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Home My WebLink About11-95 _f,�`_ CTTY OF DIAMOND BAR DEPARTMENT OF COMM�,;NITY&DEVELOPMENT SERVICES 21810 Copley Drive,L'ramond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Aotline(909)839-7027 PRESS �'°^'. BUII.DING PERMIT APPLICATION FIRMLY ' � JOBSITE 2 ��A'��ER wal n DQ APP�ICATION� 'Z '?� PERMIT )'�� P/C o ADDRESS � DATE NUMBER � # T° APf��L �� TRACT .Y S�L l D TEE J � CONST.__�/�� GROUP p OWNER f�DrDi� LE.E o ADDRESS�IL� fEA�IK�RM�?i31� DR. ZONING SETBACKS Z cinr0_��r0 dAR ZIP � S TEL61 'Z -�S FRONT pyy p . p APPLICANT �Rlvd/ �I��✓L4 TEL.�/�-/.,n8-�hf3 REAR � zd SIDE/SIDE STREET RW ❑ � CONTRACTOR F��l/ bN SIDE p oclrrFu L��K.�otii 21P�283 5 TEL l _ Z6 PROPOSED USE $A�k Y�� B6 E�j P/07.'J �R�/� w ARCH/ENG/ z DESIGNER ��M� kS /�ba vE 1 �- a ADDRESS NO.DWEL NO. NO. cn UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION 5FR/ADD/REM O p I HEREBV AFFlRM UNDEp VENALTY OF PERAIRV THAT I Md IXEMPT FROM THE CONTRACTORS L4 Garage/Carport. W CENSEUWFORTIEFOLLOWINOREASON(SEC.7oa1.6BUSWESSANDPROFESS10N5CODEMlYpTYOR (f� C� COUNTYWHICHREOUIRESAPEHAH7TOOONSTAUCT,ALTEA,IMFfiOVE,OEMOIJSH,ORRECAIRANYSTRUG W P81i0/DeCk � < NRE,PRIOR 70 RS ISSUANCE,ALSO REWIRES THE APPLICANT FOR SUC!{pEpM17 TO flLE A SIONED w �� STATEMQJT THAT HE OR SHE IS LICENSED PURSUANT TO 7NE PROVI510N5 OF THE CONTMCTORS L4 � CENBE UW(CHAPTER e(COMMENCINO WITH SECTION'l000)OF DIVISION J OF THE BUSINE59 AND�PRO u' POOUSp9 . _ � FESSIONS COO�OR THAT ME OR SHE IS E%EMPTTHEREFROAI AND 7HE BA515 FOR THEALI,EOED EXEMP• (!j TION.ANVVIOLATIONOFSECTION7031.5BVANVAPPLICANTFORAPERAIITSU&IECTSTHEAPPLICANTTO Z� Re-Rool � A C1VIL PENALTY oF NO7 AqRE THAN FIVE HUNDRED DOLLARS(i50oJ.): � ❑lASONRJEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESA3THEIflSOLECOMPENSATqN, O CpmmBfC�� Z WILL DO THE WORK,ANU THE 9TRUCNRE 19 NO7 INTENDED OR OFFERED f-0R 3ALE(SEC.7041,BU51- �J ' � NESS AND VROFESSIONS CODE THE CONTMCTORS LICENSE UW DOES NO7 APPIY TO AN OWNER OF j - PROFERTY W/i0&1RDS OR IMPROVES THEREON,AND WHO DOES SUCN WORK HIMSELF OR HERSELF OR W iHHDU0HHI50RHEROWNEMPIOYEES,VROVIDEDTHATSUCHIYPROVEMEMSARENOTWTENDEDOR m � . � OFFERmFORSALEIF,HOW6VE{�7ryEBURDINOOFIM7ROVEAlENT1950LpWfTHWONEVEAROFCAMPI.E Z TIOH.THE�OWNER�BUILDER WILL HAVE THE 9UROEN OF PROVIN(i T}{AT HE OR SHE DID NOT BUILD OR , � WPROVE FOR 7HE PURP0.SE OF SALE} . . . . W �4�OwNER OF RiE PROPEHfY,AM E%ClUSNELV CAN7RACTIN(3 WrtT1 LICDISED CONTRACTORS CL TO CONSTRUCT THE Pf10.lECT(SEC.70N,BUS7NE55 AND PROFESSION3 CODE:THE CONTRACTpqg�Ll- VBIUfltIOf1 qp,�,ppEq � • LU CENSE UW DOES NOTAPPLY TOAN OWNEp pFA VROPERTY WHO BU0.D3 OR W PROVES 7HEREON,AND � ' S M'HOCOHfMCTSFORSUCHPRO.lECTSWITHACONTRACTOR(S)LICENSEDPURSUANfTOTHECONTRAG p�qNnTy DESCRIPl10N FEE � roas uc�sE uw.