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Home My WebLink About11-864 i�1� �, �, i , ��_ CITY OF DIAMOND BAR G�Y��f I I � 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 a DDRESS � APPLICATION PERMIT �o �� z p/� o DATE NUMBER� fi^� # � ISSUE /' TYPE //�(e! OCC APN LOT TRACT DATE � /I CONST. Y GROUP °C OWNER � ZONING SETBACKS p ADDRESS FRONT qyy p Z CITY ZIP TEL. o APPLICANT TEL. S DE/SIDE STREET RW ❑ z ¢ CONTRACTOR � � ,� � SIDE ❑ o ADDRESS _ � PROPOSED USE Ll1A� 1� ...0[��s..�� I R��lX��,�S CITY ZIP�� TEL.�K+4 J 70��2 --^-p- v �— w ARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � <n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNEA-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENAL7Y OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G3f8g0/CBfPOR W CENSE LAW FOR THE FOLLOWING REASON(SEC.7031.5 BUSINESS AND PROFESSIONS CADE:ANV CITY OR (n U CAUNlVWHICHRE�UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOlISH,ORREPAIHANYSTRUG w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck � STATEMENT hiAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS ll� � � CENSE LAW(CHAPTER B(CAMMENCING WI7H SECTION 7000)OF DIVISION 3 OF Tl1E BUSINESS AND PRO- POOUSPB . , 0 FESSIONSCO�E)OR7HATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALIEGEDE%EMP� � V TION.ANVVIOUTIONOFSECTION7o31.5BYANYAPPLICAN7FORAPERMITSUBJECTS7HEAPPLICANTTO Z Re-Roof � A CIVIL PENALTY OF NOT MORE THAN FIVE HUNORED DOLLARS(SSoo�.): ZOI,ASONRJEROF7HEPROPER7Y,ORMVEMPLOVEESWITHWAGESAS7HEIRSOLECOMPENSATION, � COrt1fflBfCl21 WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SAIE(SEC.7ou,BUSI- J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW OOES NO7 APPLV TO AN OWNER OF � PROPERTV WHO BUIlDSOR IMPROVES THEREON,AND NhiO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NO7 IN7ENDED OR m w OFFEREDWRSPLEIF,HOWEVERTMEBUILDINGOHIMPROVEMEN71550LDWITHINONEYEAROFCOMPLE- � TION,THE OWNER-BUILOER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OP � IMPROVE FOR 7HE PURPOSE OF SALE). S _ w ❑I,AS OVJNER OF 7HE PROPERTV,AM EXCIUSIVELV CANTMCTING WITH UCENSED CONTRACTORS � TO CANSTHUCT THE PR0.IECT(SEC.70l/,BUSINESS AND PHOFESSIONS CADE:THE CONTRACTORS LI- V8IU8f1011 �� ADJ.AREA W CENSEUWDOESNOTAPPLV70ANOMMEROFAPROPERttWHOBUILD50RIMPROVE57HEREON,AND � NM1IOCANTRAC75FORSUCHPROJECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECONTFAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). �� ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q U � � DATE OWNER U Z w � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTY OF PERJURV 7HAT I AM IICENSED UNDER PROVISIONS OF CHAPTER � d e(COMMENCING WITH SECTION 7000)OF DNISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X MV LICENSE IS IN FULL FORCE AND EFFECT. m 11J /� � � LICENSE CLASS LIC.NO._I �9�� . V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIRM UNDER 7ENALTY OF PERJURV ONE OF THE FOLLOWING DECLARA710N5: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SEIF�INSURE FOR WORKERS' _ Q COMPENSATION,AS PROVIDED BY SEC710N 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE �U Q OFTHE WORN FOR WHICH THIS PERMIT IS ISSUED. � w _I HAVEAND WILLMAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION Q 37000F THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS '3Q� ��`Q/� ISSUED.MV WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION �� • -( N' J j CARRIER �LJY,r C,�fF /� PI.AN REVIEW ZPOUCV NUMBER � ��/./Y �I ¢ �G��L2�,-o,--�rl ELECTRIC 0 (IHISSECTIONNEmNOTBECQMR.EfEDOFTHEPEM4�ISPoRONEMNt)REDDOIWlS(5700)ORLESS} PLUMBING Z I CER7IFV 7HAT IN THE PERFORMANCE OF 7HE WORK FOR WHICH TNIS PERMIT IS ISSUED.I MECHANICAL �} SHAIL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORNERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE = SUBJECT TO 7HE WORKEFS'COMFENSATION 7qOVI510NS OF SECTION 37oa OF THE LABOR /� CA�E,I SHALL FORTHWITH COMPLV WITH THOSE VROVISIONS. �SSUANCE � /i � �� p DATE:� APPLICANT. —��df�� [I LL�r�/1 SMIP / J WqRNING FAIWRE 70 SEWRE WORKERS'COMPENSATION OOVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTAN EMPIOVER TO CRIMINA�PENALTIES