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Home My WebLink About18337 (28) � �—� CITY OF DIAMOND BAR ��---��` ---- DEPARTMENT OF COIvIIvIUNTI'Y&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS "'-��' BUILDING PERMIT APPLICATION FIRMLY } JOBSITE 13�� , 1V�� U2. (••, APPLICATION PERMIT I��'�j P/C^ o ADDRESS DATE a "I �b 1' NUMBER � # lJ� � ISSUE ,i r �U TYPE OCC APN L T TR•�Af T DATE � CONST. GROUP °C OWNER i C a2 u�'Q O " ADDR �S I �12 (', ZONING SETBACKS 0 Z CITY � N � ZIP TEL. FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW ❑ z Q CONTRACTOR SIDE ❑ o CDDRES d � � , Z�P � TEL. I PROPOSED USE � IJ l.��` o Or w ARCH/ENG/ z DESIGNER , w NO.DWEL. �, NO. NO. � ADDRESS UNITS STORIES �_ BEDROOMS � CITY ZIP TEL. N cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEFEBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CON7RACTORS LI� G8f8QB/CBfpOR W CENSEIAWFORTHEFOLLOWINGREA50N(SEC.7o37.5BUSINESSANDPROFES510NSCODE:ANVCI7VOR (n U CAUN7YWHICHREOUIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE.DEMOLISH,ORRE7AIRANYSTRUC- � w TUFiE.PRIOR TO I75 ISSUANCE,AL50 RE4UIRE5 7HE APPLICANT FOR SUCH PERMI7 70 FILE A SIGNED w Palio/Deck STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PHOVISIONS OF THE CONTMCTORS LI- � CENSE LAW(CHAPTER B(CAMMENqNG WI7H SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PRO� � POOVSp2 � FESSIONS CODE)OR 7HA7 HE OFi SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED E%EMP- (� V TION.ANVVIOLATIONOFSECTION7031.SBVANYAPPLICANTfOFAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENALTV OF NOT MOFiE 7HAN FIVE HUNDRED DOLURS(t500�.): ❑I,AS OWNER OF THE PROPERTY,OR MY EMPLOYEES W ITH WAGES AS 7HEIR SOLE COMPENSATION, Z � Commercial WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED fOR SALE(SEC.7011,BUSI- J � NESS AND FROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTV NTiO BUILDS OR IM PROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGHHISORHEROWNEMPLOYEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m -��Q ..OFFEREDFORSALE.IF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NO7 BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). ❑I,AS OWNER OF THE PROPERTV,AM E%CLUSIVELY CON7RACTWG WITH LICENSED CON7RAC70H5 7� F� TO CANSTRUCT THE PRQIECT(SEC.7oa4,BUSINESS AND PROFESSIONS CADE:7HE CON7RACTORS LI� Ve1U2110f1 Zv � ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPER7VWHOBUILDSORIMPHOVESTHEREON,AND � WHOCONTRACTSFORSUCHPRQIECTSWITHACANTRAC70R(S)LICENSEDPURSUANTTOTHECONTRAC- �UANTITY DESCRIPTION FEE TORS LICENSE LAW.). / � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ( O 0�"' � � �� ^� � � OC� e C F I . � o �- ZDATE OWNER U ' �, O _ � w � � LICENSED CONTRACTORS DECLARATION w 2' I HEREBY AFFIRM UNOER PENALTV OF PEiLIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � . � 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND Z X �MY IICENSE IS IN FULL FORCE AND EFFECT. / � LICENSE CLASS I G• LIC.NO. `� I�� j V DATE V ,��• CONTRACTOR d W � � ��Q WOR RS'COMPENSATION DECLARATION � � Q . . i � I HEREBY AFFIRM UNDER PENAL7Y OF PEfiJURY ONE OF THE FOLLOWING DECLARATIONS: . Z � Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ a CAMPENSA710N,AS PROVIDED BY SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE W OF 7HE WORK FOR WHICH THIS PERMI71515SUED. ' � � W I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS{iEOUIRED BV SECTION Q370o OF 7HE LABOR CODE,FOR THE PERFORMAN�/E OF THE WORK FOR WHICH THIS PERMIT IS �I"S� ¢ ISSUED.MY WORKEFIS'c0 PENSATI�N RANL,CARRIER AND POLICV NUMBERAflE: CONSTRUCTION r�.� �y► � CARRIER J li4 ��( PLAN REVIEW __ /� Z POLICY NUMBER�� L��, � ELECTRIC , �\).