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Home My WebLink About10-990 / " -��'— DE ARTM NT OFC OMMUNITY&DEVELO��T�ER��.CES� � 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �'9�'� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE ` APPLICATION PERMIT p/C n O ADDRESS ��'�J C�'! DATE � -ta NUMBER�D# P/` O'- � APN LOT TRACT „ DA EE Q` , '� CONST.�1�>_��GROUP p OWNER� o ADDRESS�Q� ��►�w �-�r ZONING SETBACKS Z CITY�nw.•_..�. �Ar ZIPQ��(y�rTEL. FRONT q�y � g APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ � CONTRACTOR�ASa �. ��_ Cf1�1C�va� �,�1 . SIDE Q ADD SS�y\2b ��\ 'OYL � CITY��L�2_��t ZIP� TEL�I��y0(O aH � PROPOSED USE oARCWENG/ z� DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION � OWNER-BUILDER DECLARATION� � SFR/ADD/REM p I HEREBY AFFIRM UNDER PENALIY OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� G8f890/CefPOfi W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCITYOR (� U COUNryWF1�CHREWIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREFAIRA/JYSTRUG W w TURE,PRIOR TO ITS ISSUANCE.AL50 FEOUIRES THE APPUCANT FOR SUCH PERMIT TO FILE A SIGNED w Patlo/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE LAW(CHAPTER�(COMMENCWO WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PR0. � POOVSpB � FESSIONSCODE)ORTHATHEOHSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� TqN.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS hIE APPLICANT TO Z Re-Roof A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(f600).): Q ❑I,ASOWNEROFTHEPROPERTV,OFMVEM7LOVEESWITHWAGESASTHEIRSOLECOMPENSATpN, � COfTIRIBfCi01 Z WILL DO 7HE WORK,AND 7HE STRUC7URE IS NOT INTENDED OF OFFERED FOR SALE(SEC.7aa,BU51- J � � NESS AND PROFESSIONS CODE:hiE CANTRACTORS UCENSE LAW DOES NOT APPLV TO AN OWNER OF � ��_.J PROPERTY WFIO BUILDS OR IMPROVES THEREON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROU(L1 HIS OR HER OWN EMPLOVEES,7ROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREOWflS/�LEIF,HOWEVER,THEBUILDINOORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPIE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT ME OR SHE OID NOT BUILA OR = IMPROVE FOq THE PURPOSE OF SALE). ' ❑I,AS OWNER OF THE PROPERTV,AM EXCIUSNELY CONTMCTINO WfTH LICENSED CONTRACTORS � TO CONSTRUCT TME PR0.IECT(SEC.7w1,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS ll- V8IU0�lOf1 ADJ.AREA W CENSE LAW DOES NOTAPGLV TO AN OWNER OF A PROPERTV WHO BUd.DS OR IMPROVES THERC-0N,AND � WFIOCONTRACTSFORSUCHFR0.IECTSWITHACONTiiACTOR(S�LICENSEDPIJRSUMlTTOTHECONTRAG� QUANTITY DESCRIPTION Y TORSLICENSELAWJ. FEE � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ?� U � DATE OWNER � Z U �¢ LICENSED CONTRACTORS DECLARATION w 2 I HEREBY AFFIiiM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCINO WITH SECTION 7000)OF DIVISKKJ J OF THE BUSINESS AND PROFESSION9 CODE,AND Z ' �� MV LICENSE IS IN FULL FORCE AN�EFFECT. m � LICENSEGLASS Ll C C'R� LIC.NO.•��AZSS � V DATE ��3� ��I CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION � �' U � I HEREBV AFFIRM UNDER PENALIY OF PERIURV ONE OF THE FOLLOWING DECURATIONS: Z � _INAVEANDWILLMAINT/JNACERTIFICATEOFCONSENTTOSEIF�INSUREFORWORKERS' a Q COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR NT11CH THIS PERMIT IS ISSUED. � w _1 HAVE AND WILL MAINTAIN WORHERS'COMPENSATION INSURANCE,AS REOUIFED BY SECTqN Q 3700 OF THE LABOR CODE,FOF THE PERFORMANCE Of THE WORK FOR WHICH THIS 7ERMIT IS _ �f� ISSUED.MV WORNERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBERAAE: CONSTRUCTIO ,'�+ J -- j CARflIER P N REVIEW 0 POLICV NUMBER dZ ELECTRIC � 0 (iHSs[craNrlE�raoraEclJf�,w.ErIDOFnEpEw.arsFoqoMEF�DREppptlAAS(S�pplpq�ESS} PLUMBING W Z I CEHTIFV THAT IN THE PERFOqMANCE OF THE WORK FOR WHICH THIS PERIAIT I51S5UED,l MECHANICAL � SHALL NOT EMPLOV ANV PERSON IN ANV MPNNER 50 AS TO BECOME SUBJECT TO THE (/� WORKERS'CAMPENSATION LAW$OF CALIFORNIA AND AGREE THAT IF I SHOULD BECAME INSPECTION FEE SUBJECTTOTHEWORNERS'COM7ENSATIONPROVISIONSOFSECTION77000FTHElABOR �,..�� O CODE.I SHALL fORTHWI7H COMPLv WIiH 7HOSE PROVISIONS. SSUANC �!j, p DATE: APPLICANT. IP _ � �� W � WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAOE IS UNLAWFUL,AND SHALL BE ENERGY P/C � � SU&IECTANEMPLOVEFTOCRIMINALPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT � DOLURS(5100,000).IN ADDITION TO THE COST OF CAMPENSATION,DAMAQES AS PROVIOED FOR IN � ¢ SECTqN 37oB OF THE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. ETENTIO FE ' r O U OCONSTRUCTION LENDING AGENCY pqp-e�� $�� 1 HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV L J%rT ��C7 a FOF THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.70G7,CIV.C.). Z W � LENDER'S NAME � LENDER'SADDRESS � TOTAL FE ��S-� � 't-�O �/,Z• � I CERTIFV TNAT I HAVE READ THIS APPLICATION AND STATE THAT hIE ABOVE INFORMATqN IS CORRECT. w I AGREE TO COMPLV WITH ALL CI7Y AND COUNTY ORDINANCES ANO STATE LAWS REUTINO TO BUILDINO ��Q� d ` � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATNES OF THIS CAUNTV TO ENTER UPON THE Z ABOVE� ENTIONED PROPEFTV FO INSPECTION PURPOSES. COMMENTS O J � � '�1s/1't� .5 m PERMITTEE NAME(PRINT) � Q � � 51(3NA7UREOFPERMI77E DA7E � RECPT.NO. PAID BY V/WDATION WHITE—DepaAment Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy . � ' , �;��;i� CO�V�O� DIAfViON� �AIR J .� �... � �Itla7��`V��Itl ��'li�� _ . �a�p�c��ooa �c�� i,�� aa��p oa�p�c�4a�o�a; o' ��:- � ^��a��F��i;: SET BACK � � FLOOR JOIST FTGS/FORMS/STEEL ' ry � �,, '1; FHA REQMTS ELECTRIC GROUND � � ` 1 ° UNDER FLOOR DUCT GROUND PLUMBWG � UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HL 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 FENGNG 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 C��a � COMMENTS B��r+asA �� 1•' � �,,JA. -;�•�,,�— ��4 109� s ��ce,.�___lv0l�l�►n� �. -��,�. � � � - >�d SEPTIC TANK SIZE SEEP PIT/U SIZE a � : � y¢�, �