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Home My WebLink About10-1190 ^ �„`_ CITY OF DIAMOND BAR �/ DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ` 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building[nspection Hotline(909)839-7027 PRESS '�", BUILDING PERMIT A�PLICATION ,, FIRMLY o� JOBSITE �y � APPLICATION PERMIT�D r P/C ADDRESS 'O V��Y��tCC \ _ DATE NUMBE � # � APN LOT TRACT �SSUE � i / TyPE p�C DATE�J � / O CONST. GROUP p OWNER l p ADD SS 1 ZONING SETBACKS FRONT RW ❑ o APPLICANT Z TE REAR � � SIDE/SIDE STREET qyy p � CONTRACTO GL SIDE � ADDR SS . Ai � CITY Z� T . PROPOSED USE w ARCH/ENG/ a� DESIGNER ADDRESS NO.DWEL. NO. NO. v� UN ITS STORI ES BED ROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM � O � I HEREBV AFFIRM UNDER PENhL1Y OF PERIURV THAT I AM EXEMPT FPOM THE CANTRACTORS LI� G8f8 0/C8 f2 W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCIiVOR (n 9 � C� COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,AITER,IMPROVE.DEMOLISH,OPREPAIRANVSTRUC- W patio/Deck < TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNEO w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CANiRACTORS LI- CENSE UW(pUPTER o(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB , 0 FESSqNSCODE)OR7}UTHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORhiEALLEGEDEXEMP� C7 V TION.ANYVIOLATIONOFSECTION7031.SBVANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof � A CML PENALTV OF NOT MORE THAN FNE HUNDRED DOLLARS(t60o).): � ❑I.ASOWNEROFTHEPROPERTV,ORIAVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, COfI1RIBfCl01 WILL DO THE WORI(,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oN,BU51� � � NESS AND VROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT A7PLV TO AN OWNER OF ? . PqOPERTY VA10 BUILOS OR IMPROVES THERE-0N,AND WHO DOES SUCH WORN HIMSELFOR MERSELF OR Q THROUOII HIS OR HER OWN EMVLOVEES,PROVI�ED 7HAT SUCH WPROVEMENTS ARE NOT INTENDED OR m Q OFFEREOFORSALEIF,FqWEVER7MEBUILDINGORIMPROVEMENTIS50lDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDEF WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OP � IIAPROVE FOR THE PURPOSE OF SAL�. w ❑I.ASOWNEROFTHEPROPERTV,AMEXCLUSNELVCONTRACTIN�WfTHLICENSEDCONTRACTORS . Q TO CONSTRUCT THE PRQIECT(SEC.70/�,BUSINESS AND PROFESSIONS CODE:THE CANiRACTORS LI- V81U9�1Of1 qp�,qqEq W CENSE LAW DOES NOTAPPLV TO AN OWNER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTRACTSFORSUCHPR0.IECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTiUC- QUANTITY DESCRIPTION rau ucENSE uw.�. FEE � ❑I AM E%EMPT UNDER SEG B.8 P.C.FOR THIS REASON � ?j U LL DATE OWNER ¢ Z U � �Q LICENSED CONTRACTORS DECLARATION w 2 I HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT 1 AA/�ICENSED UNDER PROVISIONS OF CHAPTER � .�' P Y � G(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z �� 4V LICENSE IS IN FULL FORCE AND EFFECT. m � LICENS�C S LIC.NO. /� � V DATE/ CONTRACTO d W � WORKERS'COMPENSATION DECLARATION . � � I HEREBV AFFIRM UNDER PENAL7Y OF PERIURY ONE OF THE FOLIOWING DECLARATqNS: V N Z • O _I HAVE M1D WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORNERS' _ Q PENSATqN,AS PROVIOED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U THE WORN FOR WHICH THIS PERMIT IS ISSUED. w � � w I HAVEAND WILL MNNTAIN WOHI(ERS'COMPENSATION INSURANCE.AS FEWIRED BV SECTION Q ' 370o OF 7HE UBOR CODE,FOR THE PERFOqMANCE OF E WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATI CE C FIER AND POLICY NUMBER ARE: CONSTRUCTION jCARRIER � PLAN REVIEW ZPOLICV NUMBER ELECT Q � (iH55ECt10NNE�NOTBEGOf.i3E7mOFiHEPEP/.TT6FORONEFiIR�DRm00LL/�11100)ORLESS} W Z �CERTIFY THAT IN THE FERFORMANCE OF THE WOR1C FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C� SHAI.L NOT EMPLOY ANV PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE (/� WORKERS'COMPENSATION IAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECAME INSPECT FEE S SUBJECTTOTHEWOq!(ERS'COM7ENSATIONPROVISIONSOFSECTION37000FTHELABOfl � �� COOE.I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ANCE � p DATE: APPLICANT. SMIP W � WARNIN6:FPJLURE TO SECURE WORKERS'COMPENSATION COVERAOE IS UNUWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVEFTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPER DOLURS(f 1 ao,000),IN ADDITION TO THE COST OF COMPENSATION,�AMAGES AS PROVIDED FOR IN J SECTION 37oe OF THE LAHOR CODE.INTEREST,AND ATTORNEV'S FEES. � .O ^ oC ETENTION FEE: i i OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � r � I HEREBY AFFIRM UNDER PENALTV OF PERJURV iHAT THEFE IS A CONSTRUCTION LENDINO AGENCY FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERAIIT IS ISSUED(SEC.3081,CIV.CJ. Z W � LENDER'S NMIE F— LENDER'SADDRESS w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CARAECT. TOTAL FE ES / � � w � I AGHEE TO COMPLV WITH ALL GTV AND COUNTV ORDINANCE 0 STATE UWS RELATINQ TO BUILDIN6 � CANSTRUCTI ,AND H EBV AUTHORIZE REP TATIVE F T CWNTV TO ENTER UPoN THE ' . Z ABOVE�MENT ED ERTV FOR INSPEC, P POSES COMMENTS � � J � m P ITfEE E(PRl \, . � "L� � SKi M DATE — RECPT.NO. PAID BV VALIDATION WHITE—Depertment Copy,VELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicanl's Copy c��v o� �i��o�� i�s��c�oo� ��co�� - �Da�p�c��oa �o �� ot��r�c�a .�- o��p��o�a �� o` � -i��,�a{�; �"i�� .., �� 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 FIfJAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlTUB 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. F1RE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY '��Q� '', � EIVTS _ �_ K -� l 3 1 J� � COIV�M � �ev� wo� � SEPTIC TANK SIZE SEEP PIT/U SIZE � a � � ��