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Home My WebLink About18062 (32) CITY OF DIAMOND BAR C�� --�� -- DEPARTIvIENT OF COIvIIvfUNTI'Y&DEVELOPMENT SERVICES .1� I 21825 E.Copley Drive I '`� (909)860-3195 Fax(909)861-3117 PRESS ��'%��*��` BUILDING PERMIT APPLICATION FIRMLY o DDRIESS 2 O DATE CATION��/ O� NUMBER! ��Z� #/C o� ISSUE TYPE OCC APN LOT TRAC DATE CONST. GROUP °C OWNER O o ADDRESS ZONING SETBACKS Z CITY ZIP TEL. � FRONT RW O o APPLICANT TEL. SIDE/SIDE STFIEET RW ❑ ¢Z ' SIDE ❑ CONTRACTO / � ADDRESS �J � CITY�� g�� ZIP TEL. PROPOSED USE v� o ARCH/ENG/ iz DESIGNER NO.DWEL. NO. O. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFI(iM UNDER PENALTV OF PERIURY THAT I AM EXEMPT FROM THE CANTRACTORS LI� GefeJO/C2fpOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANYCITVOR (n U CAUNTYWHICHREOUIRESAPERMITTOCONS7RUC7,AL7ER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� W Patio/Deck Z TURE,PRIOR TO ITS ISSUANCE.AL50 REOUIfiES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CANTRACTORS LI- w � CENSE lAW(CHAPTER 9(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooVSpa � FESSIONS CADE)OR THAT HE OR SHE IS EXEMP77HEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- V TION.ANV VIOLATION OF SECTION 7031.5 BYANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT T0 Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDfiED DOLLARS(f5o0).): 1-- QI,ASONRJEROFTHEPROPER7Y,ORMYEMPLOVEESWI7H�WAGESASTHEIRSOLECOMPENSATION, 0 Z WILL DO THE WORK,AND THE STRUCiURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7044,BU51- J COrtIRIBfCl81 �� NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY VhlO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSEIF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMEN7S ARE NOT INTENDED OR m � OFFEREDFOfiSALE.IF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE OID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPEHTV,AMEXCWSNELYCONTRACTINGWITHLICENSEDCONTRACTORS � TO CANSTRUCT THE PRQIECT(SEC.70�a,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� VaIU2fI0f1 ADJ.AREA W CENSE UW DOES NOTAPPLY TO AN ONRJER OF A PROPER7Y wH0 BUILDS OR IMPROVES TNEREON,AND � WHOCANTRACTSFORSUCHPR0.IECTSWITHACONTFACTOR(5)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORSLICENSELAW.). � ❑I AM ExEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � U � � DATE OWNER U Z w � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � Q„ e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z X MV LICENSE IS IN FULL FOFiCE AND EFFECT. �/ � � L�CENSE CLASS /� LIC.NO.�J�/ j V DATE OT�I � V� CONTRACTOR I�C n- W � WORKERS'COMPENSATION DECLARATION � � ¢ � IHEREBYAFFIPMUNDERPENALTVOFPERIURYONEOF7HEFOLLOWINGDECLARATIONS: Z Q � IHAVEANDWILLMAINTAINACERTIFICA7EOFCANSENT705ELF-INSUREFORWORKERS' 2 CAMPENSATION,AS PFOVIDED BV SECTION 37UOOFTHE LABOH CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w _I HAVE AND WILI MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION Q 370o OF THE LABOR CADE,FOR THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS ' /�v��d ISSUED.MV WORN 5'COMPENSATION IN NCE CARRIER AND POLICV NUMBERARE: CONSTRUCTION J � CARRIER PLAN REVIEW ZPOLICYNUMBER Z�'�� ELECTRIC Q p (iHISSECIIONNE�NOTBE00A1R.ETEDOFTHEPEHMf�ISFORONEHUI�DRED�OLtNlS(E100)ORLESS). PLUMBING � Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL �•� ^' i W I ��._� ,,:�� 1 I' , (.r} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE � '� �-�� ,� _, . N WORKERS'COMPENSATION LAWS OF CALIFORNIA,ANDAGREE 7HAT IF I SHOULD BECOME INSPECTION FEE � Q� � /J = SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SEC710N 370o OF THE LABOR I IVI A� � � 7(l f17 /t � COOE.I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE I r.V J(. p DATE: APPLICANT: SMIP � J WARNING FAILURE TO SECUFiE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C I:�"1Y r, � SU&IECT AN EMPLOYER TO CRIMINAL PENAL7IES AND CIVIL FINES UP 700NE HUNDRED THOUSAND ENERGY PERMIT � � �-='�-- DOLLARS(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE.INTEHEST,AND ATTORNEV'S FEES. RETENTION FEE: ~✓ Q �� d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOF THE PERF-0RMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W �Z LENDER'S NAME i F— LENDER'SADDRESS � ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEWFORMATIONISCORRECT. TOTAL FEES �yr 7O w I AGREE TO COMPLV WITH ALL pTY AND CAUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ZA80VE-MENTIONED PROPE V FO INSPEC710N PURPOSES. COMMENTS 0 J � •� m PERMITTEE NAME(PRINT) � Q _ � � SIGNATUREOFPERMI77EE DATE = RECPT.N0. 0 PAID BY L VALIDATION ~ WHITE—DepaAment Copy,YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENROP—File Copy,GFiEEN—ApplicanYs Copy I _. _ . . ' . . . • .. . � . . .✓ h". .. � ., . . . . . , . . . . . ��11 �Y Ld�YVY911�JV� 'L�UW� ��WP�tl�V V Y ll11�WOV!/II Y� D�Y�� Q� �� " � ��?� � `� �� ' SET BACK ' FLOOR J�IST � �------ +----- ----_...__.. _.__._.. _...._._.__._._ ---- -._---- FTGS/FORMSlSTEEL FHA REQMTS __ __._ ---- ---___ , l.__--- -----.. ..---- -...__...___ __ ------ ELECTRIC GROUNQ _ ' ; UNDEFi �LOt�R DUCT --- --- -. . _.._._...----_.__ __ --- GROUND PLUMBING ; UfVDER FLOOR CUt�IDUIT i _____ SLAB GRADE _Y_ FIREPLAGE FOUNDATION__�_ _ TEMP POWER � ; FIREPLACE BOND BEAM --- --- ------. __.t __ __.......__... ----_. __._..__ __......__. W,4TER SERVICE _j � ___ __ ' MID HT. Bt7ND BEAM RDOF SHEATHI(VG ,� Zf .OL�{_ j' f 8 FT. BdND BE,4M ------------_._.- i --- � --- -+- - -- FRAMINGNEIVTILIATIOfV � _ _.__ ` � FINAL BOND BEAM � ----t --- -._....._--- ROOF COVER G�'f��_�-/� PRE-GRAi�{NG 1 _ _ -_�_-_. ROUGH HEATING i BENCHING � ROUGH ELECTFiIC �-t ROUGH GRADING � ' _ -- --- --- ROUGH P�UMBING ; FINISH uRADING -- -- -- ------ SHOWER/TUB TEST i POOL ELECTRIC —__�-...-- -------------- -- . .._ �_ .___ __ EXT. LATH/SIDING ; i POfJL FENClNG . ------ -�----._....__.__ _.._...___ --------- WALL INSULATION � POOL FIRl�L I CEILIiVG IfV�ULATIOiV ' OFF SITE IMPS. DRYWALL NAILING _ i DEDICATIONS , � SEWER ' FINAL ENC�. SEPTIC TANK LANDSCAPE;IRRIG. � SEEP PIT/L.L. i ON SITE 1MPS. GAS AIR TEST FINAL ZONING FINAL CONST. ; � GlRE DEPT. FINA!. � - ; __..---- ---.._..__.._- -- ----_ FINAL HEATING + HEALTH DEPT. FINA� FIPJAL ELECTRIC � � DEV. FEE� PAID FINAL PLUMBIMG I j ENERGY - - ----� --._.._.. � I— ---- ___ - --- C�G�'�'.�'o-�m� _ � - -___ CO�iiiMENl"S SEPTIC TAi�K SIZE SEEP PIT/U SIZE - -- . � __. _.__._� � � __--- --- ------......__ ---- . � � �