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Home My WebLink About17256 (25) � CITY OF DIAMOND BAR . y � �, ------��"--- DEPARTMENT OF CONA�IUMTY&DEVELOPMErI'�R�� . s,:_---,_ ._: � �w Zia2sE.coP�ey��e JU.N 17 2002 (909)860-3195 Fax(909)861-3117 PRESS ��'<"»»�� BUILDING PERMIT APPLICATION JUN 18 2QQ� FIRMLY ' � JOBSITE ,..�n r�� rel r�n r., .� ( � 11 APPLICATION O PERMIT � P/C o ADDRESS V � DATE D I � NUMBER�_ # � ISSUE TYPE OCC APN 8cD LOT TRACT DATE CONST. GROUP °C OWNER � O " ADDRESS O 0 ZONING SETBACKS Z CITY �•Pl ZIP� b� TEL. b FRONT RW ❑ o APPLICANT TEL. SIDE/SIDE STREET RW ❑ z ¢ CONTRACTOR C� SIDE ❑ ADDRESS � � CITY �[�fAlflNt ZIP TEL�� - PROPOSEDUSE �� G�vh�D f��;r��I�Q w ARCH/ENG/ � -�w� �'"� z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � <n DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT I AM E%EMPT FROM 7HE CANTRACTORS LI- G8fd96/C8f�10R W CENSELAWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITVOR (n U COUNTVYhiICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYS7RUC- W P8Si0/DBCk w 7URE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNE� W � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTOHS LI- � � CENSE UW(CHAPTER e(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� POOVSPe � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHElLLEGEDE%EMP- C7 � TION.ANV VIOLATION OF SECTION 7031.5 BV ANYAPPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Root A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5500).): � ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOVEESWI7HWAGESASTHEIRSOLECOMPENSATION, � COffIrtl8fCl21 � � Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7014,BUSI- J N NESS AN�PROFESSIONS CODE:THE CONTNACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO�OES SUCH WORK HIMSELF OR HERSELF OR 2 THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT IN7ENDED OR m QOFFEREDFORSALE.IF,HOWEVER,THEBUIIDMGORIMPROVEMENTIS50LDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER-BUI�DER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w OI.ASOWNEROFTHEPROPERTV.AME%CLUSIVELYCONTRACTINGWITHLICENSEDCANTRACTORS � TO CANSTRUCT THE PRQIECT(SEC.70�4,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� VelUetlOfl ADJ.AREA W CENSEUWDOESNO7APPLYTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND � WHOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(5)UCENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑1 AM EXEMPT UNDER SEC. B.8 P.4 FOR THIS REASON Q �� U � � DATE OWNER v Z W � LICENSED CONTRACTORS DECLARATION W ¢ � I HEREBY AFFIHM UNOER PENALTV OF PEiiJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSIONS CODE,AND Z �X MV LICENSE IS IN FULL FORCE AND EFFEC7. m � UCENSECLASS gl�3�iq h I��,�.No. �o bYb � V DATE Ib)1 II 1 n� CONTRACTOR {C CL. a W � WORKERS'COMPENSATION DECLARATION � Q = U � I HEHEBV AFFIRM UNDER PENALTY OF PE0.IURY ONE OF THE FOLLOWING DECLARATIONS: Z Z _I HAVE AND WIIL MAINTAIN A CERTIFICA7E OF CONSEN770 SELF�INSURE FOR WORKERS' _ COMPENSATION,AS PROVIDED BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMI715ISSUED. � 0 w I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION A /!