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Home My WebLink About15559 (23)-` -- CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT T.. C 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION 1OBSITE ADDRESS 23300.E GOLDENSPRINGS, DR ADDRESS APN LOT TRACT OWNER MT CALVARY LUTHERAN CHURCH ADDRESS . CITY A IP TEL. APPLICANT TEL. CONTRACTO TEMP -AIR HTG & A/C INC ADDRESS 6 — CITY LA HABR zip 90631TEL (562)694-4$ ARCWENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFInM UNDER PENALTY OF PERJURYTHAT IAM EXEMPT FROM THE CON7RACTORS LI- CENSE LAW FORTHE FOLLOWNG REASON (SEC. 7031.6 BUSINESSAND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES APERMITTO CONSTRUCT.ALTER, IMPROVE, DEMOUSH.OR REPAIRANY STRUC- TURE. PRIOR TO ITS ISSUANCE, ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 0 (COMMENCING WITH SECTION 7000) OF DIVISION 3 O THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS Fon THE ALLEGED EXEMP- 710N. ANY VIOLATION OF SECTION 7031.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS WWI): O L AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WOPK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044. BUSI- NESS AND PROFESSICNS 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 NTENOED OR OFFERED FOR SALE IF.HOWEVERTHE BUILDING OR IMPROVEMENT IS SOLD WITHINONE YEAR OF GOMPLE- YON, THE OWNERBUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR .IMPROVE FOR THE PURPOSE OF SALE). ❑LAS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7041 BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI. CENSE LAW DOES NOT APPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTORS) LICENSED PURSUA14TTO THE CONTRAC- TORS LICENSE LAW.). O IAM EXEMPT UNDER SEC. B. Is P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER s (COMMENCING WITH SECTION 7000) OF DIVISION 3 O THE BUSINESS AND PROFESSIONS CODE AND MY LICENSE IS IN FULL FORCE AND EFFECT. LICENSE CLASS C20 LIC.No. 363290 DATE 147-2( 0 0 CONTRACTOR TEMP—AIR HTG & WORKERS'COMPENSATION DECLARATION A/C, INC IHE .8 FIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS;• _1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELFINSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. XX I HAVE AND WILL MAINTAN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSA7ON INSURANCE CARRIER AND POLI'NUqERARE� CARRIER UNITED PACIFIC ITIS. CPOLICYNUMBER(T%IO SECTION NEEDNOT BE OOAIfTETEDOFTHE F£RMITIS RXiONE OOl1.A1CERTIFYTHAT NTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSArKN LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUSJECTTOTHE WORKERS'COMPENSATION PROVNSIONSOF SECTION 37000E THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: 9 14 2000apptlCANT- WARNING; FALURETO SECURE WORKERSCOMPENSATKXI COVERAGE IS UNLAWFUL.AND SHALL BE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TOONE HUNDREOTHOUSAND DOLLARS ($100,0W), INADDITION TO THE COST OF CCMPENSATON, DAMAGES AS PROVIDED FOR IN BECTON 3706 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 WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CIV. C.). LENDERS NAME LENDERSADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THATTHE ABOVE ON IS CORRECE I AGREE TO COMPLY WITH ALL CITY AND COUNTY OR STATE LAW TING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOS S .130,4KING, PRESIDENT — I -or PE ITT ENAME(PRINT) _ - 9114/2000 $ R O ERMITT DALE ESS FIRMI V APPLICATION— �� 1 0!C DATE NUMBER ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ 1 PROPOSED USE / NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADDIREM Garage/Carport WPatioMeck I=- PooUSpa 0 Z RB -Roof C1 Commercial In Valuation ADJ.AREA QUANTITY DESCRIPTION FEE cc 3 noJ�c w wevIllills J a U v Q 13 S U w CONSTRUCTION PLAN REVIEW ELECTRIC 9Q - PLUMBING MECHANICAL INSPECTION FEE ISSUANCE +� SMTP �7 ENERGY P/C '1 r ENERGY PERMIT r .T17�i RETENTION FEE: j� r �i q I7 ABA t Ntl PRE -ALT FEE: J ;� TY TOTAL FEES d COMMENTS RECPT. NO. PAID BY VALIDATION " YYru I t—uepanment copy, Tnuuw—rinance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN—Applicant's Copy INSPECTION SETBACK_ DATE INSPECTOR INSPECTION DATE INSPECTOR FLOOR JOIST FTGS/FORMSISTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT -GROUND PLUMBING UNDER FLOOR CONDUIT. SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE -MID HT: BOND BEAM ROOF SHEATHING 8 Fr. BOND BEAM -FRAMING]IVENTILIATiON FINAL BOND BEAM '' ROOF COVER PRE -GRADING ROUGH HEATING - BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POWELECTRIC EXT. LATH/SIDING POOL FENCING -'WALL INSULATION POOL FINAL CEILING INSULATION, OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTICTANK--" LANDSCAPEARRIG. SEEP PIT/L:L. ON SITE IMPS. GAS AIR TEST, Ma FINAL' ZONING FINAL CONST. FIRE DEPT. FINAL 7.. - FINAL HEATING t.. HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY' COMMENTS SEPTIC TANK SIZE SEEP PIT/Lf SIZE L