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Home My WebLink About16941 �x��r-��l CITY OF DIAMOND BAR `-----�� -- DEPARTIv�NT OF CONIIvIUNITY&DEVELOPMENT SERVICES I T,_� 21825 E.Copley Drive (909)860-3195 Faac(909)861-3117 PRESS ��'%�� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE Q APPLICATION PERMIT P/C I �r o ADDRESS DATE ~D NUMBER �� q Q `^3`T�� ISSUE TYPE OCC APN LOT T CT DATE CONST. GROUP p OWNER �r'�� "�i o ADDRESS ZONING SETBACKS oCITY + ZIP 7 TEL. REORT RW ❑ Z APPLICANT S SIDE/SIDE STREET RW ❑ ¢ CONTRACTOR SIDE ❑ o CDDRESS ZIP TY PROPOSED USE -e�l> � ' �D CL. 0 w ARC N ' z DESIGNER a ADDRESS c NO.DWEL, NO. NO. � CITY � ZIP T UNITS STORIES BEDROOMS cr� cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p , I HEREBV AFFIRM UNDER PENALTV OF PE0.IURY 7HA71 AM E%EMP7 FROM THE CONTRACTORS LI� GefBJB/C0fF10R " W CENSELAWFORTHEFOLIOWMGREA50N(SEC.7031.SBUSINESSANDPROFESSIONSCADE:ANYCITYOR (n U COUNTVWHICHREOUIRESAPEf1MITTOCONS7RUCT,ALTER,IMPROVE,DEMOLISH,ORFEPAIRANYSTRUC� W Patio/Deck w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT T FILE A SIGNED w � STATEMENT THAT HE OR SHE IS LICENSED PUflSUANT TO THE PROVISIONS OF TH ONTRACTORS LI� � /� � CENSE LAW(CHAPTER B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF BUSINE55 AND PRO� POOVSPO J � FESSIONSCODE)OHTHATHEORSHEISExEMPTTHEREFROMANDTHEB ORTHEALLEGEDEXEMP• (� V TION.ANV VIOUTION OF SECTION 7031.5 BV ANV APPLICANT FOR A P SUBJEC75 THE APPLICANT TO Z Re-Roof A CIVIL 7ENALTY OF NO7 MORE 7HAN FIVE HUNDRED DOLLARS � ❑I,ASOWNEROFTHEPfiOPERTY,ORMVEMPLOVEES WAGESASTHEIRSOLECAMPENSA710N, � Commercial - Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INT D OR OFFERED FOR SALE(SEC.7odt,BUSI- J N NESS PND PROFESSIONS CADE:THE CAN7RAC70 CENSE UW DOES NOT APPLV 70 AN OWNER OF � I PFOPER7VWHOBUILDSORIMPROVESTHEREO NDWHODOESSUCHWORKHIMSELFORHERSELFOR Q THROUGH HIS OR HER ONM EMPLOVEES,P IDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREDFOFS�LE.IF,HOWEVEf�7HE8 INGORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE- Z TION,7HE OWNER-BUILDER WILL H THE BURDEN OF PROVING 7HA7 HE OR SHE DID NOT BUILD OR � IMPROVEFORTHEPURPOSEOF E). w ❑I,AS OWNER OF THE P PERTV,AM EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRAC70RS Q TO CANSTRUCT THE PRO T(SEC.70!<,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI� V8IU8IlOf1 ADJ.AREA W CENSELAWDOESNO7 PLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND ^` � NMOCANTRACTSF SUCHPROJECTSWITHACONTMCTOR(S)LICENSEDPURSUAN7707HECANTRAC- QUANTITY DESCRIPTION FEE Y 70RS LICENSE .). � ❑I A XEMP7 UNDER SEC. B.d P.C.FOR 7HI5 REASON Q � U � � D OWNER � Z w � LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER Z � � � 8(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESSAND PROFESSIONS CODE,AND � 1X MV UCENSE IS IN FULL FORCE AND EFFECT. �� '�� m 1 C1 '\`� � � UCENSE CLASS LIC.NO.