� Q 3700 OF THE LA80R CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS I��`/. 1 v ISSUED.MY WORK MPENS 7 0N INSU ANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION ;�a( ¢ � PLAN REVIEW � CARRIER Z POUCY NUMBER �J�L�.L��'f ELECTRIC --�----��"' � a �rv7 /'\�I � � (iHISSE(.'f10NNE�NOTBE00lAF'LEfFDOFTiEPERMITISFORONEHUPDREDDOLLNiSK��)�LESS). PLUMBING ' 1� � W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PEfiM1T IS ISSUED,I MECHANICAL C} SHALLNOTEMPLOVANYPERSONINANYMANNERSOASTO S BJEC7TO7HE L N WORKERS'CAMPENSA710NLAWS ORNIA,ANDA ET IF SHOUIDBECOME INS°ECTIONFEE = SUBJECTTOTHEWORKERS'COM ENSATIO PR ISIO OFS TIO 37000FTHELABOR I � COOE,I SHALL FORTHWITH COMPLV ITH T OS ROV IONS. ISSUANCE � � I__.... � DATE: a O APPLICANT SMIP W � ��y.��--_�.�'__ J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLA UL,AND SHAIL BE ENERGY P/C ��---- J � SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUP700NEH DREDTHOUSAND ENERGYPERMIT DOLLARS(f100.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATfORNEV'S FEES. RETENTION FEE: I� � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBVAFFIRM UNDER PENALTY OF PEf1JURY THATTHERE IS A CONSTRUCTION LENDING AGENCY n- FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMI7 15 15SUED(SEC.3097,CIV.CJ. Z W � LENDER'S NAME F-- LENDER'SADDFESS ^ � ICEfiTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETFIATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES �/_�• �� w I AGREE TO COMPLV WITH AlL CITV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OFTHIS COUNTY TO ENTER UPON THE � ABOVE-MENTIONE�PiiOPERTV FOR INSPEC710N PURPOSES. Z ��N COMMENTS � a n _ ¢ PE EE NA E(PR T) �D I� V I � � � SIGNA RE E I DATE ` = RECPT.NO. PAID BY �a VALIDATION ~ WHI —Department Copy,YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN—A licant's Co PY. PY, PY, PP PY . .. . . . .. . . . . .��..�.. ..nl . . . .i."�'Q�Yr` �.. . . .. . . • J. - ` ' . ' .. .. . . .. � `bYY� II �� 1rllU�I1�U V� �YY�Y r IfYV�Y l�a\l 11 ��Y V U 11�\'t`dU V� ��1�G�G�O� DD Q`t� �� r� �� U � �Q4� 0� p o SET BACK ! ,' � FLOOR JOIST �;' ' -z-� ----- --_._ -__ � FT'GS/FORMS/STEE� � ;. FHA RECZMTS —� -- --;..___ _..----- -_.�---------._..____ �_ ELECTRIC GROUND ' UNDER FLOQR DUCT --- ---- --- -----,- - ---- ----_____ : ;_ � ___._._� GROUND PLUMBING � UNDER FLOOR C��DUIT � � ` — � --- --- - .^ . _ _____---�—_ _. _ SLAB GRAQE FIREPLACE FdUNDATION __�_ � • _ TEMP POWER � FIREPLACE BOND BEAM _ W,4TER SERVICE MID HT. BOND BEAM � ' ROOF SHEATHING 8 Ff. BOND BE;��1 . i , . , -- FRAiVIINGNENTILIATION FINAL BOPJD BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING --- ------- --- -----.....__ --- ROUGH PLUN16lNG i FINISH GRADING SH.OWER�fU6 TEST j POOL ELECTRiC _ _� EXT. LATH/SIDING POOI.FENCING WALL.IfVSULATION POOL FINAL j CEILIf�G INBULATION OFF SITE IMPS. DRY1�/ALL NAILItVG DEDIC,4TIONS SEWER FIiVAL ENG. SEPTIC TANK . LANDSCAPE/IRRIG. SEEP PIT/L.L. ' aN SITE IMPS. GAS AIR TEST FINAL ZOiVING FINAL CONST. FIRE DEPT. FINAL ^ ---��'"-'-'-___._ FINAL HEATING HEALTH dEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FIfVAL PLUMBING ENERGY C�G�i Of�OC�o f . CO�/i�il ENl"S _� '� , SEPTIC TANK SIZE SEEP PIT/U SIZE -- � � � �. � ' , � , , —__-----