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Home My WebLink About18135 ^ .�� __ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES /� E 21825 E.Copley Drive - (909)860-3195 Fax(909)861-3117 PRESS ��%_:M�+ BUILDING PERMIT APPLICATION FIRMLY � JOBSITE �� APPLICATION /fi PERMIT /Q'1�PlC o ADDRESS DATE •t� NUMBER �J # � ISSUE TYPE OCC APN LOT TR CT DATE 6 Z CONST. GROUP p OWNER o ADDR S ZONING SETBACKS Z CITY � P �y 7� TEL. FRONT qyy ❑ g APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACT R SIDE ADDRE S V � � CITY' ZI TEL.� PROPOSED USE ` o ARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. � ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS I � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIHM UNDER PENALTV OF PERNRV THAT I AM EXEMPT FROM THE COMRACTORS LI� G8f898/CBfpOh W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.58USINESSANDPROFESSIONSCODE:ANVCITYOR (n C-� COUNTVWHICNREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTAUC� w TURE.PRIOR TO ITS ISSUANCE.AL50 REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIQNED w P8t10/DBCk � STATEMENT THAT HE OR SHE IS LICENSED WRSUANT TO THE PROVISIONS OF 7HE CONiiUCTORS LI� � CENSE LAW(CNAPTER o(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESSlWD PRO� POOUSPO O FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALLEOED E%EMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BV M!V APPLICANT FOq A PERMIT 5U&IECTS THE APPLICANT T0 Z Re-Foof � A CML PENALTV OF NOT MORE 7HM1 FIVE HUNDRED DOLURS(t5a0).): ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATqN, 0 Commercial Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTEN�ED OR OFFERED FOR SALE(SEC.70M,BU51� J � NESS IWD PROFESSIONS COOE:THE CONTRACTORS UCENSE UW DOES NOT APPLV TO AN OWNER OF � PROPER7Y NR10 BUILDS OR IMPROVES THEREON.AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGH HIS OR HER ONM EMPLOYEES,PROVIDED THAT SUCH UAPROVEMENTS ARE NOT INTENDED OR m � OFFEREDFORSALEIF,HOWEVERTI'IEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUIIDER WILL FUVE THE BURDEN OF PROVINQ THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I.AS OWNER OF THE PROPEHTV,AM EXCLUSNELV CANTRACTING WITH LICENSED CONTRACTOFS � TO CONSTRUCT THE PR0.IECT(SEC.70a1,BUSINESS ANO PROFESSIONS CADE:TNE CONTMCTORS LI� VBI110tIOf1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOYMEROFAPROPERTVWHOBUILDSORIMPROVESTHEFiEON,AND � WFIOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)UCENSEDPURSUANTTOTHECONTRAC� QUANTITY DESCRIPTION TORS LICENSE UW.). FEE Q ❑I AM IXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ?� U � ¢ DATE OWNER H Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIRM UNOER PENALN OF VERIUHV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � . � D(COMMENCINO WITH SECTION 7000)OF OIVISION J OF TME BUSINESS AND PROFESSIONS CODE,AND Z LLI �Y LICENSE IS W FULL FORCE AND EFFECT. m � LICENSE C SS LIC.NO. � S � � V DATE � CONTRACTO d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER VENALTV OF PERIURV ONE OF THE FOLLOWINO DECLARATIONS: Z � I MAVE M1D WILL MAINTNN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WOR)(ERS' a � COMPENSATION,AS PROVIDED 8V SECTION 370o OF THE LABOR CADE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � Qw _I HAVE ANO WILL MAIMAIN WORKERS'COMPENSATqN INSURANCE,AS REQUIRED BV SECTION 37ao OF 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS I S� 30 � ISSUED.MV ON I IER AND V NUMBER ARE: CONSTRUCTION �/ ^� J j CARRIER PLAN REVIEW Z POLICV NUMBEFi ELECTRIC Q � (i}I5SECIKXJNE�NOTBEOOA/PLEfEDOF71-IEPERMTISFnRONEFiU�pFiEppqlqHS(ftpp)pqLESS} PLUMBING � W Z I CERTIFV TMAT IN THE PERFORMANCE OF THE WORK FOR WMICH THIS PERMIT 4S ISSUED,1 MECHANICAL C,�} SHAIL NOT EMPIOY ANY PERSON IN ANY MANNER SO AS TO 9ECOME SU&IECT TO THE (/� WORKERS'COMPENSATqN LAWS OF CALIFORNIA,AND AOREE THAT IF 1 SHOULD BECOME INSPECTION FEE ? SUBJECT TO THE WORKERS'CAMPENSATION PROVISIONS OF SECTION 370o OF THE UBOR a. CODE.1 SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE `�' � b p DATE: APPLICANT: SMIP i W J WARNIN�:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C �y SU&IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CNIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(f100.o00),IN ADDITION TO 7HE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN / J SECTION37080FTHELABORCADE,INTEREST,ANDATTORNEV'SFEES. �� oC RETENTION FEE: � OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: ' � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.�. Z W � LENDER'S NAME H LENDER'SADDRESS w 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CORRECT. TOTAL F E ES I 2„�� O � 1 AOREE TO COMPLV WITH ALL CITY AND CWNTV ORDINANCES AND STATE UWS RELATIN�TO BUILDING � CONSTRUCTlON,AND HEREBV AUTHORRE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z /�BOVE�MEMqNED PROPERTV FOR INSPECTqN PURPOSES. COMMENTS � J � m ITT NAME(PRINT) Q � � � � SI RE F DATE = RECPT.�O. PAID BY VALIDATION ~ WHITE—Deperiment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy (��1`Y c�A� ��lal�l��9 [ffi�� DI�1�(�l��fJ'0�(� ff�C�C��f�Q� 0� U o D[a'1� OG�J��;�[� ' � u o�'�J -, bQ`� ,; [�n�� o � SET BACK :'� FLOOR JOIST FTGS/FORMS/STEEL � FHA REQMTS ELECTRlC GROUND UNDER FLOOR QiJCT , GROUND PLUMBING ` UNDER FLOOR CU�IDUIT --� � SLAB GRADE FIREPLACE FOUNDATION TEMP P4WER _ FIREPLACE BOND BEAM WATER SERVICE MID HT. BQND BEAM ROOF SHEATHfPVG ��/`��- �^ • 8 FG BOND B�AM FRANi1NGNEfVTIIIATtOM FINAL BOND BEAM ROOF COVER (��G/a Z- �t�� PRE-GRA�ING RUUGH HEATING BENGHlNG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUNiBING FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL iNSULATION POC3L F1NAL CEILIfVG INSULATION OFF SITE IMPS. DRYWALL NAILIh1G DEDICATIONS SEWER RNAL ENG. , SEPTIC TAf�lK LAtJDS�APE/IRRI�. -r- SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FlNAL ZONING FINAL COPJST. � GIRE DEPT. FIiVAL FINAL HEA7ING HEALTH DEPT. Fih1AL FIfVAL ELECTRIC DEV. FEES PAID FIiVAL PLUMBING ENERGY � _ �U"`��00.�� ;;'i_ ; Ci��J SEPTIC TANK SIZE SEEP PIT/U SIZE � " � � � � � � .