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Home My WebLink About10-1088 - .- . � _ __ __ _ _ _ �F� CITY OF DIAMOND BAR ��T�'� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ��/�� 21825 Copley Drive,Diamond Bar,CA 91765 � � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �"';9�°•. suir,�irrc rE�iT ArrLicATioN � �IRMLY I ' � JOBSITE o ADDRES��d �� DATE CATION NUMB R �'��p�� APN LOT TRACT f�) � J � � � DATE /V`�� CONS .'��I��i�R'(`qOUP p OWNER o ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT pyy � g APPLICANT TEL. REAR � zd SIDE/SIDE STREET RW ❑ � CONTRACTOR ' L ((� SIDE � � CIT`/ E ZIP�_ TEL. — PROPOSED USE � •e 7r If 'e/�' � w ARC N y3 ? - iz DESIGNER , /S � NO.DWEL. NO. �' � NO. � ADDRESS u� UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION S0.FT. � �la6TOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O ' p I HER�V AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FAOM THE CANTRACTORS LI� G2f8g0/CBfPOfS W CENSELAWFORTHEFOILOWINQREASON(SEC.7071.SBUSINESSANDPROFESSIONSCODE:ANYCITVOR (n ZCOUNTVWHICHRC-0UIRESAPEFU/ITTOCANSTRUCT,ALTER,IMPROVE.OEMOLISH,ORFEPAIRANVSTRUG W P9i10/DBCk W TURE,PRqR TO RS ISSUANCE,/�LSO HEOUIRES THE APPLICANT fOR SUpi PERMIT TO FILE A SIONED W g STATEMENT THl1T HE OR SHE IS LICENSE�PURSUANT TO THE PROVISIONS OF THE CONTRACTORS U� c CENSE UW(CHAPTER o(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooUSpe • �'.�;Z_ `1 FESSIONS CODE�OR T}IAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEOED E%EMP- (� - �� TKKJ.ANY VIOLATION OF SECTION 7071.5 BV ANY APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500).): 0 ❑1ASONMEROFTHEPROPERTV,ORMYEMPLOVEESWITHWAOESASTHEIRSOLECAMPENSATION, � COrt1rtIBfC18I Z WILL DO 7HE WORI(,AND 7HE STRUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7o�I,BU51� J � N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT A7PLV TO AN OWNER OF / PROPERTV WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIMSELFOR HERSELF OR � S ^ l.. � � V7 � THfiOU(3H HIS OR HEF ON?J EMPLOYEES,PROVIDED THAT SUCH IMPROVEMEMS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,FqWEVERNEBUILAINGORIMPROVEMENTIS50LDWITHINONEVEAROFCOMPLE• Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVWO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR T1/E PUHPOSE OF SALE). W ❑I,AS OWNER OF THE PROPEHTV,AM E%q.U51VE�Y CONTMCTINO WfTH UCENSED WNTRACTORS [[ 70 CqNSTRUCT 7HE PR0.1EC7(SEC.7a�,BUSINE55 AND PROFE5510N5 CODE:7HE CONTRAC70RS LI- VelUa�lOn ADJ.AREA W CENSEIAWDOESNOTAPPLVTOANONAJEROFAPROPERTVWFIOBUILDSORIMPROVESTHEREON,AND WHO CONTRACTS FOR SUCH PRQIECTS WITH A CANTRACTOR(5)LICENSED PURSUANT TO THE CONTqAG Y w' J/�} 70RS LICENSE UW.). QUANTITY DESCRIPTION FEE � � ❑I AM E%EMPT UNDER SEC� � �+ B.8 P.C.FOR THIS REASON � � U LL DA7E oWNER � � LICENSED CONTRACTORS DECLARATION w � I NEREBV AFFIRM UNDER PENALTY OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � D�COMMENCWC3 WITH SECTION 7000)OF DNISION 3 OF THE BUSINESS AN�PROFESSIONS CODE,AND Z �� AIV LICENSE IS IN FULL FORCE AND EF