�. � ❑��E%EMVT UNDER SEC. B.8 P.C.FOR THIS REASON JQ � � U � DATE ONRJER �H Z U ♦ O W �¢ LICENSED CONTFACTORS DECLARATION � � � � � � � OC w I MEREBV AFFIRN UNDER PENALTY OF PERNRV THAT IAM LICENSED UNDER PROVISION9 OF CMAPTER � � � Y�COI.WENCRW WITM SECTION 7D00)OF DIVISION J OF THE BUSINESS MID PROFESSIONS CODE,AND Z �� MY L/CENSE IS W FULL FORCE AND EFFECL p m � UCENSE CLASS B LIC.MO. �•� � `� � - - � V DATE CON7AACTOR a _ . W � WORKERS'COMPENSATION DECLARATION � � �� -� - � I HEREBYAFFIRM UNDER FENALTV OF PERIURY ONE OF THE FOLLOWVNO DEC(ARATqNS; U � � (� - .. . Z . . . . � _I HAVE�AND WILL MAINTAW A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' a � - _ COMFENSA710N,AS PRpVfpm BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U� OF 7HE WO{iK FOA WHICFI TH�g PERAl1T t9 ISSUED. � W � � � _I FiAVE AND WILL M/JNTAW WORKERS'COMPENSATION INSURANCE.AS REWIRED BY SECTION � /�� O 77000F�THELABORCADE,FOHTHEPERFORMAIJCE�OFTHEWOPo(FORWMCHTHISPE{WRIS, /SVS ISSUED.MYWORKEA5COMPENSATIONINSURANCECAARIERAND.POLICYNUMBERME: �CONSTRUCTION > �R�� PLAN REVIEW 0 � POLICV NUMBER . 7d.. ELECTRIC � (r�ssEcrqrrr�IDr+oTeewns�ErmoFn�a�a.rrswaor+Er�noou.wsg+oo�or��ssl PLUMBING ' . w Z I CEflTIFY THAT W THE PERFORMANCE OF THE WORI(FOR WHlpi Ti15 PERMIT IS ISSUED.I MECHANICAL C•} SHALL NOT EM71.OV ANY PERSON W ANY MpNNER SO AS TO BECOME SUBJECr TO THE' (J� WORKERSCOMPENSATqNLAW50FCALIFORN10.M1DA6REETHATIFISHOVLDBECOME INSPECTIONFEE SUAIECTTOTHEWORKERS'COMVEN9ATIONPROVISIONSqF SEC710N7700OFTHELIBOR "� ' � � '� o coo�,i srwu war�mnni coMa�v Hn iosE Paovi G)rs. ISSUANCE 3 - `p oATE:.� L�I�pp�;�cqt�`T �SMIP 1J --� WARNINO:�FALURE TO SECURE WOiUCERS'COMPENSA710N CAVERA IS UNUWFUL,AND SHALL BE ENERGY�P/C � J �y SU81ECtANEMPLOYERTOCRIMW�LPENALTIESANDGVILFWESUPTOONEHUNDREDTH0U5AND ENERGYPERMIT DOLL.ARS(f10o,aoo),IN ADDITON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTqN 370C OF 7HE LABOR COOE,INTEREST,ANDATTORNEYS FEES. � � � w RETEN"fION FEE: O CONSTRUCTION LENDING AGENGY PRE-ALT FEE: � 1 HEREBV AFFIRM UNDER FENALTY OF PERIURY THAT THERE IS ACONSTRUCTION LENDWO ACiENCY FOH TME PERFORMANCE OF THE WORK FOR WHICYI TMIS PERMR IS tSSUED(SEC:30W,CtV.C.). Z W ��. LENDEftS NAME � � ' F— IENDER'SADDRE53 � w� T +++/// ICEiiTIFY7HAT1/UVEREADTHISAPPLICATqNANDSTATETHATTHEABOVE WFORMATION1900RRECT. TO ITAL FEES / �/ �� 1 ACiREE TO COMPLV VATH ALL C7TV AND COUNTV pqpW/WCFg iWD STATE UWS REUTPXi TO BULLDINO 6 � CONS7RUCilON,ANp HEREBV AUTHORIZE REPHESENTATNES OF 7HI5 COUNTY 70 ENfER UPON iHE � Z ABOVE-MEMIONEDPROPERTY,FORINSPECTqNPURPOSES. COMMENTS " � Fna v l� yrl� G, _ m PERMIT�7�E�{Fj�a.