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Home My WebLink About17762 /� CITY OF DIAMOND BAR ��- ----��` -- DEPARTMENT OF COrRvIUNITY&DEVELOPNIENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS �`'-�w�'� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE •2�SC� �� 4aK I�CH� 1� DATE CATION � I v� NUMBER ��/C ADDRESS � `� APN LOT � TR CT �'48YR7 D TEE � '` "� ONST. GROUP p OWNER �f�vldiN�i i I �ifitY�S LC..� ADDRESS_`�� O �TU�CE I�V� ZONING SETBACKS Z CITY�"�D'Rj�IUCc ZIP OS 3TEL.31G�S�L'.3'�� FRONT RW ❑ p APPLICANT TEL. S DE/SIDE STREET RW ❑ , z Q CONTRACTOR � � � (G SIDE ❑ ADDRESS iU� , °C � PROPOSED USE � CITY h w�L+-- ZI 7 a TEL.2: D�� o ARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIqM UNDER PENALN OF PERIURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- G2f8QB/CBfpOfl W CENSEUWFORTHEFOLLOWINGREASON�SEC.7o31.5BUSINESSANDPROFESSIONSCADE:ANYCI7VOR (n U CAUN7YWHICHREOUIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,�EMOLISH,ORREPAIRANVSTFUC� w TURE,PRIOR TO I7S ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE LAW(CHAPTER e(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSpB � FESSIONSCADE)ORhiATHEORSHEISEXEMP7THEREFROMANDTHEBASISFORTHEALIEGEDE%EMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BY ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO Z Re-Root A CIVIL PENALTY OF NOT MORE 7HAN FIVE HUNDRED DOLLARS(f5o0).): Z ❑I,ASOWNEROFTHEPROPER7Y,ORMYEMPLOYEESWITHWAGESAS7HEIRSOLECOMPENSATION, 0 COrt1rtIBfClel - WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED fOR SALE(SEC.70�a,BUSI� J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTY WHO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OFi HERSELF OR Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED 7HA7 SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEREDFORS/�LEIF,HOWEVER7HEBUILDINGORIMPROVEMENTISSOIDWITHINONEYEAROFCAMPLE� � TION,THE OWNER-BUILDER WILL HAVE THE BUPDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). _ ❑I.AS OWNER OF THE PROPERTV,AM EXCLUSIVELV CANTRACTING WI7H LICENSED CANTRACTORS W � TO CONSTRUC7 THE PRQIECT(SEC.70�a,BUSINESS AND PROFESSIONS CADE:THE CONTHAC70R5 LI- V81U0liOn ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEROFAPROPERTYWHOBUILOSORIMPROVESTHEREON,AND � WHOCANTRACTSFORSUCHPRQIECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). ¢ O I MI EXEMP7 UNDER SEC. B.6 P.C.FOR THIS REASON Q � U � � � � u" DA7E OWNER F !/ z W 2. (ncrp.f� (o � LICENSED CONTRACTORS DECLARATION W i 2 I HEREBV AFFIRM UNDER PENALTY OF PERJURV THA7 I AM LICENSED UNDER PROVISIONS OF CHAPTER Ur d B(COMMENCING WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PROFESSIONS CODE,AND Z `X MY LICENSE IS IN FULL FORCE AND EFFECT. m � LICENSE CLASS LIC.NO. j � J V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION a � I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z 0 1 HAVE AND WILL MAIN7AIN A CERTIFICATE OF CANSENT 70 SELF�INSURE FOR WORKERS' a Z ¢ CAMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FORTHE PERFORMANCE W �OF THE WORK FOR WHICH THIS PEf1M1T IS ISSUED. � � w �1 HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LABOR CADE,FOR THE PERFORMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUED.MY WORKERS'COM ENSATION I SURANCE RRIER AND POLICV NUMBER ARE: CONSTRUCTION J s+�..