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Home My WebLink About14474 (32)CITY OF DIAMOND BAR - — DEPARTMENT OF COMMUNITY & DEVEL PVQk 21660 E. Copley Drive Suite 190 ' (909) 860-3195 Fax (909) 861-3117 PRESS ,: BUILDING PERMIT APPLICATIOx. _.--pl-FIRMLY ADDRESS JOBSITE 2• 11726 oI6rd 7'a,.Z4V (7en*e,, Dpi L' e- APN LOT TRACT OWNER/ - ADDRESS Ho e lV-1 AU S C. OL !_ CITY b/PN.OGAO % ZIP9/ 6, TEL. R/n-5 APPLICANT TEL. CONTRACTOR IP • ��%�) -��/" � � dE / �C - ADDRESS Z Sob k1/iFinJCE_'_ JJ L•/jz CITY TEL. 3 15-SQZF ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS Ll- CENSE F CENSE LAW FOR 7HE FOLLOWING REASON (SEC.7031.6 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REOVIRESA PERMIT 70 CONSTRUCT. ALTER IMPROVE, DEMOLISH, OR RE PAIR ANYSTRt7D TUBE. PRIOR TO ITS ISSUANCE. ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CCNTRAC70RS LL CENSE LAW (CHAPTER 9 (COMMENCNO WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PRO- FESSIONSCODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- T10N.ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO AC7VIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (3500).}. O LAS OWNER OF THE PROPEPITY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WALL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 70". BUSI- NESSAND PROFESSIONS CODE: THE CONTRACTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVESTHEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT MENDED OR OFFEREDFORSALE IF. HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE- .. THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALEL 0 L AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70", 13USINESS AND PROFESSION CODE: THE CONTRACTORS U. CENSE LAW DOES NOT APPLY TOAN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND 7'040 CONTRACTS FOR SUCH PROJECTS WITHACONTRACTOR(S) LICENSED PURSUANT TOTHE CONTRAC- TORS ONTRAOTORS LICENSE LAW.). D I AM MPF B. i P.C. FOR THIS REASON D E A" — OWNER LICENSED CONTRACTORS DECLARATION I HEREBYAFFIWA UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER B (COMMENCING 10TH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE. AND MY LICENSE 6 N FULL FORCE AND EFFECT. LICENSE CLASS LIC. NO. DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _I HAVE ANO WLLLWNTAN A CERMCATE OF CONSENT TO SELFMNSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND W.U. MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REOUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMITIS ISSUEO. MY WORKERS' COALPENSATON INSURANCE CARRIER AND POLICY NUMBER ARE. CARRIER POLICY NUMBER QHBSECIICN NEEDNOT BE COMF%ETED OF" PERMTIS FORCING HUNDRED OOUAFLS (S10q ORLCS4 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 WORKERS' COMPENSATION LANES OF CALIFORNIA,ANO AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE.I SHALL FORTMNTH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT. WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (61 00,000). N ADDITION TO THE COST OF COMPENSATION. DAMAGESAS PROVIDED FOR N SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGCNCY FOR THE PERFORMANCE OF THE WORK FOR WHK.7N THIS PERMIT IS ISSUED (SEC. 3097, CIV. C.). LENDERS NAME LENDERSADORESS I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT 1 AGREE TO COMPLY WITH ALL CRY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMITTEE (PRINT) iC RMTTEE DATE APPLICATIO PERMIT P/C DATE _ NUMBE M ISSUE TYPE OCC DATE GROUP ZONING SETBACKS FRONT �q p; RW ❑ REAR U 1, I ❑ SIDE/SIDE STREET R ❑ SIDE - ❑ PROPOSED USE t' ac s o Lei0 14,4srI-AJAI 'L3 C NO. DWEL NO. 0. UNITS STORIES BEDROOMS DESCRIPTION' SO. FT. FACTOR PSF ADJ. AREANALUATION SFFVADD/REM Garag&Carport WPatimDeck -- - u- PooVSpa ZRe -Roof 0 Commercial - m Valuation 10 - � 6J ADJ.AREA OUANTITY DESCRIPTION FEE . Q U JW W C7 Z m J a U _ 2 Q 2 U W ' Q CONSTRUCTION PLAN REVIEW ELECTRIC I PLUMBING ' MECHANICAL J INSPECTION FEE ISSUANCE - j A SMTP IF �-j 4 ENERGY P/C r"T_YOFDIAAIpn�BAR ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES LG COMMENTS RECPT. NO. e, PAID BY VALIDATION WHITE—Department Copy, YELLOW—Finance Copy. PINK—Anassor Copy. GOLDENROD—File Copy, GREEN—Applirant'B Copy - v 1 OF DIAMOND BAR •,,,; p 1.I PECTION RECORD'' SET BACK i 1 t - ; _. `,.. �. , 1 I FLOOR JOIST I FIGS/FORMS/STEEL ' I FHA REOMTS ELECTRIC'GROUND-- - UNDER FLOOR DUCT " GROUND PLUMBING " '=' UNDER FLOOR CONDUIT-' • i SLAB GRADE- 0jai FIREPLACE FOUNDATION - TEMP POWERFIREPLACE BOND BEAM - WATER SERVICE - -' - = - MID HT. BOND BEAM ROOF.SHEATHING - 8 FT. BOND BEAM - I FRAMING/VENTILIATION „ - FINAL BOND BEAM I ' ROOF COVER .. - PRE -GRADING ROUGH HEATING _ 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. .SEPTIC TANK..._ . _ _.. _._ LANDSCAPE/IRRIG. SEEP PIT/L.L. -. - ON SITE IMPS. -GAS AIR TEST FINAL ZONING -FINAL-CONST. - F.IREDEPT. FINAL FINAL HEATING - - HEALTH DEPT.' FINAL _ .. • - , - ' FINAL ELECTRIC _ DEV.;FEES PAID _ FINAL PLUMBING ENERGY i -COMMENTS . .. __. i SEPTIC TANK SIZE' SEEP. PIT/U-SIZE _ _.