMERUPON7HE Z ABOVE-MENTpNED PROPER7Y FOR INSPECTKIH PURPOSES. COMMENTS � J. � m PERM�77EE NUAE lMY7T) � .Q UJ N SIONAiUREDFCERMff7EE � DATE � ,i RECPT.NO. PAID BY VALIDATION WHI7E-DepaAment Copy.YELLOW--Finance Copy.PINK—Assessor Copy.GOLDENROD--FJe Copy;GREF1�Applkant's Copy �@�'�l �3F G�I�E�'��3D �.d�F� , ��4��:�@��! ��C��C3 � .0 , . _ . �0�� L � �1 I - �� . .� x ."�,wa �L� . �a�� .y�. � r � �' � � - a _ i.�,c_t vi`i. _ ,�„�- .3"'�,,�_. '�' _ a �ETBACK . �-LUORJOIST , -------------�-------- ----_--- ---- — � -- ------- ------ ------ - — FTGS/FORivlS/STEFL I FHA REOfd�TS -- --- ----.._._---- —�-------�------------- ---- ---------- ----- - ---- — FL[C�RIC GROUPdQ � � UPdDER FLOOR OUCT GROUPJD PLUMBING � —� U�JDER FLOOR COhJDUIT SLAB GRADE � _ � FIREPLACE FOUP!GATIOPd ��EN1P POWER � FIREPLACE EOND BEAM WATER SERVICE lNID HT.BOND BEAM ROOF SHEATHi�lG 8 FT.B�ND BEAIvI FRAMIfJG/VENTILATIOld FIPIAL BOND BEANI ROOF COVER PRE-GRADINGY R�UGH HEATING � DENCHIPdG _ ROUGH ELECTRIC � _� ROUGH GRADING ROUGH PLUN1E31PJG I FINISH GRADING SHOWER/TUBTEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FIfVAL CEILING INSULAT{ON OFF SITE IMPS. QRY4VALI_NAILING ___ �_ � __ _ _ dEDICATI0N5__ _ _ SENlER FINAL ENG. SEPTICTANK LA.NDSCAPE/IRRIG. SEEP PIT/L.L. QN 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 FINAL PIANING FINAL EiVGINEERING J• � � � --- COMMENTS ----- ----------- ---- — — SEPTICTANKSIZE SEEP PIT/U SIZE --- -- "— �— I �� __ 1 CITY OF DIAMOND BAR UEPARTMENT OF CONI14UN11'l' S:DEVELOPI�IENT SERVICES � ��w 21825 Copley Dri�•e,Diamond Bar,CA'9176� � .� (909)839-7020 Fax(909)861-3117 Buitding Inspection Hotline(909)839-70� PRESS �'�`""', BUILDING PERNIIT APPLICATIOn �R, FIR�lILY � JOBSITE 2` `�O ��lQ�d/Nd� APPLICATION PERMITr�� P/C ¢ ADDRESS o DATE NUMBEA � � APN LOT TRACT DA EE CONST. / K.I((J'�,ROUP `�' I � p OWNER L .:I p ADDRESS Z 1G2� F i�.W/N d L.!-4 ZONING S ACKS FRONT z CITY [7ieFfn�rs�a� ZIP�l'7G S TEL.9 n'SG/179�j REAR RW � � APPLICANT TEL. ❑ QSIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE � � ADDRESS � C�TY ZIP TEL. PROPOSED USE � o ARCWENG/ z DESIGNER � ADDRESS UNITSWEL } STORIES L NO. � C�N ZIP TEL. BEDROOMS_�� `n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BUILDER DECLARATION O SFR/ADDlREM Q I MEREBY AFFIRM UNDER PENALTV O':7ERJURY THAT 1 AM E](EIAPT FqOIA THE CAVTRACTORS LI� Ga(8CJ8/C8fj10A W CENSELAWFORTHEFOIIOWINGREA50N SEC.70.7t.58U5WE55AN�PROFES510N5CODE:ANYCITVOR (J� � ZCOUNTYWHIqiREdU1RE5APEqMITTOCAYSiAUCT,ALTEA,UAPROVE.DEF10LI5H2ORRECAIpANV9TRUG W NRE,PRIOR TO ITS ISSUANCE,ALSO qEOUIRES THE AP7lICANT FOR SUCH PEfW.IT TO FILE A SIGNED w Patio/Deck �w STATEA�ENT 7T1AT HE OR SHE�5 IJCENSED PUpSUANT TO TME GROV1510.45 OF THE CAMRACTORS l4 ^ CENSE LAY!