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Home My WebLink About11-615 �,` � CITY OF DIAMOND BAR �}�-�� DEPARI'MENT OF COMMUNITY&DEVELOPMENT SERVICES [� `� 21825 Copley Drive,Diamond Bar,CA 91765 � PRESS '� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 ��9w�� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE APPUCATION PERMIT �L--�_ � P!C ADDRESS � DATE NUMBER �# 1SSUE TMPE � GROUP � APN OT TRACT DATE S CONST. °C OWNER � ZONING SETBA KS o ADD SS a� FRONT RW ❑ Z CITY � � ZI � REAR ❑ i g APPLICANT TEL. SIDE/SIDE STREET RW ❑ � � CONTRACTOR SIDE � � C17Y {�)Q!V `C. � ZI T PROPOSED USE w ARCH/ENG/ z DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � C1TY ZIP TEt. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION cr� � OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEIAPT FAOM THE CONTRACTORS LI- � G8f8Q0/C8fP011 W CENSEUWFOHTHEFOLLOWINOREASON(SEC.703t.6BU51NE55ANDPROFE��ONSCODE:ANVCITVOR ZCIXJNTYWFIICNREW1qE5�PERMRTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,OR(iEPAIRANVSTRUG W pySlO/DBCI( w TURE,PFIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANi FOR SUCM PERMIT TO FILE A SIONED w � STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS ll� �J„ pOOUS 8 � CENSE UW(CMAPTEP D(COMMENCING WITM SECTION 7000)OF DIVISbN 3 OF THE BUSINE55 AND PRO� rt P FESSIONSCODE)ORTHATHEORSHEISEXEMPTiHEREFROMANOTHEBASISFORTHEALLEGEDE%EMP- V TION.MlV VIOlAT10N OF SECTION 7031.5 BV ANV APPLICPNT FOR A PERMIT SU61ECT5 THE APPLICNfT TO Z Re-Roof � A CIVIL VENALTV OF NOT MORE h1AN FNE HUNDRED DOLLARS(f�W)J: Q ❑I,ASOWNEROFTHEPROPERTV,oRMYEMPLOVEESwIiHWAOE5AS7HEIRSOLECOMPENSA7lON, � COmmerCial Z WILL DO THE W�RK AN9 THE STRUCTUFE IS NOT INTENDEO OR OFFERED FOR SAIE{SEC.7aa�,BU51� ...1 N NE55 AND PROFESSIONS CODE:THE CONTFACTORS UCENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPEHTVWHOBUILASORWPROVESTHEREON,PNDWHODOESSUCHWORKHIMSELFORHERSELFOR m [[ THROUOM HIS OR HER OWN EMPLOYEES.PRONDED THAT SUpi IMPROVEMENTS ARE NOT INTENDED OR QOFFEAEDf-0RSALEIF.HOWtI�ER,TMEBUILDINGORIIAPROVEMENTISSOLDWITHINONEYEAROFCOMFLE� z TION.THE OM�NER-BUILDER WILL HAVE THE BURDEN OF PROVINC THAT IiE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). ❑I,AS OWNER OF THE PROPERTV,AM EXCLUSIVELY CONTRACTINO WITH LICENSED CONTRACTOH9 �j,q�, Q TO C�NSTRUCT THE PqOJECT(SEC.7oN,BUSINESS AND PROFES510NS COD£�THE CONTRACTOftS ll� V0IU811IXi dW� ADJ.AREA W CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPERTVNM1IOBUIIDSORIMPROVESTNEREON,AND � VJf10CANTRACTSFORSUCHPqQ1ECTSWITHACONTRACTOR�S)UCENSEDPURSUANTTOTHECANTRAG QUANTITY DESCRIPTION FEE Y TORS UCENSE LAW.). �J � ❑1 AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON Q � � � O�7E OWNEH U Z W � LICENSED CONTRACTORS DECLARATION w 2 �HEREBV AFFIRM UNOEfi VENALTY OF PERJURV THAT I MA UCENSED UN�ER PROVISIONS OF CHAPTER � d B(COMMENCINO WITH SECTION 7000)OF DIVISION J OF THL BUSMESS AND PROFESSIONS CODE.AND Z X MY LICENSE IS