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Home My WebLink About11-544 CITY OF DIAMOND BAR � ---��'— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ��'°�"� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE /OZZ S�G,LI7/�'� �CJ �/vi/�-/`g APPLICATION PERMIT / p/C ADDRESS DATE NUMBERJ��# � ;�j OCC APN LO TAACT DATE � Q / ONST. %�l� GROUP p OWNER o ADDRESS ZONING SEfBA KS Z CITY ZIP � ✓ TEL. r r FRONT Ryy � o APPLICANT �x� TEL. � y' � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE p ADDRESS 1 � CITY i ZIP�s�-�/I TEL. PROPOSED USE V w ARC . G �� z DESIGNER w NO.DWEL. NO. � NO. � ADDRESS u� UNITS STORIES BEDROOMS N CITY ZIP TEL. � DESCRIPTION SQ.FT.� FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION p SFR/ADD/REM � I HEREBV AFFIqM UNDER PENALTV OF PERIURV TNAT I AM EXEMPT FROM THE CAMRACTORS LI- G8f8g0/CBIPOR � W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.60USMESSANDPROFESSIONSCODE:ANVqTVOR (n C� COUNTVN?11CHREOUIRESAPEfiMITTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIRANVSTRUG W Patlo/Deck L TURE,7RIOR TO ITS ISSUANCE,/�L50 FE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W g STATEMENT h1AT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF hIE CONTMCTORS LI� CENSE LAW(CHAPTER i(CAMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooUSpe , 0 FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� V TION.ANV VIOL.ATION OF SECTfON 7031.6 8V ANV�PPLICANT FOR A PERMIT 5U&lECTS iHE APPLICANT T0 Z Re-Roof A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5600).): 0 ❑I,A90NRJEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COfI'1f11BfCIaI Z WILL DO THE WORK,AND THE STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.7aa,BUSI- J � NESS AND PROFESSIONS CADE:TNE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF ? VROPERTV NT10 BUILDS OR IMPROVES hIEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROU(L1 HIS OR HER ONRJ EMPLOVEES,PROVIDED THAT SUCH IMPROVEMEMS ARE NOT INTENDED OR m Q OFFEREDf-0RS�LEIF,FIOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,7HE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD ON � � IMVROVE FOR 7HE PURPOSE OF S�LE). � . w ❑I,ASOWNEROF7HEPROPER7Y,AME%CWSNELYCANTRACTINOWfTHLICENSEDCONTRACTORS � TO CONSTRUCT THE PRQIECT(SEC.7011,BUSINESS AND PROFESSIONS CODE:TNE CONTRACTORS LI- V8IU8IlOf1 ADJ.AREA W CENSE UW DOES NOTAPPLV TO AN ON7JER OFA PROPEHTV NRiO BURDS Ofl IMPROVES THEREON,AND � MM1IOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOR�S)LICENSEDPURSUANTTOTHECANTRAG QUANTITY DESCRIPTION Y TORS LICENSE UW.). . FEE � O I AM E%EMPT UNDEH SEC. B.8 P.C.FOR THIS REASON Q � U LL DATE OMMER F Z U �Q LICENSED CONTRACTORS DECLARATION W . CL I HEREBV AFFIRAI UNDER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � o(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z ' �� MYLICENSEISINFULLFORCEAND EFFECT. � d�� 9� � � LICENSE CIASS LIC.NO. � U DATE CONTRACTOR d W � WOAKERS'COMPENSATION DECLARATION Q � U N I HEREBV AFFIRM UNDER VENALTY OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z � _IMAVEANOWILLMAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWOqKERS' _ Q COIdPENSATION,AS 7ROVIDED BV SECTION 370o OF THE LABOR CODE,FOH THE PERFORA/ANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � w _I NAVE AND WILI MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370o OF THE LABOR CODE,FOq THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS J ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION j CARRIER PLAN REVIEW � POLICV NUMBER Zd ELECTRIC '� 0 (fF�Il55ECTqNNE�NOTBECOAPLE7EDOFT-IEPERI.TTISFORONEFRNDFEDDOLLF�Rig100)OqLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH 1HIS PERMIT IS ISSUED,I MECHANICAL � C7 SMALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE [/� WORKERS'COMPENSATIONLAWSOFCALIFORN10.ANDAOREETHATIFISHOUIDBECOME INSPECTIONFEE SUBJECT TO THE WORKERS'COMPENSATION PR ISIONS OF SECTION 37 OF THE LABOR -�j CODE, HALLFORTHWITNCOMPLYWI7HTH PR ISIONS. ISSUANCE �• 0 p DATE: APPLICANT. SMIP w ENERGY P/C � J WAHNIN(3:F ILUFE TO SECURE WOiiKERS'COMPENSATION CAVERAGE IS UNUWFUL,AND SHALL BE � SU&IECTANEMPLOVERTOCRIMWALPENALTIESANDCIVILFINESUPTOONEHUNDREDTMOUSAND ENERGYPERMIT OOLUAS(t100,o00),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION]708 OF THE LABOR CODE.WTEREST,AND ATTORNEV'S FEES. w RETENTION FEE: � O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION IENDING A�ENCV FOR THE PERFORMANCE OF THE WORN FOR WHIp1 THIS PERMIT IS ISSUED(SEC.30G�,CIV.C.). Z W �Z LEFIDER'S NMIE � !— LENDERSADORESS w I CERTIFV THAT 1 HAVE READ THIS MPLICATIpN/�ND STATE THAT THE ABOVE INFORMATION IS CAqRECT. TOTAL FE ES �� I AGREE TO COMPLV WITH/�LL CIiY AND CAUNTV ORDINMICES AND STATE UN5 REUTING TO BUILDINO � CONSTRUCTION,ANDHEREBVAUTFIORIZEREPRESENTATIVESOFTNISCWNTVTOENTERUPoNTHE Z ABOVE�MENTIONED PRO EFTV FOR INSPECTqN PURPOSES. COMMENTS 0 �-/ � V�� QPERMITTEE E RI �/ � � ✓ / NA DAT RECPT.NO. PAID B VALIDATION ~ WHITE—De artmant Co YELLOW�Inance p py. Copy,PINK—Assessor Capy,CiOLDENROD—File Copy,(iREEN—Applicant's Copy CO�"V �� DiAi1�OND ��►�i I�IS��90f� �ECOR� � . �, . , .. � �� oa�p�c�400a �s:B,��. ��,:.�t��a��r ��. .. �a��a��r c��a��;��" �.�o x, *p 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 �L 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.C:, . 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 1 l . ENERGY C�� COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � a �x� ��a . . k'r _ ,� P .��'C . � . �".