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Home My WebLink About10-1049 �---. _�`_ CITY OF DIAMOND BAR �• DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS 'TM"� BUILDING PERMIT APPLICATION FIRMLY a� JOBSITE � � APPLICATION�� `,�^' PERMIT p/C ADDRESS �� DATE -��'� NUMBER/0•-/0�9# � � APN LOT TRACT �SSUE /O, 7ypE �C DATE / ��_��CONST.�,�,Q GROUP p OWNER f� p ADD SS !�'t ZONING SETBACKS z CITY , ZIP TEL. FRONT qyy � � APPLICANT TEL. REAR � �� SIDE/SIDE STREET qyy ❑ CONTRACTOR � SIDE ' p o CDDR SS ZIP q�Q�TEL. PROPOSED USE�tO (�.lt7�� (��"C C£� (�V 1 w ARCH/ENG/ A`- �� z DESIGNER � -�►�lD�`��`�O a ADD ESS NO.DWEL. NO. " NO. � CITY ZI�TEL. UNITS STORIES BEDROOMS N DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION p SFR/ADD/REM p I HEREBV AFFIRM UNDER PENAL7Y OF PERIURV THAT I AM EXEMPT FHOM THE CANTRACTORS LI� G8f8QB/CBfPOfS W CENSEUWFORTHEFOLLOWINaREASON(SEC.7037.6BUSWESSANDPROFESSIONSCODE:ANVCITVOR (n U CpUNJyy.7{Ip/REWIIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRAIJYSTRUC- w NRE,PRqq TO ITS ISSUANCE,ALSO REQUIRES THE APPUCANT FOR SUCH PERMIT TO FILE A SIONEO w Petlo/Deck , � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE UW(CHAPTER D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PR0. � PooUSpa FE5310NS CODE)OR hIA7 HE OR SHE IS E%EMPT 7HEREFFOM AND TF7E BA515 FOR THE ALLEOED EXEMP- C7 TION.ANV VIOLATION OF S�CTION 7031.5 BV ANV APPLICANT FOR A PERMIT 5U&IECTS THE APPLICANT TO Z Re-Roof � A CML PENALTY OF NOT MORE THAN FIVE HUNDi7ED DOLURS(f500).): � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECAMPENSATbN, COrt1RIBfCl81 WILL 00 THE WORK NND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.701�,&1S6 � N NESS AND PROFESSIONS CqDE:THE CONTMCTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OP IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSEIF OR HERSELF OR wTHROU(iM NIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEHEDFORSILEIF,HOWEVERTMEBUILDINGORIA/PROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TIDN,THE OWNER-BUIIAER WILL HAVE THE BURDEN OF GROVINQ THAT HE OR$HE DID NOT OUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I.AS OWNER OF THE PROPEFTV,AM E%QUSNELY COMRACTINO WfTH LICENSED CONTRACTORS � TO CqNSTRUCT THE PRQIECT(SEC.7W1,9USINESS AND PROFESSION9 CODE:THE CONTRACTORS LI- VBIUefIOl1 �� ADJ.AREA W CENSELAWDOESNOTAPVLYTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON.AND � � W/10CAMRACTSFORSUq1PRQ1ECTSWITHACAN7RACTOR�S�LICENSEDPURSUANTTOTHECONTRAG OUANTITY DESCRIPTION � Y roas ucENse uw.�. FEE � ❑I AA1 EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � U �'1' DATE oWNER � Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIiiM UNDER PENALN OF PERJURV THAT I AM LICENSEO UNDER PROVISKKJS OF CHAPTER � � e(COMMENCIN(I WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSKKJS CODE,AND Z �� MV UCENSE IS IN FULL FORCE AND EFFECT. m � UCENSE CLASS LIC.NO. OP� 1 '`� � �/`.`��' �,�w � w DATE��IC�11!Q CONTRACTOR d �i r.i ry� � WORKERS'COMPENSATION DECLARATION � � U � I HEREBV AFFIRM UNDER PENALTY OF VERIURV ONE OF THE FOLLOWING DECURATKKJS: Z ' � �I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOR WOqKERS' _ � COMPENSATION,AS PROVIDED BYSECTION 37000FTHE lAeOq CODE,FOR THE PERFORMANCE U � OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w W � � _1 HAVE AND WILL MAINTAW WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE Lt�BOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHlpi THIS PERMIT IS /�^ 1� � J ISSUED.MV WORI(ERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTR C oL� ./.!) j CARRIER PLAN REVIEW Z POLICY NUMBER ELECTRIC Q 0 (fMSSECIqNNE�NDTBEWIrR.EfFDOFiFEPE{AfrISFOqp�Elql�pREppqlqqS(f�pp)pqLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT I$ISSUED.I MECHANICAL C,�} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECAME SU&IECT TO THE (/� WORKERS'COMPENSATIONLAWSOFCALIFORNI/�AN�AQREETHATIFISHOULDBECOME INSPErT�FEE � SU&IECT TO THE WOPo(ERS'COMPENSATKKJ PROVISIONS OF SECTION 3700 OF THE LABOR �� S CODE,I SHALL FORTHWITH COMPLV WI THOSE PR IONS.� E6SLd@D1Gb� O r� p DATE:1�y��7APPLICANT. IP • W � WARNING FAILURE TO SECURE WOflKERS'COMPEN TION COVERAOE IS U WFUL,pND SHALL BE ENERGY P/C � SU6IECTANEMPLOVERTOCRIMWALPENALTIESANDCNILFINESUPTOONE UNDREDTHOUSAND ENERG� OOLLARS(f 100,aa0),IN/�DDITION TO TNE COST OF COMPENSATION,DAMAGES AS PROVIDED FOH IN � SECTqN 3708 OF THE LABOR COOE.INTEREST,AND ATTORNEVS FEES. NTI N FE � .D� OCONSTRUCTION LENDING AGENCY p�q�p._ � � I HEREBV AFFIPM UNDER PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDINO AOENCV %�� /�O a- FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME � LENDER'SAD�RE55 � TOTAL FEES � �J4 � I CERTIFV 7HAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE MFORMATqN IS CORAECT. w I AGREE TO COMPLV WITH ALL CITY AND COUNTV OqDINANCES AND STATE LAWS REUTINO TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNT'TO ENTER UPON THE � ABOVE�MENTIONED PROPERTV FOR INSPECTqN PURPOSES. Z � �� CG� COMMENTS � J 1 � � m ITTEE NAME(PR I� � � a �g Cz,�� J !A .r I � (n �'PERMI7TEE DATE � RECPT.NO. ' PAID BY VALIDATION WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENFiOD—File Capy,GREEN—Applir,anYs Copy CITV O� DIAiV�O�D �AR IY�SPEC�'GOi� ��CORD : `O[YJ�pC�C�400[n� i �. r` � OL�1�pG:�40[� Da�aC�C�O�I `DGQ4C' ��1��C�� ,�,�,: SET BACK FLOOR JOIST FTGS/FORMS/STEEL " FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION � FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING 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. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY ��o � COMMENTS �� .�� s c �,-r�o --��,�.. �� SEPTIC TANK SIZE SEEP PIT/U SIZE a � �, ��= �, . �