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Home My WebLink About14999CITY OF DIAMOND BAR �r DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES j r' 21660 E. Copley Drive Suite 19b (909) 860-3195 Fax (909) 861-3117--� PRESS RiTif'nTNir 01R,ik t tr A 'r TC it1nN o FIRMLY JOBSITE APPLICATION PERMIT P/C ADDRESS DATE NUMBER # ISSUE TYPE OCC APN LOT TRACT` DATE o CONST. GROUP OWNER J-il��.i� �- + '6 00 ^: • ADDRESS '� � -+' t L � � ZONING SETBACKS FRONT RW ❑ CITYDL f ZIP �' TEL ��4 -" I^a APPLICANT TEL. REAR 71SIDEISIDE STREET RW ❑ SIDE ❑ CONTRACTOR PROPOSED USE �G v `' s' LXi ADDRCITY ESS ZIP _ TEL. - I'v iza T5 ffi d� 4 ARCH/ENG/iii LI a + t fits DESIGNER NO. DWEL. NO. NO. UNITS STORIES BEDROOMS_ ADDRESS CITY ZIP TEL. DESCRIPTION SO. FT. FACTOR PSF ADJ.AREANALUATION SFR/ADD/REM OWNER -BUILDER DECLARATION - I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS U. (n _ Garage/Carport CENSELAWFORTHE FOLLOWING REASON (SEC. 7031.5 BUSINESSAND PROFESSIONS CODE: ANYCITYOR LIJ Patio/Deck COUNTYWHICH REOUIRESAPERMrFTOCONSTRUCTALTER,IMPROVE, OFMCLISH, OR REPAIRANYSTRUC. TUBE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED LJJ STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- LL CENSE LAW (CHAPTER B (COMMENCING WITH SECTION 7080) OF DIVISION 3 O THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP-,ss PooUSpa Z RB•ROO} TION. ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTSTHE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ($00),I: - QI�ISOWNEROFTHEPROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, 0 J Commercial - WILL Di'S -LHE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUST- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY To AN CWNER OF PROPERTY WHO BUILDSOR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELFOR HERSELF OR. THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT?NTENDED OR m OFFERED. FOR SALE. IF, HOWEVER THE BUILDING OR IMPROVEMENTIS SOLD WITHINONEYEAR OFCOMPLE. TION. THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE O I. AS OWNER OF THE PROPERTY, AM EXCLUSIVELYCONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- Valuation - A VADJ.AREA CENSE LAW DOES NOTAPPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND OUANTJ. DESCRIPTION FEE WHOCONTAACTSFOFI SUCH PROJECTS WITH CONTRACTOR(S) LICENSED PURSUANTTOTHE CONTRAC- TORS LICENSE LAW.). ❑ 1 AM EXEMPT UNDER SEC.P,`, ,,, B. & P.C. FOR THIS REASON 0 DATE G'3/ OWNER ,i �- _- U W LICENSED CONTRACTORS DECLARATION _j U.1 1 HEREDY AFFIRM UNDER PENALTY OF PERJURYTHAT IAM LICENSED UNDER PROVISIONS OF CHAPTER 9(OOMMENCINGWITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND Z m MY LICENSE IS IN FULL FORCE AND EFFECT � d LICENSE CLASS LIC. NO. DATE. - CONTRACTOR.;:..... _. a"'._ WORKERS' COMPENSATION DECLARATION d I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WI LL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURF FOR WORKERS' - Q 2 COMPENSATION, AS PROVIDED By SECTION 37w Or THE LABOR CODE, FDA -THE PERFORMANCE W �c OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. / I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE, AS REQUIRED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS'OOMPENSATKOJ INSURANCECARFIE&AN15 POt1C`Z NUMBER AR E: - CONSTRUCTION - CARRIER ,._..-.�'.-..:�� PLAN REVIEW ELECTRIC POLICY NUMBER W; ., (MSSGMIONNE®NDTsEa%vLFrEDDFTHEPFR ISFbRbNEHunnr'akDDOU"wasi iao)oRt'Ess) PLUMBING _ I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WNICH7HISI'PERMIT IS ISSUED, i MECHANICAL - SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, ANDAGREETHAT IFTSHdu`o SECOMC INSPECTION FEE SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 37000FTHE LABOR - x CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE DATE: APPLICANT: SMTP , 2 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALLSE a ENERGY PIG NO SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT x DOLLARS ($10D,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGE3AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. RETENTION FEE:M.£p PRE -ALT FEE: CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THATTHERE IS A CONSTRUCTION LENDING AGENCY-. :. ...:.. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CIV. C,). LENDER'SNAME__ LENDER'S ADDRESS yp FEES TOTAL f S I CERTIFYTHAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING - CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY RINSPECTION PURPOSES. COMMENTS I PERMITTEE NAM (P 1 ) - -- Li SIONATUREOPPERMITrEGATE RECPT. NO. PAID BY VALIDATION wHi fE--uepanment Loopy, Ytuuw—rmance copy, rlrvrt—Assessor copy, uvm nvv- rm wpy, urlc=l mppucanrs copy INSPECTION RECORD El, 6. I FLOOR JOIST CIRO' ND NG i _CONDUT 1011A � D S VVII 1 .__ .... .I + MID € T aOND BEAM 8 _7,BOND BEAM 51 @ — FINAL 'S AA "O ROUGII 'IF' El H GRADING ROJG FINISH GRADING S. Aad rCt c P001 Ea B a }CYC �. T i POOL FENCING POOL A OFF SIT IMP E ,�s jP T, NK i LANDSCAPE/IRRI SEP FIRE F—,EP,, FINAL FINAL CONST I i d ;`gyp A L3 H DEPT . E l.T� L7 9 { i'