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Home My WebLink About11-1456 CITY OF DIAMOND BAR �xp I�� --� -��— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 `� I � b � � {� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS "��' BUILDING PERMIT APPLICATION FIRMLY o DDRIESS ' V �D'fl DATEICAT Z. � � NUMBEF��`�v�T" t►/C � ISSUE ��a �/ NPE OCC APN LOT TRACT DATE �� CONST. GROUP °C OWNER O LL ADDRESS ZONING SETBACKS � FRONT qyy p Z CITY ZIP TEL. � APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ ¢ a� CONTRACTOR �� SIDE p o ADDRE S •� PROPOSED USE y'\�� /1f�d <<8��c� Q pl.�tC,I�•�-� CITY ` ZIP�� TEL. �1 r-e w ARCWENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CIN ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION 0 SFR/ADD/REM I HEREBV AFFIRM UNDER PENALTY OF PERIURV THA7 I AM E%EMPT FROM THE CONiRAC70RS LI� Gdf8g0/CefPOA W CENSEUWFORTHEFOLLOWINGPEASON(SEC.7031.SBUSINESSANDPROfE5510NSCADE:ANVCITVOR (n U CAUNTVWHICHREOUIRESAPERMITTOCANSTRUCT.ALTER,IMPROVE,DEMOLISH,ORFEPAIRANYSTRUC- W Patio/Deck w TURE,PRIOR TO ITS ISSUANCE,ALSO RE�UIFES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CONTRACTORS LI- � CENSE LAW(CHAPTER e(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF TME BUSINESS AND PRO- � POOUSPB O FESSIONS CADE)OR THAT HE OR SHE IS EXEMPT THEREFROM ANO THE BASIS FOR THE ALLEGED EXEMP- C7 V TION.ANYVIOLATIONOFSECTION7o31.5BYANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(S5o0).): Z ❑I,ASONMEROFTHEPROPERTV,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COfilfflBfC18I WILL DO THE WORK,AND THE STRUCTURE IS NO7 INTENDED OR OFFERED FOR SALE(SEC.701�,BUSI- J N NESS AND PROFESSIONS CODE:THE CONTiiACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERN NMO BUIL�S OR IMFROVES THEFiEON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEREDFORSALEIFHOWEVERTMEBUILDINGORIMPqOVEMENTI550LDWITHINONEYEAROFCOM7LE- � TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FORTHE PURPOSE OF SALE). Q_ ❑I,ASOWNEROF7HEPFiOPER7V.AMEXCLU5IVELYCONTRACTINGWITHLICENSEDCONTRACTORS TO CONSTRUCT THE PRQIECT(SEC.70t�,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- VelUeilOfl `� ADJ.AREA W CENSE UW DOES NOT APPLY TO AN OYMER OF A PROPERTV WHO BUILDS OR IMPROVES 7HEREON,AND r � NTiOCON7RAC75FORSUCHPROJECTSWITHACANTPACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). 0 ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � � DATE OWNER F- � w � LICENSED CONTRACTORS DECLARATION w � I HEHEBY AfFIRM UNDER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CODE,AND Z X MY UCENSE IS IN FULL FORCE AND EFFECT. m LLl � LICENSE CLASS � LIC.NO. � j V DATE CONTFiACTOR d W , `� WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENAL7Y OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z � � _I FIAVE AND WILL MAINTAIN A CERTIFICA7E OF CONSENT TO SELF�INSURE FOF WORKERS' _ CAMPENSATION,AS PFOVIDED BY SEC710N 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE W O OFTHE WORN FOH WHICH THIS PERMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICV NUMBERARE: CONSTRUCTION 1�� J j CARRIER ! PLAN REVIEW ZPOLICVNUMBER �yp��6 ELECTRIC Q 0 (IFiLSSECTIONNEmNOTBE00MPLEfEDOFTI-IEPEWMISFORONEMNDREDOOLLAfLS(5100)ORLE55). PLUMBING W Z I CER7IFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH iH15 PERMI715 ISSUED.I MECHANICAL ��} SHAIL NOT EMPLOY ANV PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&IECT TO THE WORKERS'CAMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR ^'i � CODE,1 SHALL FOR HWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE r��- �� 1,� � � C�� SMIP � �04 p DATE: APPLICANT. �] J WARNING:FAILUFE TO SECURE WORKERS'fAMPENSATION COVERAGE IS UNLAWFUL.AND SHALL BE ENERGY P/C � SU&IECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(5700,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION3�08OFTHELA80RCODE,INTEREST,ANDATfORNEV'SFEES. RETENTIONFEE: O�.� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBY AFFIRM UNDER PENALTY OF PERJURV 7HAT THERE IS A CONSTRUCTION LENDING AGENCY �� 1_�J FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED�SEC.3097,CIV.C.). Z W � LENDER'S NAME 1— LENDER'S ADDRESS � TOTAL FEES 1�'. �`�' � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. W I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE LAWS REI.ATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. Z COMMENTS � J = J m PERMITTEE NAM INT) � � � � � SIGNATU 7TEE DA E = RECPT.N0. PAID BY � VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy CB�Y �� D8�6VaOV�� A� � 1�9�f�1��0�� C�6�� oa�p�c�400a �a� oa�p�c��oQ � oa�p�c�400a oa� oa�p�c��a SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MIQ H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION 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/SIDtNG POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATIQN OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG__ _ _ __ SEPTIC TANK �ANDSCAPE/IRRIG. 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 ___ --- -- -- ---- - _..__.__. ._._._-.._- -- �� COMMENTS -- —�-�--ti"+�1�'-�-`� � � NA ti�,�w� S� � 1� ��s vt � � SEPTIC TANK SIZE SEEP PIT/U SIZE a - — � � ,. . a :