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Home My WebLink About18971 _ �?.` _ CTTY OF DIAMOND BAR DEPAR'TMENT OF COMMUNITY 8c DEVELOPIvIENT SERVICES ` -:,,,w� 21825 E.Copley Drive (909)860-3195 Faz(909)861-3117 PRESS .�.'"'"' BUILDING PERMIT APPLICATION FIRMLY y JOBSITE APPLICATION NUMB R�� 02-406 o ADDRESS 22553 Lark Spring Terrace DATE 1Of07/02 � APN t.OT TRACT D TEE � I I (G?��- ONST. GROUP p OWNER Schlanfman o ADDRESS 22553 Lark S I1II Terr ZONING SETBACKS z CITY Diamon 8L Z�p TEL. FRONT RW O � APPLICANT TEL. REAR � zSIDE/SIDE STREET qyy p oCONTRACTOR B ue Haven SIDE ADDRESS 2 lIIe ar � o CIN �tar10 • Z�P 917 iTEL. 9 7. ] PROPOSED USE POOI � Spa o ARCH/ENG/ a DESIGNER a ADDRESS NO.DWEL. NO. NO. v� UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECIARATION SFR/ADDIREM O p 1 HEREBV AFFlRM UNUER PENALTV OF PERtt1RV THAT I AM EXEMPT FROM THE CONTMCTORS LI- G8f9A9/CB�OR W CENSEUWFONTHEFOLLOWINOqEASON(SEC.�o91.5BUSINE55ANDPROFE5310N3CODE:ANYCITYOq (n ZCOUNTVWHICHFiEWIRESAPERMITTOCON3TRUCT,ALTER,IMPROVE,DEMOUSM,ORREPAIRANVSTRUC- W P9110/DBCk w NRE,PPpR TO ITS ISSUANCE,AL50 REIX11RE5 THE APPUCANT FOR SUCH PEIiM1T TO FILE A SIGNED W r� STATEMENT TMqT ME OR SME IS UCENSEO PURSUANT TD TME PROVISIONS OF THE CONTRACTORS�I� � CENSE UW(p1APTER D(WMMENCINO WITH SECTION 1000)OF�IVISION 3 OF THE BUSINESS AN�PRO- � POOVSpB S ZO FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEOEOE%EMP- (� V TION.ANYVIOUTIONOFSECTION7031.58YANYAPPLICANTFORAVERIAITSU&IECTSTHEMVLICANTTO Z Re-Root A CIVIL 7ENALT'OF NOT MORE THAN FNE HUNDRm DOLURS(S5o0)J: 0 ❑I,ASONMEqOFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPEN5A710N, � Commercial Z WILL DO THE WORK,Ml0 THE STRUCTURE IS NOT INTENDED OR OFFERE�FOR SALE�SEC.7001,BU51- J � NESS ANU PROFESSIONS CODE:THE CONTRACTORS LIGENSE LAW DOES NOT�iPLV TO AN OWNER OF ? � PROPEflTVriHOBUILD50FIMPROVESTHEHEON,ANDWHO�OESSUCHWORKHIMSELFORHERSELFOR ' W TMROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS RRE NOT INTENDED OR m � OFFEREDFORS/LLEIF,MOWEYERTF7E6UILDINGORIMPROVEMENTISSOLDWITHINONEYEAROfCOMPLE- � 710N,THE OWNER-BUILDER WILL HAVE 7HE BURDEN OF PROVING THA7 HE OR SME DID NOT BUILD OH � IMVROVEFORTHEPURPoSEOFSALE). w ❑I,ASONMEROFTHEPROPERTV.AME%CWSNELYfANTRACTINOWITHUCENSEDCONTRACTORS � TO CONSTRUCT TNE PROJE:CT(SEC.7ou.9USINESS ANO PROFESSIONS CODE:THE CONTRACTORS LF V81UHflOf1 .�ZS�OOO ADJ.AREA = CENSELAWDOESNOTAVPI_VTOANOWNEROFAPROPERTVWHOBUILDSOHIMPROVESTHEREON,AND � NM1IOCONTMCTSFORSUCHPRQIECTSWITHACqNTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAG pUANTITY DESCRIPTION Y TOqS LICENSE LAWJ. FEE � ❑I AM EXEMPT UNDEFl SEC. B.6 P.C.FOR THIS REASON U w �.� J � � DATE ONMER H Z U � LICENSED CONTRACTORS DECLARATION W � 1 HEREBV AFFIRAI UNDER PF:NALTV OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CMAPTER � `' y� � � 9�COMMENCINOWITHSECTION]OW)OFDIYISION30FTMEBUSINESSANDPROFESSIONSCADE,AND Z "� y J LLI ��ICENSE IS W FULL FOflGE AND EFFECT. m �\.A ! y, 0 LICENSE1CLASS C53 �,�.Na. 618892 � 1 ' V �ATE l� 7 �2 CONTRACTOR C. Brubaker d � � �W � WURKEflS'COMPENSATION DECLARATION Q �� I XEREBYAFFIRM UNDER PENALTY OF PEHJURV ONE OFTHE f-0LLOWWG DECURATIONS: U � � Z O I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENTTO SELF-INSURE FOR WOflNFqS' _ Q COIAPENSAiION,AS PqOVIDED BY SECTION 3]00 OF THE IABOR CODE,FOR THE PERFORMPNCE U OF THE WORN FOR�NHICH THIS PERMIT IS ISSUE�. W 0 � W _I HAVE AND WILL MAWTAIN WORKERS'CAMPENSATION INSURANCE,AS REDUIRED BY SEC7bN Q 3T00 OF THE