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Home My WebLink About12536 (14)CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES c > 21660 E. Copley hive Suite 190 (909)B60-3195 Paz(909)861-3117 BUILDING PERMIT APPLICATION JOBSITE CM ADDRESS Z Ciq y- f4 40-C)'96 21(% IVR APN LOT TRACT OWNER ADD SS & L %t C0 CITY ZIP IqL73- -TEL APPLICANT TEL CONTRALTO S ADD SS CINZIP�lI� TEL ARCFVENG/ DESIGNER ADDRESS CITY ZIP TEL OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS L4 CENSE LAW FORTHE FOLLOWING REASON (SEG 7071.5 BUSNESSANO PROFESSIONS CODE: ANY CITY OR OOUN TY WHICH REQUIRESAPERMrTM CONSTRUCT. ALTER. IMPROVE, DEMOLISH, OR REPAIR ANY STRUG TURF- PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LF CENSE LAW (C/NPTER B (COMMENCNO WITH SECTION 7DOO) OF DIVISION S OF THE BUSINESS AND PRO- FESSIONS CODE)ORTHAT HEORSHE ISEXEMPT THEREFROMAND THE MIS FOR THE ALLEGED EXEMP- TION. ANI' VIOLATION OF SECTIO17031.5 BY ANYAPPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS 15500).): O L AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEG 70". BUS]• NESS AND PROFESSKXHS CODE. THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROl10N HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE F,71D'WEVERTHE BUILDING OR IMPROVEMENT IS SOLD V17THN ONE YEAR OFCOMPLE- TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DD NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). D L AS OWNER OF THE PROPERTY.AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEG 70x1. BUSINESS ANO PROFESSIDNS CODE: THE CONTRACTORS LI- CENSE LAW DOES NO7APPLY TORN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO CONTRACTS FOR SUCH PROJEU'TS WITH A CONTRACTORIS) LICENSED PURSVANTTOTHE CONTRAO- TORS LICENSE LAW.} O 1 AM EXEMPT UNDER SEG B. i P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HERERYAFFIRM UNDER PENALTY DF PERORYTHAT IAM LICENSED LINGER PROVISIONS OF CHAPTER 6 (COMMENCOKL WITH SECTION 7000) OF DMSION 7 OF THE BUSINESS AD PROFESSIONS CODE. AND WY LICENSE 6 N FULLFORCEAND EFFECT. L/ Q UCENSE CLASS JjjV LIC. NO. DATE 60 CONTRACTOR WOR ERS' COMPENSATION DECLARATION 1 HERE AFFIRM LINDER PENALTY OF PERAM ONEOFTHE FOLLOWING DECLARATIONS:_ I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION. AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERrorMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �I HAVE AND WILL MANTA:N WORKERS' COMPENSATION INSURANCE. AS RECUNED BY SECTON 7700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKER�1COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ME CARRIER n - 1 A POLICYNUMBER kL` irm SECTION NEEDNOT BE CCAH.ETMOFT E PERMIT B RIR ONE HUFOREDDOIIARS 8100) DR LESS) I CERTIFYTHATN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON N ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS! COMPENSATION UAWS OF CALL RNIA, ANO AGREE T/ULDBECOME SUBJECT TO THE WORKERS'COMDENSAT H T,— ` O SEMI FTHE LABOR COD 1 FORTTHYATH COMPLY WI IO1 qq I DATE: G APPLICANT: I WARNING: AZUR TO SECURE WORKERS' COMPENSATION COVERAGE IS LAWFUL, SHALLBE SUB.IECT AN EMPLOYER TO CRIMINAL PENALTIES ANDCLFINESUPTOON HONOR SMD M DOLLARS (I 100•DW), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN I SECTION 3708 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY FOR THE ERFO UNDER OF THE OFPERJURYFOR RYTUT ISPEISACONSUED(SE .LENDING AGENCY ,. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEG 3097, GV G). I LENDER'S NAME LENDER'S ADDRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. AGREE TO COMPLY WITH ALL CRY AND COUNTY ORD24ANCE5 AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE .. ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. �/z DV4UR6OFnRNMEE E (PRT)INn D GATE PRESS FIRMLY ERMT 1 *L.� DATE- NUMBER/� A ISSUE TYPE OCC DATE CONST. GROUP. ZONING SETBACKS FRONT RW ❑ REAR p SIDEGIDE STREET RW ❑ SIDE 0 - PROPOSED US 2 a r . XC e-do:�' " _"I NO. DWEL NO. • 4 I. , . NO. - UNITS • STORIES BEDROOMS DESCRIPTION SO. FT.- FACTOR PSF ADJ. AREAIVALUATION SFRIADDIREM CD /C GaTagaarport WPatlo/Deck LL- POOVSpa ZRe -Roof Commercial m Valuation U ADJ.AREA QUANTITY DESCRIPTION FEE _j 13 W LU W T.D Z_ G] J CL J Q U 2 2 U W � Z CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL - INSPECTION FEE ISSUANCE x Julio SMIP ENERGY PIC ENERGYPERMIT RETENTION FEE: PRE-ALl GI17Y QF' �i D IL TOTAL FEES COMMENTS RECPT. NO, PAID BY VALIDATION ITE—Department Copy. YELLOW—Finance COPY. PINK—A33e330r wpy, UULycrvntjLr–rRe Lopy. %PHt=LW— MIcam s %mpy CITY OF DIAMOND BAR;,; " INSPECTION RECORD', SETBACK c } `,.: FLOOR JOIST`• `... ' FTGS/FORMS/STEEL = FHA REOMTS ELECTRIC GROUND UNDER FLOOR DUCT -' GROUND PLUMBING UNDER FLOOR CONDUIT - -SLAB GRADE- --- - ' FIREPLACE FOUNDATION '. '.. . ' l ' .. •-:: • .. r,'.. j • . " ` TEMP POWER -- - ' _ FIREPLACE BOND BEAM -- _ - WATER SERVICE-- : - ROOF SHEATHING' _.. _ _ _ ro-.;J .:MID HT. BOND BEAM 8 FT. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER ' ,': ROUGH HEATING t 1 _110 xo _ ` _ -._.. PRE -GRADING BENCHING ROUGH ELECTRIC - ROUGH GRADING ! ` ROUGH PLUMBING FINISH GRADING ! :- SHOWERIfUB TEST : - � POOL ELECTRIC ! •• EXT. LATH/SIDING POOL FENCING. WALL INSULATION POOL FINAL . CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER. _.._.... :.. .. .. FINAL ENG. SEPTICTANK. - _ _ --- LANDSCAPE/IRRIG. SEEP PIT/L.L.- ON SITE IMPS... .. ; .. GAS AIR TEST, - - - FINAL ZONING FINAL CONST.' - -FINAL HEATING ! t-�z �oE�jC _ c- -" " - FIRE,DEPT. FINAL HEALTH DEPT. FINAL "FINAL ELECTRIC DEV. FEES PAID I FINAL PLUMBING ENERGY COMMENTS----- I I SEPTIC TANIG-SIZE',aI u SEEP PITA) SIZE'