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CITY OF DIAMOND BAR COMMUNTTY DEVELOPMENT DEPARTMENT .,,.� 21660 E.Copley Drive Suite 190 PRESS (909)8603195 Fax(909)861-31 t9 ��'""' BUILDING PERMITAPPLICATION � FIRMLY 0� JOBSITE ���` �p� APPLICATION ---�--/--`- PERMIT � P� ADDRESS �� �d I�'J�T�J,�_�.�-'e�.�s' �• DATE �� NUMBER O # $ ISSUE TYPE OCC APN LOT TRACT DATE CONST. GRaUP p OWNER " ADDRESS �L��� t!`I��-�S C� ZONING SETBACKS gCITY_,�� ZIP - TEL.�`� FRONT py�/ ❑ APPLICANT TEL. REAR ❑ � SIDE/S�DE STREET RW ❑ � CONTRACTOR���'a✓� � 7� , SIDE ❑ ADDRE S_.i s o�_. �^�'�//.a i�as S7' ,�. /P..-G�f'.�.9� °C v '=_r��� PROPOSED USE /�NT�2-1(J � CITY ZIP�TEL.�2�` �" 5 Y.v o ARCH/ENG/ - z DESIGNER W NO.DWEL. NO. NO. a ADDR SS � � � UNITS STORIES BEDROOMS � CITY _ ZIP TEL.��„� cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-B�ILDEF DECLARATION SFR/AD�lREM O p I HEREBY AFFIRM UNDER PENAL7Y OF PERJUeY TNAT I AM EXEMPT FROM THE CONTRACTORS U- � G8f890/CeryOR W CENSEUWf-0RTHEFOLLOWMGREASON(SEC9o31.58U51NESSMIOPROFES510NSCODE:ANYCINOR U COUNTYWMICHREQUIRESAPERMITTOCONSTRUCi,ALTEH,IMPROVE,DEMOLIbH2ORREPAIRANYSTHUG W Pd�iO/D6CIC w TURE,PRIOH TO ITS ISSUANCE,ALSO REOUIHES THE APPLICANT FOR SUCH PERMR TO FILE A SIGNED W STATEMENT THAT NE OR SHE IS LiCENSED PURSUMIT 70 THE PROVISIONS OF iHE CANTRAC7`oNS LI- � CENSE UW(CHAPTER 9(COMMENCINfi WITH SECTION 7000)OF DIVISION 9 OF THE BUSINESS AND PRO• � PODUSpB FESSIONS CODE)OR THAT HE OR SHE�S EXEMPT THEREFROMAND THE BASIS GOR TNE ALLEGED EXEMP- � TION.ANVVKK,ATIONOFSECTION7o31.5BYANYAPPLICANTFORAPEAMITSUBJECTSTHEAPPI.�CpNTTO Z RB•ROOf � A CIVIL PENALTY Of NOT MOPE THAN FtVE HUNDREO DOLLARS(SSoo�:�� Q ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, COR1fI181'Ci81 Z NAIL 00 THE WORK.M!D TFIE STRUCTURE IS NOT IN7ENDED OR OPFEREO FOR SALE(SEC.7oN,BUSF � � .NE55 AND PROFESSbNS COOE:THE CANTNACTORS LICENSE lAW DOES NOT AVPLV TO AN OWNER OF = PROPERTY NRiO BUILDS OH IMPROVES THEREON.AND NMO DOES SUCH WORN HIMSELFOH HERSELF OR � THROUGH HIS OR HEROVM EMPLOYEES,PqOVIDEDTHAT SUCH IAIPROVEMENTS AR6 NOT M7ENDED OR m Q OFFEREDNRSALE.IF.HOWEVERTIEBUILONGORIMPROVEMENfI55DlDWfTHINONEVEAROFCOMPLE Z iION,THE OWNEH-BUILDER WiLL HAVE THE BURDEN OF PROVINO THAT HE OH 6NE UID NbT BUIIA OR = IMPFOVE FOR THE PURPOSE OF SALE). w ❑I,ASONRJEROfTNEPNOPER7Y.AMEXCLUSIVEIYCONTRACTINOWITHUCENSEDCON7RACiORS � To CANSTRUCT THE PRO.IECT(SEC.70��,BUS�NESS AND PROFESSIONS CODE:THE CONTHACTORS U- V811181i0� ADJ.AREA W CENSELAWDOESNO7APPLYtOANOWNEROFAPROPERYYWHOBUILO50RIMVROVESTHEREON,AND � WHOCONTRACTSFORSUCHPHOJECTSWITHACONTRACTOR(57UCENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPT'ION �E � TORSUCENSEUWJ. � ❑I AIA EXEMPT UN�ER SEC. B.6 P.C.FOH THIS REASON � `''y � ¢ 2 �v Q DATE OWNER � Z W � LICENSED CONTRACTORS DECLARATION W � ¢ • �. OC IHENEBYRFFIRMUNOERPENALTYOFPERJURYTHATIAMUCENSEDUNDERPROYISIONSOFCHAPTER � a o I�h�MENCINO 4A7H SECTION 7000)OF DMSKKJ 3 0F 7HE BUSINESS AND PROFESSIONS CODE,AND Z � � X MY LICENSE IS IN FULL f-0HCE AND EFFECT � LLI � �", �'���_ � LICENSE CU1SS� LIC.NO.���L'� j / � V DATE i"�f"�i� ,���CONTRACTOR �� d � LLI 1 T"T � WORKERS'COMPENSA710N DECLARATION Q � G s � IHEREBYAFPIRMl1NDERPENALTYOFPERJURYONEOFTHEFOLLOWINGDECLAHATI0N5: Z 2 �,f?i-. pT_r. � _IHAVEANDYVILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORNqqKERS' _ �{�! �� � CAMPENSAiION.ASPROVIDEOBVSECTION370oOFTNEIAB�RCODE,FORTNEPERWRMANCE `U � l /. O Oi THE WOPK FOR WHICH THIS PERMIT IS ISSUEO. � � (,r_1 HAVEAND WILL A/AMTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIfiED BV SECTION � 770o OF TME LABOR COOE.FOR THE PERFORMANCE OF7HE WORK WR WHICH THIS PERMIi IS 9 �' �7� ISSUED.MY WORKERS'COMFENSATKKJ INSUiWJCE CARRIEfl AND POUCY NUMBEfl ARE CONSTRUCTION J ;/' y� j CARflIER ��L.�I�".�Zv/- LAN REV � C�' ��' 2 POIICV NUMBER i!'��n f� ELECTRIC Z(�,(s•� ¢ � (fHISSECT%7NNE�NO78EOOMM.EfEDOF'f/�PEP�M'BFORONEM.PDREDDOLIARS(51001pRLESS�. PLUMBING Y 8�n�Ia� Z I CERTIFV THAT M THE PEFFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS�SSl1ED,I MECHANICAL S�� 'E7S-� (} SHALL NOT EMPLOV ANY PERSON IN ANY AIANNEP SO AS TO BECOME SUBJECT TO THE (q WORKERS'COMPEN5ATIONlqN50FCALIFORNIA.AN�AOREETHRTIF15HOULOBECOME INSPECTION FEE SU&IECT TO THE WORKERS'CAMPENSATION PROVISIONS OF SECTION 3700 OF TNE LABOR s CADE,I SNALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE �fl '�4 � i . � p DATE: /'�� 3-C JAPPLICANT.. . SMIP � .b�Cs � WARNINO:F�ILUqE TO SECURE VYORKERS'COIA ENSA710N COVERAGE IS UNLAWFUL.AND SHALLBE ENERGY P/C � SU&IECTANEMPLOYERTOCFIMINALPENALTIESANOCIVILFINESUPTOONENUNOREDTHW5AN0 ENERGYPERMIT DOU.ARS(S1oa.a00).IN ADDITIpN TO THE C0.STOF COMPENSATION,�MAAGES AS PROV�DEO FOR IN � SECTION 3708 OF THE LPHOfi CADE,INTEflEST,AND ATfOHNEYS FEES. RETENTION FEE: - �,�u, S Q OCONSTRUCTION LENDING AGENCY PpE-ALT FEE: _����� 11 � I HEREBY AfFIRM UNDER PENAL7Y OF PERJURY THAT THERE IS A CONSTqUCiION LENDING ACaENCY FOR THE PERFORMANCE OF 7HE WORN fOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C,). Z � LENDER'S NMIE ��Q7 �"' LENDER'S ADURESS W i CERTIFY TFUT 1 HAVE