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Home My WebLink About13153 (17)UI,hIIIJO 1i,11i CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 \/ BUILDING PERMrr APPLICATION JOBSITE ADDRESS ADDRESS '• APN LOT TRACT d i OWNER ADDRESS 1 CITY ZI TEL APPLICANT TEL I CONTRACTOR Q LL% ADDRESS 5 CITY ZIP TEL ARCWENG/ 1 DESIGNERr� ADD i CITY IP TEL OWNER -BUILDER DECLARATION ] I HEREBY AFFIRM WDEq PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LI• J CENSE LAW FOR THE FOLLOWING REASON (SEC.7031.S BUSINESS AND PROFESSIONS CODE: ANY CITY OR 7 CONTYWHICH REOIARESAPERMR TO CONSTRUCLALTER IMPROVE.DEMOUSH OR REPNRANY STRUC- i TUBE PRION TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED E STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE UW (CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THEA.LEGED EXEMP• s TIDItU N.ANY VIOLATION OF SECTION 7671.5 BY ANYAPPNT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUMORED DOLLARS (5600.): O LAS OWNEROF THE PROPERTY. MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION• 2 WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE ISEC. 70//• BUST - NESS AND PROFEAND CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO SULDS OR IMPROVES THEREON. NO DOES SUCH YORK HIMSELF OR HERSELF OR THROUGH NIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH LNPROVEMENTS ARE NOT MENDED OR OFFERED FOR SALE IF. HOWEVER THE BLAIMNG OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF CCMPLE- TON, THE OWNER -BUILDER 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 (SEG 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U. CENSE LAWOOES NOTAPPLYTOAN OWNER OFAPROPERTY WHOBUIIDS OR IMPROVES THEREON•A7D WHOCONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S) LICENSED PURSUANTTO THE CONTRAC- TORS UCENSE LAW). O IAM EXEMPT UNDER SEG B. I P.C. FOR THIS REASON DATE OWNER [Z LICENSED CONTRACTORS DECLARATION C INEREBYAFFIRM UNDER PENALTY OF PERJURYTHAT IAM LICENSED TINDER PROVISIONSOF CHAPTER L 9 (OOMMENCNO WITH SECTION 7DDO) OF DMSKN 70F THE BUSINESS AND PROFESSIONS CODE, AND 5 MYLKCNSE R N FULL FORCE AND EFFECT. 'qty LICENSE B LIC. NO. B' j DATECONTRA CTOR_ _ Lal WORKERS' COMPENSATION DECLARATION n 1 HEREBYAFFIRA UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: n _I HAVE AND WILLMANTANA CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION. AS PROVIDED BY SECTION 3700 OF THE LABOR CODE FOR THE PERFORMANCE THE WORK FOR WHICH THIS PERMIT IS ISSUED. 2 HAVE AND WILL MANTAN YORKERS' COMPENSATION INSURANCE, AS REWIRED By SECTION O 57000E THE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS _.ISSUED. MY WdO ER COMP TION INSURANCE CARRIER AND POLICY NUMBER ARE CARRIER �/■i11� POLICY NUMBER j(THISSECIIONNEMNOTBEOEMIETTDOFTHE PEFMT ISFORONE HUNDREDDOLI/VIS(IOD)ORLESSG L 1 CERTIFYTHAT NTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I j SHALLNOT EMPLOYANY PERSON N ANY MANNER BOAS TO BECOME SUBJECTTO THE j] WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERSOOMPENSATION PROVISIONS OF SECT ION OOOFTHELABOR j IS FORTHWITH COMPLY WITH THOSE O L DATE: MPLICAFNT. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL• ANO SHALLSE JL. SUBACTAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100.000(. IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES CONSTRUCTION LENDING AGENCY 1 I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTKN LENDING AGENCY FORTHEPERFORMANCE OF THE WOR F ��.///W��LHICH THIS PERMIT IS ISSUED (SEC. 7097. CIV. r-1.LENDERS NAME Y1 �- LENDER-SADDRESS I CERTIFY THAT I RAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION 15 CORRECT. I AGREE TO COMPLY WITH ALL CRUN YAND COUNTY ORDINANCES AND STATE LAWS RELATW O TO BUILDINGCONSTRUCTION. AND HEREBYAUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE.MENTIONED PROPERTY FOR INSPECTION PURPOSES .,,n 1f1� LLL �'i' m PERMITTEEWW /T Cn y SIGNATUREOF ERMITTEE DAT PRESS FIRMLY APPLICATION si PERMITNUMBS `() DATE NUMBER I .1�� If It ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS .. FRONT RW ❑ REAR ❑ I:]- SIDEISIDESTREET RW ❑ SIDE ❑ PROPOSED USE S L NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFWADWREM •D cf.)Gamge/CimpeR 1 4125 LL) .Z LI- PoCVSPa ZRe -Roof O Commercial - m Valuation ADTAREA QUANTITY DESCRIPTION FEE 4 - _U W W C7 Z GO a U Z 6 S f 37 )�1y CONSTRUCTION LE PLAN REVIEW—- 0 U it ELECTRIC�� PLUMBING 5`0 MECHANICAL SQ'` 0 _ INSPECTION FEE ISSUANCE SMTP ENERGY P/C ENERGYPERMIT V RETENTION FEE: r CisD PRE -ALT FEE: TOTAL FEES 2?,o(o •43 Z'Z1 btbr COMMENTS RECPT. NO. PAID BY VAUDATI WHITE—DePartmenl Copy. YELLOW—Finance Copy, PINK—ASS63SOT GM. LiUL JLNHL)Lr-rue LAPY. 9jH=N—AP)IIICanr3 wpy CITY OF DIAMOND:BAR , . INSPECTION RECORD ;��I'= !I��.�.:��'l��•�r.4 �' 4'.l►`'��-�:/��,lEl.��^ �"•.� ' �� i .�i11��:•!�c��'�?(��t F"�' N_11�.�:•��.°`f��1.��. SET B_ ACI: FLOOR JOIST _. r , _;.- : .., • i 1 " i ' 1 �: FTGS!FORMS,'STEEL 1 FHA REQMTS ;ELECTRIC GROUND _. " UNDER FLOOR,DUCT;;' GROUND PLUMBING 1 UNDER Fl. OR COPS!If LT, SLAB GRADE _._.. FIREPo%t .F,:06pDA 70N -.; < r; .: :.. • • :>':1 . •; ; • % ; ,, TEMP POWER FIREPLACE 13OP 5.6[',IM `j.- , :;+ c �• ; WATER SERVICE.. MID HT BOND BEAM .ROOF SHEATHING;.. ` j '-�-i` : _.. 8 Ff. BOND BEAM FRAMING, VENTILIATION - FINAL BOND BEAM ROOF COVER PRE -GRADING y` t' " '•'�- '\� !ROUGH HEATING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING -- - - FINISH GRADING SFIO�'VER/TUB TEST `"-' ' POOL'ELECTRIC 1 EXT LATH/SIDING. J'POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. -- DRYWALL NAILING .: 1DEDICATIONS ; :•' SEWER FINAL ENG. SEPTIC TANK SEEP PIT/L.L. ��/ �'� r� LANDSCAPE/IRRIG. ON SITE IMPS. _ :GAS AIR TEST FINAL ZONING FINAL CONST.�_ FIRE DEPT. FINAL Fi%'AL HEATING .. HEALTH DEPT. FINAL ,FINAL ELECTRIC - DEV. FEES PAID FINAL PLUMBING ENERGY C0MMENTS SEP.TiCITiM SIZE SEE P'IT/U SIZE ,