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Home My WebLink About18067 _ _�� _ CTI'Y OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fa�c(909)861-3117 PRESS �`'��" BUILDING PERMIT APPLICATION FIRMLY ¢ DDRIESS II�J� � !�7 IiWVL/ l _ �-GO-� � O��I y. / APPLICATION PERMIT P/C o DATE NUMBER k � ISSUE /� TYPE OCC APN LOT� TRACT - --� ��,� DATE � � U✓ CONST. GROUP � OWNER r O o ADDRESS � (JQ ZONING SETBACKS Z CITY ZIP TEL - fj FRONT Ryy ❑ o APPLICANT TEL. REAR ❑ � SIDE/SIDE STREEf RW ❑ � CONTRACTOR ��fA- ��.f � SIDE ❑ ADDRESS � CITY ZIP TEL. PROPOSED USE w ARCWENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRAI UNDER PENALTV OF PERri1RV THAT I AM E%EMPT FROM THE COMMCTOqS LI- G8f899/CBfPOR W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.5BUSINESSMlDPpOFE5S10NSCODE:ANVCITVOq (n C-� COUNTVWHICNREOUIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISN,OHREPAIRANYSTAUG w NRE,PRqR TO ITS ISSUANCE.ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w Patio/Deck � STATEMENT THAT HE OR SHE IS IJCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO• POOVSPB � � FESSIONSCODE)OR7HATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHE/�LLEGEDE%EMP- � U TION.ANVVIOLATIONOFSECTION7o31.5BVANVMPLICRNTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof A CML VENALTV OF NOT A/OqE THAN FIVE HUNDRED DOLURS(f500).): � ❑I,ASOWNEROFTHEPROPERTV,OPMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � Z WILL DO TFIE WORK,M1D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7014,BUSI- J CORIRIBfCl81 - N NESS AND PROFESSIONS CODE TNE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � 1 PROPERTV NR10 BUfLDS OR IMPROVES THEREON.AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q iHROUGH HIS OR HEH OWN EMPLOVEES.PqOVIDED 7}UT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVER,hIEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCqMPLE� Z 710N.THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO h1AT HE OR SHE DID NOT BUILD OR � IAIPROVE FOR 7HE PURPOSE OF SALE). � w ❑I,AS OWNER OF THE PROPERTV,AM EXCIUSIVELV CANTRACTING N7TH LICENSED CONTRACTORS Q TO CONSTRUCT THE PR0.IECT(SEC.701�,BUSINESS AND PROFESSIONS CODE:THE COMRACTORS U� V81U0NOf1 ADJ.AREA W CENSELAWDOESNOTMPLYTOANOMMEROFAPROPERTVWMOBUILDSORIMPROVESTHEREON,/WD = NM1fOCONTRACTSf-0RSUCHPR0.IECTSWI7HACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTMC- �E ~ TORS LICENSE UW.). �UANTITY D CRIP710N Y � ❑I AM E%EMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � � r ?� U � DATE '��` OWNER U � ¢ Z U �Q LICENSED CONTRACTORS DECLARATION W . CL I HEREBY AFFIRM UNDER PENALTV OF PERIURV TMAT I AM LICENSED UNDER PROVISIONS Of CHAPTER � � Y(COMMENCINO WITH SECiqN 7000)OF DNISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z � LLI MY LICENSE IS IN FULL FORCE AND EFFECT. m 0 IICENSE CLASS LIC.NO. � U DATE CONTRACTOR d W / � WORKERS'COMPENSATION DECLARATION � � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWIN6 DECIARATbNS: Z � _I HAVE M!D WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ Q CAMPENSATION,AS PROVIDED BY SECTION 37000FTHE LABOR CODE,FOR THE PERFORMANCE U Q OF 7HE WORK FOR WHIC}I THIS PERMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE.AS REWIRED BY SECTION Q 3700 OF THE LABOR CODE.FOR THE PERFOfiMANCE OF THE WORK FOR WHICH THIS PERMIT I$ 4/{..