(CHAPTER B(CO)AMENCWO YATH SECTION 7000)OF OIVISION]OF THE oU51NE55 AYD PRO- � PooVSpa � FESSIONS CODE)OR TT7A7 HE OR SHE 15 EXEMP7iHEREFROrA AND THE BA515 FOR 7HEALLEGED E](EldP• (3 V TION.AN1'VIOLATON OF SECTION 703t.5 BY AHY ApVIICAIT FOR A PERMR SU3JECT5 THE APPLICANi TO z R2-ROOI � � A CML ENAL7Y OF NpT tAORE iHAN FIYE HUN�RED DOLLARS(5500).): I � .ASOYlNEROFTHEPqOPERTY.ORAIYEMPLOVEESYATHWAGESlS7HE1RSOLECOMPcNSATION, COmmOrCial � Z 'MLL THE Y/ORK,ANO TF1E STRUCTURE IS NOT IHTcNDED oR OFFERcD FOR SALE(SEL.7ai,BU51- O � NESS AND PROFESSIONS CADE TME CONTRAGTORS ULENSE U1Y DOES NOT APPLY TO AN OWNER OF � PROAEHTY VA-10 BUILDS OR IMPROVES TNEREQY,AND WHO DOES SUCH 1VORK HIMSEIF OR NERSEIG OR Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUp1 uAPqOVEMEMS ARE NOT INTENDED Ofl m w OFFEAEDFORSPLEIF,HOWEVERiHEBUILDW�ORUAPROVEMENTI550lDVATHWONEYEAROFCA.V.PIE� � TION,THE OWNER-BUILDER WILL HAVE TME BURDEN OF PROVINC THAT IiE OR SHE OID NOT 9UIlD OR Z IMPqOVE FOR THE PURP05E OF SALE�. _ ❑I,ASOWNEROFTHEPROPERTY.AMEXCWSNELVC-0NTRACTIN6WfTMLJCENSEDCOMfiACTORS W � TO CANSTRUCT TNE PRQIECT(SEC.70U,BUSINE55 AND PROFESSION9 CODE THE CONTRACTORS U� V81UdlIM ADJ.AREA L11 CENSEIAWDOE9NOTAPPLVTOANOWNEROFAPROPERiYWHOBUILDSORIUPROVE57HEREON,AND F WHOCOMRACTSFORSUp1PROJECTSWITHACONTRACTOR(9)LICENSE�PUPSUANTTOTMEGONTRAG Q�f�,j'��'y DESCRIPTION Y TORSLICENSELAW.�, �E � L]I AM EXEM7T UN�ER SEC. �J U P ,�.p � (�� B.d P.0 FOR iHIS REASON V c zDATE �I- I�=I OYrt1ER � L U . �Q LICENSED CONTRACTORS DECLAAATION W LC t NEPEBY AFFIRM UHDER PENALTY OF PERJURY TMAT I,VA LICENSED UNDER PROVISIONS OF CHAPTER � 9(COMMENCW6 VrtTH SECTbI!7000)OF DM510N]OF THE BUSINE55 AND PROFESSIWJS CADE,M:D Z I E� X IAY LICE1lSE IS IN FULI FORCE ANO EFFECT. LL! m � UCENSE ClASS LIC.NO. � � (~j �ATE CONTFlACTOR � W � � WORKERS'COMPENSATION DECLARATION a � 1 HER'c8Y FFFIRM UNDER VEWLLTY OF PERJURI'ONE OF THE FOLLOY/ING DEpARAT10N5: V T � Z Z _INAVE,WDIYILL/.�NTAINACERTIFICATEOFC01.5ENTTOSELF-INSUREFORYfOAI('cR5' _ � ¢ COM7ENSATION,lS PROVIDED BY SECTION]700 OF THE LABOR COOE,FOA THE PERFORMAIJCE U Q OF THE vlCRIC:OR YMICH THIS P'c.i!AIT IS ISSUED. W w _1 HqVE NJD 1YI�L IdAl17TAW YlORKERS'CO!APENSATION InSU�ANCE,AS REOUIRED BY SECTID0.7 � H Q ]7ao OF 7Hc V.EO.I CO�c FOq THE PERi-0AMANCE OF TH_\YORI(FOR YlHICH THIS PEFMI715 ISSUc�.lAY1•:O.iiCeRS'CO)dPENSATIONINSU.iAl:CECAqR1ERM1DPp�ICY�lInl.gERAAE CONSTRUCTION jcaaaieq PLAN REVIEW � � POLICYNWAdER ELECTRIC O�/i �� Z � Q o mnsr�avn�rnra=_a�.:�ocfneaEa.�.sr�sroar�r_Mxs.��oo�uAs�s,ro�o�iEssi PWMBING w Z I CERTIFV P.+AT RJ TME P'cRFOR1.IAt;CE OF TH'c YIORN FOq YMIp1 T111.5 PERMIT IS ISSUED,1 MECHANICAL � �� C} 5H�noT ErAP�O'!M'Y PERSON IN ANY 1.1�tJ.