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Home My WebLink About17627 (35) _ _��` _ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNTI'1'&DEVELOPI�NT SERVICES 21825 E.Copley Drive I (909)860-3195 Fa�c(909)861-3117 PRESS �`'��" BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE /,;Z� `D�ci�.� /J a., � APPLICATION�,�,\�� NUMB R �� p/C ADDRESS `�' `'�� DATE 1 � APN LOT TRACT ISSUE TYPE OCC � DATE CONST. GROUP p OWNE�L�— S � o ADDRESS S�� ZONING SETBACKS Z CITY�//�K�D/'� / IP. TEL. a'� � FRONT Ryy ❑ g APPLICANT TEL. REAR ❑ � SIDE/SIDE STAEET RW O � CONTRACTOR L. SIDE ❑ ADDRESS � CITY ZIP%`�`� .�L: PROPOSED USE oARC Gf �z DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BUILDEF DECLARATION SFR/ADD/REM O p I HEREBY AFFIRAI UNDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CONTRACTORS LI- GefB J0/CBfPOfI W CENSELAWf-0RTHEFOLLOWINOfiEASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANVCITVOR (n U COUNTYyJFIICHREOUIRESAPERMITTOCANSTAUCT,ALTER,IMPROVE,DEA/OLISH,ORREPAIRANVSTRUC- w TURE.PRIOR TO ITS ISSUANCE.AL50 REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Petio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � � CENSE UW(CHAPTER D(COMMENCWQ WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOUSPB O FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFqOMANDTHEBASISFORTHEALIEOEDEXEMP� (� V TION.ANVVIOLATIONOFSECTION7031.SBYANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CML PENALTV OF NOT MORE THAN FNE HUNORED DOLURS(f50o�.): Z~ ❑I,ASOWNEROFTHEPFOPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, Q WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED fOR SALE(SEC.704�,BUSI- J Commercial - � NESS AND PROFESSIONS CAOE:7NE CONTRACTORS LICENSE LAW DOES NOT APPLV TO M!OWNER OF � PROAERTV NT10 BUILDS OR IMPROVES 7HEREON,AND WHO OOES SUCH M/ORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDF-0RSALEIF,HOWEVER7HEBUILDIN60RIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- . Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO 7T/AT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPER?V,AME%CLUSIVELVCANTRACTINGWfTHLICENSEDCONTRACTORS � TO CANSTRUCT THE PqP1ECT(SEC.701a,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� V81UfiIlOf1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPflOPERTVWHOBUILDSORIMPROVESiHEREON,AtJD � NM1�OCONTRACTSFORSUCNPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOhIECON7RAG pUANTITY DESCRIPTION FEE TORS LICENSE UW.). � ❑I AM E%EMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q ?� U � OATE OWNER � Z U � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERJURV T1AT I NA LICENSED UNDER PROVISIONS OF CHAPTER � D � e(COMMENCINO WITH SECTION 7ooa)OF DIVISION 3 0F THE BUSINESS AN�PFOFESSIONS CADE,AND Z � �� MV UCENSE IS IN FULL RCE AND EFF T. m � LICENSE CLASS LIC.NO. �/��Y— � U DATE CONTRACTOR a W � WO KERS'COMPENSATION DECLARATION � � I HEREBV AFFIqM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECLARATIONS: Z � I HAVE ILL AIAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOF VIORKERS' ¢ Z = Q CQM SATION,AS PROVIDED BV SECTION 3100 OF TME LABOR CODE,FOR THE PERFORMANCE U , Q E WORK FOR WHICH THIS PERMIT IS ISSUED. � � _1 MAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTqN Q 3700 OF hIE LA80R CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPE ATION INSU RIER M1D ER CONSTRUCTION j CMRIER � F � �� PLAN REVIEW � POLICYNUMBER Z ELECTRIC Q � fniss[c7aNr+E�rareEoor.w�E7moFnfrEa►tt�sroaoHEwror�o (tiro�oa�ssl PLUMBING w Z I CERTIFY THAT IN 7HE PERFORMANCE OF THE WORK FOR WHI TH PE IT I ISSUED,I MECHANICAL ' C'} SHAlLNOT EAIPLOV Y PERSON W ANY M O BE SU&1 T OTHE (/� WORKERS' MP SATION LAWS OF CALI qNIA, REE H D BECAME INSPECTION FEE � SU&IECTT TH RKERS'COMPENSAT N PRO 0 THELABOR � COD I S TH ITHCOMPLV WIT HOSE I 5. ISSUANCE - ' - � � � - � p DATE: w PLICANT: SMIP ' W J WARNINQ:F UR O SECURE WORKERS'COMPENSAT COV IS UNLA ,AND SHALL BE ENERGY P/C � U I J ��1,, l� � SUBJECTAN M VERTOCRIMINALPENALTIESANDCIVIL UPT NDREDTHOUSANO ^rl/�n DOLUWS(f100,000),INADDITIONT07HECOSTOFCAMPENSATION,DAA/AOESASPROVIDEDFORIN ENERGYPERMIT !I/ J SECTION 37oe OF THE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. [C RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV THATTHERE IS ACONSTRUCTION LENDINQ AOENCY ---' - ' � FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUE�(SEC.30B1,CIV.C.). Z W � LENDER'S NAME � � LENDER'SADDRESS � w 1 CERTIFY THAT I HAVE READ THIS APPLICATqN AND STATE THAT iHE ABOVE INf-0RMATION IS fARRECT. TOTAL FE ES � I AGREE TO COMPLV WITH ALL CITV AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILOINO � CONSTRUCTlON,AND HEREBV AUTHORIZE RESENTATIVES OF THIS CWNTY TO ENTER UPON THE Z ABOVEMENTIONED PROPERTV FOR INS PURPOSES. COMMENTS � C � �/ .\ _ .. ¢ PERMITTEE N (P / �r � � ! (/�`�+ � SIONATURE O D E � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENR D—File Copy,GREEN—Applicant's Copy � (G��'�1� �� 1��fl� ��L� 9�i9��"Q�4� f�$�� o ^ o . ` �C�ir Oa DG�`u� O�G�� ' �C�ir00a DG15� DG��G�p SET BACK �� FLOOR JOIST �.• � FTGS/FORMS/STEEL FHA REQMTS EL.ECTRIC GRdUND UNdER FLOOR DUCT � GROUND PLUMBING UNDER FLOOR CU�IDUIT �— SLAB GRADE ~ FIREPLACE FOIINDATION TEMP POWER FIREPLACE BQND BEAM WATER SERVICE MID HT. SONQ BEAM ROOF SHEATHING 8 Fl�. BOND,BEA(Vl FRAMINGNENTlLIATION FINAL BOND BEAfvI ' ROOF COVER PRE-GRRDING ROUGH HEATIIdG BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SH�WERlTUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING ! WALL INSULATIOhI POOL FINAL CEILIP�lG IfVSULATION OFF SITE�MPS. DRYWALL iVAILING DEDICATIONS SEWER � FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS: � GAS AIR TEST FINAL ZONING FINAL CtaNST. F!RE DEPT. FINA� FIIJAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY �.dA.I�9..d+t /�,�A�it. ��,./e 2 �i'Res�� . . � ��a C��5 - - , �� — � SEPTIC TANK SIZE SEEP PIT/U SIZE � � � � � .. �.: � � � , � �