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Home My WebLink About10-1166 (5) _��„`_ CITY OF DIAMOND BAR �� O � �� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � � �3 � 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 PRESS '��'� BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE 9� "] ` APPLICATION PERMIT � '` #/C ADDRESS � �'�� •� DATE NUMB �� ISSUE //'�I / �� TYPE' �r OCC /�97-� APN LOT TRACT DATE CON � � GROUP � p OWNER � ADDRESS ZONING SETBACKS 0 z CITY q ZIP TEL�9 — � FRONT Ryy p p APPLICANT TEL. REAR p Z SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ o CDDRESS ZIP TEL. PROPOSED USE LTT�� '�"/I"y'� _ G�i� �� o ARCH/ENG/ - � � z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES " BEDROOMS cn u� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEHEBV AFFIRM UNDER PENALTY OF PERIURV THAT I AA/E%EMPT FROM THE CONTRACTORS LI� G8�89B/CefpOfl W CENSEIAWFORTHEFOLLOWINGHEA50N(SEC.7031.SBUSINESSANDPROFESSIONSCOOE:ANVCITYOR (f� U COUN7VWHICHREOUIHESAPERMI7TOCONSTRUCT,ALTER,IMPROVE.DEIAOLISH,ORREPAIRANYS7qUC- � w TURE.PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPUCANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � S7ATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CAN7RAC70R5 LI- � � CENSE UW(CHAPTER e(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSPa _ Q FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREF{iOMANDTHE8ASI5FORTHEALLEGEDEXEMP- C7 V TION.ANV VIOLATION OF SECTION 7091.5 BY ANY APPLICANT FOR A PERMI7 5U&IECTS THE APPLICAN7 T0 Z Re-Raof � A CIVIL VENALTY OF NOT MORE hiAN FIVE HUNDRED DOLURS(S50o).): Z �I,ASOWNEROfTHEPROPERTV,ORMVEMPLOVEESWITNWAGESASTHEIRSOLECOMPENSATION, � Cof11f11BfCial WILI DO THE WORK,AND THE STRUCTUHE IS NOT INTENDE�OR OFFERED FOR SALE(SEC.701�,BUSI� J � NE55 AN�PROFESSIONS CADE:THE CONTRACTORS LICENSE LAW DOES NO7 APPLV 70 AN OWNER OF � PROPERTV WHO BUILOS O{i IMPROVES 7HEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THA7 SUCH IMPROVEMENTS ARE NO71N7ENDED OR m Q OFFEREDFORSALEIF,HOWEVERTHEBUILDINGOHIMPROVEMENTISSOLDWI7HINONEYEAROFCOMPLE- 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,ASOWNEROFTHEPROPERTV,AMEXCLUSIVEIYCON7RACTINGWITHIICENSEDCON7qACTORS Q TO CONS7RUCT THE PRQIECT(SEC.70��,BUSINESS AND PROFESSIONS CADE:THE CANTRACTORS LI- V81U2110l1 ADJ.AREA W CENSEIAWDOESNOTAPPLVTOANOWNEROFAGROPERTYWHOBUILDSORIMPROVES7HEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITHACANTfiACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE � Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � � DATE OWNER F � w � LICENSED CONTFACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PENALTY OF PEfiJURV 7HA71 AM LICENSED UNDEH PROVISIONS OF CHAGTER � � e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� MY UCENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CIASS LIC.NO. j . V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION a � I HEREBY AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECLAHATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSEN7 70 SELF-INSURE FOR WORKERS' a 2 Q COMPENSATION,AS PROVIDED BV SECTION 37000F TME LABOR CODE,FOR THE PERFORMANCE U OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. w � � W I HAVE AND WILL MAINTAIN WORKERS'COMPENSA710N INSURANCE,AS REOUIRED BV SECTION � Q3700 OF THE UBOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICY NUMBERARE: C NSTRUCTI �O�D O Q � CARRIER PLAN REVIEW � POLICV NUMBER ELECTRIC Z Q � (1}iI55ECIlONNEmNOTBE00MiiEfEDOFiHEPEfUMISFORONEHUPDREDDOILAFiS(f100)ORLESS). PLUMBING Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C} SHALL NO7 EMPLOYANV PERSON IN ANY MANNER SOAS TO BECOME SUBJEC7707HE � WORKERS'COMPENSA710NLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE ? SUBJEC7 T0 THE WOqKERS'COMPENSATION PROVISIONS OF SECTION 3700 0F 7HE LABOR � `l CADE,I SHALL FORTHWITH COMPLV WITH THOSE PHOVISIONS. lJ O IP . p DATE: APPLiCANT: J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS 11NUWFUL,AND SHALL BE ENERGY P/C � SUBJECTANEMPLOYEFTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f100.000�,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE.MTEREST,AND ATTORNEV'S FEES. FE ' � OCONSTRUCTIONLENDINGAGENCY PRE-A F/� � I HEREBV AFFIf1M UNDEFi PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCV /. � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.Q�. Z W � LENDER'S NAME F– LENDER'SADDRE55 � TOTAL FEES ?� � I CEFTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. W I AGREE TO CAMPLV WITH ALL CITY AND CAUNTY ORDINANCES AND STATE LAWS REUTING TO BUILDING � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER U70N THE � ABOVE�MENTIONED 7ROCERTV FOR INSPECTION PURPOSES. Z COMMENTS � �/ ��/� �� aPERMI77EE NAME(PRIN7� �/� � � . C/J .i. N ATURE OF PERMITTEE DATE _ - RECPT.NO. PAID BY VALIDATION � ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENR ile Copy,GREEN—Applicant's Copy �B�Y �I� DB�a�Vd01�� ff� oY�SI�(��'80� I�I��D Oa�pC�(�400a o'�4C� Q�I�pL(�40G3 OG��pCC�4�0a � �'G�L -. D[��pCC�4�:�,°'' � _ _ _ _ _ _. _ . SET BACK FLOOR JOIST FTGS/FORMS/STEEL �O� FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlfUB TEST POOL ELECTRIC EXT. LATH/SIDING 9 �ix� POOL FENCING _ _ __ __ WALL INSULATION �� POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID _ FINAL PLUMBING ENERGY C�"l �o � --- COMMEIVTS ��^ �130/� � SEPTIG TANK SIZE SEEP PIT/U SIZE a :� � --- -- -- � � . , ,.