�1=R 50 AS To BECAS!E SUBJEGT TO THE (/� Y10RNER5'COMPENSA710N I,pYlS OF CALIFORtnA�NDAGREE TMA7IF I SHOUTA BECOlAE INSPECTION FEE SUdJECT TO THE 1'/ORKEHS'COMPENSATION PriO`/ISIOYS OF SECTIOtI]70o OF THE LABOrI �`�� O CAOE.�SHALL FOFTHY/ITH CO�AP�Y WITH THOSE PROVISIONS. ISSUANCE _ p OATE: APPLICANT: SMIP W J VIARNING:FAiLURE TO SECURE\'JOAxERS'COMPENSATION COVERAGE IS 11NLAvlFU�,AND SMALL BE ENERGY P/C � SUdlcCT.V1EM?LOYERTOCRI!AWlyPENALTIESM'DCINLFIIJESUPTOON�ItUNDREDTMOUSAN� ENERGYPERMIT DOLLARS(5 t OO.OU]),W ApDIT10N TO THE COST OF COMPENSA7IQV,DAAtAGES AS PROVIDED GOR IN � SEC710N]70!OF THE LA80R COO�INTEfiEST M!p ATTOfl17EY5 FEES. RETENTION FEE: � ( p CONSTRUCTION LENDING AGENCY . PRE-ALT FEE: � I MEREBV:.FFIii1A UNDER PeNlyTy OF PcRNRY THAT THiRE IS ACONSTRUCTIDN IENDUJ6 AGENCY FOR TT1E PERFOR!AAHCE OF THE WORK FOR YMICH TFII$PEWAIT IS ISSUED ISEC.]097,CIV.C.). Z W � IENDER'S NNAE F— LENDER'SRODRE55 w I CERTIFY THAT 1 HAVE ReAD T}US AGPUCATION AND STATE TMAT THE Il90VE INFORAIATpN IS CORRECT, TOTAL FE ES � �5 . ( '� � 1 AGilEE TO COIAPLY VIITH A��CITY AND COUNTY OqDWANCES AND STATE UWS REUTW6 TO OUILDING ` � CONSTRUCTION.ANDHEREBVAUTHORIZEREPRFSENTATIVESOFTMISCWNTYTOEHTERUPONTHE Z A90VE�MENTIONED PFOPERTY FOq WSPEC710N 7URPOSES . p ��'�� ` COIdMENTS m PEfiM AA7E(PR1N'T) L Q �' ZO N T�� P� E DATE � RECPT.NO. PAID BY VALIDATION� � WHITE—Depanment Copy,YELLOW--Finance Copy,PINK—Assessa Copy,GOLDENR06—File Copy,GREEN—Appticant'g Copy � ,,, � :� �I�1�' �2� �3�A�9C5�� s4R ' 9�1SP��T�C�iV R�CC?Ra m � � � � � o , e - SET BAGK FLQOR JQIST FTGS!FQRMS/STEEL FHA REc�MTS � ELEC7RIC GROUND i1PJDER FLO(Ja D�JCT GROUND FLUMBING Uf��1DEi� FLOC3R CGNDUIT SLAB GRADE �FIREPLhCE FOUNCiATION • TEiV1P POWER FiREPLACE 60ND 8EAlv1 WATER SERVICE � UiID HT. 80Nd BEA�,1 I ROOF SHtATHWG _ �8 FT.BG�iG BEA��4 � FR,4Pd11P�I�/�IEM1JTIL.��iC�{� i i�iN�L�i�}Pdl� �cAM —,--- ROG�Ci��R � �P�E-C�RADITlG � � RO!irH I-t`A71RlG i— �-B—�N-CHIP�EG �_-- Fi0!�GN ELECTRiC ' � f�� JUGN�Rr�Di�JG ; RC�!JGH PLUMSIvG �};� �FINI�N GSADIMG ' - SHO`�JE�?�'7"tJB TE�T �--- PJ4L ELEGTRIC � EXT. LAii�/,�{DIPJG � ��-—POGL FENCIidG WALI_�t�1Sl IL�i'I�.�f�f I I _ !P�QL FIl�iAl. __ —� CE(LING fNSULATION QFr=�I�t Ifv1PS. ' � DRYWALL NAILIS�7G i ' DEDICATIOf�1S SEWER FINAL EPJG. SEPTIG TAhIK. LANDSCAPE/IRRIG. SEEP PIT,rL.L. ' ON SITE IMPS. G.4S AIR TEST FINAt ZON1�1G FlNAL CGNST. FIRE�EPT. FlNAL FiIUAL HEATIfdG __ HEALTH DEPT. FINAL r-- �INAL EL�CTRIC---- �—__— ----------- DEV. FFES PAID � FINA!_P�UIV181Nu j EN�RGY ---_-_ — �------ -- -- -- �--- - 4 � � --- ---_,_—._-__-- -----L_------------- -----_._.. t�t�M��l��I TS ------ --- ------------- -- - --------- SEPTIC TANK SIZE ----- -------- -------- -- — SEEP FIT/U SIZE — --- - � :, s �.�. 'c�.' " - — — � '-- I