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Home My WebLink About17201 (25) � � CITY OF DIAMOND BAR _ � ��[) -�----��` --- DEPARTMENT OF COIvIIvIUNTTY&DEVELOPMENT SERVICES ''I ' 21825 E.Copley Drive JUIW��1��Q�1 - (909)860-3195 Fax(909)861-3117 PRESS '"��"�2��45 La�IT�i�PERMIT APPLICATION FIRMLY � JOBSITE� 1 APPLICATION `�, l PERMIT f�l P/C o ADDRESS=�LAUrQ�I��If� Qr•) diamondba� DATE ��y L��1 NUMBER� # � ISSUE TYPE OCC APN L LOT TRACT DATE CONST. GROUP p OWNER 0 o ADDR�SS O O � ZONING SETBACKS Z CITY I� ZIP r7 TEL. FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW ❑ z ¢ CONTRACTOR KC 0 GO C U SIDE ❑ ADDRESS U O � ciTv Wa1hN ZIPa��gg TEL�o - -��1 PROPOSED USE -��A�f p�- ��{�� o ARCH/ENG/ Vdh C�YhD• �z DESIGNER NO.DWEL. N�-' NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM EXEMPT FROM THE CANTRACTORS LI- G3f29B/C2fpOA W CENSELAWFORTHEFOILOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITVOR (f� U COUNTYNMICHHEOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- w TURE,PFIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHAPTER 6(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB FESSIONSCODEJORTHATHEORSHEISExEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� (� �_�TION.ANVVIOUTIONOFSECTION7031.5BYANYAPPUCANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Root A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500).): Z ❑I,ASONMEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COmm0fCi01 - WILI DO THE WOFK,AND THE STRUCTURE IS NOT INTEN�ED OR OFFERED FOR SALE(SEC.7ad,BUSI- J � NESS AND PROFESSIONS CADE:THE CANTRAC70RS LICENSE LAW DOES NOT APPLY 70 AN OWNER OF � , PROPERTY WHO BUILDS OR IMPROVES h1EREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m QOFFEREDFORSPLEIF,HOWEVER7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR TME PURPOSE OF SALE). w ❑I,AS OWNER OF THE PROPERlY,AM EXCLUSIVELY CONTRACTING WITH IICENSED CONTRACTOflS � TO CANSTRUCT THE PRQIECT(SEC.7014,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V8IU0IIOf1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � NMOCANTRACTSFORSUCHPFiOJECTSWITHACON7RAC70R�S)LICENSEDPUHSUAN770THECAN7RAG OUANTITY DESCRIPTION FEE Y TOFS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. 8.6 P.C.FOR THIS REASON Q � U � � DATE OWNER U Z W � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERJURY THA71 AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(COMMENCING WITH SECTION 7ooa)OF DIVISION 30F THE BUSINESSAND PROFESSIONS CODE,AND Z MY LICENSE IS IN FULL FORCE AND EFFECT. ��j/�u m � LICENSE CLASS�L�w�'�''/-1 1�)I� LIC.NO. �� /_ � I U DATE I�� CONTRACTOR G G�O CAN a � W i � WORKERS'COMPENSATION DECLARATION Q 'I = U � I HEREBV AFFIRM UNDER PENAL7Y OF PERIURV ONE OF THE FOLLOWING DECLARA710N5: Z � � I HAVE AND WILL MAMTAIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOR WORNERS' _ COMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE.FOR THE PERFORMANCE U Q F THE WORK FOR WHICH THIS PERMIT IS ISSUED. � _ � i w I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION ^v. /� Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS j� �� \ ISSUED.MY WORKER��`�/�M(�jE'NSATI N INSyU�R1�NCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION v � l/�*J j CARRIER �1��1Q ��IV PLAN REVIEW � ZPOLICY NUMBER�1��'S ELECTRIC Q � (�FiI55ECi1(XJNEmNOTBEOJMPLEfEDOFT1iEPERMfTISFORONEHUPDREDD011ARS(f100)ORLESS). PLUMBING ' W _��_...