� j � � J U DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION Q �� NI HER BV AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWING DECUMTIONS: � Z � 0 �t HAVE AND WILL MAMTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR VIORKERS' a Z ¢ CAMPENSATION,ASPflOVIDEDBYSECTION37000FTHELA80RCODE,FORTHEPERFORMANCE w �Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w I HAVE AND WILL MAIN7AIN WORKERS'CAMPENSA710N INSURANCE,AS RE�UIRED BV SEC710N n+� Q 3700 OF THE V BOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH E IT IS �l � � ISSUED RNERS'CAµRENSATION SURA E ARRIE AND POLIC M� CONSTRUCTION � Q 7 � CARqIER t-L1 PLAN REVIEW ZPOLICY NUMBER ELECTRIC a (4��1. �`U � (�HISSEC?IONNE�NOTBEOJMPLETEDOF71-IEPERMfTISFORONEM1K7fiEDDOlL1RS(5100)ORLESS). PLUMBING = Z I CERTIFV THAT IN THE PERFORMANCE OF THE WOHK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL `I�.J� (3 SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE -��"«�'�'^ ` �-- _' (n WORNERS'COMPENSATIONUWSOFCAIIFORNIA,ANDAGREETHATI LDBECOME INSPECTION FEE �r 7 �� SUBJECTTOTHEWORKERS'COMPENSATI PROVISiOI{�OFSE TION37o0 FTHEUBOR �- ��^ � C E,I HALL FOFT WITH COMPLV WIT T SE PR VISIONS. , ISSUANCE I �� SMIP p DATE: � � APPLICANT. JENERGY P/C I WARNING:FAILURE TO SECURE WORKERS'CO NSATION COVERAGE IS UNLAWFl1L,AND SHALLBE LL SU&IECTAN EMPLOVER TO CflIMINAL PENAL AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT r DOLURS(5100,000),IN ADDI710N TO THE COST OF COMPENSA710N,DAMAGES AS PROVIDED FOR IN ,..� � � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. - _ � RETENTION FEE: y�-._+.-- — .__—....— � O � CONSTRUCTION LENDING AGENCY - PRE-ALT FEE: '� � O � I HEREBV AFFIRM UNDER PENAL7V OF PER1UfiV THAT TH CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WH PERMIT IS ISSUED(SEC.3oB7,CIV.C.). Z � W � LENDER'S NAME /J Q � . /I ^' �..� fJ �r H LENDER'SADDR ✓� w� TOTAL FEES 1 I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. �l �� I AGREE TO COMPLV WITH ALL CITY AND CAUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING � � CANSTRUCTION,AND HEREBV AUTHORIZE FiEPHESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOV�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � r 1� �� vl.� m PERMITTEE ME(PRI ) � 4 � Q � � SIGNA7UR F PERMIT7EE TE = RECPT.NO. PAID BY VALIDATION ~ W TE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,G LDENROD—File Copy,GREEN—Applicant's Copy (;�b)��y�6b.s�` . .... ,- _.. . .„.,�.: �.. > , . .... � �, ��rr iad' . .�:�{, 4 r.w . ..aY:ka,.:�w...v • .,. r�.,, , .. .. _. , ... , .,.... .-. ... . . . . . .. . .. �� a� l�� Y �� '�� .� ��° -.a:n�V�( -rA��.1�.�4 � � �� + a �a �' r�, �a ❑ � a ��^.. � p _�le?