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Home My WebLink About11-865 o � jz��zor� �,,�`_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ��P�� ,w , 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-70 PRESS "��' BUILDING PERMIT APPLICATION �ie FIU�MLY o� JOBSITE 'I APPLICATIO PERMIT Q p/C ADDRESS ONCi�"'e �"_h� DATE �IavG/ �� NUMBER��V�� # °^ APN LOT TRACT �SSUE TYPE !f- �� OCC s� DATE CONST. /" GROUP p OWNER x �'iiKA��IL'�' t�7�� 0 ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT qyy p � APPLICANT TEL. ' REAR p � SIDE/SIDE STREET RW ❑ ¢ � CONTRACTOR � — SIDE p ADDRESS�' � CITY ��fl�t�/�� ZIP�� TEL. PROPOSED USE l�lD�f��/�L�.�..,o ,,,�' ��e�� w ARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM O ' I HEREBY AFFIRM UNDER PENALTV OF PERIURV THA7 I AM EXEMPT FROM 7HE CONTRACTORS LI- G2f89B/C01POR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANVCI7YOR (n U COUNTyWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- � W TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT 7HAT HE OR SHE IS LICENSE�PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � � CENSE LAW(CHAP7ER 8(CAMMENCING WITH SECTION 7ooa)OF DIVISION 3 OF THE BUSINESS AND PRO� POOVSpB � FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM ANO THE BASIS FOR THE ALLEGED EXEMP- (� TION.ANVVIOLATIONOFSECTION7031.SBVANVAPPLICANTFOHAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CIVIL�ENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(f5oo).): � ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOIECOMPENSATION, � Commercial Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OH OFFERED FOR SALE(SEC.7ou,BUSI� J � NESS AND PROFESSIONS CADE:TME CANTRAC70R5�ICENSE UW DOES NO7 APPLV TO AN OWNER OF � PROPER7Y WHO BUILDS OR IMPROVES 7HEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGH HIS OR HER ONM EMPLOYEES,PROVIDED THA7 SUCH IMPROVEMENTS ARE NOT IN7ENDED OR m Q OFFEREDFORSALEIF,HOWEVER,7HEBUILDINGORIMPROVEMEMISSOLDWITHINONEVEAROFCOM7LE� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUIID OR � IMPROVE FOR THE PURPOSE OF SALE). ❑I,AS OWNER OF THE PROPEHTV,AM E%C WSIVELV CON7RAC71NG WITH LICENSED CANTRACTORS Q TO CANS7RUCT THE PROJEC7(SEC,)0�6,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U8�1On � D '� ADJ.AREA W CENSELAWDOESNO7APPLVTOANOWNEROFAPROPER7VWHOBUILDSOPIMPROVESTHEREON,AND � NMOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � . ❑I AM EXEMPT UNDEH SEC. B.6 P.C.FOR THIS REASON Q � U � � DATE OWNER U Z w � LICENSED CONTAACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENALTV OF PERJURY 7HAT I AM LICENSED UNDEF PROVISIONS OF CHAPTER � � 8(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z MV LICENSE IS IN FULL FORCE AND EFFECT. � LICENSE CLASS �'� —_�7 LIC.NO. J� ? 1��U � T V DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION Q NI HEREBYAFFIRM UNDER PENALTV OF PERIURY ONE OFTFIE FOLLOWING�ECLAHATIONS: Z � _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSEN770SELF-INSUREFORWORKERS' _ Q CAMPENSA710N,AS PROVIDED BV SECTION 37oa OF THE LABOR CODE.FOR THE PERFORMANCE W Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � QW _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION 3700 OF 7HE UBOR CADE,FOR THE PERFOHMANCE OF THE WORK FOR WHICH 7HI5 PERMI715 J ISSUED.MV WORNEfiS'CAMPENSATION INSURANCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION �� Q � CARRIER � PLAN REVIEW ¢ POLICYNUMBER ��,d ��LTr�G I ELECTRIC � (i}iISSECTIONNE�NOTBENIdPLEfEDOFTIEPEPMfTISFORONEHUPDREDD0I.LPAS(t100)ORLESS). PLUMBING Z I CERTIFV THAT IN THE PERFORMANCE OF THE M/ORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL �} SHALI NOT EMPLOY ANV PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE Uj WORKERS'COMPENSATION LAWS Of CAUFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECT�ON FEE � SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHEUBOR � �� ~ CADE,I SHALL FORTHWITN COMPLV WI7H THOSE PROVISIONS. ISSUANCE ��/) p DATE:D�3J'ZO/I APPLICANT: ✓- .�'�•--� SMIP j. �V J WARNING:FAILURE 705ECURE WORKERS'COMPEN TION COVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5100.000�,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PPOVIDED FOR IN J� � SECTION 3708 OF THE UBOR CODE,INTEREST,AND ATTORNEV'S FEES. FlETENTION FEE: �Q" OCONSTRUCTION LENDING AGENCY P A T FE�; � 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCV ��,jr�. � FOP THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7097,CIV.C.), a Z �/� W �T LENDER'S NAME � �: " . i H LENDER'SADDRE55 w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE TNAT THE ABOVE INFORMATION IS CAFRECT. TOTAL F E ES � n�� I AGREE TO COMPLV WITH AlL CITV AND COUNTV ORDINANCES AND STATE lAWS PELATING TO BUILDING . � CANS7RUC710N,AND HEREBYAUTHORIZE REPRESEN7ATIVES OF 7HI5 COUN7YT0 ENTER UPON THE . Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � � r � OUl�J�( m PERMITTEE NAME RINT) � � Q � ,�--__—� � �`�.?e/I � SGT U�O PERMITTEE DA = RECPT.NO. PAID BY O� VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy C9�V O� �0�(�d0�lD �AIR iNS�I��O�l ff3��C0�� oa�p�c�400a oa4� a��p�c�4oa oa��c�4aoa a�� oa�p�c��ar. 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�f�JAf� MID HT. BOND BEAM ROOF S�I�� l � 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING RpUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlTUB 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 F�NAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY --- ---- -- --- _.....-- ----------- ------ --- — C�� f — ------------- -- COMMENTS �_i�.,,.:��dl►��Z �► _ SEPTIC TANK SIZE SEEP PIT/U SIZE a -- - � r� n