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Home My WebLink About10-1124 I� CITY OF DIAMOND BAR , " � � �� . C `----��— DEPARTMENT OF COMMUNITY&DEVELOPME V ES �� 21825 Copley Drive,Diamond Bar,CA 91765 ,��►1 ►'1�� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 ��J f� �'°�' BUILDING PERMIT APPLICATION D-- �p�� FIRMLY ' � JOBSITE �G 8 G'vIli��1 � N � �� >- APPLICATION PERMIT /C o ADDRESS � DATE NUMBER Q"" � p � APN LOT TRACT DATE �/ D'7-"' �� CONST._� OCC p OWNER S .- G D t� GROUP p ADDRESS L ZONING SETBACKS FRONT g CITY�� ZIP�'lr6 . TEL.[Y � <X��i f REAR RW � APPLICANT TEL. ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR � 'L.' SIDE 0 ADDRESS � CITY ZIPG3/>SUfEL. �c7��4J PROPOSEDUSE w ARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS cr� � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O Q I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS U� QBfdgB/CB�OII W CENSE UW FORTHE FOLLOWINO REASON(SEC.7031.5 BUSINESS AND PROFESSIONS CODE:ANV GTV OR (n V CIXINTVVhIICNRE0UIRESAPEHMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- W TURE,PRqR TO ITS ISSUMICE,ALSO REQUIRES THE APPUCANT FOR SUCN PERMIT TO FILE A SIGNED w Patlo/Deck � STATEMENT THAT HE OR SHE IS LICENSE�PURSUANT TO THE PROVISIONS OF THE CONTRACTORS ll� CENSE LAW(GiAPTER e(COMMENCINO WITH SECTION 7000)OF OIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB � FESSIONS COD�OR THAT HE OR SHE IS EXEMPT TMEREFROM AND THE BA515 FOH THE ALLEOED E%EMP- (� V TION.ANY VIOLATION OF SECTION 7071.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof ' A CML PENALTY OF NOT MORE THAN FNE HUNDRED DOLLARS(f60o).�: � ❑I.ASONMEROFTHEPRpPERTV,ORMYEM7LOYEESWITHWAGESA$THEIRSOLECOMPENSATION, � COrtIrtI0fCl81 Z WILL DO THE WORK�ND 7HE STRUCTURE IS NOT INTENDED oR OFFERED f-0R SALE(SEC.7a�,BU51� J � ' � HESS AND PHOFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � VROPERTY WFIO BUILAS OR IMPROVES THEREON,AND NMO DOES SUCH WORN HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERTMEBUILDINOORIMPROVEMENTISSOlDWI7HINONEVEAROFCOMPLE- Z TIDN,7HE OWNER-BUILDER WILL MAVE THE BURDEN OF PqOVINO THAT HE OR SHE DID NOT BUILD Oq � IMPROVE FOR THE PURPOSE OF SALE). . W ❑I,AS OWNER OF THE PROPEf�;AM EXIX.USIVELV CONTRACTINO WITH LICENSED CONTRACTORS Q TO CONSTRUCT TME PROJECT(SEC,70N,BUSINESS ANO PROFESSIONS CADE:THE CONTRACTORS LI� V81U8t1Of1 ADJ.AREA W CENSE LAW DOES NOT APPLV TO AN ONMER OF A PROPERTV NM1iO BUILOS OR IMPROVES TMEREON,AND � NM1IOCONTMCTSFORSUCHPROJECTSWITMACONTRACTOR(S)UCENSEDPURSUANTTOTMECONTMP QUANTITY DESCRIPTION roas uceNSE uw.�. FEE � ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ?� U LL DATE OWNER H Z U � LICENSED CONTRACTORS DECLARATION w � 1 HEREOY AFFIRM UNDER PENALTY OF PERJURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � � Y(COMMENGNO WITH SECTION 7000)OF DIVISION J OF THE BUSINE55 AND PROFESSIONS CODE.AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT.. m � LICENSE CLASS C� a�� UC.NO. ��7 �3�O � � q/�� 1 J w DATE � C��O? CONTRACTOR �iy/P �� d � WORKERS'COMPENSATION DECLARATION � � � I HEREBY AFFIRM UNDER 7ENALTV OF PERIURY ONE OF THE FOLLOWING DECLAAATIONS: � � Z � _I HAVE AND WILL MAINT/JN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ � COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � w _I HAVE AND WILL MAINTAIN WORHERS'COMPENSATION INSURANCE,AS RE�UIRED BV SECTION Q 37000F THE LABOR COOE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERAiIT IS ISSUED.MV WORKERS'COA/PENSATpN INSURANCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION � CARRIER PLAN REVIEW � POLICV NUMBER zd ELECTRIC W ,(II-0SSEC�ONNE�NOTBECOf.qFTmpFh�pEMiT�$FpqpdEFilA�OfiFODq1.ViSR70D)ORLE$$} PLUMB� ,('� Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED.I a.S �,/ G.�S SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO E (/) WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AORE�AT IF I SH��pME INSPECTION FEE � SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS ECTION 3 ��f THE LABOR ^ I CODE�,I S,HA/�,1-,F�O�RTHWITH COMPLV WITH THO�pP WS�, � / � O DATE:� qpP�ICANT: SMIP c� c�— / ENERGY P/C w ' � J WARNINO:FNIURE TO SECURE WORKERS'CAMPENSATION CAVERAOE IS 11NLAWN�,M1D SHALL BE J � SU&IECTANEMPLOVEFTOCRIMINALPENALTIESANDqVILFINESUPTOONEHUNDREDTHOUSAND ENERGY� OOLLARS(f100,000),IN ADDITION TO THE COST OF COMPENSATKKJ,DAMA�ES AS PROVIDED FOR IN � SECTqN 3708 OF THE LABOR CODE,MTEREST,AND ATTORNEV'S FEES. ON FEE: � � O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALN OF PERJURY THAT THERE IS A CONSTRUCTION LENDINO AOENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,C1V.CJ. Z W � LENDERS NAME 1— LENDER'SAODRESS w ICERTIFVTNATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES � � � IAGREETOCOMPIVWITHALLGTVlWDCOUNTYORDINANCESANDSTATEUWSPEUTWOTOBUILDINO � CONSTAUCTION,AND HEREBV AU7}iORIZE REPRESENTATNES OF THIS COUNTV TO ENTER UPON THE ' Z ABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES COMMENTS ' � �J'/✓ LC��7S m PERMI77EE N Q � C/) // / �� N SIONANH PER E ATE � RECPT.NO. PfUD BY VALIDATION WHITE—Department Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplkanPs Copy L ,.-��t`�?�. �,1'�� r✓�.:�r� � � f� $�r'� i� I� ��`��w� �`s �i�� +�� B14� L�� .S��U �i.,�.�c'r,1�?5��{�z�� IYVS��C�10� R{EC�R� �.;�-s E.�!�� ..' �'� �;� oa�p�c�ooa �a -_ oa�p�c��p` : oa��c�400a �:. a��- . oa�a� �� SET BACK FLObR JOIST FTGS/FORMS/STEEL ' ? FHA REQMTS ELECTRIC GROUND UNDER F�OOR 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 ELECTR�C ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POQL 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 �� .. ,. . COMMENTS ' SEPTIC TANK SIZE SEEP PIT/U SIZE (�l �7 C� , , .; � �= . ' l