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Home My WebLink About18387 CITY OF DIAMOND BAR � ---�� ---� DEPARTME?�'T OF COrM�IUNITI'&�DEVELOPIviENT SERVICES ' 21825 E.Copley Drive (909)860.3195 Fax(909)861-3117 PRESS ��'-.«r�� BUILDING PERMIT APPLICATION FIRMLY } JOBSITE � ,O�y�JNL APPLICATION �O� PERMIT P/C o ADDRESS DATE �r �Py�UMBER # � ISSUE TYPE OCC APN LOT TRACT _ DATE CONST. GROUP °C OWNER �04�-�� O ADDR#ESS /�(vg �02��'G ZONING SETBACKS Z CITY Yi�ivv t�eL ZIP�j7[� 7EL.�G!-L�(.�J FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW ❑ � CONTRACTOR G�C.L/�'� i C,. SIDE p O ADDRESS �'L- PROPOSED USE o CITY G�lf/.t/G ZIP�� TEL.�[�� o ARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDFi00MS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION SFWADD/REM O p 1 HEREBY AFFIRM UNDER PENALTV OF 7ERJURY THAT I AM E%EMPT FROM THE CANTRACTORS LI� GBfa B/C8 R W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.5BUSINESSANDPFOFESSIONSCODE:ANYCITYOR (n g � U COUNTVWry1Cl1qEWIRESAPERAIITTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANYSiRUC� w NRE.PRqR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCN PERMIT TO FILE A SIGNED w Pdt10/DBCk � � STATEMENT THAT HE OR SHE IS LICENSED PUFSUM7T TO TME PROVISIONS OF iHE CONTMCTORS LI- . � � CENSE UW(CHAPTER B(COMMENCINQ WITH SECTION 7000)OF DIVISION 3 C�F THE BUSMESS M!D PRO- POOVSPB � FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AN�THE BASIS FOR THE/�LLEGED E%EMP� (� , V TION.ANVVIOLATIONOFSECTION70.91.5BYANVAPPLICAN�FORAPERMITSUBJECf57HEAPPUCANTTO Z Re-Root � A CML PENALTV OF NOT MORE 7HAN FIVE HUNDRED DOLLARS(f50o).): 0 �I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASIHEIRSOLECOMPENSATiON, � COmfflefClal Z WILL DO 7HE WORK,/JiD THE STRUCTURE IS NOT INiENDED OR OFFERED FOR SALE(SEC.70I�.BU51- J N NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DO'c5 NOT APPLV TO AN OWNER OF � PROPERTV WFIO BUILDS OR IMPROVES THEREON,AND NM1IO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUl3H HIS OR HER OWN EMPLOVEES,PROVIOED THAT SUp71MPROVEMENTS ARE NOT IMENDED OR m Q OFFEREDWRSALEIF,HOWEVER,THEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- . Z TION,THE OWNER�BUILDER WILL MAVE THE BUROEN OF PROVING'HA7 HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). �yJ ❑4�OWNEROFTHEPROPERTV,AME%CLUSIVELVCANTRACTINGWITHLICENSEDCONTRACTORS � TO CONSTRUCT THE PROJECT(SEC.70N,BUSINESS AND PROf'ESSIONS CADE:THE CONTRACTORS LI� V0W3�lOf1 � ADJ.AREA ' W CENSE LAW DOES NOTAPPLV TO AN ONRJER OF A PROPERtt WHO aUII,DS OR IMPROVES THEREON,AND � NRIOCONTRACTSFORSUCHPR0.IECTSWITMACONTRACTOR(5)UCENSEDPURSUANTTOTHECONTRAC QUANTITY DESCRIPTION FEE TORS L�ICENSE UW.). � yIl AM EXEMPT UNDER SFC. B.8 P.C.FOR THIS REASON Q I �//�'✓I'j� u � D U LL' DA� OWN � � � �� Z U � LICENSED CONTRACTORS DECLARATION W ' � I HEREBV AFFIRM UNDER PEIULTY OF PERIURV TMAT I AM LICENSED UNDER PROVISpNS OF CHAPTER � d 0(COMMENCWG WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PP.OFESSfONS COOE,AND Z `X MY LICENSE IS IN FULL FORCE AND EFFECT. � LICENSE CLASS[� ��+ �j r^ � F. LIC.NO.��/ L S�+� J V DATE ��J �A3 CONTRACTOR d W � � WORKERS'COMPENSATION DECLARATION -� � v s�✓1.'�-1- c. Q � I HEREBV AFFIRM UNDER PENALTV OF PERIURY ONE OF THE FOLLOWINO DECIARATIONS: Z A y'^R`— r cr�..�c_.