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Home My WebLink About10-1033 _ _ _ -� . `� CITY OF DIAMOND BAR � �� COMMUNITY DEVELOPMENT RTME -;,. 21660E.CopleyDriveSuite190 �� ,�� pRESS . (909)860-3195 Faz(909)861-3117 ' �"""', BUILDINGPERMITAPPLICATION FIRMLY � JOBSITE Q^ � �``�`_ ��n�\ APPUCATI�O�N PERMIT P/C o ADDRESS��i(� �'� � �� DATE LV'��3�D NUMBE�V�/�33 # issue rvPe occ � APN LOT TRACT DATE ��'��D CONST.�7?�'C�/� GROUP p OWNER o ADDR SS ✓� ZONING SETBACKS z CITY ZIP TEL. FRONT RW ❑ o APPLICANT��1PS(�s �y��` TE . REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR � SIDE ❑ o ADDRE PROPOSED USE G"�'/��LG_ GEN��F�C� �J{�r CITY ZIPG�Q�TEL. w ARCWENG/ z�� ""-i��`� z DESIGNER w NO.DWEL. j NO. � NO. a ADDRESS � CITY ZIP TEL. UNITS I STORIES BEDROOMS� cr� v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-B�ILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERJURV 7HAT I AM EXEMPT FROM 7HE CONTRACTOf75 LI- G8f99B/CafPOfl W CENSELAWFORTHEFOLLOWINOREASON(SEC,7031.5BUSINESSANDPROFESSIONSCODE:ANVCI7YOR (n U �p�1N7yWHK.y{REWIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANVSTRUC� w w NRE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUC11 PERMIT TO FILE A SIGNED w PaUo/Deck � STATEMENT THAY HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CANTRACTORS LI- � � CENSE UW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOUSPB � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORhIEALLEOEDE%EMP- (� V TION.ANYVqLAT10NOF5ECTION7031.bBVANVAPPLIClWTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Rool A CNIL PENALT/OF NOT MORE TH/J!FIVE HUNDRED DOLl.ARS(5500).): � OI,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � CORIR16fCI81 Z WILL DO THE WORK,AND THE STRUCNRE IS NOT INTENDED OR OFFEFED FOR S�LE(SEC.7Wa,BUSI- J � NESS AND PqOFESSIONS CODE:THE CONTfUCTORS LICENSE LAW OOES NOT APPLV TO Ml OWNER OF � PROPERTV WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUp1 WORN HIMSELF OR HERSELF OR I W TM��H HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSPLEIF,HOWEVERTMEBUILAINOORIMPROVEMENTISSOLDWITMNONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BUROEN OF PROVWG THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SAIE�. w ❑I,AS OWNER OF THE PROPEHTV,AM E%CLUSNELV CONTRACTING WfTH LICENSED CONTRACTORS � TO CONSTRUCT THE PROJECT(SEC.7014,BUSINE55 AND PROFESSIONS CODE:THE CONTMCTORS LI� VeIU9NOf1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEROFAPROPER7YWHOBUILDSORIMPROVESTHEREON,AND � NM1IOCONTRACTSFORSUCHPR0.IECTSWITHACONTRACTOH(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION � �E Y TORS LICENSE LAW,). �� ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON � U � DATE OVMER ¢ Z U � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDEFi PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISpNS OF CHA7TER � � V(COMMENqN�WITH SECTION 7000)OF DNISION]OF THE BUSINESS AND PROFESSIONS CODE,AND Z OAIY UCENSE IS W FULL FORCE AND EFFECT, � �� IICENSE CLASS+�{ LIC.NO. � ~ DATE I'�.J L"� 4 � V CONTRAC70R d W � WORKERS'COMPENSATION DECLARATION Q �� U � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECIARATIONS: Z , � � _I HAVE/WD WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR NORKERS' a '� 2 COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE IABOR CODE,FOR THE PERFORMANCE U OF7HE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � � _I HAVE AND WILL MAINTAIN WOR!(ERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTqN Q 37a0 0F THE LPBOR CODE,FOR THE PERFORMANCE OF THE WOH1(FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARflIER AND POLICY NUMBEH ARE: CONSTRUCTION J j CAHRIER S PLAN REVIEW � POLICY NUMBER Zd ELECTRIC p (nassEcfqNME�No78E00M11PLEi�oF7ViEpEF�,iitsFdqpdEHlRixiEDDql/�fis(flm�oqLESsl PLUMBING W yy Z I CERTIFY THAT W THE PERFORMANCE OF THE VlORK FOR WHICH 7HI5 PERMIT IS ISSUED,I ANI (•} SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SOAS TO BECOME SU&IECT TO THE r�� WORKERS'COMPENSATION LAWS OF CALIFOFN10.PND AOREE THAT IF I SHOULD BECOME INSPECTION FEE � S CODEE I�STH/�LL FORTHWITH Cp1Ap�y SATKKJO pOVROV S� SECTION 37000F THE LABOR ISSU pC.S�/V p DATE: LD��D APPLICANT: SMIP W � WARNINO:FAILURE TO SEWRE M/OFiKERS'COMPENSATION COV OE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJECTANEMPLOYERTOCRIMIN/�LPENALTIESfWDCMLFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLV F13(5700,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTqN 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. NTION E: W O CONSTRUCTION LENDING AGENCY PRE- . ��. � I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT iHERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. Z W � LENDER'S NAME F— LENDERSADDRESS w ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETIiATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES � � � I AOFEE TO COMPLV WITII ALL CfTY AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBY AUTFK)RIZE REPRESENTATIVES OF THIS COUNTV TO ENTER U70N THE Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS O J � m PERMITTEE NAA/E(PR1NT) Q � N SIONATUREOFPERMITTEE DATE � RECPT.NO. PAID BY G I� O VALIDATION WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy ��`l�l°af� ��1�(� �o� �� uw�� c� � .. C��1� ��,�� . . OG�1�C� U o Do '-G�� o � �° o Do Q fl`� �G� 0 m �^;Y,..' �,: SET BACK ' FLOOR JOIST ` FTGS/FORMS/STEEL - • � . FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CU�IDUIT SLAB GRADE FIREPLACE FOUNDATION TEh/IP POWER FIREPLACE BOND BEAM_ . WATER SERVICE MID HL BOND BEAM - ' - ROOF SHEATHING � • � - 8 FT. BOND BEAM FRAMING/VENTILIATIOM1I FINAL BOND BEAM RUOF COVER � � PRE-GRADING ROUGH HEATING � BENCHING ROUGH ECECTRIC Fa ROUGH GRADING ROUGH PLUMBING FINISH uRADING 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 TAhiK LANQSCAPEJIRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL F1iVAL ELECTRIC DEV. FEES PAID FINA�PLUMBING ENERGY ��o COi�MENTS ' -�,;,�A r�,�.,,..� � O Z� �� SEPTIC TANK SIZE SEEP PITJU SIZE � � � � � .