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Home My WebLink About17515 _�1 CITY OF DIAMOND BAR '��,�', EX�lRED �-----�'�`--- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive J U N 19 20Q2 '�" (909)860-3195 Fax(909)861-3117 PRE$$ ��'��w BUILDINGPERMITAPPLICATION FIRMLY o� JOBSITE / � � �� r APPLICATION I � �f �j PERMIT 1--�j) P/C ADDRESS_ DATE ��NUMBER # � ISSUE TYPE OCC r° APN 'LOT TRACT DATE CONST. GROUP p OWNER v o ADDRESS ZONING SETBACKS � Z CITY ZIP TEL FRONT RW ❑ � APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ z ¢ CONTRACTOR D SIDE ❑ Q ADDRES � CITY ' ZIP �/,7��TEL. I PROPOSED USE C7 S�/ , I�� i w ARCH/ENG/ � �� G �y� ' z DESIGNER a i w NO.DWEL. NO. NO. � 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 AFFIRM UNDER PENALTY OF PERJURY THAT I AM El(EMPT FROM THE CONTRACTORS LI- GefB J6/CBfPOff W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITYOR (n U COUN7VWHICHREOUIRESAPERMITTOCONSTRUC7,ALTER.IMPROVE.DEMOLISH,ORREPAIFiANYS7RUC- w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT 70 FILE A SIGNED w Patio/Deck STATEMENT 7HAT HE OR SHE IS LICENSED PURSUANT TO THE PqOVI510NS OF THE CONTRAC70RS LI� � CENSE UW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AN�PRO- � Pool/Spa O FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� (� V TION.ANV VIOLATION OF SECTION 7031.5 BY ANV APPLICANT FOfl A PERMIT 5U&IECTS THE APPLICANT T0 Z Re-Roof A CIVIL PENALTY OF NO7 MORE THAN FIVE HUNDRED DOLURS(5500).): � ❑I,ASONMEROFTHEPROPER7V,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrt1rtIBfClel - Z WILL 00 THE WORK.AND THE STRUCTU{iE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7a41,BU51� J � NESS AND PROFESSIONS CODE:7HE CONTRACTORS LICENSE LAW DOES NO7 APPLV TO AN OWNER OF � PROPER7V WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OH HERSEIF OR Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDE�7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREDWRSALE.IF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE�ID NOT BUILD OR � IMPHOVE FOR 7HE PURPOSE OF SALE). w ❑I,ASOWNEROF7HEPROPERTV,AME%CLUSIVELVCON7RACTINGWITHLICENSEDCAN7RACTORS � TO CONSTRUC7 THE PR0.IECT(SEC.7o1I,BUSINESS AND PROFESSIONS CODE:7HE CON7RACTORS LI� V81U8�1Of1 ADJ.AREA W CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � WHOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S�LICENSEDPURSUAN7707HECONTRAC- QUANTITY DESCRIPTION FEE Y 70RS LICENSE LAW.). � J � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � � DATE OWNER � Z w ¢ LICENSED CONTRACTORS DECLARATION w aC �HEREBV AFFIRM UNDEH PENALN OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � d D(COMMENCING WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSIONS CODE,AND Z X MV LICENSE IS IN FULL FO1RCE EFFECT. � LICENSE'C/ SS � �/� LIC.NO. ��U� j V DATE r � CONTRACTOR a W � �� WORKERS'COMPENSATION DECLARATIO a . � I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DECLARATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ Q CAyPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE `U A �l�7HE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w 'V 1 HAVE AND WILL MAIN7AIN WORKERS'CAAIPENSATION INSURANCE,AS RE�UIRED BV SEC710N � �/ � Q 3700 OF THE LABOR CODE,FOR THE PE ORMA E OF THE WORK FOR WHICH THIS PERMIT IS ( _ \r�S I� ISSUED.MY WO S'CO PENSATIO I SURA E CARRIER AND POLICY NUMBER ARE: CONSTRUCTION '\P� J � CARRIER PLAN REVIEW ZPOLICYNUMBER ELECTRIC Q � (fHISSEGTpNNE�NOTBECONPLEfmOFTHEPERMfTISFORONEFdN�OREDDOLLPAS(f100)ORLESS) PLUMBING Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (.�J SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGR THAT IF I SHOULD BECAME INSPECTION FEE SUBJECTTO THE WORKERS'COMPENSATION PROVISI NS SECTION 37000F THE LABOR 'YY� � CAD I SHA ORTHWITH COMPLV WITHTHOSE PR i s. ISSUANCE � \.J�� SMIP iJ� p DATE: APPLICANT: J WARNING:FAILURE TO SECURE WORKERS'COMPENSATI RAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C � SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCIVIL N SUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f100,000),INADDITIONTOTHECOSTOFCOMPEN ON,DAMAGESASPROVIDEDFORIN � SECTION 3708 OF THE LABOR CODE,INTEREST,AND AT70RN 'S FEES. RETENTION FEE: � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIPM UNDEFI PENAL7V OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMI7151SSUED(SEC.3097,CIV.C.�. Z w � LENDER'S NAME F— LENDER'S ADORESS � TOTAL FEES �.e J� � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPLV WIT L CITY AND COUNTY ORDINANCES ANO STATE LAWS RELATING TO BUILDING d � CONSTRUCTION,AN BVAUTHOR2EREPRESENTATIVESOFTHISCOUNTYTOENTERUPONTHE Z ABOVE-MENTIONE RO RTV FOR INSPECTION PURPOSES. COMMENTS 0 J � m PERMITTEE NA (PRINT) L Q /V � � SIGNATURE MITT DATE � �� = RECPT.NO. PAID BY VALIDATION ~ WHtTE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy r. � . .. .� ... . ... . . .. .. . , . .. .. .. .. ... .. . . . .. . .,. . . ;e. .. . , . .. . , �� 0�� a��t��' ��N� ��o�� ° �� DQ`tr� 0 ° �� 3�� Q a D�� 0 ° � o � SET BACK -- I F�OQR JQ(ST ` ': �__ .._.__ ----- � -__-- . -- __----- �_ _._._..----'--'-- FTGS/FORMS/STEEL ; ; FHA REQMTS � � ;_ _ _ ELECTRIC C.,ROUND ; i UNDER FLQQR DUCT -— --- --- --- ; _ GROUNQ PLUMBING j UNDER FLOOR CUt�!dUIT ' ______ ___ � SLAB GRADE � _ FlREPLACE FOUNQATION �_ TEMP POWER FIREPLACE BOND BEAM __ WATER SERVICE I MID HT. BQND BEAM ROOF SHEATHING �Z Z7�'/ _ 8 FT. BOND BEAM � _ FRAMIPJG/VENTILIATION i FINAL BONb BEAM ___ RO�F COVER PRE-GRADiNG , ROUGH HEATING BENCHlNG ROUGH ELECTRIC _ R�UGH GRADING__ ___ ROUGH P�UMBING ----+ FINISH GRADING -- - ----- --___-_- _ _ SHOWER/TUB TEST ; POOL ELEC7RIC __ _` EXT. LATH/SIDING ' , POOL FENC(NG � — --__--- ---- --- � WALL INSULATIOhI ; POOL FiNAL � CEILING IN�ULATION - -------- -� OFF SiTE !ri1lPS___.----- ------ ----- DRYWALL hlAILING ��T�� _. ------ ----+------------...._ �� SEWER ---- ( t=1NAL E�lG. �_----- SEPTIC TANK . LANDSGAP�/IRRfG. � SEEP PIT/L�.L. � O�!�IT�IN'iF�S. �-- ----_.._� GAS AIR TEST FIPJRL Z�JNlf�G FIN,4L COiVST. � �IRE DEPT. FIiVA� _.__._ -- FIIVAL HEATING I HEALTN DEPT. FINA� FINA�ELECTRIC DEV. FEES PAiD FIfVAL PLUMBIMG ENERGY i -- I ---- ��o. , -- CD��5 SEPTIC TANK SIZE SEEP PIT/U SIZE - _ _....----- -------.. � __._ ---____-- ---------- � � - --------- \ - --- � ' ----