� , � �, ,w .m� �. m�e � �� T e�� w,a��wb��W�� ,.e:,�, �'�'3 r � �>- . ,,. a-:� . ��s- m v. q� ,� . m,. m,m . m te SET BPCK I FLC�C�R JC�i�i �__. � _�— � ..._ _____ �_ _��— --� . __.._ ._..___ ___ ��-- - F.TGStFORMS/S i EEL lt�'-2?-i - . FHt� �l�C��[`o - -- --- - ----=:�-_�---.-- : ,_.___ __ __ -- �- --__ __ � -.__ ELECTRlG UROUND � ' ' ; �NDEE�FLt�t�6� ��3�T � I - ---� ___ � __ __-• ---_- -----__. _ ;_.____ __� ___ GRtJUND PLUMBING ` � lJ�1DER �LOC?R CC�i�iC�t11r — --�-- -- -- --- - _ � � -----._-- - ___ __� SLRBGRADE ' _j—.__� __-,- F��EPLAG��_�C7C1t�l��iTlfat� ___.;� l I . �----- -- TEMP POWER _-�-J. '_ _____-. - --!-j ��EPLFt�:E BC��1D �Et��rl _� _______� __�-- }___-- --�. WATER SERVICE,___ � � �l I futl� HT. �t7f�D B��t� _ __ ' .�_--- _. __- - b�-- --- --- ---�-,------------ -- ROOF SHERTH!'PVta �.----- - ` 1 8 F�?'.��JI�D BEAM ' �D�_ _ _ � �-- - __ _ �__ - _ � --- � FRAMINGNEPITILfr'\T1QN� � ° FIiVA�E3fl(�1`��Ek�� 1 ��yC� - _ -- - ----�--- _ �- --- __��. � --. �ooF cpv�� :�� ;�� _ _ —__ _ __ __ ---,.—__ .�__ � � ___ ___ ROUGH HEATlf�G � �ENGNI�t� `r � __ _____ .�_ ___ _______�.____ — ROUGH ELECTRIC �� RC�U�H URAf��I�C� � . �__ __- - -- -.... - --- — _ ROUCH PLUMPING � � i �IP�fSH GFi��ti�l� �-- __._— —__ _____ _. _____t _� -----.____ -----_ _......_ � SH0�1/Et�/TUB TEST ; � �'OQL�LEGTE��C � _ . (---- EXT. LATHfS1DiNG --- ---- --i� P�i�L FE�C1�� J _lGj o( ' � - -- � �-�--�-� ---� _.�..�� _____. ._-�---_ WA�L INSUL�lT(�(V � ! P��}L F1NAL i -_- ______ __ _ � ._----_ _ _.....___.._ GEILING IN�ULATIOIV i � ��SITE I�IP�. , DRYWALL NAIL{t�G —� �-- ___....-- '- -- -._��.___.__.___._ i.� � --- � C�EDIGA�'IflI�S� _.�..__ .��.4-._.�.....,.�..�..__.�� _.�.....__._. ____ �'u'�W��3 t'{�{L�. ��G. � t { -- .-- _--- � ----- `--j s��ric ra�vK . �a��sc��s��. ; � __ � ____ _____ �_.�__ ._._______.____� S�EP PITlI..L ' � � � l , ON 517�INf�'�. ; —_ ,-r .._ --__-� - ----- - GAS AIR TEST I �€N�L�a�11E�t� � � � --- ----- -�-- —_____�_. FINAL Ct�NST. ., � ____.�_.._ , ; ��R�C3Er T.F3NA� �� __ __.� _ ___ _. ____ FIN�L MEATING j � ( HEALTN DEPi" FIU�� , � ____�. L� �_� .._ __ -_ ____ _ �INAI�ELECTRIC j ' ' DEV. �EES PA�D � � _ �. 1 _ _ __.__ � - - ------ --- _ 1__--_ ��- �. FlN��L PLUf1�BfNG _ � ; Ef�ER�Y � � . � - � - � `. w � ��J ��,� '�� _ �m� �--- � � — -- ___ ` _� �_;._.�_�..�.,�_—�-� ---� - �i��T�J_, _ � � � �— � '_.___. __ ______��_---___ � -- �� _ _.._ _______.__.__..._..._.._..------ � - --_ ___. ---- _ � � ____ ______. �________ ____ �--- — ______._ _ � __ ____M_ EPTIC T�NK SlZE � SEEP PIT/U SIZE � � ---- —____ __�_ ___ ---- � �. �. 4� � � , �____----- �_.___-- .. , , , , , �£ _ ____ _ �______ _ r _ _>� � � �� ____ ___ ---..------ Y �� . C . . .�.�._ .... �-_.__.�__ x ' ..� , .. a ' . _ � .. � ' � a� , r � . � . � a' �_ .��._, .�.�.._ '_�__'___