CT. / '� m � LICENSE CLASS � / LIC.NO. ��—/ � � V DATE � CONTRACTOR � d W � WORKERS'COMPENSATION DECLARATION � � I HEREBY AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWING DECUAATIONS; V � Z � _I HAVE AND WILL M/JNTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WOR)(ERS' ¢ 2 Q COMPENSATION,AS PROVIDED BV SECTION 37o00F THE IABOR CODE,FOR TME PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � w _1 HAVEAND WI�L MAINTAIN WORKERS'CqMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMR IS / _ � � ISSUED.MV V�RS'COMPENSATION INSUqANCE CARRI AND 70LICV NUMBER AAE: NSTRUCT C jJ �� — � CARRIER � PLA REVI . � POIICV NUMBER � ELECTRIC � (fFiSSECTqNNE�NOTBE00MPLE7mOFTHEPEqMTISFpqpldEHIA�DF7EDDp1ARS(5100)OqLESS} PLUMBING W Z I CEFTIFV THAT IN THE PERFORMANCE OF THE MVRK FOR WHlqi THIS PERMIT IS ISSUED,I MECHANICAL C} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE (n WORKERS'COMFENSATION LqWSOF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE S SU&IECTTOTHEWORKERS'COMPENSATbNPROVISKKJSOFSECT10N37000FTHEUBOR Y� CODE,I SHALL FORTHWITH COMPLV WITH THOSE PR ISIONS. SSUAN � /� ��/ / p DATE:_��qp�/CANT. `�• 5 � W � J WARNINO:FAILURE TO 5 RE WORKERS'CqMPENSATION COVERAOE IS UNLAWFUL,AND SHALL BE ENERGY P/C � J � SUaIECTAN EMPIOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSMJD ENERGY PERMIT DOLURS(f1oo.000),W ADDITION TO THE COST OF COMPENSATION,DAMAOES A$PHOVIDED FOR IN � SECTION 37oB OF iNE LABOP CODE,INTEREST,AND ATTORNEV5 FEES. E7EM' N F �. G � CONSTRUCTION LENDING AGENCY � p -A T FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THATTHERE IS ACONSTRUCTION LENDINO AOENCY FOR THE PERFORMANCE OFTHE WORK FOR WNICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. �` Z W � LENDER'S NAME F— LENDER'SADDRESS � I CERTIFV THAT I HAVE READ THIS APPIICATION AND STATE THAT THE ABOVE INFORMATIOfJ IS CORRECT. TOTAL FE ES �,�C�,/Gj � I AOREE TO CAMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS RELATINO TO BUILDINO �' � CONSTRUCTION,AND HERE9Y AUTFqRIZE REPRESENTATIVES OF THIS CAUNTV TO ENTER UPON THE ' Z ABOVE�MENTIONED PROPERTY FOR 1 SPECTION PURPOSES. COMMENTS � 1�� J m ¢ PERMITfEE NAME(PRIM) . � ��,�� /o�—r c7 ' T� � SIONATURE OF FERMITT DATE �� RECPT.NO. PAID BY ^ yq�v �pq�pN WHITE—Depertment Copy,YELLOW�inence Copy,PINK—Assessor Capy,GOLDENROP—File Copy,GREEN—Applicant's Copy :;; :� . , .. -. . . c��v o� �o,��o�� . • .• �. ,. �r�, �Ytl�7��8�itl ��1"L� - � �. oa�p��aoa oa� �.,. oa�p��a ` oa�p�c��ooa: �a� -� � oa�p��-��° SET BACK FLOOR JOIST - FTGS/FORMSISTEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'L BOND BEAM ROOF SHEATHiNG 8 F7. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING , SHOWER/TUB TEST PpOL ELECTRIC EXT. IATH/SIDING POOL FENCING WALL INSULATIOM POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/lRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING • FINAL CONST. FIRE OEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY �01�o � COMMEIVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � . �'�'� �` . .