-� �'�� CARRIER y�j +y PLAN REVIEW Z POLICYNUMBER LL� ��0�+• �'�� ELECTRIC ¢ � (fHLSSECiK7fJNE�NOTBE00MPLEfEDOFTHEPERMffISFORCNEHUPDREDDOUJ�AS(f700)ORLESS} PLUMBING Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (.r} SHALL NOT EMPLOV ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE N WOHKERS'COMPENSATION IAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&IECTTOTHEWORKERS'CAMPENSATIONPROVISIONSOFSECTION37000FTHELABOR CODE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. �SSUANCE � SMIP p DATE: APPLICANT: J WARNING:FAILUHE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f100.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 37080FTHE LABOR CODE,INTEREST,ANDATTORNEV'S FEES. RETENTION FEE: � Q � CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION IENDING AGENCY � FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W � LENDER'S NAME F- LENDER'SADDRESS � � I CERTIFV THAT 1 HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES �� I w I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � ABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. Z COMMENTS � C = 0.1M.¢, �-. c�0 m PERMITTEE NA (PRINT) (/� � ' O N SIGNAT REO ERMITTEE DA = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN—A licant Co PY. PY. PY, PY� PP PY � . . . . � . . � .. .. ... � � • .. � . _ 'u.. . • • .�i' ' . . _. . . . . ., , .. . ��1�� r�' '��1��'L� �� oa�c� oa� oa�c� o�r�ao� oa� � � � SET BACK � , �� FLOOR JQIST • � FTGS/FORMS/STEEL I FHA REQMTS, . �—� ELECTRIC GROUND __ � _ � UNDER FLOaR DUCT _ � _ ; _ _ . —. GRQUND PLUMBWG � __ __ � UNDER FLOOR CU(��DUIT � - ---- _ ____ � _..._ _ __ ..__ _ SLAB GRADE ( FIREPLAC;E �-OUNDAT{ON � � � --- ---- -- _ _._- --- �----- — _. _._� TEMP POWER -- :. ---- -- -- FiREPLA�E_SC?Nf� BEAM _ - -- ..__. ____ _ ..___ WATER 5ERVICE i MID HZ. BQ�#C� BEAM ' — _ - - --_._.-- ----._.. -- ---- - __-- ROOF SHEATHIh1G 8 F7. SC?ND BEAM i — - _..--- ----- -- -----_._._.____- ---------.. FRAMIRlG/VENTILIATION FINAL BOND BEAM � --�--- - — ---- ---------------- ; ------...------.. ROOF COVER PRE-GRADING � ROUGH HEATING BENCHING ROUGH ELECTRIC �L:. ROUGH GRADING �_/./j_.,_.�� - ROUGH PLUMBING ! FINISH GRADING SHOWER/TUB TEST ( POOL ELECTRiC EXT. LATH/SIDIfVG POOL FENClNG I WALL INSULATION � POOL FIUA� ; - --- _...-- ---- ' --.._._.. CEIUNG IN�ULATIO(V , OFF SITE ItJlPS. � — ---- --- -- ---------..____�---- DRYWALL NAILING ( DEDICATIC7N� � --- --_ ____ _._....----___._.— ----- SEWER � FINAL Etd�. _____ _--- -- - _.__ _—._.__._..._.__._��_ SEPTIC TANK LANDSCAi�EfIRRiG. SEEP PIT/LL. ON SITE IMPS. � GAS AIR TEST FINAL Z�NlNG FINAL CONST. , FIRE DEPT. FiNA! FINAL HEATING �_ � HEALTH DEPT. FINAL FIPJAL ELECTRIC 3�3�lJ,� ,�� DEV. FEES PAID _ FINAL PLUMBIfVG � ENERGY � C�G�t O��- � �o � GUiViMIEi�TS _ _____ SEPTIC TAi�K SIZE SEEP PIT/U SIZE -- �" —"-� ---��-- � -- -- ----_._.__�� — _.:.---- '� � -------- � . .. _ ,