IN FULL FORCE AND EFFECT. m LLI � 0 LICENSE CLASS LIC.NO. J � V pp7E CONTRACTOR a W � WORKERS'COMPENSAT�ON DECLARATION � � U � 1 NEREBV AFFIRM UNDER PENALTV OF PE0.IURY ONE OF TME GOLLOWING DECURATIONS: Z Q � I HAV D WILL MAINTAIN A CERTIFICA7E OF CONSENT TO SEIF-INSURE FOR WORKERS' 2 � ENSATION,AS PFOVIDED BV SECTION 3700 OF THE LABOR CADE.FOR THE PERFORMANCE `U THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w 1 HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE IABOR CODE,FOR THE PERFOFiMANCE OF THE WORK FOR WNICH THIS PERMIT IS ISSUED.MV WORKERS'CqMPENSATION INSURq�j y,CEn CA IER AND POIICY NUMBER ARE: CONSTRUCTION � CARRIER �L/� Q.J �� PLAN AEVIEW � POLICV NUMBER �` �� l `�--- ELECTRIC y Q � (IWssECt10Nr1E�NoreEa'1A4Lt�EDOFnEaEaArr�SwaoNErII.NDa�Da1PRs�f�ao)oR�Es51 PLUMBING �� T W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WOR1C FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL (,'} SHAIL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE � V✓ORKERS'COMPENSATKKJ LAWS OF CALIFORNIA,AND�GREE TF1AT IF I SHOULO BECAME INSPEC710N FEE SUBJECT TO THE WORKERS'COM7ENSATION 7ROVISIONS OF SECTION 3700 OF THE LABOR �"T //r � CODE,I SHALL FORTHWITN COMPIY WIT1 hIOSE PAOV1510N5. ISSUANCE '( � SMIP p DATE: APPLICANT. � W ENERGY P/C J WARNINO:FAILURETO SECUFiE M/OflKERS'COMPENSATION COVERAGE IS UNLAWFUL,AN�SHALI BE �y SU9JECTANEMPLOYER[OCRIMINALPENALTIESANDCIVI�FINESUPTOONEHUNOHEDTHWSMIO ENERGYPERMIT DOLLAAS(f lao,o00),IN PODITION TO THE COST OF CAMPENSATqN,DNAAGES AS PROVIDED FOR IN � SECTION 37oe OF THE IABOR CODE,MTEREST,AND ATTORNEV'S FEES. R�ENTION FEE: �"� . w CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � O � 1 HEREBV AFFIRM UNDEF PENALTV OF PERJURV THAT TNEFE IS A CONSTRUCTION LENDINO AOENCV � FOR THE PERFORMANCE OF 7HE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.7oa7.CIV.C.). Z W � LENOER'S NAME F_- LENDER'S ADDRE55 /y r� ^ � I CEA7IFY TMA7 I NAVE READ THIS APVLICATION AND S7A7E TNAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES �� '' W 1 AGFEE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES ANO STATE UWS REUTWO TO BUIlDINO � CONSTRUCTION,AND HEREB�AUTHORIZE REPRESENTATIV F MIS TV TO EN7ER UPON THE Z ABOVE-MENTIONED PROP TY F S7ECTION PUFP COMMENTS � 0 J /� ^ � �•!%1 m PERMI (P Q �I �.i (!J � � DATE RECPT.NO. PAID BY VALIDATION � WHITE-0epertment Copy,YELLOW—Flnance Copy,PINK—Aasessor Copy,dOLDENROD--File Copy,GREEN—Appll fs Copy CITY O� DE�fViO�� AFi ��' If�S�I�C�'BOI� C��COR� ,,., .. . , ��I�pCC�400G} �G�� '• p OI�Q�40G3 : : . D�]�PL��4DdI� ::`. .. o � � . (�J�r,C, ' 'OG1�PL�C� r o p .; . . SET BACK � 0�, 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 FRAMINGNENTILATlON FlNAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATWG ' BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATICIN OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP P!T/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 a e� � � :