The URL can be used to link to this page

Home My WebLink About17662 (44) CITY OF DIAMOND BAR -----��'`` -- DEPARTMENT OF COMMiJMTY&DEVELOPMENT SERVICES �W , 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS �'%�� BUILDING PERMIT APPLICATION FIRMLY � o DDRIESS�� (LL/f�l L- �-� DATE CATION � � NUMBER ��#/C � , ISSUE i G ,�TYPE OCC APN LOT TRACT DATE � 1 CONST. GROUP p OWNER p ADDRES�S ZONING SETBACKS Z CI ZI TEL � � �j FRONT Ryy ❑ � APPLICANT TEL. REAR Z SIDE/SIDE STREET RW ❑ ¢ CONTRACTOR �. SIDE ❑ � ADDRE�S � CI ZIP TEL� 03 OR��ED� w ARCH/ENG/ � �z DESIGNER NO.DWEL. NO. NO. a ADDRESS = CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADD/REM I HEREBV AFFIfiM UNDER PENALTV OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- G8f89B/CBfpOfl W CENSEUWFORTHEFOLLOWINGREASON(SEC.7a31.5BU51NE5SANDPROFESSIONSCADE:ANYCITYOR (n U COUNTYWHICHRE�UIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYS7RUC- � w TURE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CON7RACTORS LI- � � CENSE LAW(CHAPTER B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� POOVSpB O FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (' V TION.ANV VIOLATION OF SECTION 7031.5 BV ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT T0 Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNOPED DOLLARS(f5oo).): � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESAS7HEIRSOLECAMPENSA710N, � CORIrt10fClal - Z WILL DO THE WORK,AND 7HE STRUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70I4,BU51- J � NESS AND PROFESSIONS CODE:THE CON7flAC70RS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV WHO BUILDS OFi IMPROVES THEFiEON,AND WHO DOES SUCH WORK HIMSELF OR HEHSELf OR � THROUGHHISORHEiiOWNEMPLOYEES,PfiOVIDE07HA7SUCHIMPROVEMENTSARENOTIN7ENDEDOR m w OFFEREDFORSALE.IF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE� � TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). �_ ❑I,ASONRJEROFTHEPROPERTV,AMEXCLUSIVELVCONTRAC7INGWITHLICENSEDCONTRAC70RS TO CANSTRUCT THE PR0.1EC7(SEC.7o�d,BUSINE55 AND PROFESSIONS CODE:THE CON7RACTORS LI- Velue�lOfl ADJ.AREA ' W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � WHOCONTRACTSFORSUCHPR0.1EC7SWI7HACANTRACTOR(S)LICENSEDPURSUANTTO7HECONTMC- QUANTITY DESCRIPTION FEE Y 70R5 LICENSE UW.). � J � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOq THIS REASON Q � U � � DA7E OWNER � Z W � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIRM UNDER PEN/�LTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d e(COMMENCING WITH SECTION 7000)OF DIVISION 9 0F THE BUSINESS AND PROFESSIONS CODE,AND Z �X MY LICENSE IS IN FULL FOFCE AND EFFECT. m � LICENSE C`U1SS Cr LIC.NO.T�S/� j ~ DATEA L�`�7 rA�� CONTRACTOR J U W � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIfiM UNDER PENALTY OF PEfiJURY ONE OFTHE FOLLOWING DECLARATIONS: Z Z _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWOHKERS' _ Q CAMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE W Q OF THE WORK FOF WHICH THIS PERMIT IS ISSUED. � Qw _I HAVE ANO WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION � � ,�/.` 3700 0F THE LABOR CODE.FOR THE GERFORMANCE OF THE WORK FOR WHICH THIS PERMI715 >> � ISSUED.MY RKERS'COMPENSA710N INSUqANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION v J �J�� CARRIER , G r' .� PLAN REVIEW Z POLICV NUMBER � � ��1� ELECTRIC Q 0 (fHISSEC'(IONNE�NOTBEOJMPLEfEDOFTHEPERMITISFORONEHUI�DREDDOILPAS(5100)ORLESS} PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUEO,I MECHANICAL C,�} SHALL NOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CAUFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE ? SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 0F THE LABOR CODE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � SMIP p DATE: APPLICANT. J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(S10o,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PPOVIDED FOR IN � SECTION37080FTHELABOflCODE,MTEREST,ANDATfORNEV'SFEES. RETENTIONFEE: � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � 1 HEREBV AFFIqM UNDER PENALTV OF PEqJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.�. . Z W � LENDER'S NAME F— LEN�ER'SADOHESS � TOTAL FEES I � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w IAGREETOCOMPLVWITHALLqTYANDCOUNTVORDINANCESANDSTATELAWSRELATINGTOBUiLDING , � CONSTRUC710N,AND HEREBV AU7HORIZE REPRESENTATIVES OF THIS COUN7V TO ENTER UPON THE � ABOVE-MENTIONED GRO RTV FO INSPEC710N PURPOSES. Z COMMENTS 0 J � m PERMITTEE NAM N7) � Q� � � SIGNATUREOFPERMITTEE �ATE = RECPT.NO. PAID BY VAIIDATION ~ WHITE—Department Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN—A licant's Co PY, PY. PY, PY, PP PY , . . ,.,. . : ... , , , ��J� �� [�7��I�i t�u`�[C� ��f�3 ��u a�(�i G��t�t�[� oa�c�a o�� ac�.��— c�� 4c aa� a � SET BAGK . FLOOR JQIST � � -- - -...-- ;_ - --------- —......- --_ ___. ._...._.. ...._. FTGS/FORMS/STEEL � 1 FHA REQMTS _ __ --•----- -...._ ___.._.. _._ � ._.--- -- ---.. ELECTRIC GROUND � � UNDER FLOOR DUCT I -- -- -- ------;----�---- --...__...------ ---- GROUND PLUMBING __�j UNDER FLOOR CU�!DUIT . ' ___._...._.- �.___.._................._.__ SLAB GRADE FIREPLACE�FOUNQATION I --. � —._ _---+-- ---- TEMP POWER __ _�_ FIREPLACE BOND BEAM _ _ �_ __ -- -- - WATER SERVICE I _ � MID HT. B(�ND BEAM � �/—-�------ ---- --._..--------- --- ROOF SHEATHING ��j �C! 8 FT. BOND BEAM `7'-—� � � �— - -- -----.._..--- FRAMINGNENTlLIATION ____ FINAL BOND BEAM ! ,,�� -- ---- ---..._........------ ' -_._._..._...---- ROOF COVER ��G�P�L PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ___ ___ ROUGH PLUNIBING FINISH GRADING __ _ __ ______ SHOWERlTiJB TEST � POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL IhISULATIOfV POOL FINAL � GEILING IN�ULATION OFF SITE IMPS. DRY�NALL N,41LI(VG DEDICATIONS SEWER FINAL ENG. SEPTIC TANK � LANDSCAPE/IRRIG. SEEP PIT/LL. ON SITE iMPS. GAS AIR TEST FINAL ZONING FINAL CONST. �IRE DEPT. FIPIAL FINAL HEATING ( HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY � ��o . C��5 SEPTIC TANK SIZE SEEP PIT/U SIZE � �� '