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Home My WebLink About14-4987 --- --- =� '!�+o r�'-�,�.,,_ CITY OF DIAMOND BAR � I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES , "� � c- 2181A Copley Drive,Diamond Bar,CA 91765 PRESS t . �k�,,> (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY BUILDING PERMIT APPLICATION i JOB SITE ADDRESS 5 y' � APPL�CRTION DATE: P/C# � ISSUE DATE: �V' � "'" � PERMI7# I`7� ��7 i = APN__�LOT TRACT • � OWNER P. TYPE CONST. OCC GROUP: �' Y• n ADDRESS ,.4 ZONING SETBACKS J .CITY��i�ZIP �I `TEL. - - I�I FRONT RW ❑ � ApPLICANT Thom��' eS TEL. -I�� ]jN' 7I�DD REAR � SIDE1SiDE STREEf RW ❑ � CONTRACTOR P i p�___R,/r��-or��H!p,n' I N G SIDE � � ADDR�E�S�S,� -�)I7�r � �1�_P��(�C �i PROPOSED USE S � CITY,�S�L1Lld�.�[Nd�ZIP J��v�TEL. �LI'- S�- -I CD�D . I V - . � ARCH/ENG/DESIGNER i13/101 IO�t1�V(1'I10/� �X� nC1 �� 'S = ADDRESS #DWEL.UNITS #STORIES #BEDROOMS � CITY ZIP TEL. DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION I � OWNER-BULLOFA DECLAHATION I = I hereby affirtn under penalty of perJury that I am exempt from the Contractor's State License Law for the reason(5) SFR/ADD/REM = indlcated helow 6y the checkmark(s�,I have placed next to the applicable item(s)[Sectlon 70315,Business and I � Garage/Carport L Rofesslons Cotle:Any cfry or county that requlres a permit to construct,alter,improve,demolish,ar repalr,any z structure,pHa to fts Issuance,also requlres the appllpirt Mr tha pertnit to Flle a signetl statemeM that he ar she N Patio/Deck I nIs lice�xed pursuaM to ihe provlsio�af the Cmitractor's State Llcense Law(Chapter 9)Commencing with Sectlon w I � 7000 of Ofvistan 3 of ttie Business and Professians Code]or mat he or she Is exempt fmm licensure and the basls for � Pool/Spa n tho alleged exempibn.My viWatlon ol5ection 7031.5 by any applicant for a permit subjects ihe applicant to a civil penatty I 'n of not more than Flve hundred ddlars($5001. Z Re-Roof � U I,as owner o(ttie property,or my employees with wages as their sale compensatlon,will do(,all of or(,portions � Commercial I � oi the work,and the strudure is not Intended or affered for sale(Section 7044,Business and Protessions Code�.The � I '.�� Contracrors'State LJcense law dces not apply to an owner of property who,through employees'or personal effort,builds m y or imprwes the property,pmvided that the tmprovements are not intended or offerea for sale.tt however,the buftding or � improvement is sold wlthln one year of tompletion,the Owner-Builder wlll have the burden of prwing that it was not buitt � or improved for the purpose of sale.�. I � '� (,I,as owner M the property,am excluslvely coMractlnB With licensed Contractors to construct the project(Section I � 7644,Business and Protesslons Code:The Contracrors'Sta�License Law does not appty to an owner of properry who Valuation: Adj.Area: Z buildsorlmprovesthereon,andwhocontractsfortheprojectswlthalicensedCantractorpursuanttotheContractors'State QUANTITY DESCRIPTION FEE I :n Llcense law.). � (,I am exempt hom licensure under the Contractor's State Llcense law for the following reason(s�: � I 3 _ ¢ 1 By my signature 6elow I acknowledge that,except tor my personal residence In which I must have residad for at least one w � Z year prior to completion of the imprwemerds covered by this permit,l cannat legalty sell a structure that I have buitt as an w I � ownar-builder it tt haS not been consWcted in Rs entlrery by licensed contractors.I understand tltat a copy ot the applicable � law,Sectlon 7044 of the Business and Professions Code Is available upon request when this appllcaUon is submttted or at I i the t�llowing Web site:http/vmw.leginfa.ca.govlcalaw.htrnl. . z I � DATE: SIGN: � , � � LIC@lSED CONTNACTOH'S DECWIATION � '� I hereby aftirm under penalty of perjury that I am Ilcensed under prwisions of Chapter 9(commencing with Sectlon 7�00) I L I � of Dlvlslon 3 ot the Business and Professions Code,and my Ilcense is in full lorce and etiect. � � 1 �2� Srq 5 � 1 ;n IJCENSE CLASS: C "J�O LIC.NO.