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Home My WebLink About13154CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES . > 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 BUILDING PERMFF APPLICA PERMIT 155) 6 joBsrTE Z'�� I DATE DATE - ADDRESSV * �'t ISSUE 3 APN LOT �2 TRACT j OWNER il GROUP ADDRESS LAY, Fj1LrhVVL_ u CITYf_bW_-_1Q14 ZIP TEL RW APPLICANT IW TEL REAR CONTRACTOR 5=0— OUJA -V- ❑ ADDRESS u CITY ZIP TEL I SIDE DES DESIGNER 1. ADD S D CITY ZIP TEL. 0 NO. NO. UNITS = OWNER -BUILDER DECLARATION D DESCRIPTION ]]I HEREBY AFFIRM UNDER PENALTY OF PERJURYTHAT 1 AM EXEMPT FROM THE CONTRACTORS LF CENSE UW FOR THE FOLLOW94G REASON (SEC. 7031.5 BU5NESSAND PROFESSIONS CODr-ANY CITY OR LADIb COUNTY WHICHREd11RESA PFAMRTO CON57AUCf,JLLTE0.1MDROVE,OEMOUSM.OR REPAIR ANY STRUC. Cf) TURF PRIOR TO ITS ISSUANCE. ALSO REOU RES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED �3 STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LN W CENSE LAW (CHAPTER a (COMMENCING WITH SECTION 7D00) OF DIVISION S OF THE BUSINESS AND PRO. FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- W TION -ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR APERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSW).k - V- O L AS OWNER OF THE PROPERTI;OR MY EMPLOYEES WITHWAGES AS THEIR SOLE COMPENSATION, WALL DO THEM AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEG 7044, BUS"NESS ZRe AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF C PROPERTY V/NO BUSDS OR IMPROVES THEREON. AND WHO DOES SUCH WORK HIMSELFOR HERSELF OR THROUGH HIS ORHEROWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT NTENDEDOR OFFEREOFORSALE IF.HowEVER THE BUIDNGOR IMPROVEMENTIS $OLDWITHINONEYEAROFCOMPLE- • TON. THE OWNERAUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR 7 IMPROVE FORTHE PURPOSE OF mcl. O LAS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS = 70 CONSTRUCT THEPROJECT (SEG 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U- L W'H CENSE LAW DOES NOTAPPLY 70 AN OWNER OFAPROPERTYO BUILDSOR IMPROVES THEREON.AND L WNCTS WINO CO TRAFOR SUCH PROJECTS WITH CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC- ONTRAOTORS TORSLICENSE LAW). O IAM EXEMPT UNDER SEC. B. a D.C. FOR THIS REASON L DATE OWNER L QUANTITY DESCRIPTION LICENSED CONTRACTORS DECLARATION HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED LINDER PROVISIONS OF CHAPTER P (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PROFESSIONS CODE, AND U MY LICENSE IS N FULL FORCE AND EFFECT. Gq UCENSf S LIC. NO. , CONTRACTOR _ _ OC WORKERS' COMPENSATION DECLARATION .n 1 HEREBY AFFI IM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF•INSURE FOR WORKERS' CC COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FORW RICH THIS PERMIT IS ISSUED. 0 UJ _X HAVE AND WiL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REWIRED BY SECTION 3700 OF THE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS T.7 Z _ ISSUED. MY Y/Dfi�E �� PEHS;TKN INSURANCE CARRIER AND POLICY COMBER ARE CARRIER POLICY NUMBER ,� Z p MM SECTION N®N17T BE COMPLETED OFTHE PERMIT 15 FOR ONE NUN7p1DOCUARSISIM OR LESS) Z I CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. 