�� Q � (1FIISSEC�qNNE�NOTBEO�MPLETEDOFTHEPERMiTISFORONEFNI�DREDDCILARS(5100)ORLESS� PLUMBING Z I CERTIFV THAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL '' � (.'} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECAME SUBJECT TO THE ' I �/j WORKERS'COMPENSATION LAWS OF CALIFORNIA,ANDAGREE THAT IF I SHOULD BECAME INSPECTION FEE � SUBJECTTOTHEWORKERS'CAMPENSATIONPROVISIONSOFSECTION37000FTHELABOR I � � COOE.I SHALL FOHTHWITH COMPLV WI OSE PR ONS. ! ISSUANCE 0 /�( n p DATE:!I��LICAN� V�/ ' SMIP ' _ � J WA�N :FAIIUR SECURE WORKEHS'C ENSATIO COVERAGE I FUL,AND 5 ALLBE ENERGY P/C I �• SUBJECTAN EMPLOVER TO CRIMINAL PENAL7IE CIVI FINES UP TOONE H DRED THO SAND ENERGY PERMIT DOLURS(5100.000),IN ADDITION TO THE COST OF C SATION,DAMAGES AS VIDED OR IN ,'1 �� SECTION 370B OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: v� � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: ^ � 1 n � 1 � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMI7151SSUED(SEC.3a87,CIV.C.). . � Z W � LENDER'S NAME � LENDER'SADDRESS � TOTAL FEES S a � I CERTIFY THAT I HAVE fiEAD THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. � I AGREE TO COMPLV WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS REUTING TO BUILDING ; ^ � ��1 �� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � �� Z ABOVE�MEN710 ED ROPERTV FOR INSPECTION PURPOSES. � {.�� Q �� `/�w� �� COMMENTS J • �• ^V•^I' � QPERM E�AME /��( r1 ^y, N w� � �/ _��. � � SI REOF E ITTEE � DATE � = RECPT.NO. PAID BY VALIDATION / ~ E—De artment Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN—A lican's Co PY� PY, PY. PY. PP PY C��`� �� LDJ s` (f!!li��l� �r`�a'(r� �G��'��u G�� G�L�� -.------�— OG�° �C� O/�� p �C, � c �;. ; I�° �C�`hl � �`t�;, OG'J ° � a � � -----�------r� , �.� ..� �� __. _.___ ' �� SET BACK I � �'�� . i � FLO�R JOIS7 � , � j - • -._._--{__ ..-- �- -�_ _ .______-- ----- --------__ --- FTGS/FORMS/STEEL F�-IA REC�MTS � - ------- . �V__- - -.�.---� .._....__ _._ ELECTRIC GRdUND � ; UNDER FLOOR CUCI" '; - - _+- --------- __.- ---....__. GROUND PLUMBING UNDER FLOOR CUh!QUIT � ' � , '______ ---- • ---- --= . ; � .; � � FIREPLACE FOUNDATION � ' SLAB GRADE � _Y --- - TEMP POWER ___ ' • _--- ---;-- -FIREPLACE BOf�D BEAM ___�______ - WATER SERVICE ' __ , MfD HT. BUND BEAi�t � . . „ • _-, __..- --- � _I _ __.. ___ .___ _._..___---- � . _ .. ROOF SH�EA7HING � . ' � ;8 FT. BOhJ� BEAi,� � . . - -- �--) �--- - ---- ---- ---�-- ; _ _.. FRAfVIINGNENTiLiATION �'��(��p2�'6Y ' _._..I_'; FINAL BO(VD BEAM ; , -- - - __.__.. __.. ROOF COVER �� PRE-GRADING _ _ ROUGH HEATING � BENCHIiJG � ROUGH ELECTRIC ��_(JL�_� _ � ROUGH GRADIPJG __ _ ___ ROUGH PLUMBlNG � FINISH uRADING : _..__ _--- - ---- -� _.. ______---- _ ____ __._.... SHOWER/TUB TEST ' ; PUOL. ELECTRIG -- --- -�- --- _ - -- ------ � _..---____.____ EXT. LATH/51DING �j��z_ �� ; � POOL�ENCE NU i --- __.....------- _ ____ ------ -__ WALL 19VSULATION -(�� _ i POOL FINAL _ CEILING INBULATION �(b.�ut ; O�F SITE IMPS. DRY1n/ALL NAILING �-'�,fo�p2. � ' DEDICATIONS __ _ _ SEWER FINAL ENG. _ _._.._...----- SEPTIC TAiVK � _ �ANDSCAPE/IRRIC;. � - .�.�� --.._- _- SEEP PIT/LL. I, ` • ; QN SITE iMPS. _...._____ _ __.....__._� �____ � _._----- — GAS AIR TEST � _ �� FINAL ZONING ^,� _ `_ _ FINAL CONST.' � i ��V/-� � �IRE DEPT. FINA! FIN?,L HEATING �� j ; HEALTH QEPT. FiNA� FINAL ELECTR{C ��/'f�� i � DEV. FEES PAID ( _ FINAL PLUMBING � I ENERGY ! --�- ----}-;------- -�_._r.__ _____.. ; . , -- .----- � - � � �� -- ' �f�O(�, aG?C��<a�� a �� ___— � ---- -- --- - -° �-------�- _._.. _-- CC)�Jr��.c.�T� �`�'�f`�'� . �.5�-� UQ't� oP' �EGLIN�{ �e.�yv�-I'eF3`r p�� SEPTIC TAiVK SIZE SEEP PIT/U SIZE —� --�--�— --�--� � — � , � _ ____ __._ ___._._._.......__..__.___ o . � �. - - — .