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Home My WebLink About17478 • CITY OF DIAMOND BAR �-----��` --- DEPARTIvIENT OF CONIMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive �"` PRESS , (909)860-3195 Fau(909)861-3117 ��'%��'�' BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE ) � � APPLICATION PERMIT �'��/��, P/C ADDRESS �k7 Q � �• � DATE 8 NUMBER�--�-�-��- # • � ISSUE TYPE OCC APN LOT RA�T DATE CONST. GROUP °C OWNER O � ADDRESS 3 °� 1Mm ZONING SETBACKS ' oCITY ZIP TEL. U p^��rf FRONT RW ❑ o APPLICANT +1�I Y _ TEL. ��3 1 S DE/SIDE STREET RW ❑ z ¢ CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE � I.: � CITY ZIP TEL. oARCH/ENG/ � �z DESIGNER NO.DWEL. NO. 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 I HEREBV AFFIRM UNDER PENALTY OF PERIURV 7HA7 I AM EXEMP7 FROM THE CONTRACTORS LI- G8f89B/CflfpOR W CENSELAWFORTHEFOLLOWINGREASON(SECJo31.5BUSINESSANDPROFES510N5CODE:ANVCITVOR (n i U COUNTIWHICHHEOUIRESAPERMITTOCONSTRUCT,ALTER,IMPFIOVE,DEMOLISH,ORREPAIRANYS7RUC- w TURE,PRIOR 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 THE PROVISIONS OF THE CONTRACTORS LI- � CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � PooUSpa FESSIONSCODE)ORTHATHEORSHEISE%EMPT7HEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� � TION.ANY VIOLATION OF SECTION 70�1.5 BV ANY APPLICANT FOR A PERMIT SU&IECTS THE APPUCANT T0 Z Re-Roof A CIVI ENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(f5oo).): I,ASOWNEROFTHEPROPEFiTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, Q Z Commercial - WIL THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7044,BU51- J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PR07ERN WHO BUILDS OR IMPROVES THEFEON,AND WHO DOES SUCH WORK HIMSELF OR HEtiSELF OR Q THROUGHHISORHERONTJEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m QOFFEREDFORSALEIF,HOWEVER711EBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BUROEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). ' ❑I,AS OWNER OF THE PROPERTY,AM E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS � TO CANSTFUCT THE PROJECT(SEC,7014,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V8IU8UOf1 �� ADJ.AREA W CENSELAWDOESNOTAPPLYTOANONRJEROFAPROPER7YWHOBUILDSORIMPROVESTHEREON,AND � WHOCANTFACTSFORSUCHPR0.IECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM E%EMPT UNDER SEC. B.6 PC FOH THIS REASON � I � lJ_. � DATE � y OWNER � , Z w � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFfIHM UNOER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z `X MV LICENSE IS IN FULL FORCE AND EFFECi. m � LICENSE CLASS LIC.NO. j � J V DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION � Q = U � 1 HEREBV AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECURATIONS: Z � I HAVE AND WILL MAINTAIN A CER7IFICA7E OF CANSENT TO SELF-INSURE FOR WOqKERS' 2 fqMPEN5AT10N,AS PfiOVIDEO BY SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE U ¢ OF THE WORK FOR WHICH THIS PEHMIT IS ISSUED. � 0 w _I HAVE AND WILLMAINTAIN WORKERS'COMPENSATION MSURANCE,AS REaUIRED BY SECTION � Q 37000F THE LABOR CODE,FOR THE PERFOHMANCE OF THE WORK FOR WHICH THIS PERMIT IS C� �.O ISSUED.MY WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION 0 J � CARRIER PLAN REVIEW Z POLICY NUMBER ELECTRIC Q 0 (fHISSECf10NNE�NOTBECOMPLEfEDOFi1-IEPERMfTISFORONEHUI,DREDDOILARS(E100)ORLESS). PLUMBING I Z 1 CERTIFV THAT IN THE PERFOqMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL U' SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � - ' Uj WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE 7HA71F I SHOULD BECOME INSPECTION FEE ��r�� .