LABOR CODE.FOR THE PERFORMANCE OFTHE WORK f-0R WHICH THIS PERMIT IS (� ISSUED.A1V WORKERS'COMPENSATION INSURPNCE CARRIERAND POIICV NUMBERAPE: CONSTRUCTION �O7�ZO j CARRIER Clarendon (� PLAN REVIEW 262.82 ZPOLICYNUMBER_ � 7� ELECTRIC Q � (fHASSECiqNNE��q7BEWMPLETIDOFTHEPERMfTISFORONEFAX�DRmDOLLARS(floo)ORLE55? PLUMBING L.1 t ,�� W � R Z I CERTIiV THAT M TNE PERFORMANCE OF THE WOHK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL ��.:j�v (,'} SHAIL NOT EMPLOY ANY PERSON IN ANV MANNER SOAS TO BECAME SU&IECT TO THE (/� VJORNERS'COMPENSATIONLAWSOFCALIFOfiNIA,ANDAGREETMATIFISHOUL�BECOME INSPECTIONFEE � SU&IECT TO THE WQRKERS'COMiENSATION PROVISIONS OF SECTION 37000F THE LABOR � CADE,ISHALLFOfl7MWITMCOMPLVWITHTHOSEPROVISIONS. ISSUANCE � _1 �_ Carol Brubaker SMIP 2.50y p DATE: lO O7I��pPLICANT� W J WAPNING:FAILURE TO SECURE WORKERS'COMPENSATKKJ GOVERAGE IS UNLAWPIJL,M!D SHi1LL BE ENERGV P/C J � SU&IECT AN EMPLOVER TO GFi1MINAL PENALTIES AND QVIL FINES UP TOONE HUNDRED TMOUSAND ENERGY PERMIT DOlURS(S�oO,oaD),IN ADDITION TO THE COST OF COMPENSATIDN,DAMAGES AS PFOVIDED FOR IN J SECTION 3708 OF THE LABOij CODE,INTEREST,ANDATTORNEV'S FEES. w RETENTION FEE: _ 2.OO O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: HS.00 � 1 HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS�CONSTRUCTION LENDING AGENCY FOfi THE PERFORMANGE OF TME WORK FOH WHICH THIS PERMIT IS ISSUEO(SEC.309],CIV.C.�. Z W � LENDER'SNAME F— LENOER'SADDRESS WICERTIF'lTHATIHAYEREAC�TNISAP LICATIONANOSTATE7HATTMEhBOVEINFORMATIONISCORRECT. TOTAL FEES SPP02-198 �O�OO ��y.J � A� � 1A ETOCOMPLVWITHN.LQTV DCOUNTYORDINIWCESANDSTATElAWSREUTINGTOBUILOING �� TRUGTION,ANOHEREHYAU RREREPRESENTTNESOFTMI$COUNTVTOENTERUPONTHE Z A �E NT NE� HOP FITV NSPECTqN PUR 5�� COMMENTS � �J � � m P ENAMEIPRIM e - � �� j � r Y Vt_ ( � SI TUREOFPERMITTE DATE ' � RECPT.NO. PAID BY VALIDATION WHITE-0epartrnent Copy,VELLOW—Finence Copy,PINK—Assessor Copy,G NRO�FIe Copy,GREEf�ApplicenYs Copy w trG °� ,�a� , y�a�k;� m $.=J-'T �� y . . �' . Y -t�+1 ' ' � $��' �'-.�s;�` �. ,v�r�. -a �- .,� r � e�,��., . . �� .m..�.. � . }m+- q a , .�. �..�. � � � � �i��' '� � ��.� n`, � w. < �..� (.'� � � � � . � � � � � ... �- ; a . J"i � � , �� . �, + y'N �. , . ��i ,... r . '�. . .. . . y .��' , yr•�w... . .. ��. . .*�. n. � , � 1� ._. :s'^r`` .. .. . , .... . , .__ ___ .. . . � ` .. . _ _. ; .. .. .,,y. ... . . : �.�r djl. �,...r� � � �� : s � �� ` � ; �,,,, ; � � �l,/a� � �R.�. . , , _ _ { _ _ . - � __ _ , , �. - �5- t :—�' ;. 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I {' . 1 ni..R . .. . __ .._ . _ . ...- f__. ..... .-v_ _ �_ _ ._...... i i a ' � > $ , „ � �� ; . . . r � � � ; _ — — i � � �� , _ — � __. . __ �e __ _ __ _< 1 _ __ , ._ �,,�. . 1 _ _ —_ � � � - . . _ � _ __ _ _ � � � ,�j F f�2,-,l�"' f,� ��''�'s` a,. �.d'�� _ .-�� '� _ r _ .. __._ , � �� , �' '° � _ ,. . � '`+ _ _ _ _._._..� __ _. _ . ; __ . _ _ _ _ . __ . _ � _ _ __ ; _ --� -{ t ,. ... _. . ..... ....... ..._.. .__. ....... . ....... ...... ...... ..._. .._. .__ . .� �� . . . _.._ _' . � .,- ._i _ ... Q.,.- - _ ' - � _ . , �,. � .' . ...._ _.. ...... _. .. .... .. . .... ..._. ..... ...._ . . .� e � " . ..... ' : , .. .__ . ._.. __.., .. ..._ , � ,� . , � . r .... . � . e � df ��Pp4j2 tl � ��t� , _ _ _ _ _ __._.. � F �� ,,� � __ I � j 1 �� ... _.. . i � � i �� _ _ _ _ _. ._.. . .. ... .. ._. R r � � _ _. �_ .. _ .._ _. � __ .-- — - - 4 �, ( . � � � �. �. _... ..._. � � r .___ ..... ._.. ..... ..... _.__. . ._... . 