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Home My WebLink About15044 (20)UI:lAilti 1116tit. ii CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY do DEVELOPMENT SERVICES 21660 E. Copley lhive Suite 190 ,(909)860-3195 Fax(909)861-3117 BUII.DING PERMIT APPLICATION MM PERMIT NUMBERI jr,sr ADDjossRESS !Q 7�f�JTIfPC/L ZONING SETBACKS FRONT REAR SIDEISIDE STREET SIDE RW RW x--- ❑ ❑ 0 ❑ APN LOT TRACT NO. BEDROOMS OWNER ADDRESS FACTOR PSF CITY ZIP TEL: APPLICANT TEL;______ CONTRACTOR .� fill C A� ADDRESS - Garage/Carport CITY - t' ZIP TEL: ARCWENG/ 'LIJ DESIGNER ADDRESS n CITY ZIP TEL. POCl/Sps e ZR@ OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LF CENSE LAW PORTME FOLLOWING MIA BUSINESS AND CODE: ANY.CnYOR Commercial DEMOIUPROFESSION$ ITTO COSEC. COUNTY TO CCN IMPROVE, STRUC- E, - PRIOR T ITS ISSUANCE, A REQUIRES THE APP SUCH PERMIT TO FALL A TURF, ENT TD ITS 6SUANCE, ISO REQUIRES THE TO THE PROVISIONS FOR SUCH PERMR TO FILE A ORSSIGNEDLI, STATEMENT THAT HE OR SME 6 PURSUANT TO THE THE CONTRACTORS RS LF DIVISI3OF 9 OF THE BUSINESS AND PRO- NCILICENSEDWI AN CENSE LAW (CHAPTER 0 (COMMENCING WITH SECTION DIVISION SHE IS FJ(EMPTTWEREFNOMAND TEEBASISFOR THE FESSIONS CODE) OR FRO A B FXFMP- S THE AP L IO FOR PERMIT SUBJECTS THE APPLICANT TO TION. ANY YKXA710NOF SECTION7031.6BYANY DRED DO LA ACME. PENALTY OF NOT MORE THAN RIVE HUMORED ($500).Y.WAG D L OWNER �THE R MY EMPLOYEES IT GS SOLE COMPENSATION, THEAS NOT INTENDED O OFFERED FOR WILL OD THE WORK AND THE STRUCTURE 6 NOT INTENDED OR OFFERED FOR BALE (SEC. 7084, BUSI- THEPROPERTY. STRUCTURE SEC." NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES HOT APPLY TO AN OWNER OF PROPERTY WHO BUSDS OR IMPROVES THEREON, AND W140 DOES SUCH WORK HIMSELF OR HERSELF OR Valuation THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED RORSALE IF, HOWEVER.THE BUILDING OR IMPROVEMENT 10 SOLD WITHIN ONEYEAROF OOMPLE- TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DRi NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). D L AS OWNER OFTHE PROPERTY AM EXCLUSIVELYCONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT ISEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW OOEB NOTAPPLYTp AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND MTND OLANT A FOR SUCH PROJECTS WITHAOCNTRACTOR(S) LICENSED PURSUANT TO THE OONTRAP TORS LICENSE JAW.} 01 AM EXEMPT UNDER SEC. B. a P.C. FOR THIS REASON �. DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM =NSED UNDER PROVISIONS OF CHAPTER P (COMMENCING WITH SECTION 7000) OF OMSION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE 6 BI FULL FORCE AND EFFECT. �r,� ///� 7�f '�(�',�' LK:ENSE CLASS �/` LIC. NO. .... ,� DATE �^ `' I — 61SO CONTRACTOR WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS I HAVE NO WILL MAINTAIN ACERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' POMP ENSATON,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILLMAINTAN WORKERS COMPENSATION INSURANCE. AS REQUIRED BY SECTION 3700 OFTHE LABOR CODE WR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMBT 15 ISSUED. MY WORKERS COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE .,. CARRIER �-TT ,� ��7-� POLICY NUMBER _i_12� IC'ZL�--Lev GT'L)CJ MIS SECTION NEED NOT BEOOMPJETEDOFTHE PEWJ/T6 FOR ONE HUNDRED DOLLARS (SIM)ORIESSJ 1 CERTIFY THAT N 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 (p WORKERS'COMPENSATION LAWS OF CALIFORNIA, ANP AGREE THAT IF I SHOULD SEOOME SUBJECTTO THE WORKERS'COMPENSATION PROMS SOF SECTION 3700 O' THE LABOR CODE. I SHALL FORTHWITH COMPLY WI SEP ISgN4. p DATE: / "" APPLK:AHP. - j WARNING: FAILURE TO SECURE WORKERS ENSATION COVERAGE IS UNLAWFUL. AND SHALL BE ry SUBJECT AN EMPLOYER TO CRIMINAL PEKES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S1 W.000), N ADDITION TO TNE.COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE. NTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HERESY AFFIRM UNDER PENALTY OF PERJURY THAT THERE 6 A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 16 6SUED (SEC. 3087, CIV C.). LENDERS NAME LENDERSADORESS I< TOTAL FEES COMMENTS 1 CERTIFY THAT I HAVE READ THIS APPLICATION MID STATE THAT THE ABOVE INFORMATION 6 CORRECT. d L AGREE TO COMPLY WITH ALL CRY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, ANDHEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE•M ED PROPERTY FOR INSPECTION PURPOSES, PE E IPRI ,I C0 SIGNATOR F PE 1 DATE PRESS FIRMLY APPLICATION DATE &I LOD ISSUETYPE DATE fx/CONST. PERMIT NUMBERI P/C III OCC GROUP ZONING SETBACKS FRONT REAR SIDEISIDE STREET SIDE RW RW x--- ❑ ❑ 0 ❑ PROPOSED USE NO. DWEL. NO. UNITSSTORIES NO. BEDROOMS DESCRIPTION $O. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport 'LIJ PBNO/Dack POCl/Sps ZR@ -Rod Commercial - co Valuation ADJ.AREA QUANTITY DESCRIPTION FEE W �. Z sU[ T CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT Ci RETENTION FEE: PRE -ALT FEE: AND 515 TOTAL FEES COMMENTS RECPT. NO. PAID BY VALIDATION WHITE—Department COPY. YELLOW—Finan a Copy, PINK—Asessw Copy, GOLDENROD—FIM Copy, GREEN--Applicanes Copy V CITY OF DIAMOND, BAR INSPECTION RECORD 7-m H j FLOOR JOIST SISTEEL I FHA REQMTS -^ GROUND UNDER FLOOR DUCT GROUND LU_M_BING I UNDER FLOOR CONDUIT u SLAB GRADE -.r FIREPLACE FOUNDATION -�- TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM , ROOFSHEATHING 8 FT. BOND BEAM, FRAMINGIVENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING j ROUGH HEATING BENCHING ROUGH ELECTRIC Da i 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 _ j FINAL ENG. �- _. SEPTIC TANK LANDSCAPE/IRRIG._w� SEEP PIT/L.L. :, ON SITE IMPS. GAS AIR TEST FINAL ZONING ! FINAL CONST. I FIRE REPT. FINAL FINAL HEATING FINAL ELECTRIC], 2� ` _ . i HEALTH DEPT. FINAL DEV. FEES PAID FINAL PLUMBING j Ij ENERGY COMMENTS I i i f SEPTIC TANK SIZE SEEP PIT/U SIZE I