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Home My WebLink About17647 _�� CITY OF DIAMOND BAR EXF�IF�� DEPARTMENT OF COMMUNTI'1'&DEVELOPMENT SERVICES 21825 E.Copley Drive J U N 18 2001 �W PRESS (909)860-3195 Fax(909)861-3117 ��'��»�� BUILDING PERMIT APPLICATION FIRMLY o ADDRIESS�� /✓��/9�� DATEICATION �_ I � ER BER�� #/C o� ISSUE TYPE OCC APN LOT T,RACT DATE CONST. GROUP p OWNER I. / -�I.''�� " ADDRE1S�S �'''� -y " ✓ ZONING SETBACKS Z CITY!/ ; %7/! O :��Q+ ZIP TE . rF,Fe�lj_ r/ FRONT RW ❑ p APPLICANT TEL. S DE/SIDE STREET RW ❑ z ¢ CONTRACTO • �r� �" "!�! �iJ � SIDE ❑ ADDRESS � � —'.� /� � CITY G�'t��:�/l�`� Y}r ZIP� �"�l TEL. �-! PROPOSED USE o ARCH/ENG/ iz DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION I p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENAL7Y OF PERJURY 7HA7 I AM EXEMPT FROM THE CONTRACTORS LI� G2f890/CflfPOR W CENSELAWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPHOFESSIONSCADE:ANVqTYOR (n U COUNTVVhiICHRE4UIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORPEPAIRANY57RUC- W P2t10/DBCk w 7URE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT fOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � � CENSE UW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOUSpe FESSIONSCADE)ORTHATHEORSHEISEXEMPTTHEREFROMAN�THEBASISFORTHEALLEGEDExEMP- (� � �710N.ANY VIOLATION OF SECTION 7031.5 BY ANV APPLICANT FOR A PERMIT SUBJECTS THE APPIICAN770 Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLLAi15(f500).): Z ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITH:WAGESASTHEIRSOLECAMPENSA710N, 0 COrt1fIlBfCldl ' WILL DO THE WORK,AND THE STRUC7URE IS NO7 IN7ENDED OR OFFERED FOR SALE(SEC.7014,BUSI- J � NESS AND GROFESSIONS CADE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PqOPER7Y NRiO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WOHK HIMSELF OR HERSELF OR � THROUGHHISORHEROWNEMPLOYEES,PROVIDEDTHATSUCHIMGROVEMENTSARENOTINTENDEOOR m I Q OFFEREDFORSPLE.IF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE- Z TION.THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THA7 HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPoSE OF SALE). w ❑I,AS OWNER OF THE PROPERTV,AM EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS � TO CONSTRUC7 THE PROJECT(SEC.7014,BUSINESS AND PROfESSIONS CODE:THE CON7RACTORS LI- V81U2t1Of1 ADJ.AREA � W CENSEUWDOESNO7APPLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVES7HEREON,AND � WHOCANTRACTSFORSUCHPRQIECTSWITHACANTMCTOR(5)LICENSEDPURSUANTTOTHECONTRAC- OUANTITY DESCRIPTION FEE Y 70RS LICENSE LAW.). �� s�� ❑I AM E%EMPT UNDER SEC. B.6 P.C.fOR THIS REASON Q � U � DATE OWNER � � Z W dN-> .S ��Jd �SZr� � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENAL7Y OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � d e(COMMENCING WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSIONS CODE,AND Z X MY LICENSE IS IN FULL RCE�D�EF.F`EC7. (�' /'� . � LICENSE CLASS �`-" LIC.NO. � V V .'