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Home My WebLink About11-1225 _�`_ CdTY 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)839-7027 PRESS ' �( �'°"'• BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE ZZ �G 1 "�� D Y' � (3� APPLICATION � (�// PERMIT _ ��/C �� ADDRESS DATE �Q NUMBER � APN LO TRACT DA EE g`A �!I ONST.`�, GROUP p OWNER S � - " ADDRESS ZZ �r"' ZONING SETBACKS Zcirv D� ZIP TEL. O FRONT qyy p � APPLICANT TEL��Z� REAR � �� SIDE/SIDE STREET RW ❑ CONTRACTO � SIDE � ADDRESS O ^ PROPOSED USE � CITY WPA'� �p}v�►�� ZIP TEL.� ^21�-Q7� . o ARCWENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFlRM UNDER PENALTV OF PERNRV THAT I AM E%EMPT FROM THE CONTqACTORS L4 Gara B/C8 W CENSEUWFORTNEFOLLOWINOREASON(SEC.7031.6BUSWESSANDPROFESSIONSCODE:MlVCITVOR (n 9 �rt U CpUN7yWN�CNREQUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORREPAIRANVSTRUC� w w TUR�PRIOR TO ITS ISSUANCE,AL50 REQUIRES 7HE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w Patlo/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE UW(CHMTER e(COMMENqNO WITN SECT70N 700a)OF DIVISION 3 OF THE BUSINESS AND PRO• POOUSPB FESSIONS CODE)OR THAT HE OR SHE IS E%EAIPT THEREFROM AND THE BA515 FOR THE ALLEQED EXEMP- (� TKKJ.ANV VIOLATKKJ OF SECTION 7031.6 BY ANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT T0 Z Re-Roof A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLURS(f6ao)J: Q ❑lASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWI7HWAGESASTHEIRSOLECOMPENSA7lON, � CommBfCi81 :_ Z WILL DO THE WORI(,AND THE STRUCTUqE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W1,BU51� J � N NESS AND PROFESSIONS CODE:TNE CONTfiACTORS UCENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTV VRiO BUILAS OR IM VROVES THEREON,AND WHO�OES SUCH WORK HIMSELF OR HERSELF OR CC THROU(3H HI$OR HER OWN EMPLOVEES,7ROVIDED THAT SUCH IMPROVEMENTS ARE NOT WTENDED OR m � OFFEREDFORSALEIF,HOWEVER71iEBUILDINGORIMPROVEMEMISSOLDWITHINONEYEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE f-0R TME PURPOSE OF SALE). W ❑I,ASOWNEROFTHEPROPER7V.AME%CLUSNELVCAMRACTINOWfTHLICENSEDCONTRACTORS Q TO CONSTRUCT THE PRQIECT(SEC.7011,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V8IU8�lOf1 ADJ.AREA W CENSELAWDOE3NOTAPPLVTOANONTJEHOFAPROPERTVWHOBUILDSORIMPqOVESTHEREON,AND � NM1IOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOq(S)LICENSEDPURSUANTT07HECONTqAG QUFwnTv DESCRIPTION Y TORS LICENSE UW.). FEE � ❑I AM E%EMPT UNDEfi SEC. B.8 P.C.FOR THIS REASON � � � U � DA7E OWNER ~ Z U � LICENSED CONTRACTOFS DECLARATION W � 1 HEREBY AFFIRAI UNDER PEN�LTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � Y(COMMENCIMO WfTH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND �� MY LICENSE IS IN FULL FORCE AND EFFECT. (� ;g�. � jAlA ENSE CLASS `�� OONTRACTOR � d ! � �,� 3�o Z�d� � WORKE S COMPENSATION DECLARATION � I HEREBY AFFIRM UNDER PENALTV OF PERJURV ONE OF TME FOLLOWING DECURATIONS: N Z �Z _�hIAVEANDWILLMAINTAINACERTIFICATEOFCONSEMTOSELF-INSUREFORWORKERS' a Q COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMMICE U OF TNE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � � _I HAVE AND WILL MAINTAIN WORNERS'COMPENSATION INSURANCE,AS FEWIRED BV SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS , ISSUE�.MV WORKERS'COMPENSATION INSURANCE CARqIER AN�POLICV NUMBERARE: CONSTRUCTION � CAARIER PLAN REVIEW 0 POLICV NUMBER dZ ELECTRIC � (Ri6SECTqNNE�NDTBECOI.PLETmOFhIEPERMTISFORpJEFiIR�DitEDDOLWLR100IOqLESS} PLUMBING �/ Z �CEFTIFY THAT M THE PERFORMANCE OF THE WORN FOF WHICN THIS PERMIT IS ISSUED,I MECHANICAL � C,�} SHAILNOTEMPLOVANVPER$ONINANVMANNERSOA5T08ECAMESU&IECTTOTHE (/� WORKERS'COMPENSATION UWS OF CALIFORNIA,AND AGREE THAT IF I SHOIJID BECAME INSPECTION FEE S SU&IECT TO THE WORKERS'COMPENSATION PROVISbNS OF SECTION 370o OF THE LABOR � � DE.I HALLFORTHWITNCOMPLV WITHTH PROVIS ISSUANC � p DATE: ~ 1� APPLICANT: � � SMIP W v�� WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAOE IS UNUWFUL,ANO SHALL BE ENERGY P/C � SUBJECTAtJEMPLOVERTOCRIMWALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHWSMID E RGYPERMIT DOlLARS(5700.000).IN PDDITION TO THE COST OF COMPENSATqN,DAMAGES/S PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,MTEREST,AND ATTORNEV'S FEES. q w RETENTION FEE' 2/�(/ O CONSTRUCTION LENDING AGENCY E-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CANSTRUCTION LENDING AOENCV � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED�SEC.30G7,CIV.CJ. Z W � LENDER'S NAME � LENDER'SADDRESS W I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL F E ES � � �J � 1 AGFEE TO CqMPLV WITH ALL CfTY AND CqUNTV ORDINMICES AND STATE UWS REUTINQ TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORRE REPRESENTA7IVES OF THIS CWNTV TO ENTER UPON THE Z ABOVE-MEMIONED PR07ERTV FOR INSPECTION PURPOSES. � � � ; „ ��—� COMMENTS �`� �CI�YCSS �.O�I ��K�I �wxiS „ilC`+�✓v�C c�v� � ��'O . m �� Q P RMITTEE NAME(PRINT) � � � � � -_ � �-9-�1 � S�A�RE� ERMITTEE DATE � RECPT.NO. PAID BY � - VALIDATION WHITE—DepaAment Copy,YELLOW�Inance Copy,PINK—Aasessor Copy,CiOLDENROD—Flle Copy,GREEN—AppliranPs Copy ClTV OF D9�,iViO�lD ��►R ift�S��C�'90N ��CORD , �y��h0a�a��ooa � i o��`�,�� o[�p�� _�:' at��P��4oc�a ��Da�{ �� o� b 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 H'T. BOND 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 SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATI�N 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 (�'t �OC��, COMMEiVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a c� � ;.. � - ---- ------�-�_—