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Home My WebLink About10-986 _��_ CTTY OF DIAMOND BAR � � - DEPARTMENT OF COMMUNITY&DEVEL�� RVICES 21825 Copley Drive,Diamond Bar,CA 91765 �,� � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline��39-7027 PRESS �'°�'� BUILDING PERMIT APPLICATION FIRMLY o ADDRIESS d I3�� I�� r I `"� � /(�_C�Q�' , y. APPLICATION PERMIT p/C � � DATE NUMBER 1__L_Q!G # � APN ,LOT TRACT ATE /� D CONST.�� GROUP p OWNER p ADD ESS I ZONING SETBACKS z CITY ZIP TEL � 9 rj ?� FRONT qyy � � APPLICANT TE REAR � ¢ SIDE/SIDE STREET RW ❑ � CONTRACTOR [ SIDE � ADDRES � � CITY ZIP TEL. PROPOSED USE w ARCWENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TF� UNITS STORIES BEDROOMS � -- � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p I MEREBY AFFIRM UNDER 7ENALTV OF PERIURV THAT 1 AM EXEMPT FPOM THE CAMRACTORS LI� G8f0 B/Ce R W CENSE UW FOR THE FOLLOW WO REASON(SEC.7031.6 BUSINESS AND PROFESSIONS CADE:ANV CITV OR (n g � ZCOUNTYWHICHRE�UIRESAPERMITTOCONSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W Petio/Deck W 7URE,PRqR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SICaNEO w i � STATEMENT THAT HE OR SHE IS LICENSED WFSUANT TO THE GROVISIONS OF THE CANTRACTORS ll� � CENSE LAW(CNAPTER e(COMMENCINO WIiH SECTION 7000)OF OIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB � FESSIONS CODE)OR THAT HE OR SHE IS E%EMPi THEREFROM AND THE BA515 FOR THE ALLEOED E%EMP- (� I TION.ANV VqUTION OF SECTION 7071.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANi TO Z RB-ROOI � A CML PENALTY OF NOT MORE THAN FNE HUNDRED DOLURS(5500).): � ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOYEESWITHWAGESAS7HEIRSOIECOMPENSA710N, CommBfCi91 . � VltLL DO THE WORK�ND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W�,BUSI- � � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV MM1IO BUIIDS OR IMPROVES THEREON,AND NMO DOES SUCH WORN HIMSELF OR HERSELF OR w TMROUGH HIS OR HER OWN EMPLOVEES,VROVIDED THAT SUCN IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVEq7HEBUIlAIN00RIMPROVEMINTI550lDWITHINONEVEAROFCOMPLE- Z TION,TME OWNER�BUILOER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BNLD OR � IMPROVE FOR THE PUqPOSE OF SAL�. w ❑I.AS OWNER OF TME PROPE{7n',AM EXQUSNEIY CONTRACTINO WfTH LICENSED CON7RACTORS [[ TO CONSTRUCT THE PRQIECT(SEC.7041,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS LI- �V8IU2SI011 ADJ.AREA W CENSE UW DOES NOTAPPLV TO AN ONMER OF A PROPERTV WHO W ILDS OR IMPROVES THEREON,ANO � WHOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECANTMP pUANTITY DESCRIPTION TORS LICENSE UW.). FEE Q ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON JQ � � U � DATE OWNER � Z U F LICENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PEN�LTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �r � e(COMMENCINO WRH SECTION 7000)OF DIVISKKJ J OF THE BUSINESS AND PROFESSIONS CADE.AND Z IDI X MV LICENSE IS M FULL FORCE AND EFFECT. m � �S LLI �/�[x� . � LICENSE CLASS G � UC.NO. �^`� v � u , ~ DATE CONTRACTOR rC) d y �� W r E^ � WORKERS'COMPENSATION DECLARATION w h N. N I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOW WO DECLARATKKJS: �� r� �� _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' �� G� � COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE UBOR CADE,FOR THE PERFORMANCE OF THE WORK FOF WHICH THIS PEpM1T IS ISSUED. � �� (/ w yC I HAVE AND WILL MAINTAW WORNERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION 0 3700 OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOq WHICH TFIIS PERMIT IS ISSUED.MV WO RS'COMPENSATIyON�INSURANyC�E CARRIER AND POLICY NUMBER ARE: CONSTRUCTION � CARqIER c-�t 1 T► /� pWrf REVIEW 0 POLICV NUMBER ��.�L �` Zd. ELECTRIC � (fl-hSSECTqNNE�NOTBE00f.4LEfmOFTYEPEFUNTISFOqpNEF0.1H]PFDDOILAPS�t1ao)ORLESS} PLUM ING /� W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL C} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE � WORKERS'COMPENSATIONLqW50FCALIFORN10.M1DAGREETHATIFISHOUlDBECOME INSPECTIONFEE SUBJECTTO THE WORNERS'COMPENSATION PROVISbNS OF SECTION 37000F THE UBOR � S CQDE,I SHA FORTHWITM COMPLV WI THO�E PROVISIONS NC _ � OQ � p DATE: O � APPUCA . SMIP W ENERGY P/C J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAO NUWFUL,AND SHALL BE J � SUBJECTANEMPLOVEFiTOCRIMINALPENALTIESAN�CIVILFINESUPTOONEHUNOREDTHWSAND ENERGYPERMIT DOlLARS(f 700,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOP IN � SECTION 3708 OF THE LABOR CODE.INTEREST,AND ATTORNEv'S FEES. A�E I D' O OCONSTRUCTION LENDING AGENCY PRE•ALT FEE: � 1 HEREBV AFFIRM UNDER PENAL7V OF PERIURV iHAT THEFE IS A CqNSTRUCTION LENDWG AQENCV � FOR THE PERFORMANCE OF THE WORK FOR WHlCH TMIS PERMIT IS ISSUED(SEC.30D7,CIV.C.). Z W � LENDER'S NAME � � LENDER'SADDRESS W I CERTIFV THAT I HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL F E ES ��""�� I AOREE TO COMPLY WITH ALl CT'AND COUNTV ORDWANCES AND STATE UWS RELATWO TO BUILDINO � CONSTRUCTION,ANDHEREBYAUTFbRIZEREPRESENTATIVE50FTHISCWNTVTOENTERUPONTHE Z ABOVE-MENiqNED PROPERTY FOR INSPECTqN PURPOSES. COMMENTS ' 0 i - � � m fTTEE NAME(PRl � Q � /J\ U � SIONATUREO DATE - � RECPT.NO. PAID BY VAUDATION HITE—Deparlment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROD--File Copy,OREEN—Applir,anYs Copy COTY O� DIAMOV�D �AFi �� ]�I��:��`P�EC�'�01� ��CORD 51 �.,f_��,;:_ . �_, . _ . - _ - �_.. � . - .,.� . � `` '0[►��pGC�400.�n1 "D�'� � Qi�1�pCC��40G3 �=: Ot�I�pC�C��OCOUYI - QGJ4C��= ` ��.�C� � � 4. SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UfJDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHIfVG 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING 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 PITIL.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 , C��` . COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a :� a :h� ,�; r.� � � _��