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Home My WebLink About13365 �� CITY OF DIAMOND BAR F DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suite 190 �w (909)860-3195 Faz(909)861-3117 PRESS �� BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE APPLICATIONp /�_ G�'C' NUMBER 133�5# � �� ADDRESS �� ` � � DATE 0' � PERMIT P/ ISSUE �-j TYPE OCC � APN LOT TRACT DATE ✓ �� T CONST. GROUP I � OWNER .O•Ar. O p AODRESS � l.N ' ZONING SETBACKS � Z CITY � ZI TEL. FRONT RW ❑ g APPLICANT TEL.�jI�� REAR ❑ SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ � ADDRESS PROPOSEDUSE�#� RQO�l9 .FI�✓I'f'I�G��s �/d((1l�S � CIN ZIP TEL. �.f,�� i w ARCH/ENG/ � z DESIGNER J �� ' OI/A(N �/• W NO.DWEL. NO. 2 NO. a ADDRESS • �� UNITS STORIES BEDROOMS � CITY Cj�til�r +�� ZIP t TE •Z�' 4' � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFlRM UNDER PENAL7Y OF PERNRY THAT I AM E%EMPT FROM THE CONTRACTORS LI- G8ffl9B/C8�1012 W CENSEUWf-0flTHEFOLLOWINGREASON(SEC.7031.58USINESSMIDPROFESSIONSCADE:ANVCITYOR (n U COUMVNMMJIRC-0UIRESAPERMRTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIRANYSTAUC- W P8f10/D9Ck � TURE.PRIOR TO ITS ISSUANCE,ALSO HEW IRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS L�- � CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSpB FESSpNSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMAN�THEBASISFORTHEALIEGEDEXEMP- C7 TION.ANY VIOLATION OF SECTION 7037.5 BV ANYAPPLICANT f-0R A PERMIT SU&lECTS THE APPLICANT TO Z Re-Root � A CML PENALTY OF HOT MORE THAN FNE HUNDRED DOLURS(f5oo).): � � OI.ASOYMEROFTHEPROPERTY,ORMYEMPLOYEESNATHWAGESASTHEIRSOLECOMPENSATION, � COrtIR1BfCl81 -� MALL DO THE WORK AND THE STRUC7URE IS NOT INTENDED OR OFFERED FOR S/�LE(SEC.70a�,BUSI- J � NE55 AND PROFESSION9 CODE:T1E COHTMC70RS LICENSE UW DOES NOT APPLV TO AN OWNER OF � VROPEHTY WMO BUILDS OR IMPROVES h1EREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR CC TNROUGH HIS OR HER ONTI EMPLOVEES,VROVIDED THAT SUCH IMPROVEMEHTS ARE NOT INTENDED OR m � � ,OFFERmFORSALEIF,FqWEVER7MEBUILDINGORIMPROVEMENTISSOLDWfTHINONEYFAROFCOMPLE- Z 'TqN,THE OWNER�UILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BU�LD OR � IMPRDVE FOR THE W RPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERfY,AMEXCLUSIVELVCONTMCTINOWfhILICENSEDCONTRACTORS � TO CONSTRUCT THE PRQlECT(SEC.70H,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81Ufi110f1 ADJ.AREA � W CENSE UW DOES NOTAPPLY TOAN OVMER OFA PROPERTV WF10 BUILDS OR IMPROVES THEREON,AND � WIpCONTRACTSFORSUq1PRQ1ECTSWITHACON�RACTOR(S�LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE � � TORS LICENSE UW.). 0 ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q 3 � ' . � � ; Z DATE OWNER � �-t�� LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRLI UNUER PENALTY Of PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � i(COAIMENCWO NrtTH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z M A W I� �1 AA n �� A/YLICENSE IS IN NLL FORCEAND EFFECL m � ��y� V �J �J�� f''T �. _. � � UCENSECUSS LIC.NO. j � s 1 VS'f��A1��;��g 1D � �, m Q.m._.._ �,.� W DATE CONTRACTOR a ---•,�u.��h.'