HomeMy WebLinkAbout13381 _!�� CITY OF DIAMOND BAR t"
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
a 21660 E.Copley Drive Suitc 190
(909)860-3195 Fax(909)861-3117 PRESS
'�� BUILDING PERMIT APPLICATION FIRMLY
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c� ISSUE �_���� � TYPE OCC
APN LOT TRACT DATE CONST. GROUP
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ADDRESS . ZONING SETBACKS
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� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUILDER DECLARATION SFR/ADD/REM
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Z NRE,PRIOR TO ITS ISSUANCE,ALSO itC-0UIHES THE APPLICAHT FOR SUCH PERMIT TO FILE A SIGNED
w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CONTfiACTORS LI- W
� CENSE LAW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION]OF THE BUSINESS AND PR0. � PooUSpa
FESSqNS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR hIE ALLEOED EXEMP-
TION.ANYVIOl.AT10NOF5ECTION7o31.6BVANVAPPLICANTFORAPERMIT5U81ECT5THEAPPLICANTTO Z R8-R00}
� A CMl PENALTY OF NOT MORE THAN FNE HUNDRED DOIURS(f5oo�.):
� ❑I,ASOWNEROFTHEPROPER7V,ORMYEMPLOVEESWITHWAGESAS7HEIRSOLECOMPENSA710N, � COrtIfIIBfCl81 � -'
NALL DO THE WORK.AND TME STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.70u,BU51� J
NESS AND PROFESSION9 CODE:T1E CONTMCTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF
y PROPERfYNR10BUILDSORIMPROVESTHEREON,ANDWHODOESSUCHWORNHIMSEIFORHERSELFOq =
Q T}1f10UGHHI50RHEROWNEAIPLOYEES,PROVIDEDTHATSUCHIMPROVEMEMSARENOTINTENDEDOR m � �
� ,OFFERmFORSALEIF,liOWEVER7NEBUILDINQORIMPROVEMENTIS50LDWfTHINONEYEAROFCOMPLE-
Z `TION,THE OWNERAUILDER WILL HAVE THE BUHDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR
� WPROVEFOHTNEPURPOSEOFSALEJ.
W ❑I,ASONRIEROFTHEPROPEHTV,AAIEXCLUSNELYCOHfRACTINOWfTHLICENSEDCONTMCTORS
Q TO CONSTRUCT THE PRO.IECT(SEC.7041,BUSINESS AND PROFESSIONS CODE:IHE CONTMCTORS LI- V21118I1Of1 ADJ.AREA �
W CENSEUWDOESNOTMPLYTOANOWNEROFAPROPERTYWFiOBU1LDSORIMPROVES7HEREON.AND
� WHOCOMMCTSPoRSUCHVRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUMRTOTHECONTMG QUANTITY DESCRIPTION FEE � �
� TOR4 LICENSE UW.�.
O ❑I AM FXEYPT UNDER SEC. B.i P.C.FOR THIS REASON U
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FQ LICENSED CONTRACTORS DECLARATION W . _..�a
CC I NEREBV AFFIRM UNDEH PENALTY OF PER1UfiY hIAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � +-+�'-�
� 0(COAIAIENCUq WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PROFESSIONS CADE,AND Z
��� W LICENSE IS IN FULL FORCE AND EFFECT.
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t� WORKERS'COMPENSATION DECLARATION � �-" " "` " . ".-�_ �L.•�,'�,Y
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N 1 HEREBY AFFIRM UNDER PENALTY OF PE0.IURY ONE OF THE FOLLOWING DECURATIONS: � � ���� '
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� _I HAVE AND WILL MAINTAIN A CEHTIFICATE OF CONSENT TO SELF•INSURE FOR WORKERS' 2 .
COMOENSATION,AS PROVIDED BY SECTON 37000F THE LABOR CODE,FOR THE PERFORMANCE �U
OF hIE WORK FOR WHlqi THIS VERMIT IS ISSUED. �
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w _1 HAVE ANU NALL M/UHTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION
Q 37000F TME U1BOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH iHIS PERMIT IS /
ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION
j �pqiEp PL/1N REVIEW I S �
� POLICV NUMBER ELECTRIC I
0 (ncssEcro+r�ra7seoa.RErIDOFnfvEaMrswaariEMx�moal.�R+m�oaiEssl PLUMBING
Z I CERTIFV THAT IN THE PEFFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAI
(,r} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE
� WORKERS'CAMPENSATION UYIS OF CALIFOHNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
S SU&IECTTO THE WORKERS'COMPENSA710N PROVISIONS OF SEC710N a7000F THE UBOR s
CADE,1 SHALL FORTMYIiH COMPLY WITH iHOSE PROVISIONS. ISSUANCE
� SMIP �•
p DATE: � APRICANT. ,
� ENERGY P/C
J WARNINO:FAILURE TO SECURE W'ORKERS'COMPENSATION COVERAGE IS UNUWFUL,AND SHALL BE
� SU&IECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT
DOLLARS(5100,0001.IN ADDITION TO TNE COST OF COMPENSA7qN,DAMAGES AS PROVIDED FOH IN . ��
J SECTqN 37oe OF THE UBOR CODE,IN7EREST,AND A770RNEY'S FEES. RETENTION FEE:
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d CONSTRUCTION LENDING AGENCY PRE�I��EE:
� 1 HEREBYAFFIRM UNDER PENALTY OF PERIURV THAT 7HERE IS A CONSTRUCTION LENDING AGENCY I L.i
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS 7ERMIT IS ISSUED(SEC.3oe7,CIV.C.). TT-�
Z
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� LENDEfYS NAME
F- LENDER'SADDRESS
� 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STA7E THATTiE ABOVE INFORMATION IS CORRECT. TOTAC FE ES � �
w I AOREE TO CAMPLV N7TH ALL CfTV AND COUHTV ORDINANCES AND STATE UWS REIATINO TO BUILDING
� CONSTRUCTION,AND MEREBYAUT/10RIZE REPRESENTA71VE5 OF 7HI5 COUNTV TO ENTER UPON THE �
ZABOVE-MEMqNED PROPERTV FOR INSPE auavosEs. COMMENTS '
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� RECPT:NO. PAID BY VALIDATION
WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy
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SET BACK ' � '' FLOOR JOIST � ,1.
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FTGS/FORMS/STEEL �: ��.:�.. ;:;� FHA REQMTS
ELECTRIC GROUND " ` � UNDER FLOOR DUCT, r�, , •:, :.r ,, . :,�., ,. .:.,� ;
GROUND PLUMBING UNDER FLOOR CUt�iDUl�-�i.:. Y':��^�..�_ � �; �!��a'
• SLAB GRADE FIREP ,GE FQUNDA�ION = 'i•��.' ' . `,�: -
TEMP POWER ' FIREPLACf�' �73fi1D�EAM � '�.'y'J` .� ` , :` •
WATER SERVICE MID HT. BOND BEAM
ROdF�SHEATHJt��-'� �" ^- �� i '�' ��f S Ff. BOND BEAM
FRAMINGNENTILIATION y � � , � FINAL BOND BEAM,,, ; 1 :• . , < < ;.,,
ROOF COVER ��'� PRE-GRRDING :;�-.+, fi'��,_r,, �� � ��,�
ROUGH HEATING � BENCN PJ''''' �.�`.� ��`if:� _`,•, y,i.� _�+.�`i�+,.:,� •,,.,:,
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ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUNIBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRlC �
EXT. LATH/SIDING � POnL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILWG DEDICATIONS �
SEWER. FINAL ENG. • •
SEPTIC TAAIK _ _. t�, t LANDSCAPE/IRRIG.
SEEP PIT/L.L. ' ' r- ' ON SITE IMPS.
GAS AIR TEST FINAL ZONING .
FINAL CONST. • FIRE DEPT. FINAL
FINAL HEATING p er7 �i HEALTH DEPT. FINAL
FIIVAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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SEPTI,C TANK SIZE
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