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Home My WebLink About14945D 4 v M Z l� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 PRESS BUII.UINGPERMIT APPLICATION —I 1 FIRMLY JOBSITE ADDRESS r99 JAAX-CeIrl-Y-f Diam.dr �%tia G4�[ APN LOT :9a TRACT 32- f in . OWNER _60 -AJ AF1T I t AU • C.e,Ift",tiY. rdz& Ru-TAJA —J ADDRESS t -�M7f is r f -Y CITY ZIP jL3Yf TELPI"OSTIV-flk APPLICANT A -Ar f, TEL. ,TSTA_ -S3X CONTRACTOR S k A! X1 1 -r 1y OSe ttYrJ[• Lc - ADDRESS _X Q le -W15 AVV CITY j17ccTrrrw 9!j zip `��'f}• TEL n 1 -Ir Yr DESIGNER CA41IC TIF—AS flHNCA-d ADDRESS 1' X10 AIA7 -PLAfC CITY fa(Is�TiLrm ZIP q2131 TEL. •[ - S 9 OWNER -BUILDER DECLARATION I HEREBY AFFIRM TINDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7071.11 MANESS AND PROFESSIONS COOE:ANY CITYOR . COUNTY WHICH REOUIIRES A PERMTTTO CONSTRUCT, ALTER IMPROVE DEMOLISH, OR REPNRANYSTRUC• TURE. 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 Ll- CENSE FCENSE LAW (CHAPTER I (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPTTHEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION TW 1.s SY AHYAPPLKCANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CNL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (11500).): O L AS OWNER OF THE PROPERTY.OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC 7044, BUSI- NEW AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY 14410 BURRS OR IMPROVES THEREON AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HS OR HER OWN EMPLOYEES• PROVIDED THAT SUCH IMPROVEMENTS ARE NOT MENDED OR OFFERED FOR SALE CHOW'EVER THE BUILDING OR MPROVEMENTIS SOLD WITHINONEYEAROFCOMPLE- TM. THE OWNER-IIIILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR MPROyE FOR THE PURP0.5E OF SALE) j7 L AS CWHER OF THE PROPERTY. AM EXCUISNELY COMRACTNG WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS Lt. CENSE LAW DOES NOTAPPLY TO AN OWNER OF A PROPERTY PAHO BUILDS OR IMPROVES THEREON, AND WNDOONTRACTS FOR SUCH PROJECTS WITHACONTRACTOR(S) UCFNSED PURSUANT TO THE CONTRAC TORSLICENSELAW.I. O 1 AM EXEMPT UNDER SEC B. A P.C. FOR THIS REASON DATE OWNER / LICENSED CONTRACTO S CtCLARNTION 1 HEREBYAFFSW UNDER PENALTY OF PER THAT I IIOFNSED UNDER PROVISIONS OF CHAPTER ■ lCOMMENCNG WITH SECTION 7000) OF DIVISION 7 OF THE BUSINESS AND PROFESSIONS CODE. AND W LICENSE IS N FULL FORCEAND EFFECT. LICENSE CLASS LIC. NO. DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENTTO SELF -INSURE FOR WORKERS' , IO COMPENSATN. AS PROVIDED BY SECTION III OF THE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.. - —1 HAVE /NO LOLL MAINTAIN WOPoLERS' COMPENSATION INSURANCE. AS REQUIRED BY SECTION 7700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMSERARE: CARRIER POLICY NUMBER (THSSECnONNEED NOTBECOPLETEDOFTHE PERATIS PORCINE HUNDRED DOLL" DIM OR LESS) I CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I SHALL NOT EMPLOYANY PERSON N ANY MANNER SOAS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF t SHOULD BECOME SUBJECT TO THE WORKERS* COMPENSATION PROVISIONS OF SECTION 7700 OF THE LABOR OODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL BE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TOONE HUNDRED THOUSAND DOLLARS (7100.000)• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR N SECTION 7700 OF THE LABOR CODE MEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC 3N7, CN. C). I LENOERSNAME LENDERS ADDRESS ICERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CRO' AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRICTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR ION N PURPOSES. I C 4/Tk-J� �k�✓NG��w/Ac-A-� PERMI Ery /CV 1 SIGHA E MITTS DATE APPLI'DATE C ION bV I PERMIT*/60 `O NUMBER ISSUE�FM 0/1� TYPE OCC DATE VV CONST, GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDEISIDE STREET RW ❑ SIDE ❑ ROPOSED USE NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFR(ADDIREM Garage/Carport LU Patia(Deck / PooUSpa ZRe -Roof 5 Commercial - m Valuation l (�fL_ ADJ.AREA OUANTITY RescniPTI N FEE —J ^y — Q cc 4 F I).a/" V7,0 U w J w Z Go J a Q U w CONSTRUCTION 0 PLAN REVIEW- - ELECTRIC �. 0 PLUMBING % MECHANICAL` INSPECTION FEE ISSUANCE • SMTP ENERGY PIC ENERGY PERMIT uU RV — A RETENTION FEE: �� RL()ND 11 PRE -ALT FEE: —��-yy��T}j O i3n 11fr -r��SA TOTAL FEESQ 0 COMMENTS�� RECPT. NO. PAID BY DATION WHITE—Department Copy. YELLOW—Finance Copy. PINK—Assessor Copy. GOLDENROD --Pile Ccpy, GREEN—Applicant's Copy CITY OF DIAMOND BAR.,._; :.-IfJSPECTi0.N.RECdRD My F I Lij z k. _. �I'� e = 1► E;� R�� . � ;l�'� � t ►'t" ,''mss !; ih�!_ #' la.t~y= ao � _ _ .-4-'01 SET BACK �� ---� FLOOR,JOIST, .. FTG S/FO RM S!STEEL FHAREQMTS -. ELECTRIC GROUND" - "" =" = 1 ' -- 'UNDER FLOOR DUCT - GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE --" - - -I FIREPLACE FOUNDATION TEMP POWER - - - -- = - FIREPLACE BONd BEAM - -114ATER SERVICE:'-- MID HT. BOND BEAht •_ ROOF SHEATHING 8 FT: BOND BEAM FRAMING!VENTILIATION FINAL BOND BEAM.. ROOF COVER..'.:' PRE -GRADING ROUGH HEATING - -. _. BENCHING " • '.. ,, i . `, 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 ._.... .. _ _ - ...._� _ LANDSCAPE/IRRIG• . SEEP-PIT/L.L. -.:._ __ _. _ __ .. , '—'� _ ON SITE IMPS. . AAIIR�,TEST FIN L GUNST. - -- ;', :- i �' FINAL ZONING �:i �- -' FIRE DEPT. FINAL �_ FMAL-HEATING - ._ ._. .. �__ - HEALTH DEPT. FINAL FINAL" ELECTRIC _ .. __ ... - DEV. FEES PAID - __.... FINAL PLUMBING ENERGY COMMEWSLAL SEPTIC TANKSIZE' SEEP PIT/U SIZE' .