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Home My WebLink About18024� -----�="�— CTTY OF DIAMOND BAR �� ' I � DEPARTIvIENT OF COIvIIvIUMTY&DEVELOPMENT SERVICES ��„ 21825 E.Copley Drive �� :!'� - (909)860-3195 Fax(909)861-3117 ��;,� PRESS `�<��^�� BUILDING PERMIT APPLICATION FIRMLY o DDRIES��_�I I� �l,(.AL/i- � //� /��./ DATE v UMBE # >- APPLICATION 1�,� PERMIT� P/C - `p � ISSUE /�� TYPE OCC APN F TRACT DATE �� CONST. GROUP p OWNER o ADDRESS � ZONING SETBACKS Z CITY ZIP TEL. FRONT qyy ❑ o APPLICANT � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ ADDRESS � CITY I TEL. PROPOSED USE oARCH/ENG/ e d�� z DESIGNER w NO.DWEL. NO. NO. � ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q � OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM EXEMPT FROM iHE CANTRACTORS LI- G8f8JB/CBIpOR W CENSEUWFORTHEFOLLOWINOREASON�SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCITYOR (n U �JrJT`/WNICHREWIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRMIVSTAUC� w w TURE,PRIOR TO ITS ISSUANCE.AL50 REWIRES 7HE APPUCANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT T}1AT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� LL � CENSE LAW(CNAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PRO- POOUSP2 � 0 FESSIONSCOD�ORTHATHEORSHEISE%EMPT7HEREFROM�flDTMEBASISFOqTHEALLEOEDE%EMP- (� V TION.ANYVIOLATIONOFSECTION70.91.6BVANVAPPLICMITFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roo( I A CML PENALTV OF NOT MORE THAN FNE NUNDRED DOLLAAS(5500).�: � ❑I,ASOVMEROFTHEPROPERTV,ORMVEMGLOVEESWITHWAGESASTHEIRSOLECOMPENSATqN, � CORIrtIBfClel � Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFEFED FOR SALE(SEC.70M,BU51- J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT AGPLV TO AN OWNER OF � PROPERTV NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF Oq HERSELF OR � THROU�HHISORHEROWNEMPLOYEES,PROVIOEDTHATSUCi11MPROVEMENTSAPENOTINTENDEDOR m Q OFFEREDFORS�LEIF,HOWEVERTMEBUIIDINGORIMPROVEMENTI550LDWITFfINONEVEAROFCOMPLE- Z TION,THE OWNER-BUIIDER WILL HAVE THE BURDEN OF PROVINO TH�T HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W ❑I,AS OWNER OF THE PROPERTV,AM EXCLUSIVELV CANTRACTINQ WITH LICENSED CONTRACTORS � TO CONSTRUCT THE PR0.IECT(SEC.7041,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� ValUeliOfl ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEFOFAPROPERTVWHOBUILDSORIMPROVESTHERE-0N,AND = WFiOCONTRACTSFORSUCHPRQIECTSWITHACANTRACTOR(S)UCENSEDPURSUMlTTOTHECONTRAG �E ~ TORSLJCENSEUW.). OUANTITY DESCRIPTION Y � ❑I AM E%EMPT UNDEH SEC. B.8 P.C.FOR THIS REASON Q � U � DATE OwNER F Z U � UCENSED CONTRACTORS DECIARATION W � 1 HEREBY AFFIRM UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � , � D(COMAIENCING WITH SECTION 7000)OF DNISION 7 OF THE BUSINESS AND PROFESSIONS CODE,AND Z OMY UCENSE IS IN N E AND EFFEC7. — ^ � � � LICENS LIC.NO. %} 1 � U DATE CONTRACTO a W � WORKERS'COMPENSATION DECLARATION�,J�� Q � U N I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWINQ DECURATIONS: Z � I