The URL can be used to link to this page

Home My WebLink About18365 _�� _ CITY OF DIAMOND BAR — DEPARTMENT OF COMMUNTTY 8c DEVELOPIvfENT SERVICES 21825 E.Copley Drive ' (909)860-3195 Fax(909)861-3117 PRESS `'-9�� BUILDING PERbIIT APPLICATION FI R M LY o� JOBSITE � ) APPLICATION �� PERMIT P/C ADDRESS� !`� DATE � �UMBER # � ISSUE TYPE OCC . APN LOT TRACT DATE CONST. GROUP °C OWNER �� OO o ADDR SS ' ZONING SETBACKS z CITY 4�. o-C ZIP G EL. FRONT qyy ❑ g APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR � /L SIDE ❑ ADDRESS� � • ' � CITY„s,�p� (��`�-i}r ZIP' � TEL.G L/' Z��'OSZ PROPOSED USE o ARCWENG/ �z DESIGNER NO.DWEL. NO. NO. � ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.Ff: FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT I AM E%EMPT FROM THE CONTRACTORS L6 Gef990/C01POfI W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.5BUSINESSANDPROFESSKKJSCODE:ANVCITYOR (n C-� COUNTVWHICHREWIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE.DEMOUSH,ORREPAIRANVSTAUG w w TURE,PRIOR TO ITS ISSUANCE.AL50 REW IRES THE APPLICANT FOR SUCH PERMIT TO FIIE A SIGNED w Patio/Deck � , � STATEMENT 7HAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTOHS LI� � CENSE LAW(CHAPTER e(CAMMENCINO WITH SECTqN 7000)OF DIVISION 3 OF iHE BUSINE55 AND PRO� � POOVSPB � FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALLEGED E%EMP� (� TION.ANV VIOLATqN OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO Z Re-Roof A CML PENALTY OF NOT MORE TFUN FfVE HUNDRED DOLLARS(f6ao).�: � ❑I.ASONMEROFTHEPROPERTY,ORMVEMPLOVEESWITH�WAGESASTHEIqSOLECOMPENSATION, � Cpmm0fCi8I Z WIIL DO h1E WORIC,AN�THE STRUCTURE IS NOT INTENDED OR OFfEFED FOR SALE(SEC.70ar,BU51� J ' � NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � � PROPERTVWHOBUILDSORIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR wTHROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUpi IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEAEDFORSALEIF,FIOWEVER71iEBUILDIN60RIMPROVEMEN71550LDWITHINONEVEAROFCOMPLE- Z TION,THE OWNEF�BUILDER WILL HAVE THE BURDEN OF PROVINd THAT HE OR SHE DID NOT BUIID OR � IMPROVE FOR THE PURPOSE OF SALE). . w ❑I,AS OWNER OF THE PROPERTV.AM EXq.USNELV CANTRACTING WRH LICENSED CONTRACTORS [= TO CONSTAUCT hIE PR0.IECT(SEC.7W1,BUSINESS M!D PROFESSIONS CODE:THE CONTRACTORS LI- VaI119IiOf1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANONRJEROFAPROPERTVWFIOBUILDSORIMPROVESTHEFEON,MID � WHOCOMRACTSFORSUCHPRQIECTSWIh1ACONTRACTOR�S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE 70RS LICENSE LAW.). � 0 ❑1 AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q 2� U � DATE OWNER F- Z U � LICENSED CONTFACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � � 9(COMMENCWOWITHSECTION7oo0)OFDIVISION70FTHEBUSINESSANDPROFESSIONSCODE,AN� Z � �� MY LICENSE IS IN FULL FORCE AND EFFECT. m � � UGENSE CLASS�� LIC.NO. � V DATE�_��_�ti• 1%Z CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION � . � U � I EREBY AFFIRM UNDER PENALTV OF PERJURV ONE OF 7HE fOLLOWINO