7 � .. ._... . ..._. t i � DIAMOND LIAR i JOBSITE ADDRESS 22553 Lark Spring Terrace APN LOT TRACT OWNER Schlanfman ADDRESS 22553 Lark Spring Terr CITY Diamon ar ZIP TEL. APPLICANT TEL. CONTRACTOR Blue Haven ADDRESS 2318 Vineyard CITY Ontario ZIP 91761TEL. 947.6474 ARCFUENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER-BUILDER DECLARATION )HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE:ANY CITY OR COUNTY WHICH REQUIRESA PERMIT TO CONSTRUCT,ALTER. IMPROVE. DEMOLISH,OR REPAIR ANY STRUC. TURE,PRIOR TO ITS 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 LI- CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 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 A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500).): D I,AS OWNER OF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044. BUSI- NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF,HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF 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). 111.AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044. BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON.AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S)LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). D I AM EXEMPT UNDEFI SEC. B.&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(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND MY LICENSE IS IN FULL FORCE AND EFFECT. C53 618892 LICENSE C LASS LIC. N0. DATE 10 7 02 CONT Brubaker C RACTOR WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: -1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' COMPENSATION,AS PROVIDED BY SECTION 3700 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 REQUIRED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE Clarend on CARRIER POLICY NUMBER 91 (THIS SECTION NERD FIDT BE COMPLETED OFTHE PERMIT IS FOR ONE HUNDRED DOLLARS($100)OR LESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE.I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: 10/07/OZPPLICANT Carol Brubaker WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. CONSTRUCTlON LENDING AGENCY I 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(SEC. 3097,CIV.C.). LENDER'S NAME LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS AP LIGATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I A E TO COMPLY WITH ALL CITY D COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING TRUCTION.AND HEREBY AU RIZE REPRESENT TIVES OF THI COUNTY TO ENTER UPON THE A lE- NT NED ROP FITY NSPECTION PUR S 1 P EN--E(PRINT SI TLIRE OF PERMITTE DATE 0 aF 0 LL w 0 zd. Q 0 rr 0 w U W U CU) LL 0 U w CI) W W C/) H 0 0 w J LL w a- (D w w D Z J CO C/) C/) CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION PRESS FIRMLY APPLICATION PERMIT P/C 10/07/02 DATE NUMBER 02-406 ISSUE � TYPE OCC DATE CONST GROUP ZONING SETBACKS FRONT RW ^ REAR ^ SIDE/SIDE STREET RW ^ SIDE ^ PROPOSED USE POOL& Spa N0. DWEL. N0. N0. UNITS STORIES BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ.AREA/VALUATION SFR/ADD/REM Garage/Carport W Patio/Deck LL PooVSpa 520 0 Z Re-Root Commercial Valuation $25,000 ADJ.AREA QUANTITY DESCRIPTION FEE U lam) k'. J cc w W Z y CL IL Z M CONSTRUCTION 309.20 PLAN REVIEW 262.82 ELECTRIC � PLUMBING LA MECHANICAL �.J 6 INSPECTION FEE ISSUANCE SMIP 2.50 ENERGY P/C ENERGY PERMIT RETENTION FEE: 2.00 PRE-ALT FEE: 85.00 TOTAL FEES SPP02-198 30.00 r-. COMMENTS RECPT. N0. PAID BY VALIDATION WHITE-Department Copy,YELLOW-Finance Copy, PINK-Assessor Copy,G NROD-File Copy,GREEN-Applicant's Copy