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Home My WebLink About11053 (5)} D tt • .D w O 0 w zo Ltz�Al O in w Z w 1-- ' N Q D Z LU W LU LU <L 2 O d O F- U W U) tq C/A In Q Lr Fw- 4 D LU W Z cn S O O W ¢J O Z� W LU LU a N CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21660 E. Coplcy Drive Suite 190 (909) 960-3195 Fax (909) 961-3111 BUILDING PERMITAPPLICATION JOBSRE `! ADDRESS APN LOT 4RACT OWNER �Ij►.!i Il;vi nay ADDRESOy. CITY ZIP _ TELjd_- &-_j 1j APPLICANT - ` `. TELJLr-'sg¢.t.� CONTRACTOR L C b1 t� s ADDRESS �a CITY`,c�r r- A. IP _ TEL ARCHlENG! DESIGNER T7'19 V7IUe, —r - ADDRESS. 1&.S'r ADDRESS_1&4SI __bC&rP_\ a 'd%- 1 CITY Qk-0,KbQ ( IA ZIP CMU�l TEL _T1k-q0j.' OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LN CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTYWHICH RICH REQUIRES A PERMITTO CONSTRUCT.ALTER. IMPROVE. DEMOUSK OR REPAIRANY STRUC. TURF, PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO RLE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI" CENSE LAW (CHAPTER F (ODMMENCNG WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AHD PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TXXN.ANY VIOLATION Of SECTION 703; .5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICAM TO A CML PENALTY OF NOT MORE THAN IVE HUNDRED DOLLARS (SSWI.1: ❑ LAS OWNER OFTHE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WALL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERCD FOR SALE (SEC. 7044. BUSI• NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY Wf10 BUILDS OR IMPROVES THEREON. AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF. HOWEVER THE BUILDNG OR IMPROVEMENT IS SOLD WITRIN ONEYEAR OFOOMPLE- TON. THE OWNERAURDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DD NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALER O L AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTNQ WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70AA, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOTAPPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND MIO CONTRACTS FOR SUCH PROJECTS WITH AOONTRACTOR(S) LICENSED PURSUANTTOTHE OONRMC• TORS LICENSE LAW} O 1 AM EXEMPT UNDER SEC. B. i P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER a (COMMENCING WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PROFESSIONS CODE. AND MY LICENSE IS IN FULL FORCE AND EFFECT. i LICENSE CLAMTA 31�I S"I iN L-7� 1 LIC. NO. DATE J 1 • ho - L1 y CONTRACToR LA { M a,- r,, V " WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _ I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELFNNSURE FOR WORKERS' COMPENSATION. AS PROVIDED BY SECTION3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �I HAVE AND WILL MAINTAIN WORKERS' COMPENSATON INSURANCE. AS REOUIRED BY SECTION 5700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MYWOnKER'COMPENt�SATXXN I'U.- CARRIER AND POLICY NUMBER ARE: CARRIER :E�L^ Q 1'U 1"N �3 ((�� POLIOYNUMBER/yH •-I-I 1,"k 00t L,'T - (TMS SECTION NEED NOT BE COM METEDOFTE PERMIT B FOR ONE HUNDRED DOLLARS (SIOO)ORLES% I CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECTTO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WOFtKERS' COMPENSATION PROW SiO NS OF SECTION 3700 OF THE LABOR CODE. I SHALL FORTHWITH CONPLY WITH THOSE PROVISIONS. DATE: APPLICANT. WAW NG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS 13100.000). N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR COOE. INTERESE AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMITIS ISSUED (SEC. 3007,CN. C.). LENDER'S NAME LENDER'S ADDRESS 1 CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS REL 71NO TO BL&OING CONSTRUCTOR AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE46IIENTIONED PROPERTY FOR INSPECTION PURPOSES. PE E NAME (PRINT) Il - S GMA DATE PRESS FIRMLY APPLICATION PERMIT QS� P/C 01 q_ DATENUMBER N ISSUE_V TYPE OCC DATE CONST, GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDEISIDE STREET RW ❑ Ll SIDE ❑ PROPOSED USE - NO. DWEL NO. NO. .. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFWADD/REM Ca C0 Garage/Carport WPatafDeck LL PooVSpa C) Z Re -Root 0 Commercial ... m kJ4�RovAl�- A6b,oa Valuation ADJ.AREA QUANTITY DESCRIPTION FEE U 4, . cc U W LU Z � _ v A CL I L) L nollaz U_ W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING LAO .1,; • I• MECHANICAL ( • 3P INSPECTION ISSUANCE SMTP ENERGY P/C ENERGY PERMIT Z7 ::7—_(� RETENTION FEE: N . d, PRE -ALT FEE: TOTAL FEES '�i(eJ_ -)/t7 COMMENTS RECPT. NO. PAID BY1!4�1VALIDATION WHITE—Department Copy, YELLOW—Finance Copy. PINK—Aaaaseot Copy. GOLDENROD—File COW GREEN—Applimnrs Copy CITY, OF DIA,100N.D.13AR. INSPECTION RECORD'.': ro V, SETBACK; ol p �) FLOOR JOIST--- FIGS/FORMS/STEEL- t I'FHA REQfATS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING' UNDERFLOOR CONIDUIT'--:- SLAB GRADE ------ Al FI R EPLACEfObNDATION TEMP -POWER FIREPLACE BOND BEAM,i--� WATER SERVICE-' A MID Hl,BgND:BEAM ROOF SHEATHiNCC 8 Fr. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF -COVER PRE-GRANN 'ROUGH HEATING ; E; Ar I BENCHING -ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING: SHOWER/TUB`TES EXT. LATHISIDING'- POOL ELECTRIC POOL FENCING WALL INSULATION POOL FINAL. // CEILING INSULATION I ., -, ;; ,.'..�.%, OFF SITE PAPS. DRYWALL NAILING DEDICATIONS SEWER. FINAL ENG. .SEPTIC TANK.. ,_.:.._:.:. :- :- .: --_ -"_`' . '�._. LANDSCAPE/IRRIG. SEEP-PIT/LL. ON SITE IMPS., -GASAIRITEST FINAL CONST -.,. FINAL ZONING -FIRE DEPT. FINAL -FINAL-HEATING FINAL-ELECTRIC--- A HEALTH DEPT. FINAL DEV. FEES PAID -ENERGY FINAL PLUMBING • `�$/ `.'� .-f TeX' • �� - I 1 i . , - COMMENTS-.-',. pr j, SEPTIC TANK SIZE .SEEP PITA) SIZE 04 jrw T _wo