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Home My WebLink About16224 � -� � _�� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �( � a 21660 E.Copley Drive Suite 190 , �"��Pr�� (909)860-3195 Faz(909)861-3117 PRES$ ��A�^� BUILDING.PERMTT APPLICATION �'3�t;; � �}�y�,,� FIRMLY JOBSITE /� �r APPLICA'jiON PERMIT t' � P/C O � o ADDRESS��.�y� / J�O�� C�PI��' DATE /�- � �t�'vU NUMBER�d��- n �✓ I c� ISSUE TYPE OCC APN LOT TRACT DATE .�"'<<;� ' CONST. GROUP °C OWNER ��(�n('"--�I O o ADDRESST��3�,��/�Lc 1��.��L`.��' � L • ZONING SETBACKS � CITY��s�-svil�i;�rh R,�E�-1LZIP�TEL. FRONT RW ❑ APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE a G� I O � CITY ZIP TEL. o ARCWENG/ �� DESIGNER NO.DWEL. NO. NO. ADDRESS/�ff G- C-c,u.F,z,., G,�r-th.:.d`'.13� ' P L UNITS STORIES BEDROOMS � CITY �,+�l�T ZIP SE � C N �� DESCRIPTION SQ�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM {iW O p I HEREBV AFFlRM UNDER PENAL7V OF VERNRY THAT I AM EXEMPT FROM THE CONTMCTORS LI- G9fHJB/CefPOft W CENSEUWPoRTHEFOLLOWINORE/vSON(SEC.7o37.58USINESSANDPROFESSIONSCODE:ANVCITYOR (n U COUHTYWHICHREOUIRESAPERAIRTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORREPAIRANVSTRUC- W Patio/Deck � TURE.VRIOR TO ITS ISSUANCE,AL50 REW IRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTORS LI� � CENSE UW(GIAVTER 0(COMMENCINO WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PRO- � PooVSpa FESSIOHS CODE)OR 7HAT HE OR SHE IS E%EMPTTHEREFROM AND THE BASIS FOR THE ALIEGED EXEMP- C7 TION.ANY VpUTION OF SECTION 7031.6 8Y ANV APPLICAHT FOR A PERMIT SUBJECTS THE APPLICANT T0 Z Re-Raof � ACIVIL PENALTY OF NOT MOfiE hIAN FIVE HUNDRED DOLURS(i5ao�.): � ❑I,ASONMEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESAS7HEIRSOLECOMPENSATION, � COrtIf1lBfCl81 � � MALL DO THE WOHIC,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.701l,BUSI- J � NESS AND VROFESSIONS COOE:THE CON7RACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTY WFiO BUILDS OR IAIPROVES THEREON,M1D WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m 0 ,OFFEREDFORSALEIF,HOWEVEF�7HEBUILDINOORIMPqOVEMENTIS50LDWfTHINONEYEAROFCOMPLE- Z 'TqN,THE OWNEREUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W ❑I,ASOMMEROFTNEPROPERTV,AMEXCLUSNELYCOMRACTINGWfTHIICENSEDCONTRACTORS [[ TO CONSTRUCT THE PRQIECT(SEC.70w,BUSINESS AND PHOFESSIONS CODE:THE CONTRACTORS LI� VflIUallOfl � ADJ.AREA W CENSEUWDOESNO7APPLYTOANOWNEROFAPROPERTYNRiOBU1LDSOHIMPROVESTHEREON,AND � NM1qCONTRACTSFORSUCHPR0.IECTSWITHACONTRACTOR(SjLICENSEDPURSUANTTOTHEODNTRAG QUANTITY DESCRIPTION FEE � Y TORS LJCENSE UW.). 