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Home My WebLink About14944 (20)CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS --C C ADDRE-�' APN LOT TRACT OWNER /L -N ADDRESS—� S _ " CITY ZIP TEL. APPLICANT TEL. CONTRACTOR ADDRESS CITY ZIP. TEL ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION . 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS U - CENSE UW FOR THE FOLLOWING REASON (SEC 7071.5 BUSINESS ANO PROFESSIONS CDOE. ANY CITYOR COUNTY WMCH REONRES A PERMIT TO CONSTRUCT. ALTER MPROVF, DEMOUSH, OR REPAIRANY STRUC- TUBE. PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS U. CENSE LAW ICHAPTER S (COMMENCING WITH SECTION 7000) OF DIVISION 0 OF THE BUSINESS AND PRO- FESSIONS CODE) ORTHAT HEORSHE ISEXEMPTTHEREFROM ANDDTHE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7071.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OFNOT MORE THAN FIVE HUNDRED DOLLARS (MI.): CI L ASOWNER OFTHE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE ISEC. 7044, BUSI- NESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE UW DOES NOTAPPLY TO AN OWNER OF PROPERTY WHO BUNDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF On THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE K HOWEVERTHE BUILDING OR IMPROVEMENT IS SOLDWITHIN ONE YEAR OFCOMPLE- TION. THE OWNERBUIWER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O L AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U - CENSE LAW DOESNOTAPPLY TOAN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND W40 CONTRACTS FOR SUCH PROJECTS WITH AOONTRACTOR(S) LICENSED PURSUANT TO THF. CONTRAC- TM LICENSE LAW.). O IAM EXEMPT UNDER SEC a. I P.C. FOR THIS REASON DATE - OWNER LICENSED CONTRACTORS DECLARATION I HEREBYAFFU*A UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER • (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS N FULL FORCE AND EFFECT. LICENSE�� LIC. NO.1, DATE --fi// 2,"o- � CONTRACTOR �f WORKERS'COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _ I NAVE ANO WILMANTAN A CER'nFICATE OF OONSENTTO SCLF-INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 37000FTHE LABOR CODE, FOR THE PERFORMANCE OFTHE WORK FOR WHICINTHIS PERMIT IS ISSUED. I _I HAVE AND WILLMANTAN WORKERS -COMPENSATION INSURANCE, AS REQUIRED BY SECTION 5700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS iISSUED. LIYWO COIAPENSATOWINSUPANCE/GT4RRIER AND POLICY NUMBER ARE: CARRIER � POLICY N IMBER / MW SECTION NEED NOT BE COM`U1EDOF THE PERM(6 FOR DNF. HI.TDRID DOLLARLS (5:07 0q LFSo'i 1 (CERTIFY THAT LA THE BE OF THE WORK FOR WHICH THIS PERMIT IS LSSUED.1 1 SHALLNOTEMPLOYAMYPERSONNANYMR OAS TO BE COME L.L SUBJECTTOTHE j WORKERS' COMPENSATION LAWS OF CAUFANNEORNI AND AG E THATIF I SHOD BECOM. SUDRECT TO THE WORKERS'COMPENSATION PR AS SECTION 7700 OF THE LABOR CODE, SHALL FORTHWITH COMPLY WITH THOS PP T OATEt � FN. GO APPLICANT J 1 WARNING: FAILURE SECURE VARNERS'COMP .SATION COVERAGE IS UNLAWFUL. AND SHALL BE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES D CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS (L100.000). N ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE, INTEREST. AND ATTORNEY'S FEES. A CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY T THERE L A CONSTRUCTION LENDINGNCY THE PERFORMANCE OF THE WORK FOR WHICHICH C.). THIS PERMIT IS ISSUED (SEC. 5097. CIV. CJ. 3 — LENDER'S NAME LENDERSADDRESS .1 I CERTIFYTHAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. U LY WITH ALL CNTY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING ANO HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE D PROPERTY FOR INSPECTION PURPOSES. 41 r •zt RI I) pE rTEE DATE C 0 PRESS 00P FIRMLY APPLI TI NPERMIT , �, '% DATE — �'vV NUMBER It L ISSUE,� TYPE OCC DATE CONST. GROUP ZONING S ACKS Ffl NT „ RW 0— REAR. REAR. ' O SIDEISIDE STREET RW O SIDE O .PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS -DESCRIPTION SO. FT.' FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garaga/Carport - WPatio/Deck LL Pool/Spa ZSo -Root 0 Commercial m Valuation ADI.AREA QUANTITY 16ESCRIPTION FEE Q 1- U w . w w C.9 CD B Z x U w L/.'�� :9 CONSTRUCTION / PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE A✓ �d ISSUANCE 01, SAIF, ENERGY P/C ��' Vv ENERGY PERMIT •, ,{ RETENTION FEE: V %` ►lA -- PRE-ALT FEE: ' TOTAL FEES COMMENTS RECPT NO. PAID BY VALIDATION WHITE--Depar)ment Copy, YELLOW—Finance COPY. PINT—AISOSSOf wpy. L PY, U"MCI. PPpI 5 wiry - CITY OF DIAMOND, BAR INSPECTION RECORD 4N$ - DATE SETBACK INSPECTOR INSPECTION D . ATE INSPECTOR FLOOR JOIST .\ FTGS/FORMSISTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB -GRADE Vu- FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM - ROOF SHEATHING - _,�.> 8 Fr. BOND BEAM FRAMINGIVENTILIATION 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 INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPEIIRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST' FINAL ZONING FINAL -CONST., FINAL HEATING FIRE DEPT. FINAL HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE - 6w