� � _I MAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT 70 SELF�INSURE FOR WORKERS' a � COMPENSATION,AS PROVIDED BY SECTION�70o OF THE LA80R CODE,FOR THE PEHFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W W � � _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REWIRED BV SECTION Q 370a OF TME LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INSUHANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION J � � j CARRIER J/%di.a�I'�I.l�� PLAN REVIEW � �Z POIICV NUMBER D'�L�—tl"l lf K.r DD I 9 S �Z � ELECTRIC �.�� Q � (TMSSECTONNE�NOTBEOOI.AETmOFTHEPEPlMSFOHONEHUN]REDppl1/�AS�f7aolOALESS). PLUMBING W T Z I CERTIFV TMAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PEHMIT IS ISSUED,I MECHANICAL v (} SHAIL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE � WORKERS'CdAPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INS?ECTION FEE SUBJECT TO THE WORKERS'fAMPENSATION PROVISIONS Of SECTION J7oo OF THE V.BOR �..• OCODE.1 SNALL FORTHWITH COMPLY WITH THOSE PR sroNs. � ISSUANCE � �� p DA7E:�(�+LICANT: SMIP � w ENERGY P/C J WARNIN(i:FAILURE TO SECURE WORKERS'COMPENSATION CA ERAGE IS UNLAWFUL,AND SHALL BE J � SUBJECTANEMPLOYEFTOCRIMWALPEN4ITIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(f100,000),IN/�DDITION TO 7HE COST OF CAMPENSATpN.DAMACES AS PROVIDED FOR IN J SECTION 3708 OF 7HE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. O[ RETENTION FEE: L OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � � I MEREBV AFFIqM UNDER PENPLTV OF PERIURV THAT THERE IS A CONSTRUCTION LENOING AGENCV � FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUEO(SEC.9oB],CIV.C.). � � Z W � LENDEi7'S NAME . f-- LENDER'SADDRESS � w I CERTIFV THAT I HAVE RE/�D THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTA L FE ES , I ��. 1 1 � � I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND ST�TE UWS RELATINQ TO BUILOING V � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. _ COMMENTS ' 0 .' . J � N � /`�.c.1...a.,�.-c. _ m PERMITf I ¢ �.�d�d P EE DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELI.OW—Finance Copy,PoNK—Assessor Copy,GOLDENRO�File Co GREEN— py. ApplicenYs Copy ��T'l� TJ� e}i��C��R�3 �3AR 6�9SPE�7'E�i� F��C�►�D o ,.: .. �, � d �, � �. A' � Q � �, Y,.-. o � n . .� � ',�;. � s . � , " .er_ .... � •. ' �` ,,,t 't!' � � .�. •.� {� � . �w .� . . ...`� .�.,as. . ..-, . . .., .-.-.. . : . .. . ,: . . . .. ..: ... � :. ... ,....-:.: SET BACK ! � FLGUR JC?!ST FTGS/FORMS/STEEL � I I FNA REQMTS � ---t -- ------- -_ _------ -- ELECTRIC GROUND � : �NDER FLOdR DUCT ----- -- -- - -____ _______----- GAOUND PLUMBING UNDE=R F=LOOR CUMDUIT � SIAB GRADE FlREPLACE FOUNDATION � - � TEMP POWER FIREPLACE BUND BEAM - � —�------ � WATER SERVICE _ �' MID HT. BOND E3EAM • - � ROOF SHEATHING 8 FT. BOI�lD BiAM FRAMING/VENTILIATI�N _FINAL BOND BEAM �� J R�OF COVER PRE-URADING � ROUGH HEATING , BEN�'NING ROUGH ELECTRIC ROUGH GRADlNG 6_.�2 ___.______ ---- ROUGH PLUMBiNG �_ _ __ FINlSH GRAQING SHOWER/TUB TEST � POt7L ELECTRIG EXT. LATH/SIDING �'OQL FENCING WALL I�JSULATION � POOL FINAL ^ i CEILING INSUTAT�ON �OFF SITE IMPS. ` • DRYWALL NAIUNG DEDICATI(�NS SEWER — ----__— FINA�ENG. 1---- SEPTIC TANK �ANDSGAPEfEFiRIG. � SEEP PIT/L.L. taN SITE IMPS. GAS AIR TEST FINAL ZONING ' F(NAL CONST. � • � �� FIRE DEPT. FINAL . FINAL HEATING + � HEALTN DEP7. FlNAL . FiPdAL ELECTRIG DEV. FFES PAID FINAL PLUM8ING ENERGY �,_ ! 9 io az. � _— -- � .� g COfVIMIEiVTS SEPTIC TANK S{ZE SEER PIT/U SIZE � — -- . �Y .. -- --- -- , . � -� �� ,..�. - m_ o- �` :. �"� :�,��_ __.___�_____. ..__ , ° . . .�� .__._ _____ -- .�b _ � � � - � ey � -- .