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Home My WebLink About18171 (32) CTTY OF DIAMOND BAR ^-----�� --- DEPARTMENT OF CONIIvIUNTI'Y&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 F�(909)861-3117 PRESS �"%�� BUILDING PERMIT APPLICATION FIRMLY QJOBSITE �� p 5 .�, Qw,�. �� 2• DATECATION � � NUMBER�� ` 1#/CD �) � ¢ ADDRESS I � ISSUE � � I �(� TYPE OCC APN LOT TRACT DATE U CONST. GROUP p OWNER � o ADDRESS ZONING SETBACKS Z CITY ZIP� TEL. , FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW p z - Q CONTRACTOR SIDE ❑ ADDRESS /�.� � CITY ZIP TEL. PROPOSED USE < < I . w ARC NG iz DESIG � � NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION %"SQ. T. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFIRM UNDER PEN/�L7V OF PERIURY THAT I AM EXEMPT FROM THE CAN7qACTORS LI- G8feJ0/C2fpOft W CENSEUWFORTHEFOLLOWINGREASON(SEC.7o31.58USINESSANDPROFES510NSCADE:ANVCI7YOR (n U CAUMVWHICHREQUIRESAPERMITTOCANSTRUCT,ALTEF,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC-" w TURE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES 7HE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE UW(CHAP7ER B(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PRO- � POOVSpB � FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� U TION,ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO Z Re-Roof A qVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLLARS(f500)J: Z ❑I,ASOWNEROFTHEPROPERN,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrtIrt18fC181 - WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.704�,BU51� J N NESS AND PROFESSIONS CODE:THE CAN7qAC70R5 LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTY VhiO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR 2 THROUGH HIS OR HER OWN EMPIOVEES,PFOVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m 0 OFFEREDFORSPLE.IF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE 7HE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMP{iOVE FOR THE PURPOSE OF SALE). W ❑I,ASOWNEROFTHEPROPERTV,AMEXCLUSIVELVCONTRACTINGWITHLICENSEDCANTMCTORS � [[ TO CANSTRUCT THE PRQIECT(SEC.701�,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- VBIUflllOfl ADJ.AREA W CENSEIAWDOESNOTAPPLYTOANOWNEROFAPROPERTVWHOBUILDSORIMPHOVE57HEHEON,AND � WHOCANTRACTSFORSUCMPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY ESCRIPTION FEE 70RS LICENSE LAW.). � p/ � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q {L{�I.(��S JWIT�NI4I N'y11�7• � � . T� / TuJ��. � DA7E OWNER � Z w � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERJURV 7HA71 AM LICENSED UNDER PROVISIONS OF CHAPTER � t� �� d 9(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PROFESSIONS CODE,AND `X MY LICENSE IS IN FULL FORCE AND EFFECT. /� n/� � UCENSE CLASS LIC.NO. V v V �Y�/ � � � � �O � ~ DATE CONTRACTOR a � W � _ . � WORKERS'COMPENSATION DECLA N � C� J � I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DECLARA710N5: Z D T � I HAVE ANO WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORNERS' _ �,' Z CAMPENSATION,AS PROVIDED BY SEC710N 370o OF THE LABOR CODE,FOR THE PERFORMANCE w ¢ OFTHE WORK FOR WHICH THIS PEHMIT IS ISSUED. � � � w _I HAVE AND WILLMAINTAIN WORKERS'COMPENSATION INSURANCE.AS REOUIRED BV SECTION \ Q 37000FTHE LABOR CODE,FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT 15 �G . V ISSUED.MY WORKERS'C�AM�PtEN�ATION INSURANCE CARRIER AND POLICV NUMBER AR,E.:I� CONSTRUCTION J � CARRIER `"� C�I ' I�K/IyS�/B'�Cb� W� PLAN REVIEW Z POLICV NUMBEfi �AJ O /y ? N Ly � � --�-F F� � � ELECTRIC � ¢ � (fHISSEClKXJNEmNOTBE00MPLEfEDOFTHEPERMfTISFORONEHUI�DRED�OILPAS(EtOD)ORLESS). PLUMBING � � Z I CERTIFY THAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL � � C�} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGFEE THAT IF I SHOULD BECOME INSPECTION FEE SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR r ~ CAD ,ISHALLFORTHWITHCOMPLVWITHTHOSEPROVISIONS. ISSUANCE � � , � � �f p DATE; � /�O APPLICANT: � SMIP J �WAFNING:FAILURE TO SECURE WORKERS'COMPENSATION�. GE IS UNLAWFUL,AND S LL BE ENERGY P/C � SUBJECTANEMPLOVERTOCRIMINALPENAL7IESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOF IN J SECTION37080FTHELABORCODE,MTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: • �� Q � CONSTflUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AGENCY � FOR THE PERFORMANCE OFTHE WORK FOR WFIICH THIS PERMIT IS ISSUE�(SEC.30B7,CIV.C.�. Z W � LENDER'S NAME H LENDER'SADDRE55 f � TOTAL FEES {.� � �� ,��. � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORqECT. V � � 3 w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES ANO STATE LAWS RELATING TO BUILDING � CONSTRUC710N,AND HEREBY AU7HORIZE REPRESENTATIVES OF THIS COUNTY70 ENTER UPON 7HE � n�`(� ' � , � ABOVE�MEN710NED PROPERTV FOR INSPECTION PURPOSES. � V 1 Z � COMMENTS �V c/\ � � �✓. L�/ " _ m PERMITTEENAME(PRINT) � 6--i/-OZ Uj SIGNA7UREOFPERMITTE DA7E ' = RECPT.�'O. PAID BY VALIDATION ~ WHITE—Department Co YELLOW—Finance Co PINK—Assessor Co GOLD O�File Co GREEN—A licant's Co PY. PY. PY� PY, PP PY �- . .-- -. ._. - --- - � - � - - — - - --- � . ., - .. j . . . . . , ..� , _ . . .. .. � . ... . . . . , ��u� �S t�/u��L�� /r�Slw �U�'�If�L��r:l ��U�1 U`ll�� _ .,,.--.�. �.,-�.v�^�—r--a�,a. ;...g'+�^�, � .--'�'_'—. . -.. .- 0 � �� DQ� Oa�G�C, :�Q .3 OC��[°�L,�-C� �Y`� [�C� : SET BACK �!— FLOOR JOIST ; I��._"-- - - ------- -- FTGSlFORMS/STEEL ' FHA REQMTS � l � � _�� :_.____ ___ .___.__..____.__ ELECTRIC GROUND � UNDER FL�C�R DUCT � ___ __ ---------;--.__. --- _�----- ---___ _. j __.___ � __________ GROUND PLUMBWG �__ _ ' UNDER �'LOOR GC�"��L�UIT_ � ; ---,-�t� ,. --- _ _--- � --._ . _ _ _ SLAB GRADE '� �-- FIREPLACE FOUf�DATION __ TEMP POWER : FIREPLACE BOhJD SEAM ___ -- WATER SERVICE A_____�_._____ � ti91D HT. BOND BEAM ---- ---- ----� _. ROOF SHEATHIPVG � 8 �• ��N� �F�M -- ---- — .---_� _ _ .____ ___ __._.__.�___ --_ _._.. FRAMING/VENTILIATION q,s.mtr. �._ I FINAL BOND BEAM - � — - - --... ___ _. � __.._ —_. ROOF COVER PRE-GRADING i •�� __ ROUGH HE,4TING q,s,py� BENCNING — ROUGH ELECTRIC � ROUGH GRADING 4�5��-�- --- - __ .__ ----------- --___---- ROUGH PLUMBING C�,.��; FINI�H i�FiADINC� - — ------ --1 -------.. __ ___... _____.---__ _.__ _----__.. SHOWER/TUBTEST __ � I POOLELECTRIC _____ _ EXT. LATH/SIDWG i�`_ � POOL FENCING _ WALL INSULATION ; . � POOL FINAI _ , - - -— - ----- CEILING IN�ULATION ! � D�L � QFF SITE IMPS. � ' _— _�__ _ . __._._ _.._..___. � __ _ --�--- DRYWALL NAILING �� -� DED3CAl'IONS _. . ---- - - — SEWER -- --- FINAL ENG. __--�--- SEPTIC TANK LANDSCAPE/IRRiG. ' SEEP PITlL.L. ON SITE IMPS. -• � ---- ----- --- GAS AIR TEST �I FINAI..ZONING �.--- - ------ — ---__.__--- FINAL CONST. � �� __�_� , i� �=!RE DEP7. FINA"_- ---- FINAL HEATING >� � —� r HEALl"H DEPT. FINA� FINAL ELECTRIC �, � � DEV_f=_EES PAID _ FIfJAL PLUMBIf�G I , �NERGY ! 1 v �. __ _____-__ -- �� -- —-- _--- ---=-y- 41Q, �'��/�"L._r r I ; f� � �r --- —- — --�------ , ' — � . ��a:,�' I ---- -----1--�- -------- -�-u � -----... CUNiNiEii�-fS _�.2k�oL N� l��', ow�c�2 wq.�r�s `� �c�1-v<,��p,p/�r� �°�-Ws �-- -a evcuzZ�co�i Ou _�_(�� O�C_C�sw ul',��._yUr,`u- �� .....�h:'35__I✓`C___PC�- P_�-.-.,-5-t�--�-��'---- c��=�- � " ° - -�.. Ss�'�� !.h,^'t Co�c-Zt�._��Z- 9�-C'�lA_l.�1�-c�1 -- SEPTIC TANK SIZE SEEP PIT/U SIZE --- — � - --___-- � � — --- � --------______