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Home My WebLink About18049� ' CTI'Y OF DIAMOND BAR ---��` — DEPARTIvfENT OF COMMIINITY&DEVELOPIvIENT SERVICES 21825 E.Copley Drive (909)860-3195 Fau(909)861-3117 PRESS ��`<9�� BUILDING PERMIT APPLICATION FI R M LY � JOBSITE �� .J�� ,�� /` pppLICATlO PERMIT � C i ¢ ADDRESS �w"' p DATE NUMBER � ISSUE � � NPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER p ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT Ryy ❑ g APPLICANT TEL. REAR ❑ SIDE/SIDE STREET RW ❑ � CONTRACTOR �-�v�� t�Rt_ � � ficr�� (. SIDE p ADDRESS�p3� S_ i.()�CA�LT S'f� � ciTv La N�L�4 ZIP �Dw31 TELSL�'I.�EiI0�2Z'��, PROPOSEDUSE oARCH/ENG/ � z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION I � OWNER-BUILDER DECLAF7ATION SFR/ADD/REM O p I HEREBV AFFlRM UNDER PENALTY OF PERRIRY THAT I AM EXEMPT FROM THE CONTMCTORS LI- G8f8JB/C8fP011 ' W CENSELAWFORTHEFOLLOWINOREASON(SEC.7031.SBUSINESSMlDPROFESSIONSCADE:ANYCITVOR (n V COUNTYWHICNREQUIRESAPERMITTOCONSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANVSTAUC� w w TURE,PRIOR TO ITS ISSUANCE,ALSO REIXIIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W Patlo/Deck � STATEMENT THAT ME OR SHE IS LICENSED PURSUANT TO iHE PROVISIONS OF THE COMRACTORS LI� � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSPB Q FESSIONSCODE)OR7HATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEQEDE%EMP- (� V TION.ANY VqLATION OF SECTION 7031.5 8V ANV APPLICANT FOR A PERMIT 5U&IECTS THE APPLICMlT TO Z Re-Root A CML PENALTV OF NOT MOqE THAN FNE HUNDRED DOLURS(f6ao)J: � ❑I,ASOYMEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COrtIrtI0fCi81 Z WILL DO THE WORK,M1D 7HE STRUCTURE'IS NOT'fNTENDED OR OFFERED FOR'9ALE(SEC.7old,BUSI� J ^ � NESS AND PROFESSIONS CODE:THE CqNTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPERTV NR10 BUILDS OR IMPROVES 7HEREON,AND WHO DOES SUCM WORN HIMSELF OF HERSELF OR wTHROUGH MIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEFEDFORSALEIF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVEFOR7HEWRPOSEOFSAL�. w ❑I,�lS ONRJER OF TNE PROPEHTV,AM E%CIUSIVELV CONTRACTINO NTTH LICENSED CONTRACTORS �, � TO CONSTRUCT TME PROJECT(SEC,7oaa,BUSINE55 AND PROFESSIONS CODE:h1E CONTMCTORS LI- V8IU8�1Of1 ADJ.AREA �W CENSELAWDOESNOTMPLVTOANOWNEROFAPROPERTVWFIOBUILDSORIMPROVESTHEHEON,AND � NM1IOCANTRACTSFORSUCNPR0.IECTSWI7HACqNTRACTOR(S�UCENSEDPURSUANTTOTHECONTRAG QUANTITV DESCRIPTION FEE Y 70RS LICENSE UWJ. 0 � ❑I AM E%EMPT UNDER SEC. B.d P.C.FOR THIS REASON Q � ��P ��M S ?