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Home My WebLink About11-462 CITY OF DIAMOND BAR II ----��— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21825 Copley Drive,Diamond Bar,CA 91765 , (909)839-702U Fax(909)861-3117 Building Inspection Hotline(909)839-7027` PRESS '°^" BUILDING PERMIT APPLICATION FIRMLY � JOBSITE � ` � APPLICATIO PERMIT � �-4��p/C o ADDRESS �Z I �i L�N(.C'7G� A�'G DATE_ y�1.Z I 1 1 NUMBER "�# � APN LOT TRACT DATE �N � ` ONST. 4�� GROUP �� p OWNER�"7�}�„�1��} S7'2�CA�TZJJ�J p ADDRESS ' ✓ tJ = ZONING SETBACKS z CITY rJ/ f ✓�/�i ZIP TEL. 1�- FRONT. qyy � o APPLICANT � fJ TEL j�Y__ ._�� REAR � z - SIDE/SIDE STREET RW ❑ � CONTRACTOR__II'�E �C7110DL�7�/✓(,� CE�✓I��L SIDE � ADDRESS ,^.` ,�j�� CITY ZIP TEL�7/tl q��-.r�i7, PROPOSED USE ��iT��S�N C�A'►'1Jatal o ARCWENG/ �"" z� DESIGNER NO.DWEL. NO. NO. a ADDRESS <n UNITS STORIES BEDROOMS N CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFlRM UNDER PENALTY OF PEfLIURV THAT I AA1 E%EMPT FROM THE CONTRACTORS LI- GefB B/C8 fI W CENSE UW FOR THE FOLLOWINO REASON(SEC.7031.6 BUSINESSAND PROFESSIONS CODE:ANV CITV OR (n 9 � C� COUNTVWHICHREOUIRESAPERMI7TOCONSTRUCT,ALTER,IMPROVE.DEMOUSH.ORREPAIqANYSTRUC- P8}IO/DBCI( w NRE.PRIOH TO ITS ISSUANCE,AL50 REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATENENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CAMRACTORS ll� CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- u' POOUSPB � FESSIONSCODE)OH7}UTHEORSHEISEXEMPTTHEREFROMANDTMEBASISFORTHEALIEGEDEXEMP- (� V TION.ANYVIOLATIONOFSECTION7031.SBVANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � A CIVIL PENALTV OF NOT MORE THAN FIVE HUNORED DOLLARS(5500).): � ❑I,ASONRJEROFTHEPROPERTY,ORMYEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � CORIRIBfC18I I Z WILL DO THE WORK�ND THE STRUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70l1,BUSI� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF ? PROPERTY WHO BUILOS OR IMPROVES TMEFEON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PHOVIDED THAT SUCN IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,MOWEVERTMEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINQ lHAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE W RPOSE OF SALE). �y,� ❑1,AS OWNER OF THE PROPEFRY,AM EXQUSIVELY fqNTRACTWO WRH LICENSED CONTRACTORS � TO CANS7RUCT THE PR0.1EC7(SEC.7oa1,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- VelUfllion ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN OWNER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,M!D � NM1iOCONTRACTSFORSUCHPR0.IECTSWITHACONTRAC70R(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION TORS LICENSE LAW.). FEE � ❑I AA1 E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASIXJ Q � �D �� O U � OATE OWNER H � � ��7 � LICENSED CONTRACTORS DECLARATION - W S(,�� LU(�5 I.I 1'D I HEREBV AFFIRM UNDEH PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER Ur PLU � e(COAIMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z ('., � �� MV UCENSE IS IN FULL FORCE AND EFFECT. m �{ sw r � LICENSE CLASS LIC.NO. v � � V DATE CONTRACTOR��Q�]� //V/� d w f�._�.�� K � � WORKERS'COMPENSATION DECLARATION �'�"'"�- � Q � I HEREBV AfFIRAI UNDER VENALTV OF PERJURV ONE OF 7HE FOLLOWING DECURATIONS: V � Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF fANSENT TO SELF-INSURE FOR WORKERS' a 2 COMPENSATqN,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR TME PERFORMMICE U OF THE WORN f-0R WHICH THIS PERMIT IS ISSUED. w � � � _I HAVEAND WILL MAINTAIN WOHI(ERS'COMPENSATION INSURANCE.AS REWIRED BV SECTION Q 3]00 OF THE LABOF CADE,FOR THE PERFORMANCE OF THE WOR)(FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION � CARRIER PLAN REVIEW � POLICV NUMBER � ELECTRIC -ry 0 (iHISSECiIONNE�NOTBECOI.RETFDOFi1-EPE{i.niSFpqpryEFll.lDREDDOLLARS�t700)ORIESS} PLUMBING L` _T w Z �CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C,�} SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE (n WORNERS'COMPENSATIONLAWSOFCALIFORNIAANOAGREETHATIFISHOULOBECAME INSPECTIONFEE � SUBJECT TO THE WORHERS'COMPENSATION PROVISIONS OF SECTKKJ 370o OF THE LABOq � � CADE.ISHALLFORTHWITHCOMPLVWITHTHOS OVISIONS. ISSUANCE � o �L �� p DATE; Z� APPLICANT.• SMIP w ENERGY P/C J WARNING FAILUf1E TO SECURE WORKERS'CAMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE J � SUaIECTAN EMPLOVER TO CRIMMAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOILARS(f10a.o00),IN ADDITION TO THE COST OF COMPENSATION,DAMAQES AS PROVIOED FOR IN J SECTION 37oe OF THE LABOR CADE,INTEREST,AND ATTORNEV'S FEES. /� `O w RETENTION FEE: it O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS A CONSTRUCTION LENDINO AGENCV FOR THE PERFORMANCE OF THE WORN FOR WHICl1 THIS PERMIT IS ISSUED(SEC.308�,CIV.C.). Z W � LENDERS NAME � LENDER'S ADDRESS w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CORRECT. TOTAL FE ES / � � � I AGREE TO COMPLV WITH ALL CITY AND CAUN7Y ORDINMJCES ANO STATE LAWS PEUTING TO BUILDING � CONSTRUCTFON,AND HEREBV AUTI-IORIZE REPFESENTATNES OF THIS COUNTV TO ENTEF U70N THE Z ABOVE-MEMIONED PROPERTY FOR INSPECTION PURPOS� �u,� o �s �� cz � COMMENTS � ��I�k/,� � i��WtJ��w7 C��►2. m PE/�fITTEE NAM (PRIIJn/ ' ^l , ,` � � :J►'��1RE��A �i " ' ` f.�1./ LAT� V_ � � � RECPL NO. PAID BY '� VALIDATION � � WHITE—Departrnent Copy,YELLOW—Finence Copy,PINK—Assessor'Copy, OLDENROD—File Copy,GREEN—Ap icanl's Copy CY�V O� DOAiViON� �A�i .. IV�Sf�f�C�lO� V��CORD ,: D[��pC�G4�0a DGJ5�1� O�n]�C C��40G3 _ O[,��pC C�4�OlY1 DGQ4C �[YJ�pCC�4�G�: SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREP,LACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING ' 8 FT. BOND BEAM � FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADiNG ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GA5 AIR TEST FINAL ZONING FINAL CONST. � �/ FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY o �� COMMENTS - SEPTIC TANK SIZE SEEP PIT/U SIZE a � �: � �