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Home My WebLink About17845 CITY OF DIAMOND BAR (� -�---��'�----� DEPARTMENT OF COIvIIv1UNITY&DEVELOPMENT SERVICES � . 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS '"%��^�� BLTILDING PERbiIT APPLICATION FIRMLY o� JOBSITE jQ� � APPLICATION L��, _ A � PERMIT �� Q��/C ADDRESS C� uN��('� DATE V NUMBER� 0 � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER o ADDRESS ZONING SETBACKS � Z CITY TEL. (� FRONT RW ❑p � o APPLICANT TEL. � S DE/SIDE STREET RW ❑ � Z a CONTRACTOR SIDE ❑ ADDRESS � CITY ZIP TEL. PROPOSED USE w ARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � u� cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM I� O I HEREBV AFFIFiM UNDER PENAL7V OF PERIURY THAT I AM E%EMPT FROM THE CAN7RACTORS LI� G8f89B/CeryOR W CENSEIAWFORTHEFOLLOWINGREASON(SEC.7037.5BUSINESSAN�PROFESSIONSCODE:ANVCI7VOR (n U COUNNWHICHREOUIHESAPERMITTOCONSTFiUCT,ALTER,IMPROVE.OEMOUSH,ORREPAIRANVSTRUG � ' W TURE,PRIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck S7A7EMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PHOVISIONS OF 7HE CONTMC70H5 LI� � CENSE LAW(CHAPTER Y(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � PooVSpa � ' � O FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALIEGED E7(EMP- (� V TION.ANVVIOLATIONOFSECTION7031.5BVANVAPPLICANTFORAPERMITSU&IECTSTHEAPPUCANTTO Z Re-Roof � A CIVIL PENAL7V OF NO7 MORE 7HAN FIVE HUNDRED DOLLARS(S5o0).): � ❑I,ASONTJEROFTHEPROPERiV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COmm6fClel � Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oI4,BUSI- J � NESS ANO PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � TH{iOUGHHI50RHEROWNEMP�OVEES,PROVIDED7HATSUCHIMPROVEMENTSARENOTIN7ENDEDOH m w OFFEREDFORSALE.IF,HOWEVER,iHEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- 0 TION,THE OWNEfl-BUILDER WILI HAVE 7HE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). �_ ❑I,ASOWNEROFTHEPROPERTY,AME%CLUSIVELYCqNTRACTINGWITHLICENSEDCONTRACTORS 70 CANSTRUC7 THE PRQIECT(SEC.70l4,BUSINESS AND PROFESSIONS CODE:THE CON7RACTORS LI- VelUetlOfl ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEHEON,AND � WHOCAN7RAC75FORSUCHPRQIECTSWITHACONTRACTOR(S�LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR 7HIS REASON Q � � U � �O S' t'Lv S � DATE OWNER H z w I E�f , � F w. � LICENSED CONTRACTORS DECLARATION � s �L " � . I HEREBV AFFIRM UNDER PENALTY OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER Z I� S�1 d e(COMMENCING WITH SECTION 7o00)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND �� 'X MV LICENSE IS IN FULL yF�ORCE AND EFFEC7. m S N OUCENSE CLLASS �-+ � LIC.NO. �-/�'pIN�� DATE 7 �^0�-- CONTRACTOR �POC'SS/ d S�� W � WORKERS'COMPENSATION DECLARATION Q � �N� NI H BV AFFIRM UNDER PENALTV OF PERJURV ONE OFTHE FOLLOWING DECLARATIONS: Z f S Z _IHAVEANDWILLMAINTAINACER7IFICATEOFCANSENTTOSELF-INSUREFORWORKERS' _ a CAMPENSATION,AS PROVIOED BV SECTION 37o00FTHE LABOR CODE,FOR THE PERFORMANCE w OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSA710N INSl1RANCE,AS RE�UIRED BV SECTION Q 37000F7HELABORCODE.FORTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION j CARFIER _S'rL1�t �p^�d PLAN REVIEW f� Z