� U t � DATE E Q �" L 1� � W FL. Z U �Q UCENSED CONTRACTORS DECLARATION w 2 I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCWO WITH SECTION 7000)OF DNISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z ' x_'�'� MV LICENSE IS IN FULI FORCE AND EFFECT. m � LICENSE CLASS �IC.NO. � � � V DATE CONTRACTOR � a , W � � WORKERS'COMPENSATION DECLARATION Q � U � I HEREBV AFFlRM UNDER PENALN OF PE0.IURV ONE OF THE FOLLOWING DECLARATqNS: Z �Z I HAVE AND WILL AIAINTAIN A CERTIFlCATE OF CONSENT TO SELF-INSURE FOR WORNERS' ¢ Q = CAMPENSATION,AS PROVIDED BV SECTION 370o OF THE LABOH CODE.FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � Qw _I MAVE AND WILI MAINTAIN WORKEFS'fAMPENSATION INSURANCE,AS HEWIRED BY SECTqN 370o OF THE LABOR CODE,FOR THE PERF-0RMANCE OF THE WORK FOR WHICN THIS PERMIT IS ISSUED.MV WORI(ERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION � CARRIER PLAN REVIEW ZPOLICV NUMBER ELECTRIC Q p (MISSEC1YXdNE�NOTBE(�Jf.�LEfm�F71fPER4YrISFORONEFl1H7F1EDD01.LPflS(5100�OqLESS} PLUMBING W Z � I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL � C'} � SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE ? , SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR CODE,I SHALL FORTHWITH CAMPLV WI7H THOSE PFiOVI510N5. ISSUANCE � . �- p DATE: APPLICANT: SMIP W J WMNINO:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C J LL SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(f toO.00D),IN ADDITION TO THE COST OF COA/PENSATION,DAMAOES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNE'I'S FEES. oC RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THATTHERE IS ACONSTRUCTION LENDINO AGENCV FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PEFMIT IS ISSUED(SEC.308],CIV.C.). Z W � LENDERS NAME H LENDER'S ADDRESS � w I CERTIFV THAT I HAVE READ iHIS MPLICATION AND STATE hIAT THE ABOVE INFORMATION IS fARRECT. TOTAL F E ES I d I AOREE TO COMPLV WITH ALL CRY AND CWNTV ORDINANCES ANO STATE LAWS REUTING TO BUILDING � � � CONSTRUCTION,AND HEREBY AUTHORIZE FEPRESENTATIVES OF 7HI5 COUNTV TO ENTER UPON THE ' �� Z ABOV;MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � 0 �� P MITTEE N (PRINn Y ✓ I B � SI A E DAT � RECPT.NO. PAID BY VALIDATION WHITE—Depariment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs opy C��'�Y �� Q1�D��1� (�a�� '�� ° � 0� '� DCJ��, ,� �o� � � - � L�° � oa � � �a .� � ao 5ET BACK —�� FLOOR JOIST FTGS/FORMS/STEEL �__ v � �HA REGZMTS ELECTRIC GROUND __�__ UNl�ER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CU�IDUIT SI.AB GRADE �IREPLACE FOUNQRTION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND SEAM ' ROOF SHEATHING ' 8 FT. BOND BEAM FRAMING/VEfVTILIATtON FINAL BOtVD BEAM ROOF COVER PRE-GRADING � ROUGH HEATING BENGHING ROUGH ELECTRIC �o-{,d-9�^ ROUGH GRADING ROUGH PLUMBING �_�p__`�_ _ FINISH uRADING SHOWER/TUB TEST i POOL ELECTRIC EXT. LATH/SIDING A POOL FENCING WALL INSULATI(]N POOL FINAL CEI�ING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATI01�lS SEWER FINAL ENG. SEPTIC TANK LANDSCAPEIIRRIG. SEEP PIT/L.L. ON SITE IMPS. � GAS AIR TEST F1NAL ZUNING �` � FINAL CONST. ' FIRE DEPT. FINAL i ` a— �INAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FIiVAL PLUMBII�IG ENERGY ` � , O� Cy � ot ,� a a COMMEN`fs i�6�t5�. �o ��s.,�_,�.c,`-�� Wc;� . �_�Ak'��,�cD ,� �Z ' — 1 SEPTIC T/�NK SIZE SEEP PIT/U SIZE .[Y� , — � . � ,. �