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Home My WebLink About16932 CITY OF DIAMOND BAR -----�-�''�` --- DEPARTMENT OF CONA�UMTY&DEVELOPMENT SERVICES ��P��D 21825 E.Copley Drive "� (909)860-3195 Fax(909)861-3117 �U(� 19 20�� PRESS '�'%�»�� BUILDING PERMIT APPLICATION FIRMLY QJOBSITE /'',(�C Lern.o,�l DATECATION Q'-l��l PERMIT ��p/C ¢ ADDRESS � J O � NUMBER � � ISSUE TYPE OCC r APN LOT TRACT DATE CONST. GROUP p OWNER Q. �I�Y/ C-� o ADDRE S ZONING SETBACKS Z CITY ZIP TE59� 7 FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW ❑ � CONTRACT . � I SIDE ❑ o c�aEss ��D ZIP O�II �TEL. PROPOSED USE oARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. N 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 HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM E%EMPT FROM THE CONTRACTORS LI- G8fH99/C3fpOR W CENSELAWFORTHEFOLLOWINGREASON(SEC.7o31.58U51NE5SANDPROFESSIONSCODE:ANVCITVOR (n � U COUNT'WHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORREPAIRANYSTRUC� 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 PUflSUANT TO THE PROVISIONS OF THE CANTRACTORS LI� � � CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOUSPB � FESSIONS CADE)OR THAT HE OR SHE IS E%EMP7 THEREFROM AND THE BASIS FOR THE ALLEGED ExEMP� (� V TION.ANYVIOLATIONOFSECTION7031.SBYANYAPPLICANTFORAPERMITSU&1ECTSTHEAPPLICANTTO Z Re-Roat � A CIVIL 7ENALTV OF NO7 MORE 7HAN FIVE HUN�RED DOLLARS(5500).�: � ❑I,ASON?JEROFTHEPFOPERTV.ORMYEMPLOYEESWI7HWAGESASTHEIRSOLECOMPENSA710N, � Commercial - Z WILL DO THE WOFK,AND THE STRUCTURE IS NOT INTENDEO OR OFFERED FOR SALE(SEC.7041,BUSI- J � NESS AND PROFESSIONS CAOE:7HE CANTRACTORS LICENSE LAW DOES NO7 APPLV 70 AN OWNER OF � VROPERiY WHO 9UILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSEIF OR HERSELF OR � THROUGHHISORHEROWNEMPLOYEES,PROVIDEDTHATSUCHIMPROVEMENTSARENO71N7ENDEDOR m Q OFFEREDFORSALE.IFHOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPIE- Z TtON,THE OWNER�BUILDEFi WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,AS OWNEROF7HE PROPER7Y,AM EXCLUSIVELV CONTRACTING WITH LICENSED CONTRAC70RS � 70 CONSTRUCT THE PR0.IECT(SEC.70�1,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI� V81U81i0f1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPER7VWHOBUILDSORIMPROVESTHEREON,AND . � WHOCAN7RACTSFORSUCHPR0.IECTSWITHACANTRACTOH(S)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). �� ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q U � � DATE OWNER U Z W � LICENSED CONTRACTORS DECLARATION w � I HEHEBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDEH PROVISIONS OF CHAPTER � d e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CADE,AN� Z X IAV LICENSE IS IN FULL f RCE ND EFFECT. m LLI �j� Q ✓q Y LIC.NO. � / �".�� LICENSE C SS j � �- 3�p f � V DATE CONTfiACTOR / a W � WORKERS'COMPENSATION DECLARATION a � I HEREBV AFFIRM UNDER PENAL7V OF PERIURY ONE OF 7HE f-0LLOWING DECLARATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORNERS' _ ¢ COMPENSATION,AS PROVIDED BV SECTION 37000FTHE IABOR CODE,FORTHE PERFORMANCE `U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REQUIRED BY SECTION Q 37000F THE LABOR CADE,FORTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORK�p(Sw'CA�M/`PF7N SAJ7�p�N INSURA E CARRIER AND POLICY NUMBER ARE: CONSTRUCTION J /I/ !