{� ISSUED.MY VIORKERS'COMPENSATION INSUFLWCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION V�/ J j c�RRiER PLAN REVIEW + ZPOLICY NUMBER ELECTRIC Q 1 � (iHLSSECiIONNE�NOTBECOM1WLETmOFT-EPEPMTt$FOHpNEFM�DqEppqlq{L$K100)ORLE$$} PLUMBING / W Z 1 CERTIFV THAT IN THE PERFORMANCE OF THE WOR)(fOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL '(,'} SHAIL NOT EMPLOV ANV PERSON IN ANY MANNER 50 AS TO BECOME SU&IECT TO THE (n V/ORKERS'COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE = SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR LODE,I SHALL FOR7HWITM COMPLY WITH THOSE PROVISIONS. ISSUANCE � �\ p DATE: APPLICANT: SMIP f W � J WARNINO:FAILURE TO SECUF7E WOAKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C J � SU&IECTAN EMPIOVER TO CRIMINAL PENAlTIES AND CML FMES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOI.lARS(f100.000).W ADDIiION TO THE CQST OF CAMPENSATION,DAMAGES AS PflOVIDED FOR IN � SECTION 370e OF iHE LABOR CODE,INTEREST,AND ATfORNEV'S FEES. RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: " � I HEREBV AFFIRAI UNOER PENALTV OF PERIURY THAT THERE IS ACONSTRUCTION LENDING AGENCY -� �- FOR THE PEflFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,qV.CJ. Z W � IENDER'S NAME � LENDER'SADDRESS w TOTAL FEES ^ c }� �, � I CERTIFV THAT I HAVE READ 7HI5 APPLICATqN AND STATE iHAT THE ABOVE INFORMATION IS CORRECT. � I AGREE TO COMPLY WITH ALL CfTY AND COUNTV ORDINANCES AND STATE L4WS RELATING TO BUILDINO ��/r'f�� . � �I � I D O � �� L " CONSTRUCThON,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UFON THE ZABOVE�MENTIONED PROPERTV FOR INSPECTpN PURPOSES. L��I �� .t. � COMMENTS v m PEF E N (PRINTy � �.,�-2o-Z (n SIONATU PERMITTE DATE _ � RECPT.NO. PAID BY VALIDATION ~ WHITE-De ariment Co YELLOW-Finence Co PINK-Assessor Co GOLDENROD-File Co GREEN- �. P PY. PY, PY. PY. ApPlicanYs CoPY (�6�P'�' �(� m}D�Gl�il��l4� (�l�l�i ��t��'RS��I f��(f�� txnJ�Jlr'��5��u ll�."JL�:.) � '� U�liJlr' t� � n � uuCK'.Jlr'LS�u 1�/Uv d '� ° �� fl ' � SET B/aCK _r�- ~ FLOOR JQiST FTGS/FORMS/STEEL � FFlA REQMTS - _ %G�� — -- ELECTRIC GROUND ��,�� _ UI�QER FLOOR DUCT _ GR�UND PLUMBING UNDER FLOOR CUf�IDUIT SLAB GRADE FIREPLAGE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. 80ND BEAI� ROOF SHEATHING 8 FT. BOND BEAM FRAMIIVGNENTILfATtON FINAL BOND BEAM ` ROOF COVER PRE-GRAQING ROUGH HEATING BEIVGHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUiVIBINa FI�IISH uRADING ��- _� __ SHOWER/TUB TEST ' POOL ELECTRIC �f2 GL � EXT. LATH/SIDI(VG POOL FENCING � �2 WALL IfVSULATION~ POOL FI�lAL t��'f� �� CEI�ING Ih18ULATION OFF SITE IMPS. � DRYWALI.NAILING DEDICATIONS ' SEWER FiNAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT;�.L. �N SITE lMPS. GAS A1R TEST �j � 2 FiNAL ZONING � FINAI.CONST. � F!RE DEPT. FINAL FINAL HEATING p� H�ALTH DEPT. FINAL FINAL ELECTRIC � ` DEV. FEES PAID FINAL PLUMBING FNERGY �_ 'r�'D �/Z � --- — ---- --- [ � ��I° C�sG�OQ�- o �o. COf�I�iENTS _ . _, _. yG R�YccouD SEPTIC TAPVK SIZE SEEP PIT/U SIZE " M . UV , `q�: .. lJV o � V � `