The URL can be used to link to this page

Home My WebLink About10-1187 _�,�_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839� 27 PRESS �''"' BUiLDING PERMIT APPLICATION FIRMLY o� JOBSITE APPLICATION , PERMIT _��' / /C ADDRESS O DATE NUMBE� '"� / # � � APN LOT TRACT D TEE ��' ��/O ONST. L� � ROUP p OWNER L a, p ADD ESS U ZONING SETBACKS , � CITY ZI � - I-1 REOART RW ❑� APPLICANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR ' SIDE p ADDRES `fl � CITY $Nt ,-Z. ZIP . TEL - PROPOSEDUSE 'G✓� o ARCH/ENG/ � DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS cn � DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFIRM UNDER PENALTY OF PERRIRV THAT I MI E%EMPT FROM THE CONTRACTORS LI� Gflf89B/CBfpOfl W CENSEUWFORTHEFOLLOWINOHEASON(SEC.7o31.6BU51NESSANDPROFESSKKJ3CO0E:ANVCITYOR (n U COUNTVWHICHREWIRESAPERMRTOCONSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPPJRANVSTFUC� w w TURE,PHIOR TO ITS ISSUANCE,AL50 REW IRES THE APPLICAM FOR SUCFI PERMIT TO FILE A SIONED w Patio/Deck � S7ATEMENT 7HAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CANTRACTORS ll� � � CENSE LAW(CHAPTER e(COMMENqNO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOI/SP8 FESSIONS COOE)OR THAT ME OH SHE IS EXEMPT THEREFROM AND THE BA515 FOR THE ALLE6ED E%EMP- (� TION.ANYVIOLATqNOFSECTION7031.5BVANYAPP�ICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENALTV OF NOT MORE hlMl FNE HUNDRED DOLURS(f5ao).): Q OI,ASOVMEROFTHEPROPERTV,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATqN, � COrtIRIBfC10I Z WILL DO THE WORK,AND THE STRUCNRE IS NOT IMENDED OR OFFERED FOR SALE(SEC.7Ws,BUSI- J N NE55 AND PROFESSIONS CODE:THE CONTRACTORS IICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV WFq BUILDS OR IAIPROVES 7HEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THRIXIOH HIS OR HER ONT!EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREDFORSALEIFHOWEVERTMEBUIIDINGORIMPROVEMENTI550LDWITHINONEVEqROFCAMPLE- Z TION,7HE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OF � W PROVE FOR THE PURPOSE OF SALE). �y,� ❑I,ASOWNEROFTHEPROPERTV.AAIEXCLUSNELYCANTRACTINOWITHLICENSEDCONTRACTORS [[ TO CONSTRUCT THE PRQIECT(SEC.70W,BUSINE55 AND PROFESSIONS CODE THE CONTRACTORS LI- V81U811Of1 qp�,qqEq W CENSE LAW DOES NOTAPPLY TOAN OWNER OFA PROPERTV WHO BUILDS OR IMPROVES THERE-0N,M!D � WHOCONTRACTSFORSUCHPRQIECTSWITHACON7RACiOR(S)LICENSE�PURSUANTT07NECONTRAC- QUANTITY DESCRIPTION roas ucENSE uw.�. FEE � ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON J � Q 7� U � DATE OWNER ¢ Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PEN/�LTV OF PERJURV THAT I AM LICENSE�UNDER PROVISIONS OF CHAPTER � - � e(COMMENCING WITH SECTION 7000)OF DIVISION 3 Of THE BUSINESS AND PROFESSIONS CADE,AND Z L� � �� MV IICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CLASS LIC.NO. `v � V DATE � � T CONTRACTOR � � d W � WORKERS'COMPENSATION DECLARATION � Q �' U N 1 HEREBY AFFIRM UNDER PENALTV OF PERIURY ONE OF THE FOLLOWING DECLARATIONS: Z ' 0 _IHA DWILLMAWTAWACERTIFICATEOFCqNSENTTOSELF-INSUREFORWORKERS' a � ENSATION,AS PROVI�ED BV SECTION 3700 OF TME U�BOR CODE,FOR THE GERFORMANCE U TNE WORN FOR NM1IICH TFIIS PERMIT IS ISSUED. w � � Qw I HAVEAND WILL MAINTAIN WOR)(ERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION 37oa OF THE LABOR CqDE,FOR THE PERFORMANCE OF THE WORK FOR WHlpi THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATI�SU(�RA E CARRIER ANO POIICV NUMBERARE: CONSTRUCTION jCARRIER._ \\ YT //� PLANREVIEW � POLICY NUMBER �2 ��"� dz ELECTRIC � (�MSSECTqNNE�NOTBECOI.�LETmOFT1EPEp.ffSFORONEF4X�OREDDp.LAfiS(t100IORLESS), MBI I S W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHIGi THIS PERMIT IS ISSUED.I MECHANICAL - �} SHAIL NOT EMPLOY ANV 7ERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATqNLAWSOFCALIFORNIA,ANDAGREETHATIF15HOULDBECAME INSPECTIONFEE = SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 77000F THE IABOq � � CODE,1 SHALL FOR7HWITH COMPIY WITH THOSE PROVISIONS. SU � p DATE: APPLICANT: SMIP � W � WARNINO:FAILUFE TO SECURE M/ORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTAN EMPLOVEF TO CRIMINAL PENALTIES AND CIVIL FWES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLURS(f100,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAOES AS PROVIDED FOR IN � J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. w TENTIO FEE•� O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � � I HEREBYAFFIRM UNDER PENALTV OF PERJURY THATTHEHE IS ACONSTRUCTION LENDWG AOENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.C.). Z W � LENDER'S NAME � LENDERSADORE55 � TOTAL FEES �S��a- � 1 CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARAECT. w 1 AGREE TO COMPLV WITH ALL CfTV AND CWNTV ORDINANCES AND STATE UWS REU7INO TO WILDINO a � CONSTRUCTIO /WD HEREBV AUTHORIZE REPRESENTATIVES OF 7HI5 CWNTV TO ENTER UPON THE Z ABOVE�MENTIO ED PERTV FOR IN �auaao Es. COMMENTS � 0 J � m P ITTEE� (p /^'/ . � V y U 1 DA7E � RECPT.NO. PAID BY V/WDATION WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy C9TV O� DIAMOf�D �AR IiVS�IEC�'90� G��CORD 1Y � :..� . � „ oa�p�c�4aoa oa�� aa��a aa�p�t��oa :�Q�r�,� �oa � �� .� � 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 HT. BQND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERJTUB 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. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ' ENERGY ��. COMMENTS �3� -�� `� �� SEPTIC TANK SIZE SEEP PIT/U SIZE a � ' a z�- ��= �: �°�`� �