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Home My WebLink About16899 CITY OF DIAMOND BAR . �-----�� --- DEPARTIvIENT OF COMMUNTI'1'&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS ��`%H�� BUILDING PERMIT APPLICATION FIRMLY N JOBSITE ��o ��q`� APPLICATION � �q O I NUMB R #/ I�� o ADDRESS P �• �a�J SOh DATE � ISSUE /� I TYPE OCC APN LOT TRACT DATE � CONST. GROUP p OWNER I o ADDR SS — �' � . ZONING SETBACKS Z CITY • ZIP TEL.?f�I�r��_��I'�+1, FRONT RW ❑ o APPLICANT TE S DE/SIDE STREET RW ❑ z a CONTRACTOR SIDE ❑ � ADDRE S ,�' � PROPOSED USE � � CITY ZIP TE Q w ARCH/ENG/ �*. � �� iz DESIGNER__�as�h�.$ NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM � O I HEREBV AFFIRM UNDER PENALTY OF PERIURY THAT I AM E%EMPT FROM THE CONTRACTORS LI- Gyf0y0/CflfpOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCADE:ANYCITYOR (n U COUNTYWHICHREOUIRESAPERMITTOCONSTRUC7,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- W P21i0/DBCk Z TUFiE,PFiIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOF SUCH PERMIT 70 FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS Lb W � CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooVSpa � FESSIONSCODE)ORTHATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFOPTHEALLEGEDEXEMP� (� V TION.ANY VIOUTION OF SECTION 7031.5 BV ANV APPLICANT FOR A PEFiMIT 5U&IECTS THE APPLICANT TO Z Re-Roo( A CIVIL PENAL7V OF NOT MORE 7HAN FIVE HUNDRED DOLLARS(f500).): OI,ASOWNEROFTHEPROPER7V,ORMVEMPLOVEESWITH�WAGESASTHEIRSOLECOMPENSA710N, Q Z WILL DO THE WORK,AND THE STRUCTUFE IS NOT INTENDED OR OFFEfiED FOR SALE(SEC.704I,BU51� J COmmBfCl81 - � NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR CC THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NO7INTENDED OR m QOFFEREDFORSALE.IF,HOWEVER7}1EBUIlDINGOFIMPROVEMEN71S50LDWI7HINONEYEAROFCAMPLE- Z TtON,THE OWNER�BUILDEH WILL HAVE 7HE BURDEN OF PROVING 7HAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). , w OI,ASOWNEROFTHEPROPER7Y,AMEXCLUSIVELYCONTRACTINGWITHLICENSEDCANTRACTORS � TO CANSTRUCT THE PRQIECT(SEC.7o�I,BUSINESS AND PROFESSIONS CODE:7HE CON7RACTORS LI- VdlUetlOfl ADJ.AREA I W CENSE UW DOES NO7APPLY 70 AN ONMER OFA PROPER7Y WHO BUILDS OR IMPROVES THEREON,AND i � WHOCANTRACTSFORSUCHPRQIECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC-� QUANTITY DESCRIPTION FEE � � Y TORS LICENSE LAWJ. � ❑I AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON Q � � U � � DATE OWNER � . Z w ' � LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AA1 LICENSED UN�EH PROVISIONS Of CHAPTER � �� o(COMMENCING WITH SEC710N 7000)OF DIVISION J OF THE BUSINESS AND PROFESSIONS CODE,AND X MV LICENSE IS IN FUII FORCE AND EFFECT, m v ;Q�;� I LL � I � LICENSE CyLASS � LIC.NO. I _ � ~ DATE 11 �� CONTRACTOR • a � U W � WORKERS'COMPENSATION DECLARATION Q / �� I HEREBV AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECLAHATIONS: Z � I HAVE AND WILL MAIN7AIN A CER7IFICA7E OF CONSENT TO SELf-INSUPE FOR WORKERS' a Z a CAMPENSA710N,AS PROVIDED BY SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE `U OF THE WORK FOfi WHICH THIS PERMIT IS ISSUED. � � w �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION Q 370o OF THE UBOR CADE,FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS 0 ISSUED.MV Vj(Q�KE S'CA�ENSA7 INSUFA 7CE CARRIER AND POLICV