��L ry� �� i i� � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLAMTIONS: Z � Q � I HAVE AND WILL AIAINTAIN A CERTIFICA7E OF CONSEHT TO SELF-INSURE FOR WOHKERS' 2 � COMPENSATION,AS PROVIDED BV SECTON 3100 OF THE UBOR CODE,FOR THE PERFORMANCE w OF h1E WORK FOR NM1iICH THIS PERMIT IS ISSUED. � 0 W _I HAVE AND WILL MAINiNN WORKERS'COMPENSATION INSURANCE,AS REDUIRED BY SECTION ///---111 �l-� Q 37000F THE LABOR CODE.FOR 7HE PERFORMMICE OF THE WORK WR WHICH hi15 PERMIT IS � � /I / � ISSUED.MY WORNERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION ((/ l/ jc�pqiEp PLAN REVIEW ZD 2 � ra.icrNUMeEA ELECTRIC I 0 �n�ssEerqNr�Nprgeoo�.p�E7IDOF7�pea�,rrsrx�aariEr�o�ooavrs�S�m�oqtFss} PLUMBING Z 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL � (, SHALL NOT EMPLOV ANY PERSON IN ANY MANNER SO AS TO BECAME SU&IECT TO THE � WORKERS'CAMPENSATION UWS OF CALIFORNIA.AND AGREE THAT IF I SHOULO BECAME INSPECTION FEE S SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE UBOR cooE,i sH�u.Foannv�n�coMr�r wini niose Paoviswr+s. ISSUANCE � SMIP �� l� p DATE: APPLICANT: . � ENERGY P/C J WMNINO:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL.AND SHALL BE � SUBJECTAN EMPLOVER TO CRIMINAL PEN/�LTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(f100,000j,IN ADDI710N TO THE COST OF CAMPENSATION,DMIAGES AS PROVIDED FOR IN � SECTION 370B OF h1E LABOR CODE,INTEREST,AND ATTORNEI^S FEES. RETENTION FEE: 6�• f O CONSTRUCTION LENDING AGENCY PRE�LT FEE: Q I HEREBYAFFIHM UNDER PENALTV OF PERIURV THAT THERE IS A CANSTRUCTION LENDING AGENCY .i0 � d FOR iHE PERFORMANCE OF THE WORK FOH WHICH THIS PERMI7IS ISSUED(SEC.3007,CIV.C.). � Z W � LENDER'S NAME F- LENDER'SADDRESS Q ICERTIFVTHATIHAVEREADTHISAPPLICA710NANUSTATETHAT7HEABOVEINFORMATKKJISCARRECL TOTAL FEES W I AGREE TO COMPLY WITH ALL CITY AND COUFlTV OHDINANCES ANO S7ATE UWS REUTING 70 BUILDING � CONSTRUCTION,AND HEREBV AUTFIORIZE REPRESENTATIVES OF THIS CAUNTY TO EMER UPON THE ZABOVE-MEKTIONED PROPEHTY FOR INSPEC7qN PURPOSES. COMMENTS � � � �� _ , m PERMI77EE NAME PR " Q N ^ uJ SIONANRE RM EE � � RECPT.NO. PAID BY �^� VALIDATION � ~ WHITE�epertment Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD--File Capy,GREEN—Applicant's Copy , . , . . . . .. . .. . . �..,.. .., ...i ... , ., tal- , .. . � . , CI� OF DIAMOND BAR s�s��c�reo�v ��co�� 1 .;Q ` 'S'4„'�,:: s � o • � , l � � � � �� _.: . � � � � �� 3�» . ..,, � .. , ,,..�. $.Y�. :.., �.. ._r:�.. .... -: .. SET BACK � . - ' FLOOR JOIST • :+ � - • � -'� . "' ',` `� FTGS/FORMS/STEEL • . .. =� FHA REQMTS ELECTRIC GROUND � ' � 'UNDER FLOOR DUCT ,:ti, , ; , ..;�, ..�,.� _ ..�,. GROUND PI.UMBING UNDER FLOOR COMDUIT '`� = •-:�:�1 �`` � '�' �''`� SLAB GRADE FIREP AGE FOU.ND.. ION �� • � �' � TEMP POWER � FIREP A�� OND BEAM � ' ' ' �"� WATER SERVICE MID HT. BOND BEAM �•RbOF SHE1�T,'lNG^: �t ' ,.,, . ,t .� ,.� .....,- 8 FT. BOND BEAM FRAMINGNENTILIATION y � FINAL BOND BEAM., , ;.�. , .., � .,� . � ROOFCOVER -F-= PRE-GRA{yJDJG '�.-� •, <_,:;�•;.:.;�,•.• _ �, yL.. , ROUGH HEATING � BENC ING•'.�.'':'. `�"� ,=.�;: �'r�.�':�-t f..:;�,'r ROUGH ELECTRIC ROUGH GRADING RDUGH PLUiVIBING FINISH GRADING SH0IN�R/TU8 TEST P(�OL ELECTRIC EXT. LATHlSIDING PQOL FENCING WAL�INSULATION PODL FINAL CEILING WSULATION OFF 51TE IMPS. DRYWALL NAILING DEdICATIONS SEWER FINAL ENG. SEPTIC TAIVK �_. , �,� LANDSCAPE/IRRIG. SEEP PIT/L..L. � ' � , - \�� ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONS7. d .� FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL � FINAC ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY ��e e Q" ..,�" �t�r. . COMfViENTS � �. �a . . .� _ SEFTIC TANK SIZE SEEP PIT/U�SIZE � �{ _ T, s �;� �� '� �� . '� 'ti�} i � � . ;�� x .:ti rv �'`�.� , ,. .� � � •�.•.,i' } . . _ . _ • �;:. ,, . � � �r ! . �y ��" : ` ` � � •�� — � �a� ', d +�,�� a � ,�+s'� .; �— —1•�� .�r4�s:a .'a'�,/�: � ia-_ r � . � . . .. . . . . . . -