POUCYNUMBER IN1gS/Z�� ELECTRIC 1\I � Q � � (fHISSECfqNNE�NOTBE�N�PLEfEDOF7FIEPERhVTISFORONEHUI�DRE�DOUJ�RS(f700)ORLESS} PLUMBING IZ w a;�o Z i CERTIFY THAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL (} SHAIL NOT EMPLOV ANY FEPSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF 1 SHOULD BECOME INSPECTION FEE SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE IABOR � � CODE.I SHALL FOflTHWITH COMPLY WITH TH0 E PROVISIONS ISSUANCE � 1 � r, � p DATE: �d�� APPLICANT: _�P��N/!/�. SMIP J WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPIOVERTOCHIMINALPENALTIESANDCIVIIFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5�00.000),IN ADDITION 70 7HE COS7 OF COMPENSATION,DAMAGES AS PROVIDE�FOR IN � SECTION 3708 OF THE LABOR CADE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE: a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � I HEREBVAFFIRM UNDER PENALTY OF PERJURY THAT7HERE IS A CONSTRUC710N LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME � F— LENDER'SADDRESS ///�� /� � I CEFTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES � y�'( \� w I AGREE TO COMPLY WITH ALL CITY AN�COUNTV OHDINANCES AND STATE UWS RELATING TO BUILDING I \J � CONSTRUCTION,AND HEREBV AUTHORRE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE�MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS � �t P Y ►�-��"55, m PERMITT NAM (PRINT)I!Iv�'M_v Q /� / N 7 �/ � SIGNATU ERMITTEE DATE � = RECPT.�O. AID BY VALIDATION ~ WHITE—DepaAment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy �... • . ,.. , • .. . . . .. . , ,, .. _ .. �r�� ' ��6�1�1��'� �L�� o�{t�� i`��1�`i� fl��`'�11�� ' l.�� U��r��:�.Ja �Q� QG`�i � a � ' � �� ' �..._ ��__�� ____.:�_ SET BACK ; , �' ' _._ I FLOOR JOlST � ---- -- -- ...— _ __._.. __.__ ___ ----;--- - ------- ____ - -- FTGSIFORMS/STEEL �_�Z _Q'Z_ FHA REClfv1T5 - -- --- - - ----._.. ---- -._ �_.._._..- --�---_.......--- - ---- ELECTREC GROUNQ � � i UNDER FLOOR DUCT _ �.. -- -- ... ---- __...._.-• ---�------ � _ .___ GROUND PLUMBING � 5�((Z o`?� __ ----- UNDER FLQOR CU�IDUIT_�i ,� _ _____. ..... SLAB GRADE __ � r _. , �___. ,_j_FIREPLACE_FOUNDATION � � - -�------ --.... i EMP POWER � __� ...__ __.i.._ FIREPLACE BONU BEAM__ I__�__ � ----..._. WATER SERVICE _ j ___„__ __._�_MID HT. BOND BEAM ROOF SHEATHING __ I _ �8 FT. BOND BEAM ---_y - -- ---- FRAMINGNENT(LIATION �f��,��%`� - FINAL BOND BEAM ' ---- ---- L ROOF COVER i � PRE-GRADING _1_ � _ __ ROUGH HEATING ��__ BENCHING __ ROUGN ELECTRIC � �� R�UGN GRADING __....._.. --- ROUGH PLUMBING I ��L; __ ,� FINISH GRADING — ----- ----- ----- ----------- SHOWERiTUB TEST --�- � � POOL ELECTRIC EXT. IJaTH/SIDING �� ,� _ ' I POOL FENCING _ _____ WALI.INSULATION �� POOL FINAL _ � CEILING IN�ULATiON ' ��'�� OFF SITE IMPS. _ ---- -------------- QRYWALL NAIUNG ��D�dL_ dEDICATIONS _ SEWER � FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/�.L. ON SITE IMPS GAS AIR TEST FINAL ZONING FINAL CONST. �F�`�.� �i ; G!RE DEPT. FINA!. FINAL HEATING �.�).u�- ' HEALTH DEPT. FINAL FINAL ELECTRIC �.��, �t ;� DEV. FEES PAID _ � FiNAL PLUMBING `l+�p�y- � � ENERGY _ , _ _ ---� —�— , . ?G�l� �.�..��.. . —_--- � — COiVlfi(�EiVTS SEPTIC TAf�K SIZE SEEP PIT/U SIZE � � . � � ----