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Home My WebLink About13368 _!� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES _ � 21660 E.Copley Drive Suite 190 (909)860-3195 Faz(909)861-3117 PRESS �'�� BUILDING PERMIT APPLICATION , FIRMLY } JOBSITE n_^�D r A nA Z � -- APPLICATIO" g�.l / ^ � NUMBER ✓1 3(��#lC ! �i o ADDRESS �U �?� t"K' DATE . issuE � TYPE occ � APIv LOT TRACT DATE CONST GROUP °C OWNER A O � ADDRESS � L/�t - Ll'� � ZONING SETBACKS � CITY ZIP�11I� TEL. FRONT RW ❑ APPLICANT .1 .ry�, �C16,n,�_ TEL. REAR ❑ � Qr SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE��K- � � �N�N�GS (AFIIVUO'W S o CITY ZIP TEL. ,�� s• wo ARCWENG/ aDESIGNER NO.DWEL. NO. NO. ADDR SS d UNITS � STORIES �Z-' BEDROOMS � CITY ZIP TEL • y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O � 1 HEREBY AFFlRM UNDEH PENALTV OF PERNRV THAT I AM EXEMPT FROM 7HE COFl7RACTORS LI- G81HA9/CBfpOR W CENSEUWFORTHEFOLLOWINOREISON(SEC.7031.6BUSINESSANOPROFESSIONSCODE:ANYCIIVOR (n U COUHfYMMICHRC-0UIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH.ORREPAIRANYSTRUC- W Patio/Deck � W TURE,PRqR TO 1T9 ISSUANCE,ALSO REW IRES THE APPLICAHT FOR SUCH PERMIT TO FILE A SIGNED w STATEMEHT THAT ME OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTORS LI- � CENSE UW(CHAPTER G(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PR0. � PooVSpa FESSIOHS CODE)OR T}UT HE OR SHE IS E%EMPT THEREFROM AND THE BA515 FOR 7HE ALLEGED E%EMP• TION.ANY VIOLATION OF SECTION 7m1.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT T0 Z Re-Roof � A CML PENALT/OF NOT MORE THAN FNE HUNDREU DOlURS(S5W).): . � ❑I,ASON?IEROFTHEPROPERTY,ORMYEMPLOVEESWITHWAGESASiHEIRSOLECOMPENSATION, � COff1111BfCi81 . � WILL DO TME YMORI(AND THE STRUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70H,BUSI- J NESS AND PFqFES510N5 CODE:THE CONTMCTORS LICENSE UW DOES NOT APPLY TO AN OWNEH OF � PROPERTYN?IOBURDSORIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR � � TXiqUGH MIS OR HER ONM EMPLOYEES,PROVIDED 7HAT SUCH IMPROVEMENTS AHE NOT INTENDED OR m Q ,OFFERmFORSALEIF,FIOWEVERTMEBUILDINOORIMPROVEMENTISSOIDWITHINONEVEAROFCOMPI.E- Z `TqN,THE OYVNER-0UILDER VALL HAVE THE BURDEN OF VROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THS PURPOSE OF SALE). W ❑I,ASOYVNEROFTHEPROPEHfY,AAIEXCLU5IVELYCONTMCTINOWITILICENSEDCONTMCTORS Q TO CONSTAUCT THE PRQIECT(SEC.7ou,BUSINESS AND PROFESSIONS CODE:THE CON7MCTORS LI- V81U0I1Of1 ADJ.AREA W CENSEUWDOESNOTMPLYTOANOWNEROFAPROPERTYN7108UILDSORIMPROVEShIEREON,AND � 1NIOCOHTMCTSFORSUp1PRO.lECTSWITHACONffUCTOR(S)LICENSEDPURSUANTTOTHECONTRAG pUANTITY DESCRIPTION FEE � � TOqS IJCENSE UW.). 0 O I AM EXEMPT UNDER SEC. B.8 P.Q FOR THIS REASON U I 3 � � DATE ONMER � Z W ly=� ':^�i� � LICENSED CONTRACTORS DECLARATION W '" � I NEREBYAFFIRAI UNDER PENALTV OF PEFUUM THAT I AM LICENSED UNDER VROVISIONS OF CHAPTER � a, 0(COMMENCWO WITH SECTION 7000)OF ONISION 3 OF THE BUSINE55 AND PROFESSIONS CODE.AND Z _ _ . �[ W LICENSE IS IN FULL FORCE AND EFFECT. �p p�/ U { �`J td� ��i � �a� v �� LICENSE CLASS LIC.NO. � � � � (''TTV!