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Home My WebLink About13-1924 ��_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 , PRE$$ "TM° BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE / O r� �.� ��. � E DATEICATION NUMBER/� / f 2��lC� ADDRESS � 4 � APN r LOT TRACT ISSUE 7 TYPE OCC �� DATE /��J CONST. GROUP p OWNER F��"Z/E. /�=1cNLI?.lYl'1 p ADDRESS 1t � ZONING SETBACKS Z CITY 1 ZIP TEL . `.7 FRONT Ryy p g APPLICANT / TEL. • �� REAR p � SIDE/SIDE STREET RW ❑ � CONTRACT R SIDE p ADDRESS � E • O � CITY ' ZIP `� TEL. 00 f PROPOSED USE Q O � ARCWENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � rn DESCRIPTION Sd.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION 0 SFR/ADD/REM � I HER�V AFFIRM UNDER PENAL7Y OF PERNRV THAT I AM E%EMPT FFOM THE CONTMCTORS L6 GBfegB/CBfPOA W CENSE UW FOR THE FOILOWINO REASON(SEC.70.71.6 BUSINESSAND PROFESSIONS COOE:A/JV CIT'OR (n V COUNTVWHICHRC-0UIRESAPERMI77000NSTRUC7,ALTER,IMPROVE.DEMOLISH,ORREPAIRMIYSTRUC� W � w NRE,PRIOR TO ITS ISSUANCE.AL50 REOUIRES 711E APPLICANT FOR SUCH PERMIT TO FILE A SIONED w Patio/Deck � STATEMENT h7AT HE OR SHE IS IJCENSEO PURSUANT TO THE PROVISIONS OF THE CONTRACTORS L4 � � CENSE UW(CHAPTER D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� POOUSPB � FESSIONS CODE)OR THAT HE OR SHE IS E%EMPTTHEREFROM AN�THE BASIS FOR THE ALLEOED E%EMP- (� TION.ANY VqUTION OF SECTION 7031.5 BV ANV APPUCANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof A CML PENALTV OF NOT MORE hiAN FIVE HUNDRED DOLLARS(f500).): 0 ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COTRIBfC181 Z MALL DO THE WORIC,AND THE STRUCTURE IS NOT INTENDED OR OFFERED f-0R SALE(SEC.7w�,BUSI� J � N NESS AND PROFESSIONS CODE 7HE CAMRACTORS UCENSE UW DOES NOT APPLV TO Ml OWNER OF � PROPEHTY WFiO BUtLDS OH IMPROVES THEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR NER OWN EMPLOVEES.FROVIDED THAT SUCH IMPROVEMEMS ARE NOT WTENDED OR m Q OFFEREDFbR9KEIF,HOWEVERTNEBUILDINGORUAPROVEMENTI350lDWITMINONEVEAROFCQNPLE- Z TIDN,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUIIA OR � WPROVEFORTMEPURPOSEOFSALE). w ❑I,ASOWNEROFTHEPROPERTY,A/AEXCLUSIVELYCqNTMCTINOWRHUCENSEDCOFlTRACTORS [[ TO CONSTRUCT THE PRQIECT(SEC.7w�,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81UHlIOf1 ADJ.AREA - W CENSE UW DOES NOT APPLV TO AN ONMER OF A PROFERTV WHO BUILDS OH IMPROVES THEREON,AND � NMOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUAIJTTOTHECONTRAG QUANTITY DESCRIPTION TORS UCENSE UW.�. FEE � ❑1 AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � • U I � DATE OWNER � Z U ¢� LICENSED CONTRACTORS DECLARATION w 2 I HEREBY AFFIRAI UNDEF PENALTV OF PEfiJURV THAT 1 AM UCENSED UNDER PROVISIONS OF CHAPTER � /� � B(COMMENCIMO WITH SECTION 7000)OF DIVISION 3 OF THE BUSWESS AND PROFESSIONS CADE,AND Z 1/� 0 ' �� MV LICENSE IS IN FULL FORCE AND EFFECT. m � UCENSE CLASS �IC.NO. � � V DATE O�I CONTRACTOR d W � WORKERS'COMPENSATION DECLAR . � . ' � I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWINO DECURATIONS: Z � �I FIAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOF WORKERS' � � � COMPENSATION,AS PROVIOED BV SECTION 370o OF THE LABOR COOE,FOR TME PERFORMANCE w Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w I HAVE AND WILI MAINTAIN WORKERS'COMPENSATION INSURANCE.AS REWIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION � CARRIER PLAN REVIEW � � POLICYNUMBER Z ELECTRIC Q � (1HISSECiNJNNE�NO7BECOA4LEfEDOFTiEPEPMfTISFORONEFAN�OREDD0U.A1iS(f100�ORLESS� PLUMBING �' � W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICM THIS PERMIT IS ISSUED,I MECHANICAL ' �} SHAIL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE (n .WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF 1 SHOULD BECAME INSPECTION FEE = SU&IECT TO THE WORKERS'COMPENSATION P OVISIONS OF TbN 370o OF THE LABOR CODE,I SHALL FORTHWITH COMPLV WI �E PRO S ISSUANCE �^ 0 //��1� p �ATE: � D� APPLICANT: KJ �SMIP W J WAANING FAILURE TO SECUFE WORKERS'COMPENSAT RAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C J � SUBJECTANEMPLOYERTOCRIMINALPENAlTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOILARS(5100.000),IN/�DDI710N TO THE COS70F CqA1PEN5ATKKJ,DAMAGES AS PROVIDED f-0R IN J SECTION 3708 OFTHE LABOR CADE,MTEREST,ANDATTORNEV'S FEES. w RETENTION FEE:� �GYJ O CONSTRUCTION LENDING AGENCV PRE•ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS ACQ4STRUCTION LENDINQ AOENCY FOR THE PERFORMANCE OF THE WORK FOR WNICH THIS PERMIT IS ISSUED(SEC.3oY7,CIV.C.). Z W � LENDER'S NAAIE � IENDER5ADDRESS� � I CERTIFV TNAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFOqMAT10N IS CARRECT. TOTAL FE ES �� I AGREE TO COMPLV WITH AlL CfTV ANO CWNTV ORDINANCES AND STATE UWS REUTINQ TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF THIS CWNTV TO ENTER UPON THE Z ABOVE-MEMqNED PROPERTV FOR INSPECTION PURPOSES. COMMENTS ' � �4nCf 14 Cc�n A � m PE NAME(PR ' � � . CG�� - Q- ,� � REOFP ITT DATE � � RECPT.NO.I " Z PAID BY VALIDATION WHITE—Depanment Copy,YELLOW�Inence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy � � ci�v o� �e��o�� a� i�s��c�oo� ��co�� :��oa�p�c�ooa . o .�, ; , oa�r�Qc��a _ y . oa�p�c�400a �a��:- o�� " �� :.�` E� SET BACK _ FLOOR JOIST.''. ' ,., ' ,', , ' ` ' :.'' . �. ` • • FTGS/FORMSJSTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT ' •�� L ' •• � ' GROUND PLUMBING UNDER FLOOR CC�NDI�IT•� t•� ," ` �' �'�~ ' ' ' • SLAB GRADE FIREPLAC.� ��OUNDRTION ' �� ' �, � ' TEMP POWER FIREPLACE BOND BEAM�. " '� .; WATEt�SERVICE . MID H'L BOND BEAM•.. ' � � . •k-'� • • `�'� ROOF SHEATHING � � ' � ' 8 F�'t BONt��B�AM �: `.• .....: . . ` `�� `. FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OF�SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PITlL.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEA�TH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING /7�ja' • . , ENERGY . . i . , C�" �aC� - , ' COMMENTS a , .. ; . , SEPTIC TANK SIZE SEEP PIT/U SIZE a �� . � , � , .��,�r Q � � ,