0 ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q 3 � � � DATE OWNEH V Z w � LICENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PEN/�L7Y OF PERIURV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(COMMENCINO WITH SECTION 7000)OF DIVISION J OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� W IICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CUSS LIC.NO. j � V DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION Q � I HEHEBV AFFIRM UNDER PENALTV OF PERIURV ONE Of THE FOILOWING DECLAMTIONS: Z � _I HAVE AND WILL MAINTAIN A CEHTIFICATE OF CONSEN7 TO SELF�INSURE FOR WORKERS' _ COMPENSATION,AS PROVIDED BV SECTION 370o OF THE LABOR CADE,FOR 7HE PERFORMANCE U Q OF T1E WORK FOR MMICH THIS PERMIT IS ISSUED. � � 4 _I HAVE AND WILL MAINTAIN WORKERS'COMPENSA710N INSURANCE,�AS REQUIRED BY SECTION ` , 37000F THE UBOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �.i � � ISSUED.MV WORKERS'COMPENSATION INSURANCE CARqIER AND POLICY NUMBER ARE: CONSTRUCTION � � jCARRIER PLAN REVIEW �� POLICV NUMBER ELECTRIC J � �sEcrqHr�r�orgeooi,�repoFn�pEw.�r�sFoaaraE��oa.w�,s�s+oo)oatFss} PLUMBING w MECHANICAL Z I CERTIFY THAT IN THE PEHFORMANCE OF THE M/ORK FOR WHICH THIS PERMIT IS ISSUED,I �(�j SHALL NOT EMP�OV ANY PERSON IN ANY MANNER 50 AS TO BECOME SU&IECT TO THE � WORKERS'CAMPENSA7bN UWS OF CALIFORNIA ANO AGREE THAT IF I SHOULD BECAME INSPECTION FEE S SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37o00F THE UBOR _ � v.(, CODE.1 SHALL FORTHWITH COMPLV WIT1 TNOSE PROVISIONS. ISSUANCE � �� .SMIP � p DATE: APPLICANT: . J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C � � SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 7HOUSAND ENERGY PERMIT DOLURS(ilao,a0o),IN ADDITION TO 7HE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF hiE LABOR CODE,IN7ERE5T,AND ATTORNEY'S FEES. � RETENTION FEE: 2 __ d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: 6 O � I HEREBY AFFIRM UNDER PENAL7V OF PERIURV THA77HERE IS A CONSTRUC710N LENDING AGENCY ' FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED(SEC.3oe7,CIV.C.). , . Z W � �ENDER'S NAME ► n F— LENDER'SAD�RESS (�i � I CERTIFI'TMAT I HAVE READ THIS APPLICA710N AND STATE THA77HE ABOVE INFORMA7qN IS CORREC7. TOTAL FE ES ` !\�.� � � I AGREE TO COMPLV WI7H ALL CRV AND COUNTY ORDINANCES AND STATE UWS RELATING TO BUILDING v ^ � /� ZCONS7RUCTION,AND HEREBV AUTHOR2E REPRESENTA71VE5 OF THIS COUN7V 70 ENTER UPON THE /�/��///yyyyyy��' !!!'''�� n'1(I��'y '/' �.� E ,S ABOVE-MEHTIONED PROPER7Y FOR INSPEC710N PURPOSES. COMMENTS ��l/V S�U HiV �� L � 1 I � m PERMIT7EE NM1E(PRINT) Q � N SIGNATURE OF PERMITfEE OATE � RECPT.NO. � PAID BY 3 VALIDATION WHITE--Departmenl Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy � - _ _ _ ��1� �� , �. . ... .,. ,. r .:...,.. .