HAVE AND WILL MAINTAIN ACERTIFICATE OF CONSEMTO SELF-INSURE FOR WOqKERS' a � COMPENSATION,AS PROVIDED BV SECTION 3]o00F THE UBOR CODE,FOR hIE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � Qw �1 HAVE AND WILL MAINTAIN WORKERS'CAMVENSATION INSURANCE,AS REWIRED BV SECTqN � 3700 OF THE R CADE,FOR THE PERFORMANCE OF THE WORK FOq WHICH THIS PERMR IS ISSUED.MY S' S I UFANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION jCARRIER PLAN REVIEW Z POLICV NUMBER ` ELECTRIC ¢ � (1H6SECfqNNE�NO7BE00MPLET�OFT1-IEPEPMTISFpRONEFRWFiEppqlqq3(t1a0JORLESS} PLUMBING W Z I CERTIFV THAT IN hIE PERFORMANCE OF THE WORK FOR WHIC}1 THIS PERMIT IS ISSUED,I MECHANICAL CJ SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE � WORKERS'COMPENSATION IAWS OF CAIIFORNIA,AND AGREE THAT IF I SFKKILD BECAME INSPECTION FEE � SU&IECTTOTHEWORKERS'COMPENSATqNPROVI510NSOF5ECTION37oaOFTNELABOR � D H O HWITHCOMPLV WI HT/}p-/5 P OVIS��/�/�p ISSUANCE O yIi �✓W`./�..4NR'� � p DATE:<��,L� APPLICANT: SMIP W � J WARNING:FAILURE TO SECURE VlORICERS'COMPENSATKKJ COVER�OE IS UNLAWFUL,AND SHALLBE ENERGY P/C J � SUBJECTMIEMPLOVERTOCRIMINALPENALTIESMlDCIVILFINESUPTOONEHUNDREDTHWSAND ENERGYPERMIT � DOLLARS(5700.000�,W pDDITION TO THE COST OF CAMPENSATION,DAMAOES AS PROVIDED FOP IN � SECTION 37080FTHE LABOR CODE,IN7ERE5T,ANDATTORNEI"S FEES. RETENTION FEE: .�� OCONSTRUCTION LENDING AC,ENCY PRE-ALT FEE: d 1 HEREBV AFFIqAI UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCV d FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oal,CIV.C.). Z W � LENDER'S NAME F– LENDER'SADDRE55 w ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES �� I AGREE TO CAMPLV WITN ALL CITV AND COUNTV ORDINANCES AND STATE UWS RELATINa TO BUILDING �V � CONSTRUCTION,AND HEREBV AUTHOfiIZE REPRESEMATIVES OF THIS CWN7V TO ENTER UPON THE Z ABOVE�MENTI NED P PERTV FOR INSPECT PURPOSES. COMMENTS ' �'ac� o , ; � m PE 7T ql � /� q � �� SIO ATU OF ERMITTEE ATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENR D—File Copy,GREEN—Applicant's Copy ' . ,��, t�� d-°�::� tG��'�( �� l�0�1fd��1[� �G�ff� .�,.• _� '�'� �f��L�[�t��?O�D� f�f��i�� •�pT I � 0 '3Gu o J � DGQ� ��p ° ��G�]C�nJ DGQ� 0� v o � SET BACK FLOOR J�IST � FTGS/FORMS/STEEL FHA RECaMTS ELECTRIC GROUND t1NQEfi FLC?OR DUCT GROUND PLUMBING � UNQER FLOOR CUMDUIT S�AB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM W,4TER SERVICE MID HT. BOND BEAM � - � ROOF SHEATHING 8 FT. BOND BEAM � FRAMI�lGNENTILiATtON FINAL BOND BEAM ROOF COVER PRE-GRADlNG ROUGH HEA7ING F3ENCHING ROUGH ELECTRIC R�UGH GRADING ROUGH PLUNIBING FINISH GRADING SHOWERJTUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILIMG INSULATION OFF SITE IMPS. DRYWALL NAILING DED(CATIONS SEWER � FINAL ENG. � SEPTIC�ANK LANDSCAPE/IRR►G. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL.ZONING FINAL COP�lST. . FiRE DEPT. FINAt FINAL HEATING HEALTH DEPT. FINAL FINAL EL�CTRIC DEV. FEES PAID FINAL PLUMBING � �RIERC,Y � ��o � CQIVIIVI�Itl�J SEPTIC TAIVK SIZE SEEP PITN SIZE — — � � � � . � . —