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Home My WebLink About17956 (32)� � , ,Y CITY OF DIAMOND BAR ------��' — DEPARTMENT OF COIvIIvIUNITY&DEVELOPMENT SERVICES . � 21825 E.Copley Drive ''-i (909)860-3195 Fax(909)861-3117 PRESS �`'%�� BUILDING PERMIT APPLICATION FIRMLY o DDRIESS � � 3 O MAT_�'I�LL DATECATION y � ��,,,(��?UMBER�� #/C Q�'�`� l � ISSUE 'T� TYPE OCC APN LOT TRACT DATE � � CONST. GROUP p OWNER _R;'I-A (1 �CA�vN - ADDRESS l(03 8 ;JKk_p�(��LL ZONING SETBACKS Z CITY I�i/}Wt�7�v�� evP ZIP TEL.q09 RL� .,'S6.2K FRONT RW ❑ o APPLICANT lVltic.kws( S}�wtl� TEL.y�'1�(�,99•5�'%lJ REAR ❑ Z SIDE/SIDE STREET RW ❑ m CONTRACTOR_I�+c;L►AiL �:rv►oivL 5 f/o��.�i�.�nfr5 SIDE ❑ oCDDRES '� � ZIP��TEL. q��I�'.L9-5S7Q PROPOSED USE A � � oARCH/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 O p I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRAC70R5 LI- GefeJO/CBfPOft W CENSEUWFORTHEFOLLOWINGREASON(SEC.7o31.50U51NES5ANDPROFESSIONSCODE:ANYCITVOR (n U CAUNTVWHICHREOUIRESAFERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W Patio/Deck w TURE,PRIOH TO I7S ISSUANCE,AL50 RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W ' STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON7RACTORS LI- � CENSE UW(CHAPTER B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooUSpa FESSIONSCADE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFOR7HEALLEGEDEXEMP- (� � TION.ANVVIOLATIONOFSECTION7031.5BVANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNORED DOLLARS(f50D).�: Z ❑I,ASOWNEROFTHEPROPERTV,ORMYEMPLOYEESWITHWAGESASiHEIR50LECOMPENSA7ION, � COffIfflBfC181 - WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7041,BUSI� J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPERTV WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIMSELFOR HERSELF OR CL THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREDFORSALE.IF,HOWEVERTNEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BUR�EN OF PROVING THAT HE Ofl SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w O I,AS ONRJER OF THE PROPER7V,AM E%CLUSIVELY CONTRACTING WITH LICENSED CANTRACTORS � TO CONSTRUCT THE PR0.IECT(SEC.7os1,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS ll- V81U8�1Of1 ADJ.AREA W CENSE UW DOES NOTAPPLV TO AN OMMER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � WHOCANTMCTSFORSUCHPRQIECTSWITHACONTRAC70R�S�LICENSEDPURSUANTTOTHECON7RAC- QUANTITY DESCRIPTION FEE Y 70F5 UCENSE LAW.). � ❑1 AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � � DATE OWNER � Z W � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNOER PENALTY OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CODE,AND Z `X MV LICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CLASS+� l7' I LIC.NO. ��1� j V DATE �Z� J�'V�-. CONTflACTOR f-IUMfW0,�K5 a w � WORKERS'COMPENSATION DECLARATION � Q � I HEREBV AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWING DECUFATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�WSURE FOR WORNERS' _ COMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U ¢ OF THE WORK FOR WHICH THIS PEf1MlT IS ISSUED. � � w _I HAVE AND WILLMAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION /� /�� Q 37000FTHELABOflCOOE,FORTHEPEHFORMANCEOFTHEWORKFORWHICHTHISPERM1T15 �" '� yj � ISSUED.MY WORKERS'CAMPENSA710N INSURANCE CARRIEF AND POLICY NUMBER ARE: CONSTRUCTION _ _ O lJ J j CARRIER PLAN REVIEW ZPOLICY NUMBER ELECTRIC Q � (fHLSSECiIONNEmNOTBECOMPLEfEDOFTiEPEW.If�ISWRONEHUI�DREDDOLLARS(5100)ORLESS). PLUMBING W Z �I CER7IFV THA7 IN THE PEfiFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL CJ' SHALL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFOFNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � � SUBJECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR � CODE,I SHALL FORTHWITH COMPLV WITH THOSE P�iOVISIONS. ISSUANCE Y ry � nC1 ,` � ,�� SMIP P5�.l p DATE:�".S"1'O L APPLICANT: �_4(' J WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVEfiAGE IS UNLAWFUL,�ND SHALL BE ENERGY P/C � LL SU&IECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOlLARS(5100.000),IN ADOITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SEC710N37o80FTHEUBORCODE,INTERES7,ANDATTORNEV'SFEES. RETENTIONFEE: a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTY OF PERIURY THAT THERE IS ACONSTRUCTION LENDING AGENCV � FOR THE PERFORMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.�. � Z � W �� LENDER'S NAME F— LENDER'SADDRESS � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL F E ES t �� w 1 AGREE TO COMPLY WITH ALL qTY AND COUNTV ORDINANCES AND STATE LAWS REUTING TO BUILDING � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF 7HIS COUNTV 70 ENTER UPON THE �O� Z ABOVE-MENTIONED PROPERTV fOR INSPECTION PURPOSES. COMMENTS 0 J (v�;��r�tL 5��vwN�s PERMITTEE"NA'ME(P�INT) /1 �1 � ¢ dvt�.��aV•�1W►�vK^G6� l!"/Z9"OZ. � �� SIGNATURE OF PERMITTEE DA7E ! = RECPT.NO. PAID BY VALIDATION�� ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GdLDENR �File Copy,GREEN—Applicant's Copy . . . ' . . .,.. . .. , . �.t<. ��. .. �.�: ..�. . - .. . . .... .. .. . .,n ,. .... . . , �� . .. . . .. ..,.. . . , . l�y� J i( �Ylf �DIYSVHO�IS7� �L'�U� ��c��o�� r�� lf��lYL��u I��JL�J ��i`� �U�1�JIr'I,��>�U l'�..�r� ��`��_'.. � �W ?,. � '� , �d�ti� � � v�4�.� SET BACK Y� � .� FLOOR J�IST M � Y - ---.--- - - --- ---- _._..__ _ 9_.__._ ..____ , _.----- FTGS/FORMS/STEEL p�� ,�'� ' FHA REQMTS ' -:J_.._ __. --- -. ELECTRIC GROUND ��- � � UNDER FLOOR QUCT �_----- GROUND PLUMBING � UNQER FLQOR CUf�IDUIT � ' : ._- ------- ---i , , --.._._.._._ SLAB GRADE _ � ___ � FIREPLACE_FOUNDATION _' ____ __ --- - - TEMP P�WEA I FIREPLAC� B(JND BEAM � ___.-�__...__� __...,.__ �.....-- - --...__�� _.____._____ WATER SERVICE --._ _-- ----_i MID HT. �C}f�i� BEAM � - - --- -V__----------- -._....___ ROOF SHEATHING / + 8 FT. BO.ND BEAM I FRAMINGNENTILIATION 1��GZ .� I FINAL BOND BEAM _ � ___ ROOF COVER � PRE-GRADING � ROUGH HE,4TING BENGHING � ROUGH ELECTRIC ROUGH CRADING � �� -- ----�---- ----- - ___ ---_..._----�- -__......__.._._-- ROUGH PLUMBING i i FINISH uRADING ------ -------- ---- _.. ___---__ ___._._--------- ----._.__..._._. SHOWER/TUB TEST � POOL ELE�TRIC - -- ----- -----.. ------ EXT. LATH/S1DWG , POOL FENCING j UVALL IIJSULAT{ON POOL FINAL i CEfLING IN�ULATION _ �OFF SITE lMPS. _ DRYWA�L NAILlNG DEDICATIONS - - --- -- -- --�---------__...�__-__ S�WE�{ FINAL EIVG, SEPTIC TANK LANDSCAPE/IRRIG. � � SEEP PIT/L.L. ' ON SITE iMPS. I GAS AIR TEST FINAI ZONING FIN,4L CONST. ��62 , F!RE DEPT. FINAL _ FINAL HEATING , HEALTH �EPT. FINAL � - � ---- ---- FINAL ELECTRIC _1_ DEV. FEES PAID ,-- ------ ------ ____.._._._._.__ FIPVAL PLUMBlNG � j ENERGY i - ------- -..-----------r- ---...._.. C�G�fU'OG � < a CUiVIi�iEiVl'S — SEPTIC TANK SIZE SEEP PIT/U SIZE -- �---- � � -- ----- _.._.....__..--- °� � -- � ,1 ----------.