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Home My WebLink About17895 (32) ^ �� _ CTI'Y OF DIAMOND BAR � DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES ' �✓ 21825 E.Copley Drive "'� (909)860-3195 Fax(909)861-3117 � PRESS �"'�.�" BUILDING PERMIT APPLICATION FIRMLY o ADDRIESS �5�� N i��!71�"f.t" U�'" APPLICATI�N+�� NUMB R �b ! q/C DATE � ISSUE TYPE pCC APN LOT TRACT DATE CONST. GROUP p OWNER C� L p ADDRESS ��G�s� I-,"tG -� ZONING SETBACKS z CITY nIGN'��.UI Q G✓ IP _ TEL.fO�f�G�39,3,� FRONT qyy ❑ � �APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ z � CONTRACTOR SIDE ❑ ADDRESS � CITY ZIP TEL. PROPOSEDUSE ' `et�C^F� - {Z� p o ARCWENG/ ��'^ z 'DESIGNER w NO.DWEL. NO. NO. � ADDRESS � CITY ZIP TEL. UNITS � STORIES 2 BEDROOMS � cn DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O O I HEREBV AFFlRM UNDER PENALTV OF PERIURV THAT I M/E%EMPT FROM THE CAN7RACTORS LI- G8f89B/C8lPOlI W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCITVOR (n U COUNTVWHICHREOUIflESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUG w w 7URE,PRIOR TO RS ISSUANCE,AL50 REWIRES iHE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Dedc � STATEMENT h1AT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CONTRACTORS LI- � � CENSE UW(CHAPTER B(COMMENCINO WITH SECTION 70D0)OF DIVISION 3 OF THE BUSINESS AND PRO� POOUSp2 FESSIONSCADE)ORTHATHEORSHEISE%EMPTTHEREfROMM1DTHEBA515f-0RTHEALLEGEDE%EMP- (� � TION.ANY VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof � A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5500).): � �,ASOWNEROFTHEPROPERTV,ORMVEM7LOVEESWITHWAGESASTHEIRSOLECAMPENSATION, � COrtIrtI0fCi8I �- Z WILL DO THE WOR)(,M1D THE STRUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7041,BU51� J � NESS AND PROFESSIONS CODE:THE CONTPACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPEHTY NM110 BUfLDS OR IMPqOVES THEREON,fW D VM110 DOES SUCH WORK HIMSELF OR HERSELF OR � 7HROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREOFORS�LEIF,HOWEVER711EBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL MAVE THE BURDEN OF PROVIN�THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SAL�. w ❑I,ASONTJEROFTHEPROPEHTV,AME%CLUSIVELVCONTRACTINOWITHIICENSEDCONTRACTORS [[ .TO CANSTRUCT 7HE PR0.IECT(SEC.701l,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� V81U8SiOf1 tl ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTYW110BUIlD50RIMPROVESTHEREON,AND � WFIOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTMC- QUANTITY DESCRIPTION roas ucer+sE uw.�. FEE J � �AM E%EMPT UNDER SEC. �(� � B.6 P.C.FOR THIS REASON Q � U tL - � DATE OWNER F- Z U �¢ LICENSED CONTRACTORS DECLAFAT ON w 2 I HEREBV AFFIRM UNDER PENALTY OF PERNRV THAT I AM LICENSED UNDER PROVISIONS OF CiiAPTER � � G(COMMENCW6 WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSIONS CODE.AND Z �� MYLICENSEISINFULLFOFCEAND EFFECT. m � LICENSE CLASS LIC.NO. � � V DATE CONTRACTOR d W I� � WORKERS'COMPENSATION DECLARATION Q � U N I HEREBV AFFlRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWIN6 DECLARATIONS: Z 0Z IMAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWOqKERS' a Q = COMPENSATqN,AS PROVIDED BV SECTION��00 OF THE UBOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PEFMIT IS ISSUED. � Qw _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS FEWIRED BV SECTION 3700 OF 7HE UBOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS Q tf 0 ISSUED.MV WORNERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION l D�� ` J j CARRIER PLAN REVIEW Z POIICV NUMBER ELECTRIC Q � (iHI55ECilONNE�NO7BE00MPlETmOFi1-IEP61ATftSFORONEFR11�DqEppqlqRS(f700�OqLESS} PLUMBING r'�aI—c� ) � Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL I d�Jf `\ I f ' �'^��f C.�} SHALL NOT EMPLOV ANY PERSON IN ANY MANNER SO AS TO BECAME SU&IECT TO THE (/) WORKERS'COMPENSATION LAWS OF CALIFORNIA,AfJD AGREE TMAT IF I SHOULD BECOME INSPECTION FEE � SU&IECT TO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 7700 OF THE UHOR 1 � �j CODE,ISHALLFORTHWITHCOMPLVWITHTF105EPROVISIONS. ISSUANCE p DATE: APPLICANT: SMIP � �r •�j V w ��Y � I J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNUWFUL,AND SHALLBE ENERGY P/C J � SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CMl FINES UP TO ONE HUNDRED THpUSAND � '�----�--�F— OOlLARS(Stoo,o00),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN ENERGY PERMIT J SECTION 3]a0 OF THE LABOR CODE,INTEFEST,AND ATTORNEV'S FEES. t� w RETENTION FEE: � O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBV AFFIRM UNDER PENALTV OF PEFiJURV THAT THERE IS A CONSTRUCTION LENDINO AOENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.�. Z W � IENDERS NAME F— LENDER'SADDRESS w I CERTIFY THAT I HAVE READ THIS APPLICATbN AND STATE THAT THE ABOVE INFOR1AATpN IS CORRECT. TOTAL F E ES /��,�, � 1 AaREE TO COMPLV WITH ALL CITV AND CWNTV ORDINANCES AND STATE LAWS RELATING TO BU0.DING � CONSTRUCTION,ANDHEREBVAUTHOFIZEREPRESENTATIVESOFTHISCWNTYTOENTERUPONTHE � Z ABOVE�MENTIONED PROPERTV FOR INSPECTION PUFPOSES. COMMENTS � � � /`��chc�el N- (Z�C� F' 1� �,.�Q�� I PERMITTEE NAME(PRI �-� � �� 72�ycC,-<<.,� �"l� � � SIONATURE P EE DATE _ � RECPT.NO. PAID BY� VALIDATION ~ WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy �9�'� (�f� fCD8�6�1�D�� f��(f� �l�I�I�(�(��O�f� (�3��9(F�� . OG�° ° ° ' 1� �G'�GU� ' . O��C�r .oQ��l f DD GJ`u� ; OG: ° � � � n SET BACK � FLOOR JOIST FTGS/FORMSlSTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CUMDUIT S�AB GRADE FIREPLACE FOUNDATION ^ TEMP P01NER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING (�l. l%L $ FL BpND BEAM FRAMINGNENTILIATION FINAL BOIVD BEAM ROOF COVER � � PRE-GRADING ROUGH HEATING SENCHING ROUGH EIECTRIC ROUGH GRADING ROUGH PLUiVIBING FIhJISH GRADING � SHOWER/TUB TEST POOL E�ECTRIC EXT. LATH/SIDING � POOL FENCiNG WALL INSULATIOIV POOL FINAL CEILItVG INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS""'" ' ' SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS A�R TEST FINAL ZONlNG FIhJAL CONST. FIRE DEPT. FINAL FIhIAL HEATING HEALTH DERT. FINAL FINAL ELECTRIC DEV. FEES PAID FIfVAL PLUMBING ENERGY C�U Of� �. � " . COl�ifi�EfVTS . SEPTIC TAiVK SIZE SEEP PIT/U SIZE � � �� ' c� ,