DECURATIONS: Z � I MAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR NqRKERS' _ � COMPENSATqN,ASPROVIDEDBVSECilON37000FTHELABORCODE,FORTHEPERFORMANCE U OF THE WOFK FOR WHICH THIS PERMIT IS ISSUED. w W � � I HAVEMlD WILL MAINTAIN WORKERS'COMPENSATION INSURANCE.AS REOUIRED BV SECTION Q 3700 OF THE LABOR CADE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WOR1KERS'CQMPENSATION INSURANCE CARR}IE�R.AND POLICY,/N'U�M/BER AAE CONSTRUCTION j CARRIER �l��L LOMA 1��5 /rV/�� pLANREVIEW Z POLICY NUMBER r(�;�� 3 ^' G Z ELECTRIC \ Q • � (�HSSECf10NNE�NDTBE00RPLEfEDOFhEPEPoArISFORONEVUI�DFEDDOl1AR5(floo)ORLESS} PLUMBING W Z I CERTIFV 7HAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL C} SHALL NOT EMPLOV ANY PERSON IN N�V MANNER SO AS TO BECAME SU&IECT TO THE (n WORNERS'COMPENSATKKJ LAWS OF CALIFORNIAµD AGREE THAT IF I SHWLD BECOME INSPECTION FEE SUBJECTTO THE WORNERS'COMPENSATION 7ROVISIONS OF SECTpN 31o00F THE LABOH � CODE,I SHALL FORTHWITH COMPLY WITH THOSE P OVI ONS. ISSUANCE �r�� p DATE:�� APPLICANT: SMIP W J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATI COVERAGE IS UNLAWFUL,AND SHN.LBE ENERGY P/C J �y SU6IECT�flEMPLOYERTOCRIMWALPENALTIESANDCNILFINESUPTOONEHUNDREDTFKKISAND ENERGYPERMIT DOLLARS(S1a0.000�,IN ADDITION TO THE COST OF CAMPENSATION,DAMAQES AS PROVIDED FOR IN � J SECTqN 37aB OF THE LABOR CAOE,INTEREST,AND ATTORNEI^5 FEES. oC RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THATTHERE IS ACONSTRUCTION IENDING AGENCV � FOR THE PERFORMANCE OF THE WOFK FOR WHICH THIS PERMIT IS ISSUED(SEC.30D7,CIV.C.). Z W � LENDER'S NAME H LENDER'SADDRE55 � , ♦ � � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE WFORMATqN IS CORqECT. TOTAL FE ES � I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE LAWS RELATINQ TO BUILDINO � y V � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF THIS COUNTV TO ENT£R UPON THE Z ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS � �� ' ��, �.1 �,�S�n � m PERMITTEE NAME(PRINI] ' � '� ` � SIGNAT OF MITTE DATE • i = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Co GREEN— py, ApplicanYs Copy ��'�� 0��1��l9� [�1�1(� �(r��f��'��4�9 �i��I� ��t�/u4 �� . . _ ' ° ��. � �Q�� p a SET BACK u� FLOOR JOIST� ' FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT � GROUND PLUMBING UNQER FLOOR CO�IDU17 SLAB GRADE FIREPLACE FOUNDATlON TEMP POWER FIREPLACE BONQ BEAM WATER SERVICE ^ MID HT. BOND BEAM . � ROOF SHEATHING 8 FT. E,OND BEAM � FRAMINGNENTILIATtON FlNAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUiVIBING FINlSH GRADING SHOWERiTUB TEST POOL ELECTRIC EXT. IATH/SIDING POOL FENCING WALL IPISULATION POOL FINAL CEILING INBUl..ATION �F�SITE fMPS. DRYWALL NAILItVG DEQICATIONS SEWER FINAL EPJG. SEPTIC TANK LANDSCAPE/IRRIC,. SEEP PIT/L.L. ON SlTE lMPS. GAS AIR TEST FINAL ZONING FIIVAL CONST. F1RE DEPT. FINAL FINAL HEA7ING HEALTH DEPT. FINA� FINA�ELECTRIC � DEV. FEES PAID FINAL PLUPliBING ENERGY '� � C�Gfi�OG�o�, .. , �� COi�IiViEfVTS � �� , �. --- 4 SEPTIC TA(�K SIZE SEEP PIT/U SIZE � ,�� [s . � V ^ , . ,