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Home My WebLink About18193 CITY OF DIAMOND BAR p�N�l�, ' �� ^---�� — DEPARTIv�NT OF COMMUNITY 8c DEVELOPMENT SERVICES ( �� 21825 E.Copley Drive (909)860.3195 Fa�c(909)861-3117 PRESS ��'<�� BUILDING PERMIT APPLICATION FIRMLY QJOBSITE ��I �ry _��„1 ��• DATECATION ,,.I��UMB R .-�� /C Q ADDRESS Vv�'� � APN F TRACT ISSUE TypE pCC p OWNER �..�j��A DATE CONST. GROUP o ADDRESS ZONING SETBACKS Z CITY ZIP TEL. FRONT qyy p o APPLICANT TEL. S DE/SIDE STREET RW ❑ � CONTRACTOR ' SIDE p ADDRES � CITY ZIP TEL. �.• PROPOSED USE w ARC G/ I z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS ', � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM i O p I HEREBY AFFIRM UNDER FENPLTV OF PERri1RV THAT I AM E%EMPT FROM THE CONTRACTORS LI- G8f9g9/CBfpOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.6BUSINESSANDPROFESSKKJSCODE:ANYCITVOR (n U �Jp/J�'WHICHRE-0UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,OFREPAIRANYSTRUG w w TURE,PRIOR TO ITS ISSU/WCE.ALSO REQUIRES THE APPLICANT FOH SUCH PERMIT TO FILE A SIONED w Patio/Deck � STATEMENT h1AT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE LAW(CHMTER B(COMMENCWO WITH SECTION 7oDo)OF DIVISION 3 OF THE BUSINESS AND PRO- LL' PooUSpe � FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR THE ALlE0E0 EXEMP� C7 TqN.ANV V10LATqN OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT 5U&IECTS THE APPLICANT TO Z pe-Roof A CIVIL PENALTV OF NOT MORE TH/V!FNE HUNDRED DOLLARS(fGOa).): � ❑I,ASOWNEROFTHEPROPERTV.OFMVEMPLOVEESWITHWAGESASTHEIRSOLECAMPENSATION, � CORIrtI0fC181 Z WILL DO THE WOR)(,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W�,BU51- J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTY WFq BUIlDS OR IMPROVES THERC-0N,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR wTHROUGHHISORHEROWNEMPLOVEES,GROVIDEDTHATSUGiIMPROVEMENTSAAENOTINTENDEDOR m � OFFEREDFORSKEIF,HOWEVER,THEBUILDINOOFIMPROVEMENTISSOLDWRHINONEYEAROFCAMPLE- Z TION,THE OWNER-BUILDEH WILL HAVE THE BURDEN OF PROVINO TMAT HE OR SHE DID NOT BUILD OR � � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOMMEROFTHE PROPERTY,AM EXCLUSNELV COMRACTING WITH LICENSED CONTRACTOFS Q TO CONSTRUCT THE PROJECT(SEC.70r1,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- V8N8�10l1 ADJ.AREA W CENSELAWDOESNOTAPPLVTOANONRJEROFAPROPERTVWFqBUILD50RIMPROVESTHEREON,AND N'Fq CANTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(5)LICENSED PURSUANT TO THE CONTRAG ~ TORSLICENSELAW.). �UANTITY DESCRIPTIO FEE 0 ❑I AM EXEMPT UNDER SEC. B.3 P.C.FOR THIS REASON Q Y � ?� U ' � DATE pyyryEq � Z U � LICENSED CONTRACTORS DECLARATION w - � I HEREBV AFFIRM UNDER PENAITV OF PERIURV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � �(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CADE,AND Z �� MY LICENSE IS IN FULL FOFCE AND EFFECT, m � UCENSE C S LIC.NO. � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � U N I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOW Wa DECLARATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORNERS' _ � COMPENSATION,AS PROVIOED BV SECTION 370o OF THE LABOR CODE.FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W 0 � w I HAVE M1D WILL MAMTAIN WOFKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION O 3700 OF THE LABOR CODE,FOR 7HE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV�/�K/EJgs COM/PE�NSJ@TION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION j cnaRiER_i „'i�1�' "'{ PLANREVIEW � POLICV NUMBER zQ ELECTRIC • �� (f}IISSECIqNNE�PIDTBECOMRFfEDpFTHEPEPo./({�FpqpNEFiU1�DREDDOU?RS(5100)OqLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL CJ' SHALL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE (/� WORKERS'COMPENSATIONLqW50FCALIFORNIqANDAGREETHATIFISHOULDBECOME INSPECTIONFEE = SU&IECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR � COD ,I SH FORTHWITH COMPLV W HOSE PROVISIONS. ISSUANCE � /�'(�� p DATE: 1 APPLICANT� �Y�"�� SMIP - w ENERGY P/C J WARNINO:FAILUR TO SECURE WORNERS' ENSATION COVERAGE IS UNUWFUL,AND SHALL BE J � SU&IECTANEMPLOVERTOCAIMINALPEN4ITIESANOCNILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5100,000),IN ADDITION TO THE COST OF fAMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 37oe OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. � w RETENTION FEE: O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBV AFFIRM UNDER PENALTV OF PEFLIURV THAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED(SEC.�ael,CIV.C.). Z W � LENDER'S NAME � F— LENDER'SADDRESS w I CERTIFV THAT I HAVE READ THIS APPLICATqN AtJD STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES 1 . l\C� � I AGFEE TO COMPLV WITH ALL CITV AND CAUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING \tl •�J CONSTRUCTION,AND HEREBV AUTHORRE REPHESENTATNES OF THIS COUNTV TO ENTER UPON THE Y � ABOVE�MENTIONED PROPERTY FOR INSPECTION PURPOSES. Z � COMMENTS � � � � m PE EE N E PFINT) ' Q Cn ' /' � SIO UREOFPE ITTEE DATE � RECPT.NO. PAID BY VALIDATION _ _ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy � �8�'� �I� @7U�1��6�� (�Qf� D�dSi��t�l�'��a� f�f�� °�C� DIQ� DGyJ��f�C��i . D ' �� DGJ`tt� � = o � , 5El"6ACK � FLOOR JOIST ' FTGS/�ORPdiSISTEEL � FHA REQMTS ELECTRIC GROUND UNDER FLQOR DUCT GROUND PLUMBING UNDER FLOOR CU�IQUIT SLAB GRADE FlREPLACE FOUf�[DATION TEMP POWER FfREPLAGE BOND BEAM W,4TER SERVICE MID HT. B�ND B�AP11 . " ROOF SHEATHING 8 FT. BCOND�BEAM- FRAMINGNENTILIATIOf� FlNAL BOND BEAM ROOF COVER PRE-GRAVING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING ~� FINISH GRADING SHOWERrfUB TEST POOL ELECTRiC EXT. LA7H/SIDItVG P�OL FENCING WALL INSULATIUN POOL FINAL CEILIiVG INSULATION ' OFF SITE IMPS. DRYWALL NAIUNG DEDlCATIONS SEWER FItJA�ENG. SEPTIC TANK LAPIDSGAPE/IRRIG. SEEP PIT/L.L. ON SITE lMPS. �� GAS AIR TEST FINAL ZONING FlNAL CONST. rIRE DEPT. �INAI. FIIVAL HEATIRIG HEALTH DEPT. FINRL FINAL ELECTRIC _Q�� . /� �i DEV. FEES PAID FIfVAL PLUMBIhIG FNERGY � oC� a co , , COM�/IEMTS SEPTIC TAfVK SIZE SEEP PIT/U SIZE — � � �. � � �� , ; —