READ TMIS APPIiCATION ANO STATE THAT TF7E ABOVE INFORMATION IS CORRECT. TOTAL FE ES Z I Y ' �J^ � I A�REE TO COMPLY WITH ALl CITV M1D COUNTV OqDINANCES AND STATE IAWS RELATINO TO BUILDING � CONSTRUCTION.ANDHEREBYAUTHORIZEREPRESENTATIYESOFTNISCOUN7vR7ENTERUPONTHE Z ABOYE-MENTIONED PROPERTV iOH INSPECTqN PURPOSES. COMMENTS � G/V � ����k� � m PERAYTT E NA4E(PRINT)� ,. � �-'��n-'% �----.-._.. �'���*� � y SKiNA EOFPERMI E DA T�— �- �... = fiECPT.NO. PAID 8Y Z VALIDATION� ~ � WHITE-0epertment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROa-Ffle Copy,CiREEN—Applicant's Copy :�yv Yi"-�yf�� n�;. � .:"v -..�.o�u.r r 1,;3 & .e..i':��I N�.�:,.��ru,Y ��;:f� r a v�,_'.�:,�.�r ��;;,�y➢f} ; -.- i� .r�i�.�..' 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TEMP POWER _ . ._. :_ _ : �_._ `_:= FlF3Ef'LRGE BON[�BEAM � ,� .. , . . - --�- - . _.. . . . s. _ _�. WATER SE�iVICE � .'. ` -- . ` _ � , __.___._._..._ MID HT.B(JNIJ BEAM_..____ ' ^ , i_�_... _,.�. __. �_._.,�_� �,; ROOF SNEATHWG 8 tT E3�NfJ BEAM . , r „� � � _ _ --- �-�--� - --� : FRAMIN�NENTfUATIQr!���f%y !� ` FlN,4L E3C}�In SEAM�� '` �� M _ � � a+`"� �`.�' __.. � � t �µ A ` . , �.4.. , . � �, .... _.._ .. � . . _._. � _______ �_.�___. Roo�covEp� _ P�F ����r��' =� ��ra�t�Y �_ ,�_ _. ._ . _ _ _ _ .__.. __ _ _. ROUGH HEA`CING f/'' �,�y,� �� BENf NIN� . - i, ' i.i,_-1_. :_. ROiJGH ELE�TRIC ��A� �� ROUGH GRADING � ROUGN PtUMBiNG�' `����` `,� "� ' FItJiS!-6"GRAC3ING "` '...,,, . ,;,.,y, , _ __._ l/ � �y._ ___ f_,.._ .:,.�1V�IIV� _.... .-..�.r � �... ____� ___.�.. . ._ _ F'(�C3L�l��C�`Ft.l��-- , . ,' __.,. _ . EXi':LATHISIDING T-__�� � �''" L � _ _, .`� _ _� � � WALL INSUTATIt3N -�r./� �� � . . : . POC���iRlAl:_� �� ,: .— _;_ 1__ . _ .___.. . �.._....�.,.::._ _..�,__. ; CEILING INSUI.ATION -T _ �-^ l_7F� 5!T�(M9'S. ,;,., ; . -- ___. w �___.�.�. _:: ,_:_._ DRYWALL NAILING �/a� �j'f --- � D�DfCATIONS . _ _ _�____. , -.�-------- $EWER FINA�EIVC : , �_ .,_ . , v_ . ..��.� SE.PTIC TANK . __ `'_': : �_...�'�;:. ��..s: L.ANDSCAP��'ll��iG. . . • ; - . __._,.�__.___. �� SEEP PlT/LL: _ _ _..... ON StlTE Iiv1PS. ,.:,. , , -- ��,. GA5 AIR TEST'-- � � , FINAL"ZOiVINc ` � � � _ _______�._.._ � ..__ , � _____.. _�� �� ���' .__ _ _�__ ,� __ _;..�. FINAL'CONST. � •' ' Z� � FIRE DEFT' v-�NAL ' � FiNAL HEAT{NG _ ` . �HEALTN OEPT. FINA� _ -' __ +---_._ . __ __ __� � + �! _ _Ww. FINAL ELECTRiC - � ` ' f�EV E�FES PAID , �, � ---------- --- �__ _ - - - F`INAL PL MBING _ _.�t�� �� ���EE�c�Y° � �� �� _._:=� T.r� l� . 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