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Home My WebLink About10074i itffli MLU, i{ CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21660 E. Copley Drive Suite 190 (909) 660.3195 Fax (909) 861.3117 BUILDI;IGPWMITAPPLIC V---' PRESS FIRMLY JOBSITE ADDRESS i ADDRESS APPLICATION PERMIT 00 7 / P/C DATE - ` NUMBERISSU* TYPE DA EE �(? �%� CONST GROUP ' APN LOr T ACT` "�' OWNER �Z 'ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDEISIDE STREET RW ` 0 - SIDE ❑ ADDRESS U-2.: if CITY ZIP TEL.�U O APPLI ANT TEL. CONTRACTOR ESS PROPOSED USE %/I! Q,Q� I CITY. ZIP TEL ARCFVENG/ DESIGNER ADDRESS CITY ZIP TEL -NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAMALUATION OWNER -BUILDER DECLARATION SFFVADD/REM (n Garage/Carpolt - 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSELAWFORTHEFOLLOWINGREASON(SEC.7031.5 BUSNESSAND PROFESSIONS CODE:ANYCrTYOR COUNTY WHICH REOUIRESA PERMIT TO CONSTRUCT,ALTER. IMPROVE DEMOUSROR REPAIRANYSTRUC- TUBE, PRIOR TO ITS ISSUANCE ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 0 (COMMENCING WITH SECTION 7000) OF DIVISION ] OF THE BUSINESS AND PRO- W w PatiolDeCk u- POOVSPEL - - FESSIONSCODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THEALLEGED EXEMP. (9T10N. Z Re -Roof ANY VIOLATION OF SECTION 7071.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (ISOO).): 17 J Commercial O L AS OWN ER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI. NESS ANO PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH MS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m OFFERED FOR SALE IF. HOWEVER. THE BUILDING OR IMPROVEM ENT IS SOLD WITHIN ONE YEAR OFCOMPLE- - TON. THE OWNERNJULDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O L AS OWNER OF THE PROPERTY, AM EXCLUSNELY CONTRACTING WITH LICENSED CONTRACTORS Valuatl ADJ.AREA TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U. DENSE LAW DOES NOTAPPLYTOAN OWNER OFA PROPERTYYAHO BUILDS OR IMPROVES THEREON, AND QUANTITY DESCRIPTION FEE WHOCONTRACTS FOR SUCH PROJECTS WITHA CONTRACTOR(S) LICENSED PURSUANT TOTHE CONTRAC- TORS LICENSE LAW). U AM EXEMPT UNDER SEC. B. S P.C. FOR THIS REASON DATE2-;7—OWNER W LICENSED CONTRACTORS D LARATION _ I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER 0 (COMMENCING WITHSEC710N 70001 OF DIVISION ] OF THE BUSINESS AND PROFESSIONS CODE, MY LICENSE IS IN FULL FORCE AND EFFECT. CJ• Z m �l LICENSE CUSS MIC. NO. DATE CONTRACTOR a NDECLARATIO / WORKERS'COMP/OFTHE V Z - THEREBY AFFNM UNDER PENALTY OF PERJURYE WLLOWNG CIAAATONS: _ I HAVE AND WILL MAINTAIN A CERTFICAENT TO INSURE FOR WORKERS' COMPENSATION. AS PROYOED BY SEC7F THE GCOE. FOR THE ►ERFORMANCE OF THE WORK FORWHICHTHIS PERMIT W LU + _q� CONSTRUCTION I HAVE AND WALL MAINTAIN WORKERS'CINSURANCE, AS REOUIRED BY SECTION ]700 OF THE LABOR COD E. FOR THE PE EOFTHE WORK FOR WHICH THIS P ERMIT IS}�UISSUED. MY W ORKERTOOMPENSATION CARRIER AND POLICY NUMBER ARE: CARRIER PLAN REVIEW 1 L POLICY NUMBER ELECTRIC - (THIS SCCRLN NEED NOT BE OFTHE PERMTSR]BONE HLIFOREDDOl1DVLS (St00)OfHLE55} PLUMBING I CERTIFY THAT N THE P ORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL SHALL HOT EMPLOY PERSON IN ANY MANNER SOAS TO BECOME SUBJECTTO THE WORKERS COMPEN KDN LAWS OF CALIFORNI&ANDAGREETHATFI SHOUDBECOME INSPECTION FEE SUBJECT TO THE RKERS'COHAPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE, I SHALL F THWRH COMPLY WITH THOSE PROVISIONS. r ISSUANCE DATE: APPLICANT. SMTP WAF INRETOSECUREWORKERSCOMPENSATIONCOVERAGE ISUNLAWFU.,AND SHALL BE ENERGY P/C 51181ECT EMPLOYER TO CRMPIAL PENALTIES AND CMLFNES UPTO ONE HUNDRED THOUSAND DOL ISI00.000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR N ENERGY PERMIT S ION ]7oa OF THELABOA CODE. INTEREST, AND ATTORNEY'S FEES. RETENTION FEE: . . ppE•ALT FEE: CONSTRUCTION LENDING AGENCY I HERESY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSIIIU LENDiNO AGfNCV {{{(111,L1`Fr�� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PER LIED (SED ]007,CN. G). LENDERS NAME LENDERS ADDR 1CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FEES 1 AGREE TO COMPLY WITH TILL CITY AND COUNTY ORDINANCES AAD STATE LAWS RELAYING TO BUILDING CONSTRUCTICK AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE7 - 7ENTIONEDEC PROPERTY FOR INSPECTION PURPOSES. �9�+ �� * COMMENTS PEA" NAAE (PRINT) SIGNATURE OF MITI - - DATE - - RECPT. NO. 3 S_ Z- -2"/ PAID BY .3 VALIDATION WHITE—Department Copy. YELLOW—Finance Copy. PINK—Asseasar Copy, GOLDENROD—File Copy. GREEN--AcOlcant's Copy CITY OF DIAMOND.BAR 114SPECTION RECORD .Al SETBACK FLOOR JOIST FIGS/FORMS/STEEL - FHA REQMTS, ELECTRIC GROUND UNDER FLOOR 'DUCT - GROUND PLUMBING UNDER fLObR CONDUIT SLAB GRADE---.---- FIREPL)kCE FOUNDATION TEMP POWER FIREPLACE BOND BEAM - WATER SERVICE- MID HT. BOND BEAM '— ROOF SHEATHING 8 Fr. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING - BENCHING .ROUGH ELECTRIC--` ROUGH GRADING -ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC: EXT. LATH/SIDING -POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION0 FF SITE IMPS. DRYWALL NAILING I DEDICATIONS SEWER__ FINAL ENG. .SEPTIC TANK-,-: LANDSCAPEARRIG. -SEEP PIT/L.L_ON SITE IMPS. ol GAS AIR TEST-'- FINAL ZONING FINALCONST.-j- FIRE DEPT FINAL,-, FINAL HEATING HEALTH DEPT. FINAL FINAL -ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY COMMENTS I. .SEPTIC TANK SIZE SEEP PIT/U SIZE 7 7