AND qVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(5100,000).IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN !' %� � SECTION37080FTHELABORCODE.INTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: ��+ v OCONSTRUCTION LENDING AGENCY P ALT FEE: � I HEREBY AFFIRM UNDER PENALN OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY ��i �. C O . FOR THE PERFORMANCE OF THE WORK FOR WNICH THIS GERMIT IS ISSUED(SEC.3097,CIV.C.). Z �/� W � LENDER'S NAME F— IENDER'SADDRESS � TOTAL FEES �8� w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE WFORMATION IS CARRECT. � 1 AGREE TO COMPLV WITH AlL CITY AND COUNTV ORDINANCES AND STATE UWS REUTING TO BUILDING CANSTRUCTION,AND HEREBY AU7HORIZE REPRESENTA71VE5 OF THIS COUN7Y TO ENTER UPON 7HE p� ZABOVE�MENTIONED PROPEfiTY FOR INSPECTION PURPOSES. COMMENTS � �Q\�"�—' •�0� r�� S� � � o Y 54 i I�,�� \��ac -�.,-.�� s�,o� �-� w�r� al��h� m PERMI7TEE NAME RINT) - � cn � c"'-�P p ✓1�\3 N SIGNATU F ITTE DATE = RECPT.N0. PAID BY � VALIDATION ~ WHITE—DepaAment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy l CB�Y O� D0�4,61�0�1� ��►ff� � 86\9SPl��'�O� Rf��O�� oa�p�c�400a oa�� oa�a�c��oa Qa�p�c�4aoa :..��a� oa�p��a SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRAOE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM - ROOF SHEATHING 8 FT.BOND BEAM FRAMINGNENTILATION 41�.� � 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 a��_��l ___ PQOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS _ _______ ____ SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/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 PAIO _ __ FINAL PLUMBING ENERGY C��o �'�,; COMMENTS _ __ _— _— SEPTIC TANK SIZE SEEP PIT/U SIZE a c� t� .::_� Q � ;r- l _�,`_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �,� . 21825 Copley Drive,Diamond Bar,CA 91765 I (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS '"�'� BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE � APPLICATIOf'� PERMIT F� p/C ADDRESS ��it�Sv r'l/�i./t��"'-U�� G�r�1 o.J DATE `6'��o I�� NUMBER �,'��c� # �— � ISSUE � 7YPE OCC APN LOT TRACT DATE '��I CONST. GROUP p OW N ER �"'%�� Gt;l�, A� ga�.1.�S �b` I 0 ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT qyy p p APPLICANT TEL. S DE/SIDE STREET RW ❑ z � CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE Ll� �D��,S�� . � CITY ZIP TEL. T w ARCWENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cr� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENALTV OF PERJURV THA7 I AM EXEMP7 FqOM THE CANTRACTORS LI- GafByB/Ce1POR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7037.SBUSINESSANDPROfESSIONSCODE:ANYCI7YOH (n U COUNTVWHICHRE�UIRESAPERMIT70CANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC� • w NRE,PRIOR TO ITS ISSUANCE.ALSO FEOUIRES THE APPLICAN7 FOR SUCH PERMIT TO FIIE A SIGNED w Patio/Deck ' � STATEMENT TiA7 HE OR SHE IS IICENSED PURSUANT TO THE 7ROVISIONS OF THE CONTRACTOPS ll- � � CENSE UW(CHAPTER 8(COMMENCING WI7H SEC710N 700a)OF DIVISION 3 OF 7HE BUSINESS AND PRO- POOUSPB � FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM ANO THE BASIS FOR THE ALLEGED E%EMP- (7 V TION.ANV VIOUTION OF SECTION 7031.5 8V ANV APPLICANT FOR A PERMIT SUBJEC75 7HE APPLICANT T0 Z Re-Roof � A CIVIL PENAL7V OF NO7 MORE THAN FIVE HUNDRED DOLLARS(f5ao�.�: 0 OI,ASOWNEROFTHEPROPER7Y,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, Q Commercial Z WILL DO THE WORN,AND THE STRUCTURE IS NOT INTENOED OR OFFERED FOR SALE(SEC.7ou,BUSI� J � NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NO7 APPLV TO AN OWNER OF � PROPERTY WHO BUILOS OR IMPROVES THEFEON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � TMROUGH HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEREDFORSPLEIF,HOWEVER7HEBUILDINGORIMPHOVEMEN71550LDWITHINONEVEAROFCqMPLE� 0 TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THA7 HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). � '3J `Q W ❑1,AS ONMER OF THE PFiOPER7V.AA1 E%CLUSIVELY CON7RACTING WITH LICENSED CAN7RAC70RS � TO CANSTRUCT THE PR0.IECT(SEC.70/1,BUSINE55 AND PROFESSIONS CADE:THE CONTRACTORS LI� V81U2�1Of1 ADJ.AREA W