�E(PRINT7 � /� . N i /i ��/a"� %��Z �� Z- . . � 510 REI�I OFPERWTf p�7E - � RECPT..NO. AID BY V/LLIDATION WHITE—DepaRment Copy.YELLOW—Finence Copy,PINK—Assessor Copy.(30LDENROD—Flle Copy.GREEN—App1{canCs Copy CITV QF DIAIUIO'��lJ BAR INSPECTIOPV RECQRD ,. , .. :, . *Y.li � y,+�F� n� � 'X,e..� �rv �:., � � ,�.,,r, , B c��_- Q Ft. � �� _ � y . . � , _ � � , . .� . SET BACK FLOOR JOIST FTGS/FORMS/STEEL fHA REQMTS ELECTRIC GROUND UNDER FLOOR�UCT GROUND PLUMBING UNDER FLOOR CONDUIT _ � SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ROOF SHEATHItdG 8 FT.&OND BEAM FRAMINGNENTILATION FINAL BQND BEAM ROOF CdVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING � ROUGH PLUMBING FINISH GRAOING SHOWER/TUB TEST POOL ELECTRlC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAI CEIUNG 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.FIIVAL FINAL ELECTRIC DEV.FEES PAID FINAL PLUMBING ENERGY FINAL PLANING FINAL ENGINEERING . p � C�MMENTS - � �� SEPTIC TANK SIZE SEEP PIT/U SIZE - ,4II i - � ', �` CITY OF DIAMOND BAR DEPARTMENT OF*OMMLNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �'9�'� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE ��3 �EAT�-IE2Wbo17 1Q2R� pppLICATI PERMIT �- p/C o ADDRESS D;/a I�oniG �A f�� c�} 9 i 0 65 DATE �� a'/ ��\ NUMBER �� 9S p �y��l- G�S � APN$?°`F'�'Si�JL T�� TRACT J'��6 I D TEE -`-1 \�}-I � � ONST. GROUP I p OWNER GDP�E L£E o ADDRESSa?a�3L�F FEa�1�ErLv��O PR. ZONING SETBACKS w FRONT CITY�'�A�wn ��2 ZIP �6 TE�.6z6-z83-�ESa3 REAR RW � � APPLICANT F2A.�/� Y.4.�f� TEL.�f1S�-fio��L6$`Sb SIDE/SIDESTREET qyy p � CONTRACT�Q R F TZ/�N� y/3-N CJ� SIDE � ADDRESS S�� Ot��o S72b2�T � 1�N:'9f S � CITY�jAflf�+�/� ZIP�bTEL.a��-�n1�r•�fy PROPOSEDUSE�B/+LK �/q2}� 13gq� P�41�0 AIZ��} o ARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS cn UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADD/REM p I HEREBV AFFIRM UNDER PENALTV OF PERri1RV THAT I AM EXEMPT FROM THE CONTRACTORS ll- G8f8 B/CB W CENSE LAW F9R THE FOILOWINa REASON(SEC.7031.6 BUSINESSAND PROFESSIONS CADE:ANV CITV OR (n g �rt ZCWNTVHhiICHREOUIRESAPEHMITTOCANSTRUCT,ALTER,IMPROVE,DEMOL15H2ORREPNRANVSTRUC- W patlo/Deck . w NRE,PRqR TO ITS ISSUANCE,AL50 REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT h7AT FIE OR SHE IS LICENSEO PURSUANT TO THE PqOVI510N5 OF THE CONTRACTORS LI� � CENSE UW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� u' POOUSpB , � fESS10NS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BA515 FOR THEALLEGED EXEMP- � TKKJ.ANY VIOLATION OF SECTION 7031.5 BV ANV APPUCANT FOR A PERMIT SU&lECTS THE AVPLICANT TO Z Re-Roof � A CIVIL PENALTV OF NOT MORE 7HAN FIVE HUNDRED DOLLARS(5500).): � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPIOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrt1ffIBfC181 Z WILL DO THE WORI(,AND THE STRUCTURE IS NOT INTEN�ED OR OFFERED FOR SALE(SEC.7041,BU51� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS IICENSE LAW DOES NOT APPLV TO AN OWNER OF 7 PROPERTVWHOBUILDSORIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR � r`C, Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED Oq m Q OFFEAEDFORSALEIFHOWEVER�M17EBUILDINOORIM7ROVEMENTISSOLDWfTMNONEVEAROFCQMRE� Z TIDN,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVWO THAT HE OF SHE DID NOT BUILD OR � UAP{70VE FOR THE W RPOSE OF SALE). W O I,AS ONMER OF THE PROPERTV,AM E%CIUSIVELV CANTRACTING WITM IICENSED CONTRACTORS [[ TO CONSTRUCT TME 7R0.1ECT(SEC.7w�,BUSINESS AND PROFESSIONS CODE:THE CONTfUCTORS LI- V81U9fi0f1. � ADJ,AREA W CENSE UW DOES NOTAPPLY TO AN ONRJER OF A PROPERTV WHO BUILDS OR IMPHOVES THEREON,AND N'FIOCONTMCTSFORSUCHPROJECTSWIhIACONTRACTOR(5)LICENSEDPURSUANTTOTNECONTRAF oufwnrr OESCRIPTION FEE TORS LICENSE LAWJ. � ❑I AA1 EXEMPT UNDER SEC. B,8 P.C.FOR THIS REASON Q Id �� y(�7/? •�� (� U Y I � a[ ' �/ 7�.� .s� /4y� � DATE OWNER �- 0 U � LICENSED CONTRACTORS DECLARATION � � I HEREBV AFFIRAI UNDER PENALTY OF PERJURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTEfl w � Y(COMMENCING WITH SECTION 7000)OF DIVISION�OF 7HE BUSINESS ANO PROFESSKKJS CADE,AND Z' N �/�i � n �� MY UCENSE IS M FULL FO»RCE AND EFFECT. m , � ICENSE CLASS�/ `� LIC.NO. �/� ��y � � V ATE ��7 "ZO I/ CONTRACTOR d . . W � WORKERS'COMPENSATION DECLARATION � � I HEREBYAFFIRM UNDER PENALTY OF PEFJURV ONE OF THE FOLLOWING DECLAAATIONS: V � Z O _I HAVE AND WILL MPJNTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ Q COMPENSATION,AS PROVIDED BY SECTION 3�00 OF THE LABOR CODE,FOR THE PER WRMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � � _I HAVE AND WILL MAINTAIN WORKERS'CqMPENSATION INSURANCE,AS REOUIRED BV SECTION ' O 370o OF THE LA60R CODE,FOR THE PERFOPMANCE OF THE WOflK FOR WHICH THIS PERMIT IS • , �� O ISSUED.MV WORKERS'COMPENSATION INSURANCE CAqR1ER AN�VOIICV NUMBER AAE: CONSTRUCTION j CARRIER PLAN REVIEW ,�O8 • �}"�I ' • 0 POLICV NUMBER � ELECTRIC �� , 4; p (f1dSSEC1qNNE�NOTBE00A4LEfmOFhEPEqMTiSFpqpNEµlrDqEppp�LARS(S1pp1�7LES5} PLUMBING �}S . ��"1 w � Z I CEFTIFY THAT IN THE PERFORMANCE OF THE M/ORK FOR WHICH THIS PERAIIT IS ISSUED,I MECHANICAL , ' � C.