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Home My WebLink About11-579 ��_ CITY OF DIAMOND BAR /'` /'� � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �' y� 21825 Copley Drive,Diamond Bar,CA 91765 �� l ' (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS I �`°"' BUILDING PERMIT APPLICATION FIRMLY I o� JOBSITE Y� DATEICATIO e� PERMIT , '�� /C �i ADORESS �3� V NUMBER # � �ISSUE TypE APN LOT TRACT DATE � /' I � OCC I CONST. GROUP p OWNE�CLY�K(��QL p ADDRESS 23� ZONING SETBACKS Z CITY �: � ZIP TEL. 1 FRONT qyy p � APPLICANT , � ,C REAR p ¢ SIDE/SIDE STREET RW p � CONTRACTOR 1 I 1 SIDE p � ADDRE S '�D�� `_ �, � CIN `"� ZIR �'1 TEL. - PROPOSED USE .W . �C "'�.Ti - o ARCWENG/ ,� z DESIGNER nW. ADDRESS /` NO.DWEL. NO. NO. � CITY / ZIP � TEL. � UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADD/REM p I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CONTRACTORS LI� Gal89B/C81pOR W CENSEIAWFORTHEFOLLOWINGREASON(SEC.7o37.5BUSINESSANDPROFESSIONSCADE:ANYCITVOR (n U COUNTYWNICHREOUIRESAPERMITTOCANSTRUCT,ALTEF,IMPROVE,DEMOIISH,ORREPAIRANVSTRUC- w TURE,PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT 70 THE PROVISIONS OF THE CONTRAC70RS LI� � CENSE UW(CHAPTER 9(COMMENCING WI7H SECTION 70oa)OF DIVISION 3 OF 7HE BUSINESS AND PRO- POOUSpB , O FESSIONSCODE)OR7HATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� V TION.ANVVIOLATIONOFSECTION7031.SBVANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof � A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5500).): Q ❑I,ASOWNEROF7HEPROPERTY,OFMVEMPLOVEESWITHWAGESASTHEIRSOIECOMPEN5A710N, � Commercial ' Z WILL DO THE WORK,AN�THE STRUC7URE IS NOT IN7ENDED OH OFFERED FOR SALE(SEC.7011,BUSI- J � NESS AND VROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NO7 APPLV TO AN OWNER OF � PROPER7V WHO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGHHISORHEROWNEMPLOYEES,PROVIDEDTHA75UCHIMPROVEMEN75ARENO7INTENDEDOR m � OFFEREDWRSALE.IF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR 7HE PURVOSE OF SALE). w ❑I,AS ONMER OF THE PROPEHTV,AM EXClU51VELV CONTRACTING WITH UCENSED CONTRACTORS [[ TO CANSTRUCT THE PRQIECT(SEC.701<,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- VBIUdIlOf1 ADJ.AREA W CENSEIAWDOESNO7APPLV70ANOWNEROFAPflOPERTVWHOBUILD50RIMPROVE57HEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWI7HACONTRACTOR(S)LICENSEDPURSUAN7TOTHECONTRAC� �UANTITY DESCRIPTION FEE � Y TORS LICENSE LAW.). � ❑I AM EXEMP7 UNDER SEC. B.8 P.C.FOR THIS REASON Q U ti � DATE OWNER F Z U O w LICENSED CONTRACTORS DECLARATION � � w I HEREBY AFFIRM UNDER PENPLTV OF PERIURV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(COMMENqNG WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT, �'y�A m � LICENS�� SS LIC.NO. `�"—v��+�,� � VDATE � CONTRACTOR� �V'�� a W ' � WORKERS'COMPENSATION DECLAFATION �'A� Q � 1 HEREBYAFFIRM UNDER PENALiY OF PERJURY ONE OFTHE FOLLOWING DECURA710NS: Z �Z IHAVEANDWILIMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' a Q = CAMPENSATION,AS PROVI�ED BV SEC710N 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICFI TMIS PERMIT IS ISSUED. � w 1 HAVE AND WILL MAIN7AIN WOHKERS'COMPENSATION INSU{iANCE,AS REQUIRED 8Y SEC710N Q 3700 OF 7HE LABOR CODE.FOR THE PERFORMANCE OF 7HE WORK FOR WHICH 7HIS PERMIT IS SUED.MV W9RKER5'CAMPENSATI NSU�CE CARFiIE AND P L�NUMBERARE: CONSTRUCTION Q ��t +J ARRIEf7 �0�� ,�,� . �_ PLAN REVIEW 0 POLICY NUMBER��°� � ELECTRIC Z Q � (IHISSECiIONNE�NOTBEUJRWLEfEDOFTI-�PEPMfiISFORONEMNi)REDDOLLFHS(f10D)ORLESS} PLUMBING ��' W Z I CER7IFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL �} SHAIL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECAME SUBJECT TO THE (/� WORNEFS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE = SUBJEC7 TO 7HE WORKERS'COMFENSA710N PROVISIONS OF SECTION 770o OF 7HE LABOR �7 CAD ,I SH FORTHWITH COMPLY WI THOS P OVISIONS. ISSUANCE �L-� �S � p DATE:� ,1 1 APPLICANT. SMIP W ' J WARNING:FAILURE TO SECURE WORKERS'COMPENSATI N CO RAGE IS UNLAWFUL.AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVERTOCiiIMINALPENALTIESANOCIVI UP700NEHUNDREDTHOUSAN� ENERGYPERMIT DOLURS(5100,000).IN ADDITION TO 7HE COS7 OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. p� RETENTION FEE: �- OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDEA PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.�. Z ` �W -p � LENDER'S NAME YV F— LENOER'SADDHE55 � w ICERTIFV7HATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMA710NISCARRECT. TOTAL FEES ��•'4 � I AGREE TO COMPLV WITH AlL CITV AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CANSTqUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE-MENTION D PROPERTV FOR INSPECTION PURPOSES. COMMENTS � �6 �� 1 �' m PE I77EE N E PRINT) ^ ' Cn ' a �/ � � � SIG URE FP I77EE DA = RECPT.NO. PAID BY VALIDATION ~ WHITE—DepaAment Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy CI�V OI� �9A6�i�6V� �d�� B�9SV�f��'60� f��C�R�D .,, . , �rt Oa�3pC�G400a DGJ4C � OG��pCC�40p = �UyJ�p�C�400a" ,- o ,4C �a�pGC�40Q. SET BACK FLO�R JOIST " ' ' FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT • S�AB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM . RO�F COVER PRE-GRADING � ROUGH HEATING BENCHING u ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL 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 PAID FINAL PLUMBING � � ENERGY �'U'oC�o c ;,.. � COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a --- --_ � c� � � � � � �