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Home My WebLink About10-1012 ^ �` CITY OF DIAMOND BAR �„ •�� DEPARTMENT OF COMMUNITY&DEVE�� A'f, � 21825 Copley Drive,Diamond Bar,CA 91765 �� U �W� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS "°�"'� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE /�� APPLICATION /v PERMIT p/C 0 ADDRESS� c DATE �D� �~/ NUMBER 'I�'I DIZ/# � � ISSUE �/' /� TyPE / � � p�C APN LOT TRACT DATE � ��Q '( �/ CONST. PW m ROUP p OWNER p ADDRESS ZONING SETBACKS Z CI �' ZIP��TEL. FRONT RW O � APPLICANT TEL REAR p ¢ SIDE/SIDE STREET RW ❑ � CONTRACT SIDE p ADDR S � � CITY ZIP � TEL. - PROPOSED USE o ARCWENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION SFR/ADD/REM ' O p I HER�V AFFIRM UNDER PENALTV OF PERri1RV THAT I AM EXEMPT FPOM THE CANTRACTORS LI- G8f890/CBIPOR W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVqTVOR (n U pp�JrJJyW�{ICHREOUIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,OEMOl15H2ORREPAIRANVSTRUC- w W TURE,VRIOR TO ITS ISSUANCE,/�LSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patlo/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO iHE PROVISIONS OF hIE CANTRACTORS LI� � CENSE UW(CHAPTER 9(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- u' POOUSPB FESSIONSCODE)OR7HATHEOflSHE1SEXEMPTTHEREFROMANDTHEBASISFORTHEALLEOEDEXEMP� (� TION.ANV VIOLATION OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU6IECTS THE APPUCANT TO Z Re-Roof A CML PENALT/OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500)J: � ❑I.ASOWNEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrtIrtI0fC18I Z WILL DO THE WOHI(AND THE STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.70N,BUSI� J � NESS AND PROFESSIONS CODE:THE CANTRACTOFS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPER7Y WHO BUILAS OR IMPROVES THEREON,AND NM1IO DOES SUCH WORN HIMSELF OR HERSELF OR Q THROUGH HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OfFEHE0FOR5ALEIF,FIOWEVER7HE8UILDINGORIA/PFOVEMENTI550lDWITHINONEVEqROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVIN�THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR 7HE PURPOSE OF SALE). W OI,ASONIMEROFTHEPROPER7V,AME%CWSIVELYCONTRACTINQWITHLICENSEDCONTRACTORS [[ TO CONSTRUCT THE PRQIECT(SEC.7W1,BUSINE55 AND PROFESSIONS CODE:THE COMMCTORS LI- V9IU3�IOf1 ADJ.AREA W CENSE UW DOES NOTAPPLV TO AN ONTJER OF A PROPERTV WHO BUILDS OR IMPFOVES THEREON,AND � WHOCONTRACTSFORSUCHPR0.IECTSWITHACONTRACTOP(S)UCENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION Y TORS LICENSE LAW.). FEE � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ?� U � DATE OWNER �F 2 U �¢ LICENSED CONTRACTORS DECLARATION � w 2 I HEREBY AFFIRAI UNDEH PENALTV OF PEpJURV 7}NT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(CAMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� MV LICENSE IS IN FULL FORCE AND EFFECT. m J � LICENSE CLASS � LIC.NO. � U DATE O CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION � � U � 1 HEREBY AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z �Z _I HAVE AND WILL MAMTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a Q COMPENSATION,AS PROVI�ED BV SECTION 3700 OF THE LABOR CODE,FOR TME PERFORMANCE �U OF THE WORN FOR NM1IICH THIS PERMIT IS ISSUED. � 0 W �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIqED BV SECTION Q 3700 0F THE LABOR CADE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV H7(ER'COMPENSATION INSUFANCE CARRIER AND POIICV NUMBERARE: CONSTRUCTION J j CARRIER. PLAN REVIEW ZPOLICY NUMBER `A c �� I ELECTRIC Q ^� / 0 R}iLSSECiIONNE�NOTBECOh1PLETEDOFhiEPEFU,YTISFOqONEFfi.rDFED00UARi(5700)ORLESS} UM ING ��aa�� p Q W Z I CEFTIFY THAT IN THE PERFORMANCE OF THE WOHK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL U' SHALL NOT EMPLOV ANY 7ERSON IN ANV I.IANNER SO AS 70 BECAME SU&IECT TO THE [n WORKERS'COMPENSATION UWS OF CALIFORNIq AND AOREE THAT IF I SHOULD BECOME INSPECTION FEE SU&IECT TO THE WORKERS'COMVENSATION PROVISIONS OF SECTION 3700 OF THE LABOR ��C u CJO�O�E.�1 SHQALL�FORTHWITH COMP�V WITH T E PROV 1 N5.1 A CE JZJ p DATE:,�a APPLICANT:��,;��lA��i �I // SMIP � �� ENERGY P/C J WARNINO:FPJWRETOSECUREWORKERS'COMPENSATIONCOVERAGEISUNLAWFUL,ANDSHALLBE � SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED T}KK15AND ENERGY PERMIT OOILARS(S1ao,o0o),IN ADDITION TO THE COST OF CAMPENSATION,DAMNOES AS PROVIDED FOR IN J SECTION 3708 OF THE L/�BOR CODE.INTEREST,AND ATTORNEV'S FEES. w NTION FE :� f C� , O CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � I HEFEBV AFFIRA/UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDWO AGENCY � FOR THE PERFORMANCE OF THE WORN FOF WHICH THIS PERMR IS ISSUED(SEC.3087,qV.C.). W � LENDER'S NAME � LENDER'SADDRE55 �, w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORAECT. TOTAL FE ES �� v v � I AOREE TO CAMPLV WITH ALL CfTV AND CWNTV ORDINANCES AND STATE UWS REUTINQ TO BUILDINO � CONSTRUCTION,ANDHEREBVAUTHORIZEREPRESENTATIVESOFTHISCWNTVTOENTERUPONTHE ' Z ABOVE-MENTIONED PflOPERTV FOR INSpECTION PURPOSES. COMMENTS ' � \ J � m P TTEE ( I � ' � . C/� � 510 AT TT DATE � RECPT.NO. PAID BY I VALIDATION WHITE—Department Copy,YELLOW�Inance Copy,PINK—Assessor Copy,GOLDENRO�File Capy,GREEN—ApplicanYs Copy q � � � � �.r�� Y �� P'i1Hl�ltl� I�P4� - . . ,.�;-; ._�1..�•,'.� � 'ItlS��'li Y ��Itl ��V�YI� ' . 1 , - _. - � �l�3pC�C�40b�1 �o�S, � �13�C�C��tr � �J�I�C�'�OOa� - ��(i�l y; . x � . , � � � O D � o O. SET BACK FLOOR JOIST FTGS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT � GROUNO PLUMBING UNDER.FLOOR CONDUIT SLAB GRADE FIREPL'ACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM : � WATER SERVICE MID H'T. BOND BEAM � ROOF SHEATHING 8 FT. BOND BEAM � ' '' FRAMINGNENTILATION FIfdAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHWG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION P�OL 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 ��o c COMMEfVTS ._�o� e_ . -`� �. _. - _ .. _..._ . . ..._. . : _ . _ �. __. . : - .___ . _ ___. —._ . , SEPTIG TANK SIZE � � . � SEEP PIT/U SIZE a , .. ; , �� a ��- � � � � � : � : �., � _ , _ - , �.