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Home My WebLink About11-1350 � 't _.�` CITY OF DIAMOND BAR � �- / • � � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �''"'� BUILDING PERMIT APPLICATION , FIRMLY � JOBSITE ¢ ,ADDRESS /�d �D�� APPLICATION PERMIT� /^��1 p/C o DATE 2� �� NUMBE � ✓ ��# »- �jjj�! � APN LOT TRACT ISSUE TYPE OCC DATE CONST.�_ GROUP p OWNER LE-t� � o ADDRESS " ZONING SETBA S z CITY �✓!AL/�Il7" ZIP TEL. FRONT pyy � o APPLICANT �1/O AO/�- TEL. . REAR � � zd SIDE/SIDE STREET RW p � CONTRACTOR �SION L �ZQGI SIDE � ADDRES O PROPOSED USE�� Te �-��- �y�,�.pv�M�� o CIN G ZIP �T'EL. Yl �_, w AfiCH/ENG/ � DESIGNER Mnq y��v y�h Q-sfa� a ADDRESS ��—�'�/�'j" NO.DWEL. NO. NO. � CITY T a.L � ZIP�� TEL UNITS STORIES � BEDROOMS cn T��'�d�r�---- � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p �� SFR/ADD/REM � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CONTRACTORS LI� G8le B/C0 W CENSE UW FOR THE FOILOWINQ REASON(SEC.7031.6 BUSINESS AND PROFESSIONS CODE:ANV CITV OR (n g �rt ZCOUNTVWHICHREOUIRESAPEFMITTOCONSTRUCT,ALTER,I/APROVE,DEMOIISH,ORREPAIRANY9TRUC- W PgIlO/D6CI( � w TURE,PRpR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT lHAT HE OR SHE IS LICENSED PURSUANT TO THE PqOVI510N5 OF THE CANTRACTORS LI� � c CENSE LAW(CHMTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� � POOUSPB `l FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR THE ALLEOED E%EMP- (� �� TION.ANV VIOLATION OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Rool � A CIVIL 7ENAL7V OF NOT MORE THAN FfVE HUNDRED DOLLARS(f500)J: � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 Commercial WILL DO THE WORI(,�AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70u,BU51- J N NESS AND PROFESSIONS CODE:THE CONTRACTOFS UCENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTV WNO BUILAS Oq IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w THROU6H HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH UAPROVEMEMS AHE NOT INTENDED OR m Q OFFEREOFORS.LLEIF,FqWEVERTFIEBUILDINGORIMPROVEMENTI550lDWfTHINONEYEAROFCOMPLE Z TION.TNE OWNER-BUILDER WILL HAVE THE 9URDEN OF PROVWG THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W ❑I,AS OWNER OF THE PROPERTV,AM E%CLUSIVELV CONTMCTINO WI7H LICENSED CONTMC70RS Q TO CONSTRUCT THE PRQIECT(SEC.7W1,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- V8IU8�10 � ADJ.AREA LL� CENSEIAWDOESNOTAPPLVTOANOWNEROFAPROPERNWHOBUILDSORIMPROVESTHEREON,MlD � W17000NTRACTSFORSUCHPRQlECT9WITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAC� QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM E%EMPT UNDER SEC. B.8 V.C.FOR THIS REqSON � I/ G,(/ L`T U u" DATE OWNER � J V1!C-�(i/(�S � LICENSED CONTRACTORS DECLAAATION w • � r. 1 HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � D �S � e(COMMENCING WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PROFESSIONS CODE,AND Z 7 ' �� MV UCENSE IS IN FULL FORCE AND EFFECT. � sI�v S S m � UCENSE CLASS LIC.NO. � ' _• S,N�5, . ' V DATE . CONTRACTOR d �N�^ � W � � WORKERS'COMPENSATION DECLARATION � O TD ,(J J � I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECUPATIONS: V � Z � _I FIAVE ANO WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF-INSURE FOR WORI(ERS' a 2 Q COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR TME PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, w � � � _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS FEOUIRED BV SECTION Q 3700 OF THE LABOR COOE,FOR THE PERFORMANCE OF THE WORK FOR WHICN THIS PERMIT IS �� O J ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION j cn�RiER PLAN REVIEW � � � 3` _ �( C; � POLICV NUMBER � ELECTRIC � , � (�rLLSSEct%7MNE�NpieE071,w.ErEpoFTHEpEAAArfISFpqpD1EF#y�pPEpppLLAHS�t�pp)pq�F�} PLUMBING Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERAIIT I5 155UED,l MECHANICAL � �Q G.�} SHAIL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE . (/� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I SHWLD BECAME INSPECTION FEE SU&IECT TO THE WORKERS'COMPENSATqN PROVISIONS OF SECTION 370o OF THE UBOR � �'� O CO�E,I SHALL FORTHWITH COMPLV WITH TF105E PROVISIONS. ISSUANCE p DATE: APPLICANT: SMIP S w S�• � J WARNINO:FAILURE TO SECURE WOR)(ERS'COMPENSATION COVERAOE IS UNLAWFUL,AND SHALL BE ENERGY P/C �•3.��r • 1� � J �y SU&IECTAN EMPLOVEF TO CRIMWAL PENALTIES AND CNIL FINES U7 TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(f100.aao�,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN �� J SECTION37080FTHELABOFCODE,WTEREST,ANDATTORNEV'SFEES. �^_ � w RETENTION FEE: ��,) � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CQNSTRUCTION LENDING AGENCV �� ^ � � FOR THE PERFORMANCE OF THE WORN FOP WHICH THIS PERMIT IS ISSUED(SEC.7081,CIV.C.�. -�V Z �� w � LENDER'S NAME , � LENDER'SADDRESS � w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CAqAECT. TOTAL FE ES �� I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS RELA7INQ TO BUILDIN(3 (� . � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CAUNTV TO ENTEf7 UPON THE y Z ABOVE�MENTIONED 7ROPERTV FOR INSPECTION PURPOSES. � �(/ �� y� OMMENTS � � /iA'U/ AO/f ; ` (� ' � • a'. QPERMI7TEE N E(PRI ' ^ �� ) '� Q, �D ` � N � SIONATU OF I DATE G � RECPT.NO. PAID BY . VALIDATION , WHITE-0epartment Capy,YELLOW�inance Copy,pINK—Assessar Copy,GOLDENR �File Copy,GREEN—ApplicanYs Copy, � � CIT'V O� D1,4f�I0i�D ��4R t, , , . 16VS��CTION RECORD ,k , . _ ' . . , .._ > ,. � . , . � -, ; oa�p�c�400a o � � ..., aa�p�t��Q _ aa�p�c�400a ;.: Uca4� 'a�� [��"��:_�; SET BACK , FLOOR JOIST FTGS/FORMS/STEEL FHA REOMTS ELECTRIC GROUND I�NDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR GONDUIT SLAB GRADE ,� FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTlLATION �� l� 2� FINAL BOND BEAM - ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC �� ROUGH GRADING � ROUGH PLUMBING =� �� ^ FINISH GRADWG � � � SHOWER/TUB TEST POOL ELECTRIC � „� � _5�� EXT. LATH/SIDING POOL FENCING �` ��-��- WALL INSULATION ' r, POOL FINAL CEILING INSULATION OFF SfTE IMPS. DRYWALL NAILING 2, DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/4RRIG. 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 ' �'1;�� }� ' COMMEfVTS V�_e�e_�ex�-. �-,Z —�-��I,��`/jZ �5f�►_ 3 o K- �_�c �� _ � �- p ,�z�t�.� - - - --- —�5 v�_�D'r. 7 �i 1(�/�C�!`� e„��'�vti.•— c e� J�✓� �z��/au�..� `�,�,��,�`� � 3 � ��Z-� �--T- --�— -- l� �•��—� C.�w_1�v�1+�� bl� �j��o� �'o �� 31 _l ?�A-'GJ✓'„�-l�,Ll�t,�s�u� �c�- '� c� � o�.�-o�Ip ti,,,�/i L�ZeI Z _ ` 3-�1-`t-�-�=v- -�� a� ��- -- .c'�� 2�-3�-1 z � � �� I_��..C��,//� �-. $EPTIC TANK SIZE • � �Z SEEP PIT/U SIZE : a t - p� 2� ��`�2 � �,�`�'t�at,� �DIN I�+l b� �-�_1 le l t2; � �ST ov✓ �� o(c 2.y6 c_ r I�v�v6a�s �,�_1�.��-z." �` x�'7 '��1� ��l_N�R,��(ZO_oN'�'/�!�/4'LL — Z 2y-�z �� ' " �:�� a�� :::--�t� `��a��Z��^' �-��a��r�i�a,1,� �^ ' < < �--- � � � —P�o __�v��wt n�J o�3��_c� 3l� `�, ��a - �. ,��,;; � ! �t,�,�-� �-�I�i��- - _ -- � -- CtcC� �' , L 6�,c��1s�'L`�'� �w el�ev� el�p.