/ J / v • � j cnaaiea _ _ PLAN REVIEW � POLICYNUMBER ELECTRIC Q �\ � (TH4SSECTIONNE�NOTBEOJMPLETEDOFiNEPERMfTISFORONEHUI�DREDDOLVRS(f100)ORLESS). PLUMBING •�-+ W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL L} SHAIL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'CAMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SUBJECTTOTHEWOFiKERS'CAMPENSATIONP VISIONSOFSECTION37000FTHElABOR � y '�L�1�� ISH LLFORTHWITHCOMPLYWITH O PROVI51 5. ISSUANCE ��'1 �� ov v � �3 D/ SMIP �l I�/.�. 1.L I I__;_. p DATE: APPLICANT: J WAHNWG FAI�URE TO SECUFiE WORKERS'COMPENSATION COVERACaE IS UNUWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(S7oo,o00),IN ADOITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDE�FOR IN � SECTION37080FTHELABORCODE,MTEREST,ANDATTORNEY'SFEES. RETENTIONFEE: d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: �i�V' � 1 HEHEBV AFFIfiM UNDER PENALTY OF PERJURY THATTHERE IS ACONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED(SEC.3097,CIV.CJ. Z W � LENDER'S NAME F- LENDER'SADDRE55 � TOTAt FEES ��,y� � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE - � ABOVE- NTIONED PROPERTV FOR INSPECTION PURPOSES. Z COMMENTS � s�� 3 Dl m PERMITTE (PRINT) Q N Uj SIGNATUREOFPERMITTEE DATE = RECPT.�O. PAID BY VALIDATION ~ WHITE—De artment Copy,YELLOW—Finance Co PINK—Assessor Co GOLDENRO�File Co GREEN—A licant's Co P PY� PY. PY, PP PY L , . . ,. _ ._ . , .,. . ., . _. . _ .. , . , . , , ,. . (��5�� I� ��l�1(�i��N [�I�lG� ��l�p��Ot�RI ��@�� 1:/�.1 U�/WV � �JV� ��./.0 VU u �UV�JIJ.��1./lJ L'�✓UV o �GrV��.� o ��o . � � . _ ,y. ,n,. .,'p�°' ._,.��y.�!� 'yax, SET BACK � � __ FLO�R JOlST � . � � !--..__ �---. ___�_-- -�_-_— ;___ — -- ----- .___ �___..._ ___._ __ FT'GS/FORMS(STEEL ; I , FHA REQMTS -- —.;-..,_----- —. —.—.�..._------ -------- ELECTRIC GROUND i [ UNDER FLOOR DUCT j GROUND PLUMBING � _ � UNDEf� F.LOOR GU�!D�.11T_ ! ; _____ ; -- — -�-- SLAB GRADE ' _ _. ' FIREPLAGE FQUNDATION__ �___ � __ _ TEMP POWER � ._ _I___ FIREPLACE BOND BEAI��__ � � --- - --------__ _..� WATER SERVICE i MID HT. BOND BEAM _ . _......— -------------.� ------- ROOF SHEATHING � 8 FT. BOND BEAM ___ , _ FRA�/IfNG/VENTILIATION _ ; FINA�SOND BEAM __ I ____ ROOF COVER i _ PRE-GF�AQING � __ ___ ROUGH HEATWG BENCHING �i ROUGH ELECTRIC ROUGH GAADING � � ROUGH PCUMBING ; _ FINISH GRADING ----- ----- ------- SNOWER/TUB TEST � POOL ELECTRiC EXT. LATH/SIDING POOL FENCING _ _________ _. WALL IiVSULATiON j POOL FINAI. i --- - ------ —�-�--- � OFF S1TE IMPS. �� CEILIi�G IPV�ULATIOIV _ , _ __ DRYWALL N,41UNG ' DEQICATIONS SEWER FINAL ENG j SEPTIC TANK LA(VDSCAPE/IRRIG. �— SEEP PIT/LL. ON SITF_ IPv1PS. � GAS AIR TEST FINAL ZONING FINAL CONST. GIRE DEPT. FINAL � FINAL HEATING � HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUPliBING � ENERGY - - —._..---- --.._._�..-------_� ____ : �— ----- , a -.....___� s� ��o CD��5 SEPTIC TAiVK SIZE � � SEEP PIT/U SIZE — — -�_-- ------ � — -- ------- �� ----