CENSELAWDOESNO7APPLV70ANONTJEROFAPROPER7VWHOBUILDSORIMPROVES7HEREON,AND � WHOCON7RAC7SFORSUCHPROJECTSWITHACANTRACTOH(5)LICENSEDPURSUANTTOTHECANTRAC� �UANTITY DESCRIPTION FEE � TORS LICENSE UW.). �� O I AM EXEMPT UNDER SEC. B.8 G.C.FOR THIS REASON Q U � � DATE OWNER � Z W � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRM UNDER PENPLTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAP7ER � d D(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X MY UCENSE IS IN FULL FORCE AND EFFECT. � LICENSE CLASS� L'��_ LIC.NO.T� -I N✓S j . F, J V DATE CONTRACTOR a W " � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECURATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT 70 SELF-INSURE FOR WORNERS' ¢ S Q CAMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE W Q OFTHE WORN FOR WHICH THIS PERMIT IS ISSUED. � W _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE.AS RE�UIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORNERS'CAMPENSATION INSUfiANCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION ��i �O� �3 • �� J j cnqqiEa - PLAN REVIEW Z POLICY NUMBER�/�n C'j�L�j�C-I� (� ELECTRIC Q �_ � (fHISSECfqNNEmNOT8E00AW.ETEDOF7F�PEPMfTISFOPONEFM11t�DREDOq1PA5(5700)ORLESS} PLUMBING Z I CER7IFV THA7 IN 7HE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C3 SHALLNOTEMPLOYANVPERSONINANVMANNERSOASTOBECAMESUBJECTTOTHE Uj WORKERS'COMPENSATION LAWS OF CAUFORNIA,AND AGREE THAT IF 1 SHOULD BECOME INSPECTION FEE ? SUBJECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR CODE,ISFIALLFORTHWITHCOMPLVWITHTHOSEPROVISIONS. ISSUANCE �� • � `p OATE:�^�1Q/� APPLICANT: L---- SMIP 1S0 J WARNING:FAILURE TO SECURE WORKERS'COMPENS ION COVERAGE IS 11NLAWFUL,AND SHALL BE ENERGY P/C �y SU&IECTANEMPLOYERTOCRIMINALPENALTIESAN CIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(S�OU.OW).IN PDDI710N TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: a .� a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � ��5� �• � � I HEREBY AFFIqM UNDER PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCV FOF THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W � LENDE(i'SNAME /�rl� F— LENDER'SADDRESS � TOTAL FEES 8"t'• �s � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPIV WITH ALL CITV AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING � CONS7RUC710N,AND HEREBY AU7HORIZE REPRESENTATIVES OF 7HIS COUNTV TO ENTER UPON THE `( ZABOVE-MENTIONED PROPERTV FOR INSPECTION PUf1POSE5. COMMENTS� V�"\��a1 Y Ly �S� �b 6v� � �;�Y S 1�J� -F�.�� s�� m �r� �(\q / �� m PERMITTEE NM/E PRINT) � ' , ' � � �L N�^�i�B�� GS�I � ��\� `-�'r\ � SIGNAT RMITfEE 1� DA7E RECPT.NQ �Z��v PAID BY ✓ �� VALIDATION �M 2 ~ WHITE—Department Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy , �'+0�� alBi��l�� . = s - „ -�, I��Q:�O�� $��:��$� Oa�pC�C�400a o �4C� Oa�pCC�40a Oa�pCC�4aOG�1 DG��'G .: �I�nl�l?C�C��G�. SET BACK FLOOR JO1ST 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 MID H'L BONU 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/SIDING POOL FENCING WALL INSULATION POOL FINAL � CEILING INSU�ATION OFF SITE IMPS. � DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. � SEPTIC TANK LANDSCAPE/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 ��o � , ------ -------.—_.---------------— COMMENTS —_ — _—_. SEPTIC TANK SIZE SEEP PIT/U SIZE a � � - --------- --- — .�� o , �.. . . CITY OF DIAMOND BAR Community Development Department I I ' 21825 Copley Drive•Diamond Bar,CA 91765 – Building Inspection Request Hotline s (909)839-7027 <+q,D By/ Building . Planning . Engineering (909)839-7020 (909)839-7030 (909)839-7040 CORRECTION NOTICE 'J .4 am PERMIT NO.��`� DATE: 5 � j TIIVIE: �� p.m. CONTRACTOR/ Il�d�� OWNER BUILDER ADDRESS (Project Site) �'��y� /a'�`5� �V�,—=y�- ��IIS� /2LC. �Ek✓vt►I S �o2T�-IIS Si� �R vo� �d ��r��S�,E��Js 1 �i�o�,�1 ��L E�aT�F ci�aRK ��FFae rv��.b �lT � ��' S D - RG"� o �..S�R/ C.is H �C G R�.� a i � I ❑PLEASE GONTACT THE UNDERSIGNED ' �EASE MAKE CORRECTIONS AND CALL FOR REINSPECTION ❑REINSPECTION FEE REQUIRED �PLEASE MAKE CORRECTIONS AND PROCEED WITH WORK INSPECTOR: ��l�C �!�le/�'�L L (prin[namc) /v%�� SIGNATURE OF INSPECTOR: _T ti�.o9xaio