�� j � V DATE CONTRACTOR � . d W �� WORKERS'COMPENSATION DECLARATION _ N I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: � � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ Q CAMPENSATION,ASPROVIDEDBYSECTION37000FTHELABORCODE,FORTHEPERFORMANCE W OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � W _I HAVE AND WILL MAINTAIN WORKEHS'COMPENSATION INSUFANCE,AS RE�UIRED BV SECTION Q 3700 OF THE LA80R CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION J � CARRIER PLAN REVIEW Z POLICV NUMBER ELECTRIC Q � (iHISSECiIONNE�NOTBE00MPLEfEDOFhiEPERMITISFORONEHUI�DREDDOl1JAS(f100)ORLESS). PLUMBING - Z I CERTIFV THAT IN THE PERFORMANCE OF TNE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL � � (.r} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECAME SUBJECT TO THE � WORKERS'COMPENSA710N LAWS OF CALIFORNIA,ANDAGREE THAT IF I SHOULD BECOME INSPECTION FEE _ SUBJECT 70 7HE WORKERS'COMPENSA710N PROVISIONS OF SECTION 370o OF THE LABOR ��l � CODE,I SHALL FORTNWITH COMPLV WITH THOSE PROVI IONS. ISSUANCE � J � �� APPLICANT. � SMIP p DATE: J WARNING FAILURE TO SECURE WORKERS'COMPENSATION IS UNUWFUL,AND SHALL BE ENERGY P/C � SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCIV I SUPTOONEHUNDREDTHOUSAND ENERGYPEAMIT DOLLARS(5100,000),IN ADDITION TO THE COST OF COMP N ION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATT� EY'S FEES. RETENTION FEE: � � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � 1 HEREBV AFFIRM UNDER PENAL7Y OF PERJURV THAT 7HERE IS A CANSTRUCTION IENDING AGENCY � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. Z W � LENDER'S NAME I— LENDER'SADDRESS � TOTAL FEES c � I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECL � \ � w I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � � �l � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE ZABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � J � m PERMITTEE E(PfiINT) � � ¢ � ��/�-O✓ � � SIGNATUREOFP MITT E � DATE = RECPT.N0. PAID BY�. VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy ,\� t��D�`V" 'S�Ir� �'��`G�l(��1�'iI� ��I,� g��G��t� I�� nry�� G7�/�f�� , � � � , , _-----�-�..�-�-�a--�-�-,��-� .�. /7-�� 9;�_ �:. , � 0 oUVCJ��/U U�.JV V � D�� .. .. � UUV��LI U U�:J� � D(rJ��38 .O � o O a s,.[�^. SET BACK ' _ �_ � FLOOR JQIST ---_ ; ___.._._._---- FTGSlFORMSlSTEEL ' ___ � FHA REC�MTS � - -- -__— __ __...— ---._._ _ -------- ELECTRIC GROUND ' j UNDER FLaOR DUCT � J — -- -- --�-- ----- GRfJUND PLUMBING , ______ i UNDER FLOOR CU�!DUIT� � � -- --- _. _ _ »�_ _...... __ SLAB GRADE I _�_ ____ � FIREPLACE FdUfVDATION_ : TEMP POWER ; i FIREPLAGE BOND �EAM _ __ _ -� - -— W,4TER SERVICE__ __ ; ___�_ ___ _ MID NT. B�ND BEAM _..._ _.._...- ---_.__ _----- �_.......__�_ ROOF SHEATHING � 8 Ff. BOND BEAM FRAMING/VENTILIATION { I FINAL BOND BEAM � ---- __ _ ___�_ _____ __----r------ ___ ___...._. ROOF COVER i PRE-GRADING ROUGH HEATING BENCHIN� � ROUGH ELECTRIC RDUGH GRADING . _. ------_ __ _.� __._. _�_ ROUGH PLUfVIBING —�- � FINISH GRADING ---- — - SHOWER/TUB TEST ; I POOL ELEGTRIG --_` _._.___..._------ EXT. IATH1SIDiNG POOL FENCING i WALL IfVSULATION i POOL FINAL i __ _ CEILING IIVBULATION � ! OFF SITE 1MPS. --.__�_ ...._.- �-- ----- --------------- -- �_ DRYWALL NAIUNG ' � DEDIGATIONS � SEWER FINAL EhlG. ` SEPTIC TAfVK LANdSCAPE/IRRIG. -�- � SEEP PITIL.L. � ON SITE lMPS. � GAS AIR TEST FINAL ZONING � FiPlAI.COi�ST. — --- � , �=1RE DEPi. FINAL---- ---_ _`_. FINAL HE,4TING HEALTH L7�PT. FINAL FINAL EIECTRiC �--}-- � DEV. FEES PAlD FIiVAL PLUMBING I j ENERGY - -- -- ' --...._..__.__. ��o a COfViNiENTS SEPTIC TA�lK SIZE SEEP PIT/U SIZE " ---- — � �� -- ---- —._.___..______— � �. . � --------------