The URL can be used to link to this page

Home My WebLink About13584 (11)Q O O FE O W Z In CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 (909) 860.3195 Fax (909) 861-3117 PRESS BUILDING PERMIT APPLICATION FIRMLY JOBSITE ADDRESS 4V 6 APN T OWNER ADDRES*&,. CITY ZIP TEL APPL TEL CONTRACTO I IhA f ADORE CITY TEL ARCMNG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE NCENSE UW FOR THE FOLLOWING REASON (SEC, 703 1.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTYWHICHREQUW-SAPERMTTMCONS M=.ALTERIMPROVE-DEMOUSKORREPAIRANY STAt1G TURF PRIOR TO TES ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LF CENSE UW (CHAPTER f (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION.ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO ACMLPENALTY OF NOTMORE THAN FIVE HUNDRED DOLLARS (Ss00).g D LAS OWNER OF THE PROPERTY.OR MY EMPLOYEES WITH WAGESAS THEIR SOLE COMPENSATION, WILL DO THE WORIL AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7011, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF PROPERTY WTIO BUILDS OR YPROVESTHEREON. AND VAIO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH NIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT MENDED OR OFFERED FOR SALE IF, HOWEVER. THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONEYFAROF COMPLE- TION, THE OWNER BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O L AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEG 7011. BUSINESS AND PROFESSIONS CODE'. THE CONTRACTORS LI- CENSE LAW DOES NOTAPPLY TO AN OWNER OF A PROPERTY WHO BUSDS OR IMPROVES THEREON. AND WHOCONTRACTS FOR SUCH PROJECTS WRHACOMRACTOR(S) LICENSED PURSUAfTTO THE CONTRAC- TORS LOCENSE LAW.). O IAM EXEMPTUNDER SEC. B. t P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9(COMMENCNG WITH SECT 7000) OF DIVISION S OF T BUSINESS AND PROFESSIONS CODE. AND MY LICENSE O N FULL FW EFFECT. JY]` LICENSE CUSS LIC. NO. 6 DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I (NAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENTTO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 5700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE, AS REWIRED BY SECTION 5700 OF THE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR WHICH H THIS PERMIT IS ISSUED. MY WOPo(CAS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER POLICY NUMBER (m mcncN NEEDNOT BrCOM LEITDOFTTE PERMIT IS FORONE MCRCDDCLIARS (SIG7) ORLESSI. I CERTIFY THAT INTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOYANY PERSON N ANY MANNER SOAS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS COMPENSATION PROVISIONS OF SECTION 5700 OF THE LABOR CODE. I SMALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE APPLICANT. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIM NAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (SI00.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN i SECTION 5700 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEG 31 O). i LENDER'S NAME LENDER'S ADDRESS I (CERTIFY THAT( HAVE THIS PLICATION AND STATE THATTHE FORMATION IS CORRECT, I ACREEM WAIPLY HALL ANO IXXINTYORDINANCESANO WS REUTWO T08UlDIN s CONSTRUCTION, HERE AUTHORISE RFPRESEMATIVES O USC M S RELATI $ N I ABOVE -MEM TY FOR INSPECTION PURPOSES S/ z� i � P ITTEE NAME (P 1 C 7 SIGNATURE OF PERMITTEE DATE ~ WHITE --Department Copy. YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN—Applicant's Copy APPLICATION PERMIT P/C DATE NUMBER N 1� _L_ ISSUE -:Z, TYPE OCC DATE II CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDEISIDESTREET RW ❑ SIDE ❑ PROPOSEDUSE NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ.AREANALUATION SFFVADDIREM (n GaraoefCarport W Patio/Dock LL POOVSpa 0 Z Re -Roof Commercial - m Valuation 1 ADJ.AREA OUANTITY DESCRIPTION FEE 4 U (L I— U J W 2 m J a U 2 Q 2 U W (a Ir Od CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL ` - 1 ✓ INSPECTION FEE ISSUANCE • •LY r' 1� Ja �, SMIP d ENERGY PIC ENERGY PERMIT -1 ») I ! `I T ' �' '" •� - A, RETENTION FEE: PRE -ALT FEE: 'IDLJ TOTAL FE S COMMENTS RECPT. NO. PAID BY VALIDATION CITY OF DIAMOND EAR INSPECTION RECORD I'�-�.��.��a�c��...�i�..�..:.�_r�'� 5ET BACK �� E1w.E-�.�.�� e�� l�E-y.��►`G� oy.p� � FLOOR J015T 11�i±��a��i , FTGS/FORMS/STEEL -, FHA REQMTS t t' ELECTRIC GROUND _ UNDER FLOOR DUCT_. ? I, 'GROUND PLUMBING UNDER F'Lt)6WkNDUI_T •` r .' r . ! — ! •' SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE ROOF SHEATHING., .. _ MID HT�BONRBEAM ,_ �� ': ! ..i' 8 FT. BOND BEAM` FRAMING/VENZ'ILIAT6 ' i _' FINAL BOND BEAM ROOF COVER 4 PRE-GRA150G ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING - - - FINISH GRADING SHOWER.ITUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING V,IALL INSULATION - - POOL FINAL i CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEVdER FINAL'ENG. SEPTIC TANK } , ., LANDSCAPE/IRRIG. SEEP PIT/L.L. :-; Jr'; ; ' ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FiNAL HEATING _ FIRE DEPT. FINAL HEALTH DEPT. FINAL ,FINAL ELECTRIC DEV. FEES PAID I-t;.AL PLUMBING ENERGY (�01,.IUEN_TS j1 I I r r. SEPTIC TANK SIZE SEEP PIT/U SIZE