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Home My WebLink About11-1019 ��_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 PRESS "9N'� BUILDING PERMIT APPLICATION FIRMLY N JOBSITE �j 2 Q� �� APPLICATI PERMIT IT� �p/C o ADDRESS �J�� DATE_�' � NUMBER O # � ISSUE TYPE ��/�� OCC APN LO T T DATE S� I CONST.--�' -�i'� GROUP p OWNER �` AD . SS ZONING SETBACK 0 z CITY Lrl T FRONT qyy � � APPLICANT TEL. REAR � ¢ SIDE/SIDE STREET Ryy p ' � CONTRACTO SIDE p ADDR SS � CITY Z� � PROPOSED USE o ARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. cn UNITS STORIES BEDFi00MS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O � p I HEREBV AFFIRAI UNDER PENALTV OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� G8f9gB/C9fpOR '� W CENSELAWFOqTHEFOLLOWINOREA50N(SEC.7031.68USINESSANDPROFESSIONSCODE:ANVCITYOR (n U CpUMyWH�CHREWIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREFAIRANY57qUG w w TURE,PRqR TO ITS ISSUANCE.AL50 REW IRES THE AFPLICANT FOR SUCH PERMIT TO FILE A SIGNED w PeIlO/D6C{( � STATEMENT 7HAT HE OR SHE IS LICENSED PURSUAN7 TO THE VROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHMTER e(COMMENCINO WITH SECTpN 7000)OF DIVISION 3 OF THE BUSINESS AND PqO� u' POOUSPB FESSIONSCODE)ORTHATHEORSHEISEJ(EMPTTHEREFROMANDTHEBASISFORTHEALLEOEDE%EMP- � TION.ANY VIOLATION OF SECTION 703/.S BY ANY APPLICANT FOR A PERMIT SUBJECTS THE MPLICANT T0 Z Re-Roof A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLUAS(5500).): � ❑4�SOVMEROFTHEPROPERTV,ORAIVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � CommBrCl81 � Z VALI DO THE WORN,M1D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70a1,BUSI� J ' � NESS AND PROFESSIONS CADE:THE CONTiiACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPEHT�'WHO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w TMROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCM IMPROVEMENTS ARE NOT INTENDED OR m Q OFFFAEDFOR9ALEIF,HOWEVERTMEWILDINGORIMPROVEMENTISSOLDWfTHINONEVEAROFCAMPLE� Z TION.7HE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SME DID NOT BUILD OR � UAPROVE FOR THE W RPOSE OF SAIE). �yJ ❑4��NMER OF THE PROPERTV,AM E%CLUSIVELY CONTRACTIN6 WITH IICENSED CONTRACTORS [[ TO CONSTRUCT THE PRQIECT(SEC.70M,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- V01U8fIOf1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOM10N7JEROFAPROPERTVWHOBUILDSORIMPROVE57HEREON,AND I � NM1iOCONTRACTSFORSUCHPRQIECTSWITHACONTiUCTOR(S)UCENSEDPURSUANTTOTHECONTRAG OUANTITY DESCRIPTION Y TORS IJCENSE LAW.). � FEE � O I AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON � U LL DATE OWNER � � LICENSED CONTRACTORS DECLARATION � W � I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z � ' XL� AIV UCENSE IS IN FULL FORC ND EFFECT. m �� LLI ^ O j, � � LICENS CLASS UC.NO. � V DATE �L CONTRACT a W � WORKERS'COMPENSATIO ATIO - � � I HEREBV AFFIPM UNDER PENAL7Y OF PERIURV ONE OF T U � TIONS: Z 0 I AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ � PENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOF CODE,FOR TME PERFORMANCE U OF THE WORI(FOR WHIC}I THIS PERMIT IS ISSUED. W ' � � w i HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE.AS REOUIRED BV SEC710N Q 3700 OF THE LABOR CODE,FOR TH RFOR CE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WOHI(ERS'COMPENSA CE CAFRIER AND POLICV NUMBERARE: CONSTRUCTION � CARRIER PLAN REVIEW ¢ aoucv NUMeea ELECTRIC 0 (1}p95ECT10NNE�NOTBE00MPLE7mOFTEPEW.iriSFpqpNEHl�1%imDOIURS(f100)ORLESS� PLUMBING !�S '� w T Z I CERTIFV 7HAT IN THE PERFORMANCE OF THE WORK HICH PERMIT IS ISS MECHANICAL U' SHALL NO7 EMPLOY ANY PERSON IN ANY MANN AS T M U&lE E (/) WORKERS'COMPENSATqNUWSOFCALIF A,ANDA ETH F ULDBECOM INSPECTIONFEE SUBJECTTOTHEV10R10ER5'COMPENSA VROVIS OFS 37000FTHE R O CODE,I SH FORTHWITH COMPLV THOSE ISIO ISSUANCE p AT ' � APPLIC T: SMIP W J WAPNINQ:FAILURE TO SECURE WORK RS' CqVER WFUL,AND SHALI.BE ENERGY P/C � J � SU&IECTANEMPLOVERTOCflIIAINAL IE OONEHUNDREDTHWSAND ENERGYPERMIT DOLLARS(f10a,000J,IN/�DDITION TO THE COST O pN,DAMAGES AS PROVIDED FOR IN J SECTION 37oe OF THE LPBOF CODE,INTEREST,AND ATTORNEVS FEES. � _ I w RETENTION FEE: � � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AOENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. Z W � LENDEF'S NAME F— LENDER'SADDRE55 w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE MFORMATqN IS CARRECT. TOTAL F E ES • �'I L' r � I A6REE TO CAMPLV WITH ALL CITV AND COUNTY ORDINANCES/WO STATE UWS RELATING TO BULLDINO � CANSTRUCTION,AND HEREBV AUTHOqIZE REPRESENTATIVES OF 7HI5 COUNTV TO EMER UPON THE ABOVE� TIONED PRO RTV FOR SPECTION PURPOSES. COMMENTS ' 0 J � m PE EE N P Q (/) � � � N3NATU RM DATE = RECPT.NO. PAID BY �� VALIDATION ~ WHITE—DepeRment Copy,YELLOW—Finance Copy,PINK—Assessa Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CB�V OF DIAfUiOI�D �AR Ii�S�EC�lO�! F3(�CORD � ._ ,._� . � . �:oa�p�c�400a �� p :" ��`.� .� o , � e: �.{. ;� ot��b�� -� � ��t - c� �. � . � m SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM 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 OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING - / ENERGY 0 0 r° COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE k� a :-�; �_� �. .�.:� � � �.� , :�� fi �� '•�`�'t� a r � � �,.?�� ,� y "��r,,�;