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Home My WebLink About18297� - CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT ;,._ 21660 E.Copley Drive Suite 190 PRESS � (909)860-3195 Fax(909)861-3117 � '�"'� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE lgiz u-AN► �tG ��c ��Z, DATECATION � ��UMB R�� #/CO�� ADDRESS =-° APN gOT�� TRACT 1�D�I� DA EE � �� ONST. GROUP p OWNER o ADD ESF� S ZONING SETBACKS oCITY,��ptN ZIP TEL. FFIONT RW ❑ APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW p z a CONTRACTOR SIDE ❑ � ADDRESS L �— PROPOSED USE�� P °�ff ' � CITY ZIP TEL. w ARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. cn cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT I AM E%EMPT FROM THE CONTRAC70F5 LI- Gef8J6/CBfPOff W CENSELAWFORTHEFOLLOWINGREASON(SEC.7037.SBUSINESSANDPROFESSIONSCADE:ANYCITYOR (n U COUNTVWHICHREOUIRESAPERMIT70CANS7RUCT,ALTEFi,IMPROVE,OEMOLISH,ORREPAIRANYSTRUC- W Patio/Deck W TURE,PRIOR TO I75 ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUAN7 TO THE PROVISIONS OF 7HE CANTRACTORS LI� � � CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSpB FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALIEGEDEXEMP- (� � TION.ANY VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Root A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500).): � OI,ASOWNEROFTHEPROPER7Y,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, � Commercial Z WILL DO THE WORK,AND 7HE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70/a,BUSI- J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NO7 APPLV 70 AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES 7HEREON,AND WHO DOES SUCH WORN HIMSELF OR HERSELf OR � THROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTIN7ENDEDOR m � QOFFEREDFORSALEIF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYFAROFCOMPLE- Z TION,7H WNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROV OR THE PURPOSE OF SALE). _ w ASOWNEROFTHEPFOPERTV,AMEXCLUSIVELVCON7RAC71NGWITHUCENSEDCAN7RACTORS � � TO CANSTRUCT THE PRQIECT(SEC.7od�,BUSINESS AND PROFESSIONS CADE:THE CANTRACTORS LI- ValUOI1011 ADJ.AREA W CENSE LAW DOES NO7APPLY 70 AN OVMER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTfiACTSFORSUCHPRQIECTSWITHACANTRACTOR(S�LICENSEDPURSUANTTOTFIECONTRAC- QUANTITY ESCRIPTION � FEE Y 70RSUCENSELAW.). � J � ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � � U lL � DATE OWNER � Z W � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDEH PROVISIONS OF CHAPTER � d 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z �X MY LICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CLASS LIC.NO. j � � J V DATE CONTRACTOR a . W � WORKERS'COMPENSATION DECLARATION a � I HEREBV AFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWING DECURATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT 70 SELF-INSURE FOR WORKERS' _ COMPENSA710N,ASPFOVIDEDBVSEC710N370oOFTHELABOHCADE,FORTHEPERFORMANCE U ¢ OF 7HE WORK FOR WHICH 7HIS PERMIT IS ISSUED. � � w _I HAVE AND WI�L MAMTAIN WOFiKERS'CAMPENSATION INSURANCE,AS REQUIRED BV SECTION /� Q 370o OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK WR WHICH THIS PERMIT IS V ISSUED.MY WORKEFiS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION Q � CARRIER PLAN REVIEW ZPOLICY NUMBER ELECTRIC Q � (IHISSECTIONNEmNOTBE00MPLEfEDOFhIEPEM4�ISFOFiONEHUI�DREDDOILARS(5100)ORLESS). PLUMBING Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL � L} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE � WORKERS'COMPENSATION UWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE = SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR ' CADE,I SHALL FORTHWITH COMPLV WI7H THOSE PROVISIONS. �SSUANCE O � SMIP p DATE: APPLICANT. J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL.AND SHALL BE ENERGY P/C � SUBJECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(S7o0.o00).IN ADDITION TO THE COST OF COMPENSA710N,DMIAGES AS PROVIDED FOR IN J SEC710N 37oB OF THE LABOR CODE,INTERE57,AND A770fiNEV'S FEES. RETENTION FEE: � CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � O � I HEREBY AFFIRM UNDER PENAL7Y OF PERJURV THAT THERE IS A CONSTRUC710N LENDING AGENCV n- FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS ISSUED(SEC.3097,CIV.C.). �� ^ ./� W �� LENDER'S NAME � � F= LENDER'SADDRESS � � TOTAL FEES 'S5 � •g'C�� I CERTIFY THAT 1 HAVE READ THIS APPIICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. w I AGREE TO COMPLV WITH ALl CIN AND CAUNTY ORDINANCES AND STATE LAWS REIATING TO BUILDING ��0�(' � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESEN7A71VE5 OF THIS COUNTV TO ENTER UPON THE ZABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS j � ��S�i��(/4.� Qe J ¢ PERMI+✓! E ri`�' '^ � f � OY' V _D��\._ , � 1�) f/) � SIG ATUREOFPERMIT7EE ATE = RECPT.N0. PAID BY VALIDATION ~ WHITE—De artment Copy,YELLOW—Finance Co PINK—Assessor Copy,GOLDENRO�File Co GREEN—A licant's Co P PY, PY, PP PY � ��• b V �� G ��l��il�l�� (�QI� : Of��f�C�C�1��(�I I�iC�(��f�� ° o o ` f� � ' t3o . . OG�� : � ` , � � � e " . e.. . F.� .. ._ __ _ SET BACK � ,,. FLOOR JOIST FTGS/FORMS/STEEL -�y�taz - ' i FHA REQMTS � - ELECTRIC GROUND �j_�,q-c� • - � UNDER FLOOR DUCT ' -- '� GROUND PLUMBING �g_�- � UNDER FLOOR CU�IDUIT _ . SLABGRADE � FIREPLACE.FOUNDATION - - � - � -� TEMP POWER FIREPLACE BOND BEAM WATEA'SERVICE Mlp HT. BOND BEAM ROOF SHEATHING S Ff. BOND BEAM FRAMINGNENTILIATION FINAL:.BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ' . , ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlrUB TEST � POOL ELECTRIC EXT. LATH/SIDING � PQOL FENCING //:� —O� -- � WALL INS.ULATION POOL FINAL r�:�,� CEILING INSU�ATION OFF SITE IMPS. DRYINALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK � LANDSCAPE/IRRIG. SEEP PIT/LL. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY - C�G'3t�OO� o �e COiVifVIEiVTS P�G. � ��,�4- ��'�� J �',oX�. . SP� �T. �-� ups�� R.e9v� � p i Pc: �S-t� P� t��a-�c. Z �; -��z SEPTIC TANK SIZE ... SEEP PIT/U SIZE � � . .. ,� � .. ._ . , ��: . � � :�. ��;�-� �� ; ; � A