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Home My WebLink About18087 (25) l ., ' _��`_ CTTY OF DIAMOND BAR 1 �� I DEPARTMENT OF COIvIIv1UNTI'Y&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS ' �'�� BUILDING PERMIT APPLICATION FIRMLY y JOBSITE /� APPLICATION PERMIT l� P/C o ADDRESS � O - � lJ✓ DATE � O A� NUMBER # �' �� D TEE � �1 G�I�-�TMPE OCC APN LO TRACT CONST. GROUP p OWNER P1� � �1(j(,�Ijr'.�C o ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT qyy p � APPLICANT TEL. REAR � ¢ SIDE/SIDE STREET RW ❑ � CONTRACT R SIDE ❑ � ADDRES � CITY ZIP T PROPOSED USE � o ARCWENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS cn UNITS STORIES BEDROOMS � N CITY ZIP TEL. • " � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM ,p I I HEREBV AFFlRM UNDER PENALTV OF PERJUPV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G8f0gB/CflfP01� � W CENSELAWFORTHEFOLLOWINQREASON�SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITYOR (n U COUNTVWHIC}1RE�UIRESAPERMITTOCONSTRUCT,ALTER.IMPROVE,DEMOUSH,ORREPAIRANVSTRUC- w TURE,PRqR TO ITS ISSUANCE./�LSO REOUIRES THE APPLICANT FOF SUCH PER/A1T TO FILE A SIONED w Patlo/Deck � STATEMENT TFUT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CFIAPTER o(CAMMENCINO WITH SECTION 70D0)OF DIVISqN 3 OF THE BUSINESS AND PRO- � PooUSpa O FESSIONSCODE)OR7}N7HEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALLEdEDEXEMP� C7 U TION.ANVVIOLATIONOFSECTION7031.68VANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(t60o)J: � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWI7HWAOESASTHEIRSOLECAMPENSATION, � CORIRIBfC10I Z WILL DO THE WORK,M1D h1E STRUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7a4,BU51- J � NESS AND PROFESSIONS CODE:THE CANTRACTORS UCENSE UW DOES NOT APPLV TO Ml OWNER OF � VROPERTV WHO BURDS OF IM7ROVE5 THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROU(3H HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPqOVEMENTIS50lDWITHINONEYEAROFCAMFLE- Z TION,h1E OWNER�BUILOER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPEHTV,AME7(CWSIVELVCONTFACTINOWfTHUCENSEDCONTRACTORS � TO CONSTqUGT THE PROJECT(SEC.70N,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS LI- V8IU2110f1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOANON7JEROFAPROPERTVWIiOBUILDSORIMPROVE57HEREON,AND � NMOCONTRACTSFORSUCHPq0.1ECT5WITHIICANTMCTOR�S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y TORS IICENSE LAW.). 0 ❑I AM E%EMVT UNDEH SEC. B.8 P.C.FOF THIS REASON Q �2 U � DA7E OwNER � Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTY OF PERIUpY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTEF � � D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE.AND Z LLI MV LICENSE IS W FULL FORCE AND EFFECT. m � LICENSE CLA55 �i� LIC.NO. � T U DATE O CONTRACTOR d W � � WORKERS'COMPENSATION DECLARATION Q N U � I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLIOWING DEQARATIONS: � �Z _I HAVE AND WILL M/JNTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a Q COMPENSATION,AS PROVIDED BV SECTION 3�0a OF TME LABOR COOE.FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � / � Qw � I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REWIRED BV SECTION 3700 OF 7HE UBOR CODE,FOR hIE PERF-0RMPNCE OF THE WORN FOR WHICH THIS PERMIT IS � �� ISSUED.MV WORKERS' PENSr.97 ION IN URANCE CARRIER AND POLICV NUMBER ARE CONSTRUCTION c/ jCAARIER 5� r� PLAN REVIEW ��.JlO Z POLICY NUMBER �(�Fj=�_ ELECTRIC ¢ � (n+55Ecna�r��r�oreEo.�.wi.Er�oFn�vErurr�sroaorrEt�E000ulfts�siro�oa�ssl PLUMBING w Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL C.�} SHALL NOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECAME SU&IECT TO THE [/� WORKERS'COMPENSATIONLAWSOFCALIFORN10.NdDAQREETHATIFISHOUIDBECOME INSPECTIONFEE SUBJECTTO THE WORNERS'CAMPENSATION PROVISIONS OF SECTION J7o00F THE LABOR � COD�ISHALLFORTHWITHCOMPLVWITHTHOS PR ONS. A ISSUANCE ' i O � � p DATE: � APPLICANT: � SMIP � � w ENERGY P/C "'� WNHNINO:FAILURE TO SECURE WORKERS'COMPE ION COVERAGE IS UNUWFUL,AND SHALI BE J � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDqVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLAHS(5700,000),IN ADDI710N TOTHE COSTOF COMPENSATION,DAIAAGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEI"5 FEES. RETENTION FEE: ' r OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIqM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK F-0R WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.). Z W � LENDER'S NAME � F— LENDER'SADDRE55 w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTA L FE ES ��• I I �� I AGREE TO COMPLV WITH ALL CITV ANO CAUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING I�v � CONSTRUCTION,ANO HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOVE-ME^NTION/E��PROPERTV FOR INSPECTION PURPOSES. COMMENTS � ��"� �� ` � �J)fEn U ¢ PERMITTEE N E(P � ' ' � �i 5 D o� � SIGNATU RMI EE DAT i = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN—ApplicanYs Copy � � �D1�'17 C�'� f��Q�fil�f�� l��[i� � � -' � 96�9�(�[��f�l fRil��l1�� .. _..�----T.,T,�_—�_ . o �Gu � , � DGa�. �. DG�G��:� e ��c��DO� DQ� � Oa ° � o � a � SET BACK � �— FLOOR JOIST ' � FTGS/�ORPJIS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING i UNDER FLOOR CU�IbUIT __�: _ i SLAB GRADE FIREPLACE FOUNDATION TEPJIP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 F7. BOND BEaM FRAMINGNENTfLIATiON FI�lAL BOND B�AM ROOF COVER PRE-GRADING ROUGH HEATING BENCHlNG ROUGH ELECTRIC ROUGH GRADING ROUGN PLUNIBING � ^ �INISH uRADING SHOWER/TUB TEST � � POOL ELEC�1'RIC � � EXT. IATHlSIDING POOL FENCING WALL INSULATION POOL FINA� CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINA�ENG. SEPTfC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. • ON SITE IiVrPS. GAS AIR TEST FlNAL ZONING FINAL CONST. � FlRE DEPT. FINAL FIfVAL HEATING NEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBIMG ENERGY - o � � .�� , —__ COMiViEfVTS SEPTIC TANK SIZE SEEP PIT/U SI�E . � � � c� � < <'-