1 S2 SHALL NOT EMPLOY ANY PERSON N ANY MANNER 50 AS TO BECOME SUBJECT TO THE (/� 1WORKERS' COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF I SHOULD BECOME S SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF S T O 700 OF THE LABOR COO I COMPLY TH INOSE P IO . -SH'A�L_L/ff �ORT`HNaTH r a DATE; APPLICANT: LOLI WARNING: F//►►AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE I� SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TOONE HUNDRED THOUSAND I DOLLARS (5100.000), N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN FEES LL SECTION 3708 OF THE LABOR CODE. INTEREST, AND ATTORNEYS a CONSTRUCTION LENDING AGENCY O I HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT THERE ISACONSTRUCTION LENDING AGENCY Q S FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEG 5007. CV. G). LENDERS NAME= W LENDERS ADDRESS 7sC IS CORRECT. W I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION 70 p- I AOR EE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING BUILDING CONSTAUCTI K AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE z ABOVE-MENTIONEOPROPERTY FOR INSPECTION PURPOSES. t(_(A 1 m a PERMITTEE NAME I ) Dn CONSTRUCTION (n SIGNA OF PERMITTEE DATE PLAN REVIEW rION - l'J PRESS FIRMLY ATIO PERMIT 155) 6 P/C DATE DATE - NUMBER * �'t ISSUE TYPE • . ,' OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE PROPOSED USE Il9eL(.� 5 P, NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADDIREM LADIb Cf) Garape/Cs9W T �3 W peNalGdC W V- POcVSpa ZRe -Roof Commercial - m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE U , OC U W w T.7 Z GO ... J a 4 U Z Q S W � Q Cys Ott 51:50 CONSTRUCTION PLAN REVIEW 40 ELECTRIC 1 t �� PLUMBING I no, OLD, MECHANICAL 1s�100 INSPECTION FEE �r-N Z-' ISSUANCE SMIP A ENERGY PIC - N ENERGY PERMIT t' RETENTION FEE: ��✓ J CD PRE -ALT FEE: D�. TOTAL FEES J COMMENTS RECPT. NO. PAID BY VALIDATION WHITE—Department Coq. YELLOW—Finance Copy, PINK—AssessorCOpy,GOIDENROD—File COW GREEN—Applicanl'S Copy CITY OF DIAMOND.BAR . .;,ANSPECTI0N RECORD r �(4��-i=a��r(��:�. T ��i.r= �i�!.�-?�-�� ! +.'r[►E-�.��_�ci�;��.,....�;�i��r�:_ :��:�-��Y�e BACK h - I FLOOR JOIST- ;SET FTGSlFORMSISTEEL ,�,� .. FHA REOh7TS } ELECTRIC GROUND UNDER FLOOR 0ocly 'GROUND PLUMBING _ +1 y��$ UNDER FLLOOR C,Uf!D�— U17��_ 'r, St -AB GRADE - - I AlIREPLACE �'. int-- FOUNQ'ATION- 1 ; 1 � ` - • ' - ;TEMP POWER FIREPLACE BOND BEAM •: ;f : �: _J s _ WATER SERVICE -- - MID HT. BOND BEAM % �.-- �• �'-�' ROOF SHEATHII`� •_._1' ;: �'1 p ,. j'_ !"t 13 FT BOND BEAM FRAMING,VENTILIATION.te_ FINAL'BOND BEAM ROOF COVER PRE -GRADING J " ' " + ' �`Tr ROUGH HEATING BENCHI ROUGH ELECTRIC .. ROUGH GRAING ROUGH PLUMBING -- - '' FINISH GRADING SHUWER/TUB TEST POOL ELECTRIC i EXT. LATHISIDING ..,a. i -1% POOL FENCING VlALL INSULATION- POOL FINAL CEILING INSULATION _ OFF SITE IMPS. DRYWALL NAILING _ 8 o QR 1;'l v. it DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPEARRIG. SEEP PIT/LL. - ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CO JST.-. `1,2j_C FIRE DEPT. FINAL FINAL HEATING - __. HEALTH DEPT. FINAL - - FINAL ELECTRIC - DEV. FEES PAID 1. FINAL -PLUMBING ENERGY I 5tua'�_ - �`: ^-- nt.•lY is COMMENTS �SEjICTA,RK SIZE SEEPyr Ihl'J SIZE I.