The URL can be used to link to this page

Home My WebLink About107031 � CITY OFDIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21660 E. Copley Drive Suite 190 OVA (909) 860-3195 Fax (909) 861.3117 BUILDING PERMIT APPLICATION r c 0 tA.. LIJ 0 L] A Cn Ln Cn O w U O Z fA ¢ ILIJZ W f O lf.. d OO U w N N 0 O C 0 J y0 W Z fn S O Jw J J LU a O 2 O. C W (11 Z C8 i ,d U) Ch iE JOEISITE ADDRESS APN LOT TRACT OWNER ADDRESS CITY DiIA DrAr ZIP . TEL APPLICANT TEL CONTRACTOR 49 jz., fe 2 F1 n e3 ADDRE -�c CITY U ZIP -g�a TEL. -L N ARCFIIENG/ DESIGNER-L�m h ADDR SS G`�f"' (� � CITY ZIP ,92_%'4Cr L __ OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS U. CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.6 BUSINESS AND PROFESSIONS CODE: ANY CITYOR COUNTY WHICH REOUIRES A PERMIT TO CONSTRUCT,ALTER IMPROVE, DEMOUSN,OR REPAIR ANY STRUC- TURE, PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LL CENSE LAW (CHAPTER 0 (COMMENCING WITH SECTION 7000) OF DIVISIONS OF THE BUSINESS AND PRO. FESSKNS CODE) OR THAT HE OR SHE 15 EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TIMI, ANY VIOLATION OF SECTION 7031.6 BYANYAPPUCANT FORA PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSDO) ): O LAS OWNEROFTHE PROPERTY, OR MY EMPLOYEES WITH WAGESAS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUST. NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BULLS OR IMPROVES THEREON. AND WHO DOES SUCH WORK HIMSELF OR HERSELFOR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVERTHEBUILDINGOROAPnOWMENTISSOLDWITHINONEYEAROFCOMPLE- TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DO NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O L AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI. CENSE LAW DOESNOTAPPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WH FOR SUCH PROJECTS WITHA CONTRACTORtS) LICENSED PURSUANT 70 THE CONTRAG TORS LICENSE LAW.). ❑ I AM EXEMPT UNDER SEC. B. A P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM LINDE R PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 0 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE AND MY LICENSE IS IN FULLfORCE2NO FFECT. ON V LICENSE S CC `� LIC. NO. DATE ci 7 CONTRACTOR 3 WORKERS' COMPENSATION DECLARATION I HEREBYAFFIRM TINDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 37000E THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I MAVE AND WILL MAINTAN WORKERS' COMPENSATION INSURANCE, AS REWIRED BY SECTION 37000E THE LABOR CODE, FOR THE PERFORMANCE OF THE WOR( FOR WHICH THIS PERMIT IS ISSUED. MY RKE JMPENS NSU CE CARRIER AND POLICY H.IIBER ARE: CARRIER 4 POLICY WMBER Z, C (DIS SECTION NEEDNOT BE ocNF%ETEDOFT/E PERMIT 6 FORCNE H1FDREDD01 I ARS 010DI ORLES% I CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS=CT PERMIT IS 6 0,1 SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECTT E WORKERS'COMPENSATKN LAWS OF CALIFORNIA, AND AGREETHAT IF IS II SUBJECT TO THE WORKERS'COMPENSATIDN PROVISION SOF SEC 3 FTHE LABOR COBE. 5 FOWORKTH'COLIP NSATIO PRO SIGNS. DATE: 7 APPLICANT: WARNING: FALURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (9100,000L N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTI N 3700 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THATTHERE 6 A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE DF THE WORK FOR WHICH THIS PERMIT 15 ISSUED ISEQ 3007, CIV. G). LENDER'S NAME LENDERS ADDRESS I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WIT./ ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE4AENT)ONED PROPERTY FOR INSPECTION PURPOSES. Qi PEFMOTTEE NAY ryUNT) SKLNATURE OF PERM7- DqrE PRESS FIRMLY CATION O r1z6?5;, DATEAPPLI tPERMIT NUMB R N� ISSUE TYPE OCC DATE CONST. GROUP ZONING KS EXPIRED Ra r o REAR ❑ SIDEISIDE STREET �_ 0 - SIDE ❑ ROPOSED USE NO. DWEL NO. NO. _ UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport WPatio0ack - V" PooUSpa ZRe -Root GO ) Commercial Valuation ADJ.AREA QUANTITY DESCRIPTICN FEE 4 U cc U J W I9 Z m U 2 a U W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY PIC ENERGY PERMIT - RETENTION FEE: f PRE -ALT FEE: TOTAL FEES f COMMENTS rC I • .s - RECPL NO. ' PAID BY VAUDA WHITE—Dpinmont Copy. YELLOW—FlrurXs Copy. PINK—AaN66aW Copy. GOLDENHQD—FIIe Copy, GHEL14—ApplimnC6l:Opy �Vvm, • Y,OF DIAMOrID BAR SPE&ION RECORD, Xo lot SETACK7FC66);;7di FTGSIFORMSISTEEL- FHA RECIMTS ELECTRIC GROUNDff:j ;Ir-{ X3 UNDER FLOOR DUCT GROUND PLUMBING" UNDER t_,'Lf5biHbi!bUIT SLAB GRADE. (711 rU FIREPLACE FOUNDATION -T E 1.1 R: P 0 W E R -FIREPLACE BOND BEQ1' WATER SERVICE:', MID wl'.i.13C)NIQ. BEAM RbOFSHEATH1NG_--_ 8 FT BOND BEAM FRAMINGIVENTILIATION 'FINAL BOND SEAM ROOF dOVER I In: Ji�j rn -ROUGH'HEATING---: -BENCHING _7 ROUGH ELECTRIC—— -AdUGH GRADING, -ROUGH-PLUMBING- , fliTSH GRADING .2... 'SHOWER/TUB TEST. ------- "POOL ELECTRIC =.1ATH1SID1NG'__'i -POOL FENCING - 1 WALL INSULATION POOLFINAL .- CEILING INSULATION i i OFF SITE'IMPS.".1, DRYWALL NAILING DEDICATIONS SEWER - ----- FINAL ENG. SEPTIC.TANK -T3 s LAN0SCAPE/inRIG.'...:- 79EEP_PJT1LL_L____ ONSITE IMPS. GASAIR-TEST.--- FINAL ZONING FINAL. GONST-__ FIRE DEPT FINAL FINAL -HEATING -- ---- -- - HEALTH DEPT. FINAL- .... .. FINAL ELECTRIC -DE)/. FEES PAID FINAUPLUMBING ENERGY A Ix COMMENTS yj 7� SEPTIC TANK SIZE -- 'SEEP PIT/U'SIZE ------------- - --- --- T Z3 - I �7