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-- - � -- ---.. .... - ---- -—- ----- - - --- -------�--� -- � CITY OF DIAMOND BAR '" . COMMUNITY DEVELOPMENT DEPARTMENT ,..0 21660 E.Copley Drive Suite 190 • • , (909)860-3195 Fax(909)861-3117 ' � �� PRESS �''"'� B UILDING PERMIT APPLICATION FI R M LY o� JOBSITE APPLICATION PERMfT '�D7 2 p/c ADDRESS DATE_ NUMBER ♦ � ISSUE TyPE pCC • APN O TRACT DATE � CONST. GROUP p OWNER C p ADD S I 20NING SETBACKS , � , � W FRONT � CfTY IC YZIP . TEL. � ' �.� REAR RW O APPLICANT TEL. SIDE/SIDE STRElT RW O ' � CONTRACTO � C 1 SIOE p ADDRESS � CITY 71P rjTEL. PROPOSED USE o ARCFVENG/ � DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS . � �n DESCFIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BI:ILDER DECLAFiATION SFR/ADD/HEM O p I NEREBY AFFIRM UNDER PENALTY OF PERJURV TMAT 1 MI EXEMPT FROA1 iNE CONTMCTOqS Lt� G8f8QB/C9ry0R � W CENSEUWFORTHEFOLLOWINGREASON(SEC.70.t1.66U51NE5SANDVi10FESSION500DE:MlYCITYOR (/� U COVNTYNh11C11PE0UIRE511VERMRTOCONSTHUCT,KTERYPROVE.DEA10L15H.0i1REPAIRANYSTRUG W W NRE.ViUOR TO RS i55UANCE.JLLSO RE�UIRES THE APPLICANT iOP St1CH VEMIIT TO FLLE A SIGNE� w Patlo/Deck . � STATEYENT T1uT NE OR SHE IS UCENSEO PURSUANT TO TNE DRONSIONS OF iHE CONTMCTORS L4 � � CENSE UW(CNAPTER Y�COMMENCN6 WITM SECTION 7000)OF DIVISqN 7 OF iH[BUSMESS ANO PRO� PaoVSpa • � FESSIONSCODE)ORTHA7NEOR571EISE%EIAPTTHER[FROu/WOTNEBASiSFORTHEALLEGEDEXEMP• (� TION.ANYVKKATqNOFSECTION7o71.68YANV�VPLICIMFORAiEMu75U8JECTSTnEMVIIC�NTTO Z Re-qoot . . . � A CML VENALTT Oi NO7 MOR[THAN FNE MUNOREO DOIURS�SSao)$ OLASOWNEROFTHEPRDPFRTV,OfiYYEMP�OVEESWITMWACE5ASIHEIRSOLECOMPENSATION, O �mmereiat Z 1MLl DO THE WORK ANO THE STRUCNRE IS NOT IMENOED Oli OFFERED FOR SALE(SEG 70��,BU51� J ' ' , N NE55 AND OPOFESSiONS CODE:iNE CONTfUCTORS LICENSE LAW DOES NO7 APVIV TO AN OWNER OF j 7ROPERTYNM1qBU1LDSONDA7ROVESTMEPEON,NJDYVI1000ESSUpiWDRNHIA15ElFOqHERSELFOR � • WT11ROl1GHNISORNEN05M1EMVLOVEES,PROV10EDTHATSUp/MVRpVEMENiSARENO7MENDEDOR m � OFFEREDFOq9ALE1F,/10riEYEi�7i1EBULqNOORWPROVEMENTISSOIDWfTItlNONEYEAROF�pMPLE• Z TION,iME OWNER�BUILDER WILL MAVE 7ME BURDEfI OF PqOV►1�TH�7 ME OR SHE D�D NO7 BUILD OR � WtAPHOYEFORiHEPURPOSEOFSALEI �4�OWNEROFTHEVROPERTY.AME7ICAUSNELYCONTMCTINaWITHLICEh'SEUfY1MMCTOq3 � � TO CONSTPAICT TME VRO.IECT(5E4 70��.9USINE55 AN�VROFESSiONS CoOE:TME CONTRACTORS LI• V8IUBSIWI ADJ.AFiEA � � W CENSEUwpOESNOTAPPLYTOANOwNEROFAPNDOEATYWNOBUILC30R4PROVESMERE0N,11ND � MMOCONTMCTSFORSUCHPRp,lEC73WITHACONTMCiON�S�LICENSEDPURSUNfTTOMECONfRAG QUANTITY DESCRIPTICIN ' FEE � TOiiS LICENSE lAW). , - 0 O I AM EXEMPT UNOER SfC. B.d P.C,FORTHIS REASON Q ?y U ZDATE OWNER ' U . . � LICENSED CONTRACTORS DECUHATION W � IHEREBYAFFIRMUNDERVENALTYOFiEiWRYTHATIAA1lICENSEDUNOERPROV1510NSOFCHAPTER V. � p., ��COMMENCINOWITHSECTION70aD10FDNISION]OFTHEBUSWESSANOVROFESSIONSCODE,ANU Z u� W UCENSE IS W FULL FORCE/ND EiFECT. m ' ^ � LICENSECUSS �M-3co �,�.� � � V DATE 3��I'"'M CONTRACTOR • �' d � WORKERS'COMPENS��c ,,G�rte.l 11,Q� � yIHEREBVAFFIRMUNDERVENALTYOF�E0.NRYONEOFTMEFOLLOYANGOECIA(LlTqNS: Z � , . � �1 HAVE M/D MALL MAINTUN A CER7tFICATE OF CONSENT TO SELFaNSURE Fdi VpRI(ERS' � a COMOENSATp1,A5 PROv10ED BV SECTON]7ao OF TNE IABOR COOE,FOR h1E FERFONAANCE �U Q Oi T1iE WONK F01i VYHIp1 THIS PERMIT 61SSUED. � � _IHAYEM1pWILLMAiMArtIWORKE0.S'Od.1PEN5ATIONINSURANCE,ASREOUREDBY3ECT�ON Q 77000FTHEUBORCODE,FORTMEpERFOMIANCEOFiHEWORKfOH1»iIpITNiSVERM1T15 J ISSVED.MYYYO RFRS'CO 15ATIONINSURANCECMRIERAHDVOLICYNWBERME: CONSTRUCTION Q � > ��Ew_- �� mfl PLAN REVIEW � POLICYNUMBEfl � � ELECTRIC Q � (IN65ECIqNNEEDNOTBE6�tETmpFMPERMf6PoRONEHU�ORED00l1MSptOD)qiLF551 PLUMBING . �I� W Z ICERTIFYTHATWTHEPERFORMANCEOFiHEWOFIKFOHWN101THiSPERMiTlS65UED.1 MECFIANICAL U' SHALLND7EUPLOVANYPER50NWANVAIANNEH50ASTOBEW6�ESU8JECTTOTNE �• N VVORKERS'tOA1PEN5AT10NUN50FCM1FORNU,ANDAGREETMATIFISMOUIDBECOAIE INSPECTIONFEE � S SUBIECTTO7MEWORKEHS'COMPENSA7 NPROVISIONSOFSECTqN77o00FTME �OR O E.1 SMALL F'ORTMMTM CO�APLY 0.5E PROVISIONS. 1SSUANCE ' _ ��s.Q� � p �ATE:�1��1 APPLIGNT SMIP � ENERGY P/C ' ' WMNINO:iALURETOSEWREWOi1KER5'COMPENS�TIDNCOVERAGEISUNUWF'UL,ANDSX' BE � SUaIECTANEMPIAYERTOCfUMiNALPENALTIE5MIDGVILFNESUPTOONEHUNORE07110US11l1� ENERC3YPERMIT �' � DOUARS p100,000),N PDDITION TO iHE COST OF COAAPENSATION,DM/AGES AS PROVIOED FOR iN SECTION]70eOF711EUBORCOOE.INTERE3T.ANOATfORN[Y'SFEES. RETENTIONFEE: � � 0 CON5TRUCTION LENOING AGENCY pRE-ALT FEE: � IHERCBYAFFIRMUNDERVENALTYOFVEfWMTHATTHEREISACONSiRUCT10NLEN�WG�CENCY I�,'r � Z iORiNEVERFORMANCEOFT71EW0171CFORWHip/TNISVERurtI5155UED(SEGlou7,CN.CJ. �� , W � IENDERS NAYE � LENDER'SADDRE53 - � IGERTIfYTMATINAVEREADiHISAPPLICATIONANDbTATEhUTTHEABOVEINFORYATqNISCORRECL TOTAL FEES �( 2,3. I S � IAGREETOCOMPLYWITHKLpTYFNOCOUNTYORDWANCESANOSTATEUWSREUTNOTOBU�lD�NO . � CONSiRUCTiON,ANDMEREBYAUTHDqREREPRESEMATIVE50FTw5COUNTYTOEMERUPONTME • Z ABOVE�MENT70NEDVROPEHNFORMSPEGTIONYURVOSES. COMMENTS - � 0 ✓ � 1�Ia L � PE 1 E WUAE ryRINn ^ �- ' � C �/�=' (n E OF YEtat177 E DA7E � RECP7.NO. PpID BY VALIDATION � WHiTE—Department Copy.YELLOW—Fnance Copy,PINK—Assessa Copy.GOLDENROD--File Copy,GREEN—ApplM.ant'a Copy . . . _i: .'ti,�, �.C�•'i� :i„ ��� . • rvJ ' . . '- " , �..t,m !. -;i .� . • , f.. . .. .. � .. . . . . . �r ,.� , .., . . 1� � . • . . r r� CITY,O.F.�DIA�JIOI�lD BAR ':';�,'�.:' f;::' . 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POOL ELECTRIC . _ �." I '` . .... . .EXT..LATH!SIDING -; --- -�-- - -- - - -;------�-_ ; -POOL FENCING ; '. ,• . .; ,. � �. WALL INSULATION ; ' - I POOL FINAL �• • � • • � � ! � CEILING INSULATION OFF SITElP.1PS.�.' � ' ' I �• DRYWALL NAILING � DEDICA710NS ; • � � � � �� SEWER ! _ _ _..._._ FINAL ENG. . ' ' � ' --- �---- ------ -- ---- - --. ._..--�---- ,,. . SEP_TICTANK_: __ _- ...:. =�-'-:-`..-. -.-- -:-._--... .---- � • LANDSCAPEIIRRIG. . .•. � _ � , . , _SEEP.PlT/L.L.-: _ '`' '__. ON SITE Ih1PS. -- ---.._.__...- - - .. ---- •- FINAL ZONING � - . _. _ :. . • , .GAS AIR TEST;--- --�- ------ - -- - � FINAl.-CaNST.-;----- --------- ---- - - - -•--•---- - FlRE UEPT. FINAL . _ . , � :„ FINAL-HEATING----... _-- � .._.. ._ - HcALfiH DEPT:FIiJAL- : --- . --- - - - -- - --- - -� . . ---- -- � ------�-------,. � . FINAL ELECTFiIC-- ---- -- -- -- ----- ---- - - ------ - DEV. 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