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Home My WebLink About18348 (28) � --�� _ CTTY OF DIAMOND BAR � �� DEPARTME?VT OF COI�RvfUNTfY&�DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS ��'<M^� BUILDING PERMIT APPLICATION FIRMLY } JOBSITE 21050 Golden.S rin S Rd APPLICATION � �/�_ � PERMIT Q�� P/C o ADDRESS p g DATE � o��•�U v�unneER 0 n � APN LOT �+ TRACT LZ�FOG ISSUE TYPE OCC p OWNER Lakeview V111S e CO DATE CONST. GROUP p ADDRESS 129�1 Har OI' Bl. Sll L�-5 ZONING SETBACKS Z- CITY Garden Grove ziP 92840 7EL. FRONT qyy ❑ o APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ � ADDR�SS ' � CITY ZIP TEL. - � PROPOSED USE oARCWENG/ z DESIGNER � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLAFATION SFR/ADD/REM O � I HEREBV AFFIRM UNDER PENALTV OF PE0.ttIRY THAT I MI E%EMPT FROM THE CONTRACTORS LI� G8f8JB/CafpOR I W CENSELAWFORTHEFOLLOWINCREASON(SEC.70.71.SBUSWESS/WDPFOFESSIONS�'ADE:ANVCITYOR (n U �qJHTyWI{ICHREOUIRESAPERMITTOCQ45TRUCT,ALTER.IMoqpyE,DEMOLISN,ORREPAIRANVSTRUC- W patlo/Deck Z TURE,PRIOR TO ITS ISSUANCE.ALSO REWIRES THE APPLICANT FOR SUCH PEqMIT TO FILE A SIGNED w ' �, STATEMENT THAT HE OR SHE IS UCENSED WRSUNIT TO THE PROVISIONS OF THE CANTRACTORS LI� � � � CENSE UW(CHAPTER B(CAMMENCING WITH SECTION 7000)OF DIVISION]OF THE BUSINESS AND PRO- POOUSPB � FESSIONS CODE)OR T}1AT HE OR SHE IS EXEMPT iHEREFROM AND THE BA515 FOR THE ALIEGED E%EMP- C7 V TION.ANV VIOLATqN OF SECTION 7031.5 BY ANV APPUCAN,-FOR A PEPMIT SU&IECTS'fHE APPLICANT TO Z Re-Roof � A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLURS(f5o0�.): � �I.ASOWNEROFTHEPROPERTV.ORMVEMPLOVEESWITHWAGESAS7HEIRSOLECOMPENSAT'�ON, 0 COlfIrt18fC181 Z WILL DO THE WORK,M1D THE STRUCNRE IS NOT IN7ENDED OR OFFERED FOR SALE(SEL.7041,BU51� J � NESS AND PqOFESSIONS CODE:THE CONTRACTORS LICENSE�AW DOES NO'APPLV TO AN OWNER OF � � PROPERTY MM1IO BUILDS OR IMPROVES THEREON,AND NMO DOES SUCII WORK HIMSELF OR HERSELF OR � wTHFOUOM HIS OR HER OWN EMPLOVEES,PflOVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITNINONEVEAROFCAMPIE- Z TKKJ,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO'HAT HE OR SHE DID N07 BUIID OR � UAPROVE FOR THE PURPOSE OF SALE). �yJ ❑4�OWNER OF TME GROPEHTV,AM E%CLUSIVELV fAMRACTINO WITH LICENSE�CANTRACTORS [t TO CONSTRUCT TME PRQIECT(SEC.7oN,BUSINE55 M1D PROFESSIONS CODE:THE CONTRACTORS LI� V01U8iiOf1 � ADJ.AREA ' W CENSEUWDOESNOTAPPLVTOMIOWNEROFAPROPEHTVWHOdUII.D50RIMPROVESTHEREON,AND � VM1iOCONTRACTSFORSUCHPRQIECTSWITHACONTFACTOR(5)LICENSEDPURSUANTTOTHECANTRAC� QUANTITY DESCRIPTION Y 70qS LICENSE Uw.). FEE � O I AM E%EMPT UNDER SEC. B.S P.C.FOR THIS REASON Q ' � ' Q �, , ,� Z DATE OWNER � ?� � 'l �¢ LICENSED CONTRACTORS DECLl+RATION w Ov 2 � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVi510NS OF CHAPTER � S �S� � D(COMMENCINO WITH SECTION 70oD)OF DIVISION 3 OF THE BUSINESSAND PP.OFESSIONS CqOE.AND Z �� MV LICENSE IS M FULL F RCE AND EFFECT. �/� I � m �� LICENSE CLASS I LIC.NO. �VV� � -,� V DATE �` " CONTRACTOF d � W � WORKERS'COMPENSATION DECLARATION Q _ � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z 0Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WOFKLRS' a Q COMPENSATION,A9 PROVIDED BY SECTION 3]00 OF THE LABOR CODE,FOR TME PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � Qw _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIFED BV SECTION 370o OF 7HE LABOR CODE.FOR THE PERFORMMlCE OF THE WORK FOR WNICH THIS PERMIT IS ISSUED.MV WORKER�S' MPrEN^SATrION INSURA�N/CE CARqIER AND PoLICV NUMBERME: CONSTRUCTION � CARRIER .J�T�T f lIY1 U _ PLAN REVIEW ' Z POLICV NUMBER , - ELECTRIC � Q . � (fHIS5ECT10NNEIDNOTBE00AREfmOF7HEPERAMISFi�RONEM1rpFEppq1/3iS�510D�ORLESS} PLUMBING W Z - I CERTIFY THAT M THE PERFORAIANCE OF THE MIORK FOH WNICH THIS PERMIT IS ISSUED,I MECHANICAL C.'3 SNALL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE � (/� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOUID BECOME INS?ECTION FEE = SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR � CODE,I SHALL FORTHWITH COMPLV WITM StE�P�R�OVISIONS. 1 ISSUANCE � __� _ �n/� ��, N� SMIP � p DATE: APPLICANT: W J WARNIN(3:FNLURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UHLAWFUL,AND SHAIL BE ENERGY P/C J �y SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT >,,, DOLLARS(f ta0.o00),IN ADDITION TO THE COST OF CAMPENSATqN,DAMAGES AS PROVIDED FOFl IN � SECTION 3'!OB OFTHE LABOR CODE:INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: � O '- CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � � 1 HEREBV AFFIRM UNDEH PENALTV OF PERIURV THAT THERE IS A CqNSTRUCTION LENDING AGENCY � FOR THE PERFORMANCE OF THE WORN FOF WHICH THIS PERMIT IS ISSUE�(SEC.70G7,CIV.C.). Z W � LENDER'S NAME � LENDER'SADDRESS y� w I CEFITIFY TMAT I HAVE PEAD THIS APPLICATqN AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL F E ES J� j � I AGREE TO COMPLY W17H ALL GTV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � CONSTRUCTION.AND MEREBV AUTHORRE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE�MEN710NED PROPERTY FOR INSPECTION PURPOSES. COMMENTS � J � ¢ PE MI I �' /�(� � � A TTEE DATE = RECPT.YO. PAID BY VALIDATION ~ WHITE—Department Copy,YELI.OW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Co GREEN— py, Applicant's Copy �9T�' O� DV,��r�l� ��$ 8��'��'8�➢14 6��4�RD �.F.. � ' . _ ., , ... 0 �0 , l '� , ��k=, , � ,�-� �,�. ,� �" H^� ' p �r�;f` ,. �. . , . � r , � �._;. .. , ,_,. , , . � . ,� .. r, � , . .� . ,, 4 .. � � , .. >. SET BACK � � � FLOCIP JQIST � __ � ___ __ __—.4__________—;- __.__ ------ FT'GSIFORMSlSTEEL � FNA REQMTS ELEGTRIC GROUND � I UNDER FLOOR pUCT GROUND PLUMBING � �� UNDC:R FLOOR CG�IDUiT SLAB GRADE � FIRFPLACE FOUNDATION TEMP POWER _�� FIREPLAGE E30N� BEAM __ __ WATER SERVICE _ MID HT. BOND BEAM ' - ROOF SHEATHING 8 FT. SQND BEAM. _—.�__�i-�---------— --- FRAMING/VENTILIATION FINAL BOND BEAM ROOF COVER � � PRE-GRADING -- ------ — ----- _ � ROUGH HEATING � BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMSING ! � ; FINlSH uRADING � � SHOWER/TUB TEST POOL ELECTRIC EXT. LF,TH/51DING �; F'��C)L FENCING WALL INSULATION POOL FINAL CEILING INSUL,4TION � OFF SlTE IMPS. DRYWAL�NAILING DEDiCJ�TIONS SEWER _ _ _i FINA�ENG. � � SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. � dN SITE IMPS. GAS AIR TEST , �INAL ZQNING FINAL CONST. ! FIRE DEPT. FINAL �� _�_ FINAL HEATING HEALTH DEP7. FINAL. FiNAL ELECTRlC �DEV. FEES ?AID ^ �o�- �� FlNAL PLUMBlNG _ ENERGY � 0 0 a � ��r =: 4 v I:�j __ ��.�__`_ ' I � CONiMENTS - - -- - T ._.__. - - _ - -- SEPTIC TANK SIZE SEEP PIT/U SIZE . y� {: — —�— �.__ -- d ;� -- ��I ��e�� P�- — �----- ;� � � � �f ;- . �