NUMBERARE: CONSTRUCTION � J ` � � CARRIER ''�� 1 "�i PLAN REVIEW Z POLICVNUMBER��, ELECTRIC � a D� (fHISSECTIONNEmNOTBE00MPLEfEDOFTHEPEW.YTISFORONEHUPDREDDOILAAS(5100)ORLESS). PLUMBING W �Z I CERLIFV THAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL i (} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECAME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE SUBJECT 70 THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR � CADE.I SHALL FORTHWITH COMPLV WITH`T�HOSE,�PROVISIONS ! ISSUANCE l � � "/7 1./�� JKWVO ��1��P� � SMIP I � tra..�-- �• p DATE:_�_- fa_ APPLICANT:� _ —b . i � � �y �� JENERGY P/C '—' n- WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFMESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN �(� � SECTION 3708 OF THE LABOfi CODE,IN7EREST,AND ATTORNEV'S FEES. RETENTION FEE: `I � .L/[� � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: ITl f O il , � � I HEPEBY AFFIRM UNDER PENALTV OF PER1UflV 7HAT THERE IS A CONSTRUCTION LENDING AGENCY - � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oW,CIV.C.). ----`fi.---�� Z W � LENDER'S NAME . f= LENDER'SADDRESS w TOTALFEESa��, 5 ��, � I CERTIFV THAT I HAVE READ THIS APPLI ATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. � I AGREE TO COMPLV WITH ALL CITY AN OUNTY ORDINANCES AND STATE IAWS RELATING TO BUILDING � STHUCTION,AND HERE V AUTHOR� REPRESENTATNES OF THIS COUNTV TO ENTER UPON THE Z 80 E-MEN710NED PROPE FOR IN ECTION PURPOSES. COMMENTS � i �1{ I P�� -- A�vIIY`f � ¢ PER N P N �✓ (n � �� I�� SI T E OF PERMI EE,' DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—De aAment Co YELLOW—Finance Co PINK—Assassor Co GOLDENROD—File Co GREEN—A licant's Co P PY. PY� PY. PY. PP PY (�9`�� o I� �DQ6��1� �31a(� � 0��ff� f�!��CC�� D�vJ� I a �G'�`� ��- ll a , OG�'�� G�t� 0� p o SET BACK ' ( ; �LOOR JOIST • � j � 1 -- ---_ _-- _.__.._ _____�_.___._______ . - _.:_._- FTGS/FORMS/STEE� �'-��<p( , " ___ ;�FMA REQMTS � I I ELECTRIC GROUND � UNDER FLOOR DUCT � __ _ _ �_ � _ GROUND PLUMBING � _i_ ____ i UNDER FLOOR CU1�iDUIT ? -- ------ ----- _..._..._--- SLAB GRADE ___ �_FIREPLAC� FOUNDAYf"ION ;___ ` __'_ TEMP POWER � FIREPLACE BOND BEAM __ W,4TER SERVICE _ y� i MID HT. BOND BEAM : ROOF SHEATHING � fr'1 _ __ _ _ Y $ �. BONI�BEAM � _ `� �J�--- �_ _� _ � -� ----- � -- .... _ _. FRAPJIINGNENT�IIQ��'`� �,�i�' ' FINAL BOND BEAM i - - —- -- -_.---- --- ROOF COVER � � PRE-GRADING � ROUGH HEATWG _ �,i _�j�� BENGHING _ � ROUGH ELECTRIC y� � .'' ' � �OUGN GRADING --- -- --—----- ' _.._.-- -___._._._.- -I ---- ROUGH PLUf�nBING �' ; ' FINISH GRADING _ � __^ SHOWER/TUB TEST ' POOL ELECTRIC ( -- --.— - EXT. IATHlSIDIfVG �,.z .J L ' ; P�QL�-ENCING � . _ _---.......__-- ------._._ ___�._ WALL INSULATION -'t ; F'OOL FIIVRL CEILING INSULATION � I OFF SITE iMPS. � DRYWALL(VAIUNG 1�-2_o DEDICATIONS SEWER FINAL ENG. � ---- - - �-�---�---.._....._.__ _� _ r SEPTIC TANK LAPJDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST � FINAL ZONING FINAL CONST. _�Q�/ � ' F!FiE DEPT. FINAL - _� -�--- FINAL HEATING � HEALTH DEPT. FINAL FINAI.ELECTRIC �� I ' DEV. FEES PAID FINAL PLUMBING ,;FNERGY E - - � -- . ..._.._._ _.....__------_;�� _._____._. 1 - � (�G�U"O(� o c o i COiViiViEi�TS - � SEPTIC TAi�K SIZE SEEP PIT/U SIZE - � _.___ -_ __ __..._____ � � - --------- - � . . — ---------