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Home My WebLink About11-577 r CITY OF DIAMOND BAR �/ ,. �---- ��` DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 1 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �'�"'� BUILDIN PERMTT APPLICATION FIRMLY JOBSITE q ¢ ADDRESS «� rO S ' APPLICATION PERMIT �� 'j� /C p DATE �f Z � NUMBER��-� � ISSUE 7yPE �C � APN LOT TRACT DATE CONST.�� GROUP p OWNER p ADD SS ZONING SETBACKS z CITY ZIP TEL. . FRONT RW O � APPLICANT ' TEL. REAR p ¢ SIDE/SIDE STREET RW ❑ a� CONTRACTOR C ' t �' a��'+!'. SIDE p ADDRESS \ . ' � CITY �� -�S_ ZIPL��EL,�.��I,o JIS�' PROPOSED USE oARCH/ENG/ , iz DESIGNER NO.DWEL. NO. a ADDRESS NO. v� UNITS STORIES BEDROOMS � CITY ZIP TEL. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBV AFFIRM UNDER PENAL7Y OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� GafB B/C8 W CENSE UW FOR THE FOLLOWING REASON(SEC.7031.5 BUSMESSAND PROFESSION3 CODE:PNV CITV OR (n g �rt U ppUNTyµMICHREOUIflESAPERMITTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANYSTRUC- w w NRE.PRIOR 70 ITS ISSUANCE,ALSO RE�UIRES THE APPLICANT FOR SUCH PERMIT 70 FILE A SIGNED w P8t10/DBCk � STATEMEM THAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF TNE CONTRACTORS LI� � CENSE UW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � PooUSpa � FESSIONS CODE)OR 7T1AT HE OR SHE IS EXEAIPT THEREFROM AND THE BASIS FOFl THE ALLEOED E%EMP- � TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z q�qap} A CIVIL PENALTV OF NOT MORE TIAN FIVE HUNDFED DOLURS(f500).): 0 ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECAMPENSATION, 0 COff1rt18fCId1 Z MALL DO THE WORN,M!D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W�,BUSI- J ' N NESS AND PHOFESSIONS CODE:THE CONT{UCTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPEHTV WFiO BUtLDS OR IMPROVES TMEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSEIF OR w TMROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT WTENDED OR m Q OFFEREDFORSPLEIF,HOWEVER7NEBUILDWOORIMPROVEMENTISSOLDWITHWONEYEAROFCOMFLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF 7ROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W OI,ASOWNEROFTHEPROPERTV.AME%CLUSNELVCONTRACTINOWfTHLICENSEDCONTMCTORS � TO CONSTRUCT TME PRQIECT(SEC.701�,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U8110f1 ADJ.AREA W CENSE UW DOES NOTAPPLV TO AN ON7JER OF A PHOPERTV N?i0 BUIIDS OR IMPROVES THERC-0N,AND � NTIOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S�IICENSEDPURSUANTTOTHECONTRAC� QUANTITY DESCRIPTION 70RS LICENSE UW.). FEE � � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REqSON Q ,\ C� � ?� U LL DATE � `� OWNER H Z U � LICENSED CONTRACTORS DECLARATION w ' � S.� � 1 HEREBYAFFIRM UNDER PENALTY OF PERJURV THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER � � i(COMMENCINO WITH SECTION 70ao)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z , �� MV LICENSE IS P!FU�E AND EFFECT. .�f �1 m � LICENSECLASS LIC.NO. �J��Q1 � � . V DATE CONTRACTOR d "' S rrf�-fi�' � WORKERS'COMPENSATION DECLARATION Q U � I HEFEBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECIARATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ � COMPENSATION,AS PROVI�ED BY SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE U 9f THE WOFN FOq WHICH THIS PERMIT IS ISSUED. W W / � � I HAVE AND WIIL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQIJIRED BV SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK f-0R WHICH THIS PERMIT IS � Q� ISSUED.MV WORICERS' PENS TION INSU A IER AND PpOLICV NUMBER ARE: CONSTRUCTION � � 7 � . CARRIER S ��w�nd` PLAN REVIEW Z POLICV NUMBER i��c�—�=a L�—}C) ELECTRIC � Q p' (n+ISSECiN]NNE�NO7eEO�Ma.FTEooFTF�aEw.YrlSwqp�EMxofiEODounjs(S�oo)oqLESs} PLUMBING �9� W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WOH7C FO SUE i MECHANICAL G} SHALL NOT EMPLOV ANY PERSON IN ANV MANNE TO BECAME SU&IECT E (/) WORNERS'COMPENSATION LAWS OF CALIFO AND AOREE THAT IF I SHOU BE INSPECTION FEE � SU&IECTTOTHEWORKERS'COMPENSA PROVISIONSOF�CTION7700 T R CADp7 I SHALL F THWITH COMPLY THOSE P ISSUANCE �. 0 � . `p �ATE: S �,APPLI T: SMIP 1 S J WARNINO:FAILURETOSE URE RKERS' ATION WFUL,ANDSHALLBE ENERGYP/C J � SU&IECTAN EMPLOVEF TO CRI INAL P 5 FINES UP TOONE HUNDRED THOUSAN� ENERGY PERMIT DOLLARS(5700,000J,IN ADDITION E COST OF COMPENSATKKJ,DAMA�ES AS PROVI�ED FOR IN J SECTION 3108 OF THE LABOR CADE,INTEREST,AND ATTORNEV'S FEES. w RETENTION FEE: .l�G7 O CONSTRUCTION LENDING AGENCY E-A F � I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS A CANSTRUCTION LENDING AGENCY ��.�� (� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.). Z W � LENDER'S NAME F— LENDERSADDRESS � I CEFTIFV THAT I HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFOqMAT10N IS CARRECT. TOTAL F E ES / ' �/� � I AGFEE TO CAMPLV WITH ALL CITY AND CAUNTV ORDINANCES AND STATE UWS REUTINQ TO BUILDINO � CONSTRUCTION,AND HEFEBV AUTHORIZE REPRESENTATNES OF THIS COUNTV TO EMER UPON THE Z ABOVE�MEMIONED PROPEFTY FOR INSP Puaaoses. COMMENTS � Q � + J � ).�5� m PE AME(PRIN7) . . Q � L J IGNA DA7E — RECPT.NO. PAID BY p VALIDATION WHITE—Depertment Copy,YELLOW�inence Copy,PINK—Assessor Cop,GOLDENRO�File Copy,GREEN—Applicant's Copy ce�-v o� �ia�o�� Ba� i�s��c�io� ��co�� ,:�.d.�0�l�pGC54DO�J .o �. � �� o � � m � �� , � C�4 D�J4C� � `�.�l�3pG�G3 OG]�Pf�C�400a DQ4@ 'Oa�pC�C�4C��G3� SET BACK FLOOR JOtST • FTGS/FORMS/STEEL FHA RE�MTS ELECTRIC GROUND UNDER FLOOR DUCT - GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIR�PLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE M(D HT. BOND SEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATIfJG BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING � FiNISH GRADING SHOWER/TUB TEST t� POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION � 3/�� POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP P1T/L.L. ON SlTE IMPS. GAS AIR TEST FINAL ZONING FINAL CON5T. , FIRE DEPT. FINAL FINAL HEATING ' � HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY C�� CO(viMEiVTS _S_(-�oW�R- L'��R4��AF�_�O�C3�l SEPTIC TANK SIZE SEEP PIT/U SIZE a ea a -, �,:�- ;�: