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Home My WebLink About17380 (26) CITY OF DIAMOND BAR I �----�--- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ��I p�D �_ 21825 E.Copley Drive r� '� (909)860-3195 Fax(909)861-3117 PRESS �"-�� BUILDING PERMIT APPLICATION JUN 191002 FIRMLY a DDRESS 23610 Alonument Canyon APPLICATIO PERMIT � Pic p DATE � NUMBER 173� # � ISSUE TYPE OCC -- APN LOT TRACT DATE CONST. GROUP °C OWNER O o ADDRESS E�7S W. FOot}li 1 1 1 vd. #104 ZONING SETBACKS z cirv Claremont ziP 917�11 TE�. 399-3103 FRONT Rw ❑ � APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ z ¢ CONTRACT Ro�al Roof Co. SIDE ❑ Q ADDRESS �-�1Ce � CITYPmm�na ZIP 917h7 TEL.�R(ln� L�nn- PROPOSEDUSE Tear Off WOOd shakes. Install o ARCH/ENG/ 769 11ew comIlo�i ti on s__i n_ �S z DESIGNER � w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES t�,,�p BEDROOMS � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADD/REM I HEREBV AFFIRM UNDER PENALTV OF PE{iJURV 7HA71 Al.l E%EMP7 FROM THE CON7RAC70RS LI- G8f8(JB/COfpOR W CENSELAWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSAN�PROFESSIONSCODE:ANYCITYOR (n U COUNTYWHICHREOUIRESAPERMITTOCONS7RUC7,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC� W P8110/DBCk w TURE.PRIOR 70 ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUAN7 TO THE P(iOVI510NS OF 7HE CONTRACTORS LI� � � CENSE LAW(CHAPTER 9(COMMENCING WI7H SECTION 7ooa)OF DIVISION 3 OF THE BUSINESS AND PRO- POOUSpB Q FESSIONS CADE)OR 7HAT HE OR SHE IS ExEMP,7 THEREFROM AND THE BASIS FOR THE ALLEGED E%EMP- (� U TION.ANYVIOL4TIONOFSECTION7031.SBVANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof �OOO � A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(SSoo).): ZOI,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � Commercial - WILL DO THE WORK,AND THE STRUCTURE IS NOT IN7ENDED OR OFFERED FOR SALE(SEC.7a�1,BUSI� _! � NESS AND PROFESSIONS CADE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPER7Y VhiO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIMSELF OR HERSELF OR 2 THROUGH HIS OR HER OWN EMPLOYEES,PfiOVIDED 7HAT SUCH IMPROVEMEN7S ARE NOT INTENDED OR m . 0 OFFEREDFORSPLEIF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BUHDEN OF PROVWG THAT HE OR SHE DID NOT BUILD OR � IMPROVEfORTHEPURPoSEOFSALE). ❑I,AS ONMER OF THE PROPERTV,AM EXCLUSIVELY CON7RACTING WITH LICENSED CANTRAC70R5 ^ Q TO CANSTRUCT THE PRQIEC7(SEC.70�1,BUSINE55 AND PROFESSIONS CO�E:THE CON7RACTORS LI� VeluellOfl �,n,1 1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR�S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON J Q Q � U � ¢ DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRM UNDER PENALTY OF PERIURV 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 LICENSE IS IN FUIL FORCE AND EFFECT. W m � LICENSE CLASS C-39 HIC ��.No. 413067 . � wDATE S—`�,�� CONTRACTOR R�n�6��A��n d � WORKERS'COMPENSATION DECLARATION � ¢ � I HEREBV AFFIPM UNDEF PENALTV OF PE0.IURV ONE OF THE FOLLOWING DECLARATIONS: Z � 1 MAVE AN�WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' a Z ¢ CAMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE W Q OFTHE WORN FOR WHICH THIS PERMIT IS ISSUED. � � ��I HAVE AND WILL MAINTAIN WORNERS'COMPENSATION INSURANCE,AS RE�UIRED BY SEC710N /l QQ 370o Of 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICHTHIS PERMIT IS (.