�S SHALL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE y (n WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&JECTTO THE WORKERS'COM7ENSATION PROVISKKJS OF SECTIQY 37o00F THE LABOR , OCODE,1 SHALL FORTHWITH COMPIV WITH E PPOVI510 . A ISSUANCE �p�.• S ,p DATE�` `l�( APPLICAN 'G SMIP. ' 1 S �� o "'� WARNINO:FAIIURE TO SECURE WOPKERS'COMPENSATION COVERAG S UNLAWFU� SHALLBE ENERGY P/C � � J � SU&IECTAN EMPIOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOlLARS(f10o.o00�,IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN � J SECTpN 3708 OF iHE UBOR CODE.INTEREST,AND ATTORNEV'S FEES. � `O� w RETENTION FEE: O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBYAFFIRM UNDER PENALN OF PERJURV THAT THERE IS ACONSTRUCTION LENDINO AGENCY ��L}� 1 � d FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7ae],CIV.C.), � Z W � LENDER'S NAME ' F- LENDERSADDRESS W ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT. TOTALFEES �� ` � I AOREE TO COMPLV WITH AlL CI7V AND COUNTV ORDINANCES AND STATE UWS REUTINQ TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF TNIS CAUNTV TO ENTER UPON THE • Z ABOVE-MENTIONED PflOPERTV FOF INSPECTION 7URPOSES. COMMENTS � x �J2/-��.I�c y,��J(�, m PERMI AME(PRINn . . Q . `� - �P(c. (oao�3 ✓ i auo"a � 510 UREOFPERMITTEE DATE^ � � RECPT.NO. Q�� PAID BV I�S VALIDATION � WHITE—DepaAment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROO—File Copy,GREEN—Applicant's Copy CITV O� DIAiViONI� �AR IY�S�IEC�'�O� FiECOFt'� ri�}na�p��ooa o �� o��c��oQ� �� .� ��c�roo�Ws��a.�� r�� - �� SET BACK ' ' FLOOR JOIST � FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT ' GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID Hr. BOND BEAM � ROOF SHEATHiNG 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER�T'UB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SfTE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. Q 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 t��f�o y ��` COMMENTS _��—��(� �-��.•LLr �� t �z_��.i � e.�l. w�, � d r.�(s�c" v�-- � nto�/_L�a- —�o/�-��s .S i�.o � � ,�c,��U, . � i � 1 . ►� g � �� ._� '� SEPTIC ANK SIZE � � " � _ SEEP PITlU SiZE � ' 1` ., ' � � u� � � . ,'a:+�� ._ � � : ; �� „A rv Y. € r: � . ..a,.y�.h, ` ,y� a� . � � f �� }/��,� � ��' d *.,+. �' ��, -- --- -- =-- , � � _ � � (��. ►deal location for your next specia/occasion! � I I �I I-I I ��I I�I I�I ! DIAMOND BAR CENTER � , � I1600 Grand Avenue,Diamond Bar,CA 91765 I 909.839J082.1 www.diamondbarcenteccom. i j � � a � � � ec�-�e�' I � c,��a d � ; I .� �� I � � �� - ► � �� ; � -� � ��.� ,� �