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Home My WebLink About14746� CITY OF DIAMOND BAR � r�� . --� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �J� 21660 E.Copley Drive Suite 190 � � W (909)860-3195 Fax(909)861-3117 PRESS ��`� BUILDING PERMIT APPLICATION J�i FIRMLY o DDRESS ��S7S ��/�9 � � APPLICATI � PERMIT � � P/C/i�� I DATE NUMBER #_� � APN T TRACT ISSUE TYPE OCC D TE CONST. GROUP p OWNE�� OC� / U � ADDR SS s � - O ZONING SETBACKS Z CITY� �/L(O/v P TEL. O FRONT RW ❑ g APPLICANT � CI�� TE � �p REAR ❑ � SIDE/SIDE STREET RW ❑ � CONTRACTOR U �I /- SIDE ❑ � ADDRES ' PROPOSED USE <� !� �1i � G�/� � CITY ZIP TEL �Z � oARCH/ENG/ I � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. I � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AFFlRM UNDER PENALTY OF PERNRY hIAT I AM EXEMPT FROM THE CONTRACTORS LI- GHfe9B/CBfPOR W CENSEUWFORTHEFOLLOWINOR6ISON(SEC.7031.58USINESSAND7ROFESSIONSCODE:/�NVCI7VOR (n U COUNTYWHIp1REWIRESAPERMRTOCON5TRUCT,ALTERIMPROVE.OEMOLISH,ORREPAIRANYSTAUC- W patio/Deck W TURE,PRIOR TO RS ISSUANCE,AL50 REW IRES THE APPLICAHT FOR SUCH PERMIT TO FILE A SIGNED W � STATEMENT THAT HE OR SHE IS LICENSED PURSUAN7 TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE UW(CHAVTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- LL' PaoVSpa FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT 7HEREFROM AND THE BA515 FOR THE ALIEOED EXEMP- TION.ANYVqUT10NOFSECTION7031.6BYANYAPPLICANTFORAPERMITSUBJEC75THEAPPIICANTTO Z Re-Roof � ACMI VENALTY OF NO7 MORE THAN FNE HUNDRED DOLLARS(f5ao).�: � ❑I,ASOWNEROFTHEPROPEHTV,ORMYEMPLOYEESWIhIWAGESASiHEIRSOLECOM7EN5AilON, O COfI1fflBfCiel � MALL DO TME WORK AND THE STRUCTURE IS NOT IHTENDED OR OFFERED FOR SALE(SEC.701�,BU51- _1 NESS AHD VROFESSIONS CODE:THE COHiRACTORS LICENSE LAW DOES NOT APPLV TO AH OWNER OF � PROPEHTYNRIOBUILDSORIMPROVESTHEREON.ANDWHODOESSUpiWOHKHIMSELFORHERSELFOR � �"� Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED TMAT SUCN IMPROVEMENTS ARE NOT IN7ENDED OR m � QOFFEREDFORSALEIF,HOWEVEi�T1E8UILDIN00RIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z �`TIOIi,THE OWNERAUILDER WILL HAVE THE BURDEN OF PROVINO iHAT HE Ofi SHE DID NOT BUILD OR � IMPROVE FOR THE PURPQSE OF SALE). W ❑I,IISOVMEROFTHEPROPERTY,AME7(0.USNELYCONTMCTINOWIhiLICENSEDCONTRACTORS � TO CONSTAUCT THE VRO,IECT(SEC.70H,BUSINESS AHD PROFESSIONS CODE:THE CONTRACTORS LI- V81118�10l1 ADJ.AREA W CENSE UW DOE3 NOTMPLV TO AN ON?IER OF A PROPERTV WIIO BUILDS OR IMPROVES 7HEREON,AND � N7fOCOHTMCTSFOR5Ud1PR0.1ECT5WITMACONTMCTOR�S)LICENSEDPURSUAMTOTHECOHTRAG pUANTI � DESCRIPTION FEE � � TORS LICENSE LAW.). . O I AM E7(EMPT i1NDER SEC. B.8 P.C.FOR THIS HEASON Q 3 _ . • • � � ¢ DATE OWNER V W F LICENSED CONTRACTORS DECLARATION w � I HEHEBY AFFIRM UNDER PENALTV OF PERIURY hIAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � - . � Y(COMMENCINO WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PROFESSIONS CADE.AND Z �� AIY LICENSE IS IN NLL FORCE Aj1D EFFECT. � �j ��G} m L( J� ` /� �L � LICENSE CLASS LIC.NO. J V DATE �� Z�� CONTRACTOR d W � WORKERS'COMPENSATION DECIARATION a N I HEREBV AFFIRM UNDER PENALTV OF PEfUUM ONE OF THE FOUAWINO DECLAMTIONS: U � C� Q � I HAVE AND WILL AMINTAIN A CERTIFICATE OF CONSEHT TO SELF-INSURE FOR WORKERS' _ � CONPENSATION,AS PROVIDED BV SECiION 37000F 7ME LABOR CODE.FOR THE PERFORMANCE �U OF hIE WORK FOR VMICH THIS PERMIT IS ISSUED. � w �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSUMNCE,AS REOUIRED BY SECTION /^r� Q 970D OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS ,�� C/ ISSUED.MV WO/RK�caS'COMPENSyA�T /y/�I SU CE CARRIER MID POIICV NUMBER ARE: CONSTRUCTION � CARRIER `S` �� ` �"~� PLAN REVIEW � POIICVNUMBER I Z7� ` � ELECTRIC . � (IFaSSECfIONNE�NOTBE00MH.EfmOFi1#PEFA9TISinRONEHlNDF1FD00.UiRSKtro)OR�ESS) PLUMBING Z I CERTIFY THAT IN THE PERFORMANCE OF THE N9NK FOR WHICH THIS PERMIT IS ISSUEO,I MECHANICAL ^ (,r} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE N WORKERS'COMPENSATKKJ UVIS OF CALIFOHN10.NND GREE 7MAT IF I SHOULD BECOME INSPECTION FEE S SUBJECTTOTHEIMORKERS'COMPENSATION PRO N OFSECTION770oOFTHEIABOR coo¢,i u�Fo n�coMv�r wini nios ao w . ISSUANCE O p DATE: 2'� Z BO APRICANT. �SMIP w ENERGY P/C D J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNUWFUL,ANO SHALL BE � SU&IECT MI EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP 700NE HUNDRED THOUSAND ENERGY PERM �Trt Y1�C r DOLLARS(ttao,000�.IN ADDITON TO THE COST OF COMPENSATION,DMIAGES AS PROVIDED FOR IN v��, J SECTpN 37oa OF THE LABOR CODE.INTEREST,AND ATfORNEV'S FEES. � RETENTION FE : Q a CONSTRUCTION LENDING AGENCY P - LT FE . O � 1 HEHEBV AFFIRM UNDER PENALTV OF PERIURY THATTHERE IS A CONSTRUCTION LEN�INO AGENCY ' FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30Y7,CIV.C.). , Z W � LENDER'SNAME H LENOER'SADDRESS � � 1 CERTIFV THAT I HAVE READ THIS APPLICA710N AND STATE THAT THEABOVE INFORMATION IS CARRECT. TOTAL FEES , " w I AOREE TO COMPLV N7TH ALL CRV AND COUNTY ORDINANCES AND STATE UWS REU7INO TO BUILDING � CONSTRUCTION,AND HEREBV AUTiIOfiIZE REPRESENTA7IVES OF 7HI5 COUNTY TO ENfER UPON 7HE � ZABOVE-MEMIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � � �OH�� 7�ir� ¢ PEHMITTEE NAME(PRII(T) 2- Z'� OO � � � SIONANHEOFPEFUII ATE � RECPT.NO. PAID BY VAUDATION WHITE—Depertment Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—ApplicanYs Copy .. •. . �.. .. .. :f' . _ ..�.+ � ) �� "J! . t•�Y) �.. .. . . .� �. � n.r.. ♦ n . . . ..'-. \J....`Y...�n� . �' i , '1�(". � � �p�� Il �� /r11YO11�Y V� lLt/(I-1111 U . _ . � .. �Y Vhf/��9 11 �� 11�4��1J�� . ��s�� Q(� ��° ' , 0[� �°. � � , � ;��'�� ,. � � � SET BACK� . �. ' , s , ;.. FLOOR JOIST : _ . FTGS/FURMS/STEEL � FHA REQMTS ELECTRIC GROUND UNDER�LOOR DUCT. � '� �. '. GROUND PLUMBING UNDER FLOOR CUMDUIT �_ � ' • SLAB GRADE FIREPLACE FOUNDATION ' ' � " ' � TEMP POWER � FIREPLACE'BOND BEAM VVATER SERVICE - MID HT. BOND BEAM � - ' - - ' ' = - R�QF SH�ATHING - ' 8 FT. BON� BEAM. ' ', �� FR,4MINGNENTILIATIO� � ' �� FINAL BOND BEAM RODF COVER PRE-GRADING ROUGH HEATIfVG � � � BENCHING � ROUGH ELECTRIC ROUGH GRADING R�UGFi PLUfVIBiNG FINISH GRADING SHOV1lER/TUB TEST ` POOL ELEGTRlC . ' ' EXT. LATH/SIDIf�G � �� . POOL FENCING � WALL INSULATIOiV POOL FINAL CEILING INSULATION - � OFF SITE IMPS. DRYWALL NAILI�lG -- DEDICATIONS ' SEWER FINAL ENG. SEPTIC TANK — LANDSCAPE/IRRIG. SEEP PIT/L..L. � � ON SITE IMPS. GAS AIR TEST FINAL ZONING FIiVAL CO�IST. •- - FIRE DEPT. FWAL —��(..AD ___��_`�j FIM1l�IL HEATIE�G HERLTH DEPT. FINAL FIf�AL ELECTRIC DEV. FEES PAID FIi�AL PLUMBING ENERGY C�C�GjV Oo`� o � o , , - COcUiii�E�TS ` .. . , 'Iir t. !�'K' . �i�� . ' . � .- .. � ..L',j r . ./. •, ' :�1:�., f" ,i�,'�� -�- .� '� l' �A�� .=��— , . .: .4. .. ��♦ . . *Y.�- SEPTIC TAi�FC SIZE � ' "" ' '��'� SEEP PIT/U SIZE � , . . ,� . ��. � ` � , ,� . f _� � `[� � . � ° . .