��T Al/ittl`+IU.3� DATE CONTRACTOR n- W �;�r�r �-r-r�a� � SAF�TX � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIRM UNDER PEN�LTY OF PER1Uti'/ONE OF THE fOLIAWING DEttARATIONS: Z �� Q � _IHAVEANDWILLM/UNTAINACENTIFlGTEOFCONSENTTOSELF-INSUREF-0RWORKERS' 2 COMPENSATION,AS PROVIDED BY SECTION 770o OF THE 11BOR CODE.FOR THE PERFOHMANCE U Q OF THE WORK FOR NMICH iHIS PERMIT IS ISSUED. � � I HAVE AND WILL MAIMAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION / Q 97000F THE LABOR COOE,FOR TME PERFORMANCE OF THE WORK FOR WNICH THIS PERMIT IS ��[^ /_ j1 ISSUED.MY WORKERS'CONPENSATION INSU{UNCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION �7/� _ 7/�C (�� j �pqiEp PLAN REVIEW 4V l� V-- � POLICV NUMBER ELECTRIC � Q 0 (n�seena+r�IDrqrsem�rmaF7rfaewRr�swt�a�rarnaEooalnRsKiro�oa�ss�. PLUMBING w Z I CERTIFY THAT IN hIE PEHFORMANCE OF 7HE WORK fOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (} SWLLL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATIONUWSOFCALIFORNIA,ANDAGREE7HATIFISHOULDBECOME INSPECTIONFEE S SUBJECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR /� CODE.I SHALL FOHTHWIhI COMPLV WITH THOSE PROVISIONS. ISSUANCE r i � - SMIP �. � � p DAiE: � APRICANT: . � ENERGY P/C J WARNINO:FAILURE TO SECURE WORKERS'CAMPENSATION COVERAGE IS UNUWFUL,AND SHALL BE � SU&IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED hiOUSAND ENERGY PERMIT DOLLARS(S7oo.000).IN ADDITON TO7HE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN /� J SECTION 37oe OF THE LABOR CODE,INTERES7,AND ATTORNENS FEES. R�ENTION FEE: �/ Q d CONSTRUCTION LENDING AGENCY PR LT FEE: � � 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THEHE IS ACANSTRUCTION LENDING AGENCV �i FOR hIE PERFORMANCE OF THE WORK FOR WMICH THIS PERMIT IS ISSUED(SEC.30v7,CIK C.). Z W � LENDER'S NAME � F- LENDERSADDRESS � I CERTIFV iHAT I HAVE READ TNIS MPLICATION AND STATE 7HAT hIE ABOVE INFORMATION IS CARRECT. TOTAL FE ES � I AGREE TO COMPLY N7TH ALL CRY AND COUNTV ORDINANCES AND STATE UWS REUTMG TO BUILDINO CONSTRUCfION,AND HEREBV AUTHORIZE REPRESENTATIVES OF 7HIS COUNTV TO ENTER UPON THE ZABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. � COMMENTS ' 0 � m PERMITTEE NAME(PRI a �� SIONANREOFP E DAT � RECPT.NO. PAID BY � VALIDATION WHITE—Depertment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanPs Copy . . . , . . . . , . . . - K r ,,, , , ., . . . � . . . . • „ .. . , . CIT�f OF DiAMOI�ID BAR I�1S�EC1'ION 13ECOF3D � � �m° � � � ��, . . �� m � � � � � . � . ��?ky� � e � SET BACK . • �• �. �`�' FIOOR JOIST � 't � ,."; ! ,�, � ., �� FTGS/FORMSlSTEEL • �„ � :', FHA REQMTS � ELECTRIC GROUND ' • � � UNDER FLOOR DUGT � �., , .,.�.., , ., ,,;;;� GROUND PLUMBING � UNDER FLOOR CU�IDUIT '`�-.� '� :� � •:"+; :►��- >�;; � SLAB GRADE FIREP A E.FQUN ATION `--� - '•-`' �`� TEMP POWER FIREPL'A E�BOND`�EAM �'''��_' ` ' j f�` '` WATER SERVICE , MID HT. BOND BEAM - ROOF 5'HEAT,Hr►�G''... � ,"V; � � � , `..;•'. 8 FT. B�ND BEAM . . � FRAMINGNENTILIATION � � FINAL BOND BEAM., . ,,�,. , ,,, ,, • � ROOFCOVER - -1 PRE-GRADIN��•;� �J �::r�� .�� '. ;:,l ,�, �.',;,,;`<:`.,, ROUGH HEATWG ' BENC(��M1�Ci;_.;�.:.L�.�t,:� -- ` ,:; .�°..i'•<;<��'ti�;i; ROUGH ELECTRIC ROUGH GRADING ROUGH PLUIVIBING FINISH GRADING SHOWER/TUB TEST � POOL ELECTRlC � EXT. LATH/SIDING POOL FENCING WALL INSULATION POOC FINAL CEILING INSULATION OFF SITE IMPS. � DRYWALL NAILING DEDICATIONS '_ SEWER FINAL ENG. SEPTIC TANK _ _ ._,, LANDSCAPE/IRRIG. � SEEP PIT/�.L. - � — �~� ON SITE IMPS. GAS AIR TEST FiNAL ZONING FINAL CONST. Q, � FIRE QEPT. FINAL FINAL HEATING HEAL7H DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FIiVAL PLUMBING ENERGY , � � ,�� '�"n'� . - o�.:';.�,. ,.�'?<"-+a� COfViMEfVTS � . , . � , _ _ . _ . � ; SERTIC TANK SIZE SEEP PIT/U SIZE , , .�, , � � _ � �, _ � ��'�� i�a,�b��°�� _ K / �f � ��1�i� ��re ��1 . . (p� .� ��,� �� a^ . i r�r�6��`£ ��`� 6'ft � "`"s� ��€u ��E� � � ;'k� b,'�`-�s� p u�^ t�, �` r r'. lt '�. j7 .� b ^s 4 � �� • ' . s � �. ' ; �'�� ,� ,� ��: �. . � —�' ' ' � �� s�k ��,�;,� ,��, '�� V' . j� e "�� 52✓g�"L AS � \ \ ��f� �. ��?Y � , � . � _ "� , _ , ♦ , . . � ♦ . Y �` � _ . � 0 .k x �i,