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Home My WebLink About16091 (22) : , ,_�� CITY OF DIAMOND BAR ��I��""' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES q� � _ 21660 E.Copley Drive Suite 190 '�U�� L�F pRESS (909)86Q3195 Faz(909)861-3117 . ��'� BUILDING PERMTT APPLICATION FIR LY � JOBSITE . APPLICATION PERMIT I P/C o ADDRESS 22-5 Z�v /nO�.CN�Fi9�N ��-1�-s L DATE NUMBER k c� ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP °C OWNER 7"F_.vNiFF_rt �l'►�N�1 O , ADDRESS 22�2(� In�u.v�1�Wi.v ��+n-fi-� ZONING SEfBACKS Z CITY ��d3A2 ZIP ��1'�7 TEL.9v9.3`�L"�1�0 FRONT RW ❑ g APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOR A,ODI�14N« -1-Ns�4UF�S LNL• SIDE ❑ Q ADDRESS 3 S'23 u i+-� /9✓E � CITY N4kF w�o� ZIP D712 TEL.SZ'L-C�(c-53"�� PROPOSED USE o ARCH/ENG/ • iz DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEOROOMS � CI7Y ZIP TEL. y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AfFlRM UNDER PENALTV OF PERNRV THAT I AA1 EXEMPT FROM THE CONTRACTORS LI- G81H90/CHfpOff W CENSEIAWFORTHEFOILOWINOREASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANYCITVOR (n . COUNTI'WHIq1RC-0UIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRAIJVSTRUC- W Patio/Deck TURE,PRIOR TO IT9 ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMEHf THAT HE OR SHE IS LICENSED PURSUANT TO hiE PROVISIONS OF 7HE CON7RACTORS LI� W � � CENSE UW(QUP7ER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooVSpa �� FESSqN5CO0E)ORTFIATHEORSHEISEXEMPThiEREFROMAN07HEBASISFORTHEALLEGEDE%EMP- V TION.AHVVIOLATIONOFSECTION7o31.5BYANVAPPLICANTFORAPEPMITSU&IECTSTHEAPPLICAN7T0 Z Re-Roof � A CML PENALTV OF NOT MORE 7HAN FIVE HUNDRED DOLURS(i5oo).): � ❑I,ASOMMEROGTHC-VROPER7Y,ORMYEMPLOYEESWITHWAGESAS7HEIRSOLECOMPENSATION, O COrt1fi10fC101 � WILL DO THE WORK,AND THE STRUC7URE IS NOT IMENDED OH OFFERED FOR SALE(SEC.7oa1,BUSI- J NESS AHD PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLY 70 AN OWNER OF � PROPEHfYYVMOBUILDSORIMPqOVESTHEREON,MIDVMODOE55UCHWORKHIMSELFORHERSELFOR � Q hiFqUGH HIS OR HER OMM EM7LOYEES,PROVIOED 7HA75Uq1 IMPROVEMENTS ARE NOT INTENDED OR m QOFFEREDFORSALEIF,HOWEVERTMEBUIIDINGORIMPROVEMENTI550lDWITHINONEVEAROFCOMPLE- Z �'TION,THE ONMER-0UILDER WILL FUVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVEf-0HTMEPUHPOSEOFSALE). ❑I.AS OWNER OF THE PROPEHTY,AM E%ClUSNELY CONTRACTING WfTH UCENSED CONTRACTORS Q TO CONSTRUCT THE PRO,IECT(SEC.70M.BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U8f1Of1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTYN?iOBUILD50RIMPROVE57HEREON,AND � M?IOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUAMTOTHECONTRAG QUANTITY DESCRIPTION FEE � � TOFS UCENSE LAW.). J O ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q 3 c> � � DATE ONRJER V W � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTY OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �r � Y(COMMENCINO WITi SECTION 7000)Of OIVISION 7 Of THE BUSINESS AND PROFESSIONS CADE.AND Z II'/LICENSE IS IN FULL FORCE AND EFFECT. m 11J ,.y�, � LICENSE CUSS_ • LIC.N0. .7%Y Z�2 � � � V DATE �3� �Z CONTRACTOR I� I ( d W � WORKERS'COMPENSATION DECLARATION � � ¢ � I HEREBY AFFIRM UNDER PENALTY OF PER1UFiY ONE OF hiE FOLLOWING DECLARATIONS: U � Z � _I NAVE AND WILL MNNTAIN A CEIi�IFICATE OF CANSENTTO SELF-INSURE FOR WORKERS' _ COMPENSATION,AS PROVIDED BY SEC710N 370o OF THE LABOR CODE.FOR THE PERFORMANCE U Q OF THE WORK FOF WHICH THIS PERMI7 IS ISSUED. � � W _I HAVE MID WILL.MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REDUIRED BY SEC710N