-�-�,_��.._...___. Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH IS P MIT IS ISSUED,I MECHANICAL /1 �t � 1 I ' ' � (,'} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO E SUB CT TO THE � � /�'"�� 1 ! � �-'-�;�-' � WORKERS'COMPENSATIONLAWSOFCALIFORNIA,AN AG ET IFISH ULDBECOME INSPECTIONFEE � ' � = SUBJECTTO THE WORNERS'COMP PROVIS N OF SE TION 770o F TNE LABOF A CODE,1 SHALL FORTHWITH COMPLV WI H TH E PR VI ONS. ISSUANCE A AT (1 �C�117 l� O V V �� p DATE:�n",�_ APPLICANT: • SMIP ^ JENERGY P/C / 1� /1 WARNING:FAILURE TO SECURE WORKERS' PENSATION CAVERAGE IS UNLAWFUL,A HALL BE � SUBJECTANEMPLOYERTOCRIMINALPENAL7IESANDCIVILFINESUPTOONEHUNDRED USAND ENERGYPERMIT ,r'-t�T' _ -- DOLLARS(f100.000�,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN ��- � SECTION370BOFTHELABORCODE.INTEFEST,ANDATfORNEY'SFEES. RETENTIONFEE: ' ^ � ' d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEFiEBV AFFIRM UNDER PENALTY OF PERIURY THAT THERE IS A CONSTRUCTION LENDING AGENCY � FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,pV.CJ. Z W � LENDER'S NAME H LENDER'SADDRESS � � ICERTIfYTHATIHAVEREADTHISAPPLICATIONANDSTA7E7HAT7FIEABOVEINFORMA710NI5COFREC7. TOTAL FEES 1 1�� w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � � CONSTRUCTION,AND HEREBV AUTHORIZE RE ESENTATIVES OF 7NIS COUNTYTO ENTER UPON THE � ZABOVE-MEN710NED PROPERTY FOR INSPEC O URPOSES. COMMENTS � h� � ¢ PERMI EE NAME IN / �, u - o � SIGNAT RE PERMITT DA7 = RECPT.NO. PAID BY VALIDATION ~ WHITE—De rtment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GAEEN—Applicant's Copy ) , . . . .. .. .. . . ,.:)va'ir�H J:�i'I�.�, . i.. .. . L• . •. . . . .. . . . . • . � � ��`�'�,P �[� �DQ�fll C�1�9L� (��f� � o��c�u o�� C� Do Q t� �G��=,�!r� �� , �GQU`� �.�� a ' �t _ _ _ �. SET BACK FLOOR JC�IS1'' , �-- I----- --- —_--- . __ _..._-- FTGS/FORMS/STEEL � I FHA RE�MTS _ ELECTRIC GROUND � UNDER FLOOR DUCT � GROUND PLUMBING ~ UNDER FLOOR CU�IDUIT ; • SLAB GRADE _ FIREPLACE FOUNDATION � _ TEMP POWER - FIREPLACE BOND BEAM ' _-- ' ---- -. —.--..._ —.____l____.__ _ _.._ WATER SERVICE __ _ __ � MID HT. BOND BEAM � � _._ ....--�------_._ - � ---- ROOF SHEATHING �`G—OZ 8 FT. BONd BEAM � _ FRAMING/VENTILIATION FINA�BOND BEAIUI ROOF COVER PRE-GRADING :, ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRADING -- -- --.........__ --_ _ _......._._.__. ROUGH PLUMBING � , FINISH uRAC�1NG ------ -.....__ --_ --- ----_ __--- SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL Ii�SULATION POOL FINAL CEILIf�G IN�ULATION �FF SITE IMPS. QRYWALL iVAILING DEDICATIONS SEWER FINAL ENG. � ; ---- --- SEPTIC TANK LANDSCAPE/IRRIG. �— ^� SEEP PIT/L.�. ON SITE iMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINA� FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID -- -------- � _... FINAL PLUMBING ENERGY _ �— � ��o � GQ��5 — SEPTIC TAhIK SIZE SEEP PIT/U SIZE - J� — - --.._._.____ '� � -- o � , � � _______