� y� � DATE:� CONTRACTOR:��.YfLi�� n � � 7d" WOHI�P'SCOMPENSATION DECLARNTION � I � I HFAEBY AFRRM UNDFA PENALTV OF PERJURY ONE OFTHE FOLLOWING DECLARA710N5: ��n�Q � y ¢ I have and wlll malMain a Certiticate of Consertt to Sett-Insure for Worker's CompensaUon,as provided by CONSTRUCTION: U � � Sectlon 3700 of the Labor Code,far the pertormance of the work for which this permit is issued. p�,qN REVIEW: � J > _�_I have and will mairRain Worker's Compensatlon Insurance,as requlred by Sectlon 3700 of the Labor Code,for ELECTRIC: � the Dertormance of the work for which this permK Is Issued.My Worker's Compensatlon Insurance Carrler and Z¢ PoII�yNumberare:il 1�r PLUMB�NG: y CARRIFA I��G'fC�d ^� � MECHANICAL: z POLICYNUMBER�I17E -�v INSPECTION FEE: � C+ � (MIS SEC'f10N NEED NOT BE CON�IFfED IF THE P6iMfT IS F9R OPE HUNDR�DOI.LAAS(510�OR LESS�. ISSUANC E:_ � J �J = I certify that in the performance of the wak for which ihis permR Is Issued,I shall not employ any person In any manner 5o as to SMIP: 6ecome subject tn me Workers Compe�atlon Laws of Califomla.Md agree that it I sliould hecorne subl�m me W�r's � Cpnpensation provlslons oF Section 3700 of ihe Labor Code,I shall forthwlth canDly wilh those Wovlsbns. ENERGY P/C: 1 pq�: qpPLlCqNi: ENERGY PERMIT: n � WARNING:Failure to secure Worker's Compensation coverage is unlavAul,and shall subJect an employer to crlminal RETENTION FEE: '�'"Qv � penaltles and civil Flnes up ta one hundred thousand ddlars(5100,000�,In add'Rion tn the crost ot the compensaUon, PRE-ALT FEE: = damages as provided for In sectlon 3708 of ihe labor code,fnterest,and attomeys fees. = CONSTHUCTION LENDING AGENCY BSAF: i Z I hereby a�rm under penalty of perjury that there I5 a Construc4on Lending Agency for Me performance of the work for � which this permR is issued(Sec.3097,Civ.C.�. . LENDEA'S NAME: r LENDER'SADDRE55: TOTAL FEES 97•J� i� I ceNry that I have read this application and state that the ahove irrtormaflon Is cortect I agree ro compty with all clty and � counry ordlnances and state laws relatlng to building constructio+i,a�d hereby authorize represerrtatives of this county to COMMENTS: � enter upon the above-mendonad propeRy tor inspectlon Durposes. � � � � a PERMITfEE NAME(PRINn :n = SIGNANRE OF PERMfTTEE pA� RECEIPT#� � PAID BY: ✓ VAUDATION: WHITE—DepartmeM Copy,YEIIOW—Flnance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Appllcant's Copy ��, CITY OF DIAMOND BAR INSPECTIUN RECORD � � � � - a � � . � . SETBqCIU�LETTE"fi °��;' �_ :� ��' " ��.�_ TRACT AND LEDGER �� .� �°�r �� " � �<�*� ��'�� SWITCN GEAR FOQTI�IfiSsFORNfS�__�' �. �� .,��.��As,�� o�e �ri��.v��- �� , �-= � ' `� �� ' � �'�_ � a�� COMMERCIAL HOOD t1G.FLUMBiA1G��E � �� `� � �� .��'� � ��,�.�..� �� .� � T-BAR ' ,= �� 3�: ,�a �� ,� UG.Et;EG7R�CAL. `��;'�� . .,��'��yw��,��, - =°^ ,"� °�n°.�---_�,..�� INTERCEPTER ,t1F�FiGEiOtlNDJ� `""�' �.�.� `'� ��.v,� `�" �� ,��6� HOTMOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANQUT DEMOLITION ROOF SHEATHING ROOF DR,41NS FLOOR SHEATHING ROUGH CONQUIT SFIEARWALLSEXTERIOR!' �`� »„s E� �� . YPQUUSPAi: �� '�%�� r#n° � �`�„� �:�.�, � � � . �SNEAR�WAlL5„INSERIQR� �u�:�,�3, ..>�� *�' : ` ROUGHPUIM6lNG.:�s�.�� _��>" .�� ;'�%�.�. �"�� ., � � � , FRAMlNGNENTING�� ..:� �".�*��'��.,• ��,a.�� r�� RdU�Gy�ECECTRICAL; ��` ��,�a�,,,,,- ,.�>� �<i ��'a� ,. ,�,..�_ " _ y �'�` �� ,� .R �'�. - . ua--t�D ` � ° „� ,�. aOI�GH MECHANICAL� � �� . �� ,af� ROI�GH'MECHANICAIL� �� ,,, �� .r: ,,y� � RqUC�N$ELECl'RIC,4l. W(�}�C�{�1 ��d�r,� ��`��,.w. �..� ao.,, -��"��..5...�, >t 'A�"� GAS TEST .� �`�� ,,��.��y� � ,��' �„ RQUGii RL'`UMBlNG�,��",��.� ��.�:�a��'r =�,:� �;:� ��,,v�, b p 'PRE�GUNlTE �� , �� • _ . �. . _ ��N�- a�� .. _ �� .�,. � ,..��, _ .___ � �� : ;-. INSUWTION WALL POOL�PRE DECK BONDING,�, , .�-�a °�� "` � � � � . �;e.=