Q 37a0 0F THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOfl WHICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND PoLICV NUMBEq ARE: CONSTF�UCTION � CMRIER C' ��'sS =NS PLAN REVIEW � POI.ICY NUMBER T� ELECTRIC � (iHtSSECfqNNE�NOT8E0CAFIFfEDOFTHEPEFMTSFi�RONEFRRiJREDWUPAS(f100)ORIESS� PLUMBING , ! �IW C�Fir7Nt�Ec7�{ W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECAME SU&IECT TO THE n � WORKERS'COMPENSATION UWS OF CALIfOFNIA,AND AGHEE THAT IF I SHOULD BECOME INSPECTION FEE h` �r��1 S SU&IECT TO THE WORKERS'CAMPENSA710N PROVISIONS OF SECTION 3700 OF THE LABOR / u 6ZL,(,�� CODE S ALLFORTHWITMCOMPLVWITHTHOS ROVISI � ISSUANCE � DATE: Z � APPUCANT. . ��SMIP - q W WARNINO:FAILURE TO SECURE WORKERS'COMPENSA710N COVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C ��F� �� f� ��A J qy � SU&IECTANEMPLOYERTOCRIMINALPENALTIESANOCIVILFINESUPTOONEHUNDREDTHOUSAND ENEFiGYPERMIT u ��1�*'��• • - DOLLARS(f100,000),IN ADDITION TO7HE COST Of COMPENSA710N,DAMAGES AS PROVIDED FOR IN p� u ,u,d.�,�l�d'+*h��„�� J SECTION 370B OF TiE UBOR CODE,INTEREST,AND ATfORNEYS FEES. RETENTION FEE: p(Y TLL . V'd�7 �t5 Q p� � CONSTRUCTION LENDING AGENCY v�� wtl��1C'�C'' I�I�/ PRE-ALT FEE: Q I HEREBV AFFIRM UNDER PENAL7V OF PERIURV THAT THERE IS ACANSTRUCTION LENDING AGENCY � FOR 7HE PEHFOR/AANCE OF THE WORK FOR WHIC}1 THIS PERAlI71S ISSUED(SEC.3oY7,CIV.CJ. � Z W � IENDER'SNAME F-� LENDER'SADORESS � 1 CER7IFV THAT I HAVE RF1D iHIS APPLICA710N AtJD STATE 7HAT THE ABOVE INFORMA710N IS CAfiRECT. TOTAL FE ES �A� I� w 1 AGREE TO CAMPLV WITH ALL CT'PND COUNTY ORDINANCES ANO STATE UN5 REIATING TO BUILDING �� V � CONSTPUCTION,AND HEREBV AUh10RIZE REPRESENTATIVES OF THIS COUN7V TO EMER UPON THE ZABOVE-MEHrIONED PROPERTY FOH INSPECTION PURPOSES. COMMENTS � � ��..�•�+ ( J 5G� /( Y'3�• � m 7ERMIT7 NAME(PRINTJe/�A A/ . Cn �r �///�+I � SIGNA7URE OF PERMITfEE D E � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENFIOD—File Copy,GREEN—Applicant Capy . ,. . ., .. . , , . . . . .r �'• ';n.: .�,. .r ..�. , . ... . .. _ . . . c CI'�V O� C9BAM�6�� e�l� �, D�IS�[��806l�1 f�8�� . . .. . . -� �� „ �, ,��{ �� 0 � �xG. �'4c � .� :�,i 4 �� 0 }s�W+�'�'a��'��OW�',�: Y� �.D ��'�' ��xa.� � Q o c 'T ' r a-.� �, ,.�.�. . . _.,. . .. .. . , . . ... � . .,<.� :. . �SET BACK � � I ' � . � FLOOR JOIST � ,. , � �. � FTGS/FORMS/STEEL ' FNA REC]MTS � � � ELECTRIC GROUND. • ; UNDER FLOOR DUCT GROUND PLUMBWG UNDEft FLOOR CUf�IDUIT- � � SLAB GRADE FIREPLA�;�OUNDATION � � TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MIQ HT. BOND�BEAM • • �� ° ROOF SHEATHING 8 FT. BOND BEAM . ` � '� � , FRAMINGNENTlL{ATION FINAL BOND BEAM ROOF COVFR PRE-GRADING ROUGH HEATING BENCHING ROUGH E�ECTRIC ROUGH GRADWG ROUGH PLUMBING FINiSH GRADING SHOWER/TUB TEST P�OL ELECTRIC EXT. LATHlSIDING POOL FENGING WALL INSULATION PQaL FINAL CEILING ItvSU�ATION ' OFF SiTE IMPS. DRYWAL.L NAILlNG DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. • SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FI(VAL ZONING FINAL CONST. FIRE DEPT. FIIVAL I FINAL HEAT'ING � �1EAL7N DEPT. FINAL FiNAL EI_ECTFiIC DEV. FEES FAID ----.—� � -----�_ r1I�JQ.L PLUMBING � ENERGY �_ �._ — i..._ � 0 0 . :o - ,�� .�..`_�; � - - - — -- -- - —' - �` _ ' COMMENTS . � SEPTIC TANK SIZ� SEEP PIT/U SIZE _ �— --� . ;,r� ��;�� - a ,: �4 ... + y ,,,� +�'`.y°w w� x �� L y$�r� �. ,. — —. ' � ��4iA ��y�j�� p��` bt . "�; �w�r�n �'��,�$��.�} Y�. _ �_ �_._ _.._.__..-�--- �-- .iJ1� � � 1'��s�,�� '_ . � i`�" r. _� ��4` , "_ �;�, ''"- hf . .9 � y � � ` :�I Y�� K ��. � � • ' '_'