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Home My WebLink About14783 (29)CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 14 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 _ BUILDING PERMIT APPLICATION • l JOBSITE ADDRES —1 22- C- of del' Vr ac us Dr ADDRESS -1 APN LOT TRACT OWNER n ADDRESS OCAu 1 vr CITY Q O O r IP 11 %5 TE 02 " APPLICANTIN n EL =Jlb�ti F S-13J� CONTRACTOR 1A 0 -it) n H C•_n ADDR S CITY 0 0. r ZIP qQLLL5 T 5 - -PP ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LM CENSE LAW FORTHE FOLLOWNG REASON (SEG TWIX BUSINESSAND PROFESSIONS ODDE: ANY CITY OR COUNTYWMIfN REGUIRES A PERMITTO CONSTRUCT. ALTER IMPROVE. DEMOLISH, OR REPAIR ANY STRUG TURF, 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 CONTRACTORS LL CENSE LAW (CHAPTER a (COMMENCING WITH SECTION 7000) OF DIVISION 5 OF THE BUSINESS AND PRO- FEBSONBCCDE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THEALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 70013 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ISSWI.): O L ASOWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEG 7044, BUSI- NESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. W.HOWEVEK THE BUILDING ORIMPROVEMENTIS SOLD WITHIN ONE YEAROF COMPLE. TION, THE OWNERAUIDER 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 U. DO CENSE LAW ES NOTAPPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WTIDCONTRACTS FOR SUCH PROJECTS PATH ACOHTRACTOR(S) LICENSED PURSUANT TO THE CONTRAG TORS LICENSE LAW ). O IAM EXEMPT UNDER SEG 8. L P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBYAFFIRA UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER S (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE SUS:NESS AND PROFESSIONS CODE, AND MY LICENSE IS N FULL FORCE AND EFFECT. 'J •/� LMNSE CLASS �Y ...N.. r Z J DATE CONTRACTOR S% WORKERS'COMPENSATIONDECLARA N n (HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWO OECURAT✓S _I HAVE AND WILL MANUIN A CERTIFICATE OF CONSENT TO SEL INSUREFOR NIORKERS' COMPENSATON.AS PROVIDED BY SECTION 0700 OF THE LABOR E, FOR THE PERFO C OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS RECUIRE CTON 5700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR THIS PERM( ISSUED. MY WO EA5 COMPENSAT INSURAN CARRIER AND POL hUMeER AA GUUUER POLICY NUMBER ITMISSECTION NEIDIIOT BE OOMFTETEDOFTF[PEfi,FTISFOR ONE FJAJD OLLARS Tt00)ORLL F I CERTIFY THAT N THE PERFORMANCE OF THE WOR( FOR WHICH THIS PERMR IS ISSUED,1 SHALL NOT EMPLOY ANY PERSON N ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 7700 OF THE LABOR . CODE, I SHALLFORTHWITH COMPLY WI THOSEPROMSNS (�/�},�. DATE: APPLICANT: 6hO irm ou F , 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 (S 100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR N SECTION 7708 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORT( FOR WHICH THIS PERMIT IS ISSUED (SEC. 7087, CIV. G). LENDERS NAME LENDERSADORESS 1 CERTIFY THAT 1 HAVE READ THIS APPUCATON AND STATE THAT THE ABOVE INFORMATION IS CORRECT. (AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE RE P RESENTATNES OF THIS COUNTY TO ENTER UPON THE ADOVE.MENTONED PROPERTY FOR INSPECTION PURPOSES. _--lowis morY.AV P MTTE AME I1M 5%NATUAE0rPER0ITTEE DAT 0 PRESS FIRMLY APPLICATION PERMIT I70 P/C DATE NUMBER 1 N ISSUETYPE OCC DATE ('13_ CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDESTREET RW ❑ L-1 SIDE p PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT FACTOR PSF ADJ. AREAIVALUATION SFR/AOD/REM CD Garaga/CarpoIT WPatio/Dock L- PooVSpa 0u Z Re -Roof OJ Commercial - 5 m Valuation ADJ.AREA QUANTITY DESCRIPTICN FEE J Q _U LL) LU LU Z Wne,=rE S / L V STRUCTION EV1 L RIC LUMBING MECHANICAL INSPECTION FEE ISSUANCE �� • � SMIP C ■1VV ENERGY PIC ENERGY PERMIT r RETENTION FEE: PRE -ALT FEE: nl5 ' TOTAL FEES COMMENTS RECPT. NO. PAID BY t VALIDATION WHITE—Department Copy. YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN—Applicant's Copy CITY OF DIAMOND,BAR , , INSPECTION;RECORD ' :ji+�4►�c�rlsl�J �' I'= -�� ' R•� ��+'. '.I�` ��.--.{{.��G...._^I. .i�l��;�_�t�.�►'� �... ........�.,..~• 'SET BACK ..r � -� � w FLOOR JOIST _~�� I � _- • FTGS!FORPY S'STEEL FHA REQMTS '. ELECTRIC GROUND. UNDER FLOOR DUCT IGROUND PLUMBING I UNDER FLOOR CONDUIT' - (SLAB GRADE i FIREPLACE FOUNDATION !TEMP POWER FIREPLACE -BOND BEAM VATER SERVICE- MID HT. BOND BEAM 'ROOF SHEATHING 8 FT. BOND BEAM - FRAM ,ING:NENTILIATION FINAL'BOND BEAM ;ROOF COVER PRE -GRADING ROUGH HEATING BENCHING 'ROUGH ELECTRIC ROUGH GRADING ROUGI-J PLUMBING I - .-... - FINISH GRADING SHOWE_R.ITUB TEST - - POOL,ELECTRIC ; .• EXT. LATH?SIDING - - POOL FENCING I Y j %AIALL INSULATION - POOL FINAL CEILING INSULATION - OFF SITE IMPS. ,. DRYWALL` NAILING- DEDICATIONS SEINER FINALENG. SEPTIC TANK LANDSCAPE/IRRIG. j SEEP PITiL.L. I ONSITE IMPS. j ;SAS AIR TEST FINALZONING �IF1Pq'AL COPJST. FIRE DEPT. FINAL I FINAL HEATING HEALTH DEPT. FINAL---- r'FINAL ELECTRIC � - �_ DEV. FEES PAID ^—~ �- FINAL PLUMBING _z0 ENERGY _-M,llMlENTS L(- I `1 - erJ �'�-`rc�_I Tco��s3_•� r� f _• V. :SEPTIC TANK SIZE SEEP PIT/Lf SIZE ,�; -- – --- —