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Home My WebLink About17008 (42)0 2 2 O 0 Lu S �d E2 O O w 0 Lu CIL Ito co Cc O O W U w O U O Z Cn Q W D Z W ¢ w ]C ¢ 0 LL. O Xd W O U W Q; Kn (n Zo Q G W O J Z0 4 Lu Lu Z C7 U) S O W J J l%. J w O ¢ LL Z W H-- 2 Lib a- 0 CDs m a CA 0A". FS ` CITY OF DIAMOND BAR I DEPARTMENT OF COMMUNTIY & DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861-3117 PRESS zr;,� BUILDING PERMIT APPLICATION FIRMLY �I DATE NUMBER r DATE (/ CONST. GROUP ADDRESS 2_`� ADDRESS_ c_.. L FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE ec n e 'O NO. DWEL. NO. NO. UNITS STORIES BEDROOMS APN LOT TRACT OWNER V Vfj ADDRESS CITY ZIP TEL, APPLICANT TEL. CONTRACTOR ' .l C C .l f ADDRESS f Jf1. rlik Z -1.1"I CITY ZIP TC50T TEL20 ARCWE G/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I 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 REQUIRES A PERMITTO CONSTRUCT.ALTER IMPROVE. DEMOLISH. OR REPAIR ANY STRUC. TURE, PRIOR TO ITS ISSUANCE, ALSO REWIRES 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 (COMMENCINO WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO- FESSIONS OR THAT HE OR SHE IS EXEMPT THERE FROM AND THE BASIS FOR INE ALLEGED EXEMP. TION. ANY VIOLATXXN OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (15001): D L AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WILL DO THE WORK. AND THE STRUCTURE! tS 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 On IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH MI5 OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED On OFFERED FOR SALE' IF, HOWEVER THE BUILDING OR IMPROVEMENT I5 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). O OWNER OF THE PROP AM EXCLUSIVELY CONTRACTING TH LICENSED CONTRACTORS ERTLAS OWY WI TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE- THE CONTRACTORS U. To CENSE LAW DOES NOT APPLY TO AN OWT'ER OF A PROPERTY WINO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH VAIN ACONTRACTORS) LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW). O 1 AM EXEMPT UNDER SEC. B. A P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 70001 OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. ' 5 4/` ?- - LICENSE CLASS G .7 /G LIC. NO. ! C7 DATE 17" C 5 - Oft CONTRACTOR C- /f C-i//r_O WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SE1F4NSURE 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 W LL MAWTAIN WORKERS COMPENSATION INSURANCE. AS SECURED BY SEO71014 '700 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: CARRIER POLICY NUMBER (THIS SECTION NEEIINOTBE OGRLETEDOF THE PERN11T ISFOR CI E HJNCIM DOLLARS (SIOC)OR LESS) 1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I SHALL NOT EMPLOY ANY PERSON N ANY MAVNER 50 AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA ANO AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT. WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL BE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (1100.000). N ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVAED FOR IN SECTION 3701 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. CONSTRUCTION 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.). LENDERS NAME PLAN REVIEW LENDER'SADDRESS 1 CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON INC ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. MECHANICAL PERMITTEE NAy SRINtT), INSPECTION F SIGNATL$1r)PERMI7fEC Lj DATE ERMIT APPLICATION8 23d DATE NUMBER ISSUE Zd, TYPE OCC b DATE (/ CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE ec n e 'O NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM (n Garage/Carport WPatio/Deck LL Pool/Spa Z Re -Roof OJ Commercial m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J a U W LU W ' 0 Z m J a a U_ Z a S W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION F SMTP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES 16b , 00 COMMENTSJ41 I' RECPT. NO. _ PAID BY VALIDATION WHITE—Department Copy. YELLOW—Finance Copy, PINK—Assessor Copy. GOLDENROD—File Copy, GREEN—Applicant's Copy !!�� //� , _ C!T'. " OF 0;iI-a1401;�D t 11,!S—PEC.-Al,--)l\' ^+ [.-z o r. D �►YE:j�a^.0 E Ica�'.t ck.,.I - - 1►'(`1C�:<t. rr)Ci: I�`E� •?_ r',:IiIG'I FC SETBACK -------• _I ---- ! ' _ 1 ! FLOOR JOIST : I F`{,1 RF'O'.".-S _.- JDER FLOOR DUCT �_ �• Ui'_ I UNDER FI -COR COP•'DUIT -- FTGS!FORVIS'STEEL —� ELECTRIC GROUND GROUND PLUMBIING SLAG GRADE FIREPLACE FOUi 1D,,,TION_ TEMP POWER I FIREPLACE BO JD BE: WATER SERVICE _I I � _-_-- Ie.IID HT. BOND BEA?: ROOF SHEATHING _-_ I �j -- I 8 FT. 8 ND ,13r:Ai., _I I _ INGENTILIATION FRAP.I'V _ I� B I FINAL BOND BEAT: -- ROOF COVER -- I --- - -- --- -�- -NAL -- --I PRE -GRADING ----- - -- ROUGH HEATING _ 1 I BEE•JCHiNG ROUGH ELECTRIC �- I' I_ ROUGH GRADING ROUGH PLUi.IBING I I Fl.", ISH -:1ADING -- SHOWER/TUB TESTI �- POOL ELECTRIC EXT. LATH!SIDING I — ----1 - - - l POOL FENCING - WALL INSULATION I I POOL FINAL — CEILING INSULATION ! I� OFF SITE IMPS. DRYVIALL MAILING I — , DEDICATIONS SEWER ' I FINAL ENG. SEPTIC TANK L-ANDSCAPE-,'IRRIG. -- I SEEP PIT/L.L. I ON SITE I%,PS. GAS AIR TEST I FINAL ZONING FINAL CONST. I I I FIS RE DEPT. FINA'_ FINAL HEATING FINAL ELECTRIC FINAL PLUMBING _ �j ��I �+ I I HEALTH DEPT. FINAL - I ; DEV. FEES PAID i ENERGY COMMENTS SEPTIC -TANK SIZE SEEP PIT/U SIZE ,: J ---