• ..:...:, .r. ..., ;�,. . .-.. .-.,. . ., �. : ; :. ...c., :a: . ..: , � y-q��op,��.�"s'4��4'^:-'R�°'=»�; •.. ,.�.,. �.�f.�:.�.... . . . � ' . C��T �� N151tlANY. Btl� IOdW� .. . •`.__, ..-I � �� 9�laa�if'G��I�i� ��1.►id�� x .�. . ..... _ �. . . � .. � � �';"`��"�� ` `��>�� "�� ' � °`�'_ � �,- g r+ ��,�° ' O $ �?` . _ ,. � , ��.. � . F z ��- . , . . � t � . .�. . � . ,... . ,. - .� �, . . ,. , . SET BACK ' ! ( FLOOR JOIST . � ' FTGS/FORMS/STEEL �(�-�7(, i ' FHA RE�MTS � ELECTRIC GROUND j UNDER FLOOR DU.CT • GROUND PLUMBING UNDER FL'OOR CU�fDUiT � , SLAB GRADE FIREPLACE FOUNQATION ' � _ _ TEMP POWER ; i FIREP�ACE BOND BEAM WATER SERVICE MIQ HT. BOND BEAM ; ___ ROOF�HEATHING ��-o-1�a 8 FT. BOND BEAM I FRAMINGNENTIUATION m��►-�1 � FINAL BOND BEAM __ I __ ROOF COVFR PRE-GRADING � � RdUGH HEATING BENCHING i � ROUGH ELECTRIC -zs1-�l R�UGH GRADING � � ROUGH PLUMB�NG � � y FINISH GRADING ___ SHOWER/TUB TEST � �OOL ELECTRIC EXL LATH/SIDING � �o POOL FENCING � _ WALL INSULATION � POOL FINAL � CEILING INSULATION �� O r SITE IMPS. I DRYWALL NAILING �-,2�� -- DEDICATIONS SEWER FINAL CNG. � SEPTIC TANK LA�lDSCAPE/IRRIG. SEEP PIT/LL. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CC1N57. FIRE DEFT. FINAC FINAL HEATING HEALT!-i DEPT. FENAL rIIVAL ELECTRIC ' � DEV. FEES pAID � _ �iNAL PLUMEiING � ENERGY --i--------..... �-�, � `��i� D�`�"� � "'"' � y --- �----- ---_..._.._._._ I ._:. ` " O O '';,A� ��:;,�'� ,� i COMMEiVTS 5'�-01 � b.1(-� __�� SEPTIC TI�NK SIZE � SEEP PIT/tJ SIZE . ._..... .. ------ � : �'�� _: �.� __�_.�_______� ____ �-----__. .� �S�z�iSY -.Y wC'!� )rt ��y`" � ��dt#4� ;p�� `.wP ?a' �Y''.iC�, f�,� : ' ' l� w -.3 � '�.�:. .�" ;,1J4(","'P, .�4 ',.i. ',.x.� °ir�� _._ . — . __—__.� � ��SR �' r;t� '� �:;. ' —__. ��f�^�'Sf^a�_�a � .iKq �„ :f,' ,`��. . 'a �`�}£�^s�__.A � �� _._'�. ' —_ — s�s , ? \ I .r�' _�� CITY OF DIAMOND BAR , Community and Development Services Department • � � °21660 E.Copley Drive,Suite 190•Diamond Baz,CA 91765 ''^��''= Building Planning Engineering ,,��r� - (909)860-3195• (909)396-5676 • (909)396-5671 CORRECTION NOTICE File/Case: TO PERMIT NO. ZZ ADDRESS IS� �LOI,�k C1Z.�ST DATE: 3�U � {�p � E�IaJ 2, p�. ,u� � � �-� c,� o �-5 � ? 3 b.� � - �,J S'�A-�-�-�D � v cc�•� �J 6t-�' � .st(�' � �ld� �� ►�� C I2pcRM 84�5 No �v��' 6-"tsJZ i�!-�(N�, ��t�'��? 2 t�d (k��. � cavJ��-��n3 S � � c, �S S t�� A- pvNGbk L15� — ❑PLEASE CONTACT THE UNDERSIGNED LEASE MAKE CORRECTIONS AND CALL FOR REINSPECTION REINSPECTION FEE REQUIRED ❑PLEASE MAKE CORRECTIONS AND PROCEED WITH WORK INSPECTOR: R I�t'�"A�J� PHONE#: