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Home My WebLink About17356 (30)� CITY OF DIAMOND BAR EX�'I R E D ----��` — DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES I 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 �U N �7 ZOOZ PRESS "'%»�" BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE �/'""J 5� .t i��Q�`�> /S /��n DATE CATION�— �� NUMBER �� X� #/C ADDRESS_ �J C�O /% L�L K � ISSUE � TYPE OCC APN LOT TRA T DATE CONST. GROUP °C OWNER G!/ O o ADDR SS ZONING SETBACKS Z CITY � ZIP��-�-t�' L. — FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW ❑ z Q CONTRACT R �Q17)1.0 p � SIDE ❑ � ADDRESS PROPOSED USE aV� GL�� ' � CITY ZI ,�� EL._C��,[� w ARCH/ENG/ �� —�6 z DESIGNER w NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM EXEMPT FROM THE CONTRAC70RS LI- Gef899/CBfPOfI W CENSELAWFORTHEFOLIOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCI7VOR (n U COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTEH,IMPqOVE,DEMOLISH,ORREPAIRANYSTRUG � w TURE.PRIOR TO ITS ISSUANCE,AL50 REDUIFIES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck STATEMENT THAT HE OR SHE IS LICENSED PURSUAN7 TO THE PROVISIONS OF THE CON7RAC70R5 LI- � CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� � PooUSpa FESSIONS CADE)OR THAT HE OR SHE IS EXEMPTTHEREFROM AND THE BASIS FOR THE ALLEGED E%EMP- (� � TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PEflM1T SUalECTS THE APPUCANT TO Z Re-Roo( A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5500).): ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOVEESWITH:WAGESASTHEIRSOLECOMPENSATION, ❑ Z Commercial - WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFfERED FOR SALE(SEC.7o4I,BU51- J � NESS AND PROFESSIONS CODE:THE CON7RAC70R5 LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV WHO BUILDS OR IM7ROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEREDFORSALEIF,HOWEVER,THEBUILDINGORIMPROVEMEMISSOLDWITHINONEVEAROFCOMPLE- � TION,THE OWNER�BUILDEH WILL HAVE TME BURDEN OF PROVING THAT HE OH SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). � = OI,ASON7JEROFTHEPROPER7V,AME%CLUSIVELVCONTRACTINGWITHLICENSEDCONTRACTORS W � TO CANSTRUCT THE PR0.IECT(SEC.70a/,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� ValUetlOfl ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN OMMER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR�S)LICENSEDPURSUANTTOTHECANTRAG QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. � B.8 P.C.FOR THIS REASON Q � U � � DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION w . � I HEREBV AFFIRM UNDER PENAL7Y OF PERJURV THA7 I AM IICENSED UNDEF PROVISIONS OF CHAPTER � d 8(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z X AIV LICENSE IS IN FULL FOF7CE AND EFF CT. � IICENSE CLASS �� LIC.NO. ��O/ � _ j � J V DATE �D "�O CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECIAFATIONS: Z Z _I HAVE ANO WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOR WORKERS' _ CAMPENSATION,AS PROVIDED 8V SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE U I ¢ OFTHE WORK FOR WHICFI THIS PERMIT IS ISSUED. � � I W 1 HAVE AND WILI MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION (((��/� � Q 3700 OF THE LABOR CODE,FOR THE PERFOHMANCE OF THE WORK FOR WHICH THIS PERMIT IS �[' I,� ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION l� J l�V Q ��r- �i� � CAHRIER ��/�/� /�'t.�jtl� PLAN REVIEW Z POLICY NUMBER I�� h �—�` ELECTRIC Q �'/ � (fHISSECf10NNE�NOTBENMPLEfEDOFTI-IEPERMfT6FORONEM1rDREDDOLLARS(f100)ORLESS). PLUMBING Z I CERTIFY THAT IN THE PEFiFORMANCE Of THE WOHK FOR WHICH THIS PEFMIT IS ISSUED,I MECHANICAL '4"P"�=� /-�\ 'ST '��`"\ (.'} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE �t�"'��f'"^•�_ I � �.,,,...� � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECAME INSPECTION FEE i SU&IECT TO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR �,(, � CO�E.I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE A 1 n{I /� � 'I '\ � � �/ � SMIP � ' '. p DATE:�l O�D/APPL�CANT: �'�1 �+ _ � ENERGY P/C n J WARNING:FAILURETOSECUREWORKERS'COMPENSATIONCAVERAGEISUNLAWFUL,ANDSHALLBE �,r � SUBJECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT Y ' DOLLARS(5100,000),IN ADDITION 70 7HE COST OF COMPENSATION,DAMAGES AS PROVI�ED FOFi IN - _._--y--- ,,.___ � SECTION37080FTHELABORCODE,INTEflEST,ANDATTORNEV'SFEES. RETENTIONFEE: ~sM ` � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMI7IS ISSUED(SEC.3087,CIV.C.). Z � W � LENDER'S NAME � LENDER'SADDRESS � TOTAL FEES � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE TFIAT THE ABOVE MFORMATION IS CORRECT. � l � w t AGHEE TO COMPI.V WITH A�L CITV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDINCa � � CONSTRUCTION,AND HEREBY AUTHORIZE FEPRESENTATNES OF THIS COUNTV TO ENTER UPON THE ZABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS � � � . e/lJ PER `E�N �E��PRINT�) �j� � 2..��7C-`� /'r � //-06-- �/ , : � SIGNAT E FPE ITTEE OATE �/ = RECPT.NO. PAID BY VALIDATION � � ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENR06—File Copy,GREEN—ApplicanYs Copy ,. .. . .. . .. . . .. . ,_ , . , .. ,. �� a�� I� ' �� , � '�s� �� C R ��..��1 �� W:.�::_��f� , �� Q � �_ _ _._�_ _�_.. w. �„_ �,e , SET SACK i _1-T- . FLOOR JOIST __ , -----r ----- ----- ----____--- FTGS/FORMSISTEEL ; ! FHA RE�MTS +� ---- -1--------- ELECTRIC GROUND 1 UNDER FL{JOR DUGT ---- ------- --...._�._-- -___.�__.._________._. _---- __.__..___ GROUND PLUMBING �—� __ � UNDER_FLOOR CUf�;DUIT __� ! SLAB GRADE FIREPLRCE FOUf�D,4TION � TEMP POWER __ L ---- - ---FIREPLACE BOND BEAM _.__-�---.----- WATER SERVICE ' i MID HT. 60ND BEA4`�1 � ____ ROOF SHEATHIiVG j� rf/e�! �• � � 8 FT. BOND BEAM _ � FRAiVIINGNENTILIATION � ' FINAL BOND BEAM ( --- '--- ....-- ------f--. —___— ______�__---.._.._. __---..._.---- ROOF COVER i PRE-GRADIPJCa ; ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRADING � _ --- ---- —.._.._-- ROUGH PLUNIBING ! FWISH GFiRDING ___._._ --- ----- ---.___�_. _. _ — ---- -----........ SHO`J1fER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION , POOL FIN�kL � - --- --- ------ ------- CEILING IN�ULATION j OFF SITE IMPS. ' DRYWALL NAILIf�G � DEDICATIONS SEWER FINAL ENG. I. _ �' -4- ...._.._._. ��. SEPTIC TAIVK LANDSCAPE/IRRIG. I SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. � �IRE DEf'T. FINA� � � FINAL HEATIIVG HEALTH DEPT. FINAL --, FINAL ELECTRIC � ' DEV. FEES PAID — - --..____ �___._��.. ___..__ FIfVAL PLUMBIP�G ENERGY ; --- - --� ---- � � --- ------- - — �G�C�_�,Q:� , . COfViiViEi�TS SEPTIC TANK SIZE SEEP PIT%U SIZE -� � - ----.__.__ __...-------- •� � - — � � � . ---------