�� SU&lECT70THEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR �'-`�� - f L,�O� CODE,I SHALL FO{iTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE I �/• r� !(�(� � p DATE: APPLICANT. SMIP I ��` � �. !!�i I� �v JENERGY P/C I WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE I � SUBJECTAN EMPLOVER TO C{iIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(f ta0,o0o).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOH IN � 0 � SECTION37a80FTHELABORCODE,IN7ERES7,ANDATTORNEY'SFEES. RETENTIONFEE: �-�\ ° -------- O d CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF 7HE WORK FOR WHICH 7HIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. Z W � LENDER'S NAME M— LENDER'SADDRESS � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES /f 3- �� I AGREE TO COMPLV WITH ALL CITV AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING � � CqNS7FUCTION,AND HEREBV AUTHORIZE REPFESENTATIVES OF THIS COUNTV TO ENTER UPON 7HE Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � J = I m PERMI7TEE A E(P IN7) ¢ � w'�� 1�/ . cn .. I � SIGNA7UREOF RMITT D E U J = RECPT.NO. �I� PAID BY VALIDATION ~ � ITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy � • ,. • .. . . ,. . • • ' .i,,Y;.;�i�.=` . • • .. , . , .�, . ., . , y . .. . � C�� l�' ��a�i�li��I� f�l�ff� �l�l�p��u��I�! G��C�Oo f�i� � oUVLJI�l�L/u��,J�v ✓ '\� c��l�r� L�J��JU l� U �JUV OQ� . ��7�,1C;JlT L� Q o __ '-' SET BACK � �1 F�OOR J�1ST, ; .... __.__�_ _. --- ______---- --_..._ ._._ —... ____ FTGSl�ORMS/STEEL � � � �NA f�EQMTS � �---------- — — — --.-.. .._..._. _:. ---- __...-- -- ------ _._....____. ELECTRIC GROUN� ' i UNQER FLUOR DUCT � _ - { --- GROUND PLUMBING ' UNDER FLOOR CU��DUIT_�_ � ____ , SLAB GRADE FIREPLACE FOUNDATION TEMP POWER I � FIREPLACE BOND BEAM � ___ --- W,4TER SERVICE i ! MID HT. BOND BEAM __y_____'—f_ —l- _— �._-._._"'__'..._ _""'_ ROOF SHEATHING �•�J�_�p� /�. 'J�.�e.� �_I 8_FT_BOND BEAM ! — --- ------ -- --------------- --_ __._._..._ FRAMIPJGNENTILIATION �, ' �i�IAL.t30ND BEAM ---I __ _._._..____ ; �_...._._ ..._... ROOF COVER ��;IOL _� _'_PRE-GRADING � ___ ROUGH HEATING , BENCHING � ROUGH ELECTRIC ROUGH GRADING ROUGFi PIUNIBING ; FINiSH GRADING SHOWER/TUB TEST ; POOL ELECTRIC EXT. LATH/SIDING � ; POOL FENCING � WALL IfVSULATION i PC?C?L FINAL � � ....._...---- -- ___..._.__ ____..___.___ ____... - CEILING INjULATION j OFF SITE IMPS. i _ _ —........---_ .._.... -�-------_.-�..____ DRYV�/ALL N,41UNG DEDICATIOIVS � SEWER FINAL ENG. _T i SEPTIC TANK LANDSCAPE/IRRIG. SEEP PITlL.L. � ON SITE IMPS. GAS AIR TEST FINAL Z�NING --- FINAL CONST. �IRE DEPT. FINAL � — ----- ---- FINAL HEATING i I HEALTH DEPT. FINAL � FINAL ELECTRIC i DE`J. FEES PAID � FINAL PLUMBING j ENERGY ------- � -- - — —� --- � -- � I C�G�OO C� o � o � CUiViiVi E fVTS � SEPTIC TANK SIZE SEEP PIT/U SIZE ---- � -- — � � � — ------ � .