`:^� JZ O ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBERARE: CONSTRUCTION U I � CARRIER A.M.S. PLAN REVIEW ZPOLICYNUMBER Wl./ 491 R N(1 77 ELECTRIC Q F -' ^ 0 (fHISSECf10NNE�NOTBE00MPLEfEDOFT}iEPEM�RISFORONEHUI�DREDDOLIMS�f100)ORLESS) PLUMBING I�l f .�•1�^.�i�� '1"�'" 'i�i'�-` I�i � i•- ��\ J 1 I L.,_1iI Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED,I MECHANICAL � � Lj' SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE _� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE 7HA71F I SHOULD BECOME INSPECTION FEE ' ? SU&IECTTOTHEWORKERS'CAMPENSATIONPROVISIONSOFSECTION37000FTHELABOR 1 � 1- CODE,ISNALLFORTHWITHCOMPLYWITHTHOSEPROVISIONS. ISSUANCE f � SMIP p DATE: APPLICANT: ��-�- ��, ' S� � ENERGY P/C I J'��,-^---_ J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALLBE _ � SUBJECTAN EMPLOVER TO CRIMINAL PENALTIES AN�CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT � OOLURS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PFOVIDED FOR IN t � � SECTION37080FTHELABORCADE,INTEREST,ANDATTOHNEV'SFEES. RETENTIONFEE: � CONSTRUCTION LENDING AGENCY PRE-A�T FEE: O � I HEREBV AFFIHM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEHMIT IS ISSUED(SEC.7aB7,CIV.C.). Z W � LENDER'S NAME � � LENDER'SADDRESS � TOTAL FEES �+ y 7 � I CERTIFV THAT t HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CAflRECT. //J� O � I AGREE TO COMPIV WITH ALL CITV AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING � � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE-MENTION PROPERTV FOR INSPECTION PURPOSES. COMMENTS � To mbrugl'a � -- , m PERMITTEE E IN7) � ' � ( (-��-1 — J Uj SIGNATUREOFPERMITTEE DATE = RECPT.N0. PAID BY VALIDATION ~ WHITE—De artment Copy,YELLOW—Finance Co PINK—Assessor Copy,GOLDENRO�File Co GREEN—A licant's Co P PY� PY� PP PY " . � �, �. -�-, .. . . , . . ✓ ..I� � . � . . ., .:-rl" ^'(.:.'�C.., . , . . . . ' �Q��r° �� II ��l�l�f{�� '�� -- � �P-„ OG9��G�11t��J .,� ,� (�� ti�° �, . OG��°�� a�,� '� '4 ,�.��C�, � � ��.��' � --_ �� ' � FLOOR JOIST � � SET BACK __� � ,__,_�_� ---- ----- -----_....._._. FTGS/FORMSISTEEL j ! FHA REQMTS _ —� _ _ � ELECTRIC GROUND j , UNDER FLOOR DUCT _ � _ -- -,.— - - GROUND PLUMBING � ___ UNDER FLOOR CU(�IDUIT � '. -�-' -- ---- , ___ . ...______. __ -� ..._._..._. SLAB GRADE j � � �lR�PLAGE FGUNDATIC�N __ ___ --- -- _ .--- --�---- -...._. TEMP POWER _ � _ _Y_ FIREPLAGE BOND BEAM __; ____ _ W,4TER SERVICE ': MID HT. BONd BEAM ROOF SHEATHIIVG �I��'�� ••• � 8 Ff. BOND BEAM � __'��-y . . -- -------- �� ' ---- � FRAMINGNENTILIATION _ � ___� FINAL BOND BEAM - ----- - ----- ---. ROOF CC�VER _�_�.PRE-GRADING ROUGH HEATING � BENCHING _ � � __'__ �V ROUGH ELECTRIC ROUGH GRADING __ ROUGH PLUMBING ; FINISH GRADING _ ___ SHOWER/TUB TEST ; POOI ELECTRIC ___ -.-._ EXT. LATH/SIDING ; POOL FENCWG --- -- ----- -----_._. ___---�_.._._.__.__ WALL INSULATIOfV ; POQL FINAL ' ----- - ---....._. CEILING INBULATIOfV � OFF SITE IMPS. DRYWALL NAILIiVG j DEDICATIONS ___ SEWER FIiVA�ENG. SEPTIC TANK � LANDSCAPE/1RRIG. SEEP P17/LL. ' + ON 51TE IMPS. � � GAS AIR TEST FINAL ZONING FINAL CONST. � FIRE DEPT. FfNA� FIIJAL HEATING i � HEALTH DEPT. FINAL Fi�IAL ELECTRIC I I ��V. FEES PAlD ---- -- - -- FINAL PLUNiBING � i EPlERGY I �- � _._.----- --- _----------r ----- ____..___. � �,r��.�r.� � - - . ,,. .n ��, . i .. .,. ---- C��5 SEPTIG TA�1K SIZE SEEP PIT/U SIZE - -- - ---- ---�-�------A— � . --- �� _ — � __- --�--��-----��--�--_.._. � ,