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Home My WebLink About10-1121� - : ��!_ CITY OF DIAMOND BAR 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 ''°�' BUILDING PERMIT APPLICATION FIRMLY � JOBSITE I��D p�ce-�u I k�tls. o /.z/ APPLICATION PERMIT/ � p/C o ADORESS_ DATE NUMBE�( # ISSUE /� ,�Q f/��O CONST.�GROUP � APN LOT TRACT DATE � O p OWNER � ADDRESS l7 O�C�- i� ZONING SETBACKS 0 Z CITY ZIP TEL. , FRONT pyy � � APPLICANT TEL. REAR p �� SIDE/SIDE STREET RW ❑ CONTRACTOR F�I �-+ � !fJ SIDE p � CITY VOIM M61iy�_ ZIP �Ii TEL.��' . _ PROPOSED USE o ARCH/ENG� �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERNRV THAT I AM E%EMPT FROM THE CONTRACTORS LI- Gdf8g9/C9fpOR W CENSEUWFOR7HEFOLLOWINOREASON(SECJ03t.5BUSMESSAN�PROFESSIONSCODE:ANVCI7VOR (n � U �qJpJJyWr{ICHREOUIRESAPEfiMITTOCONSTRUCT,/�LTER,IMPROVE,DEMOLISH,ORREPAIRANYSTqUG w � W 7URE,PHIOR 70 ITS ISSUANCE,ALSO REWIRES THE APPLICANT FOR SUCH PERA/lT TO FILE A SIONED W Petio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS Lb � � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTKKJ 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� POOUSPB FESSIONSCADE)ORTHATHEORSHEISE%EMP77HEREFROMANDTNEBASISf-0R7HEALLEGEDEXEMP- (} TION.ANY VIOLATION OF SECTION 7031.5 8V ANV APPLICANT FOR A PERMIT SU&IECTS 7HE APPLICMlT TO Z Re-Roof A CML VENAL7Y OF NOT MORE iHAN FIVE HUNORED DOLLARS(f50o)J: � ❑I.ASOWNEROFTHEPROPERTY,OHMVEMPLOVEESWITHWAOESASTHEIRSOIECOMPENSATION, � COffIfilBfC10I Z NRLL DO THE WORK,AND THE STRUCTURE IS NOT INTENDE�OR OFFERED FOR SALE(SEC.7aa,W51- J � � NESS AND PROFESSIONS CODE THE CON7RAC70R5 LICENSE LAW DOES NOT APPLV 70 AN OWNER OF � PROPERTY WHO BUIlDS OR IAIPROVES THEREON.AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q TMROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCN IMPROVEMENTS AAE NOT INTENDED OR LO � OFFEREDFORSPLEIF,HOWEVERTMEBUILDWGORIMPROVEMENTISSOLDWITNINONEVEAROFCAMRE� Z TION,THE OWNER-BUILAER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OF � IMPROVE FOR THE PURP0.SE OF SALE). w ❑I,ASOWNEROFTHEPROPER7V.AME%CLUSIVELVCqNTRACTINOWITHLICENSEDCONTRACTORS Q TO CONSTRUCT THE PRQIECT(SEC.701t,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V81U8t1Of1 ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN ON7JEH OF A PHOPER7V WHO BUILDS OR IMPROVES THEREON,AND � WMOCONTRACTSFORSUCHPFGlECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION Y 70RSLICENSELAWJ. FEE � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � � U � DATE OWNER ¢ Z U � � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER ,1 � Y(COMMENCINO WITH SECTION 7oao)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z � �y �� MV UCENSE IS W GULI FORCE AND EFFECT. m � LICENSE CLASS � �IC.NO. � ��, � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � U � I HEREBV AFFIRM VNDER PENALTV OF PERfURV ONE OF THE f-0ILOWING DECLAAATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' a 2 COMPENSATION,AS PFOVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U OF THE WORN f-0R WHICH THIS PERMIT IS ISSUED. W � � w �1 HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTKKJ Q 3700 OF THE LABOR CODE,f-0R THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WOqKERS'COMP ATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION ��7 '� jCARRIER S(7u PLAN REVIEW 0 POLICV NUMBER � ��'y�� ,��L�. /� --/�Z Z ELECTFiIC Q � (iHSSECTIONNE�NOTBE00MR.ETmOFT1-EPEPoATISWqONEHUI�DPEDOq1/3iS�t100)ORLESS} LUMBING W Z 1 CERTIFY 1TiAT IN THE PEHFORA/ANCE OF THE WORK FOR WHICH 7HIS PERMIT IS ISSUED,I MECHANICAL C•} SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE (/j WOFKERS'COMPENSATIqJLAW50FCALIFOqNIA,ANDAdREETHATIFISHOULDBECOME ' �NSPECTIONFEE SU&IECT TO THE WORNERS'COMPENSATqN PROVISIONS OF SECTION 370o OF THE LABOR � rj CODE,ISHALLFORTHWITHCOMPLVWITHTHOSEP IONS. IS UANCE � O DATE: I!-�-�u APPLICANT: � � � SMIP W ' �- J WAANIN(i:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C J � SU&IECTANEMPLOVERTOCRIMINILPENALTIESAN�CIVILFINESUPTOONEHUNDREDTHOUSAND ENERG� DOlLARS(5100,000),IN�ODITION TO TFIE COST OF COMPENSATION,DAMAGES AS PHOVIOED FOR IN � SECTION 37oB OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. TENTION �v � OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIqM UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDINQ AOENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEFMIT IS ISSUED(SEC.Joe7,CIV.C.�. Z W , � LENDER'S NAME 1-- LENDERSADDRESS w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES . , '/ ' � I AGREE TO CAMPLV WITH ALL CITY AND CAUNTV ORDINANCES AND STATE LAWS RELATINO TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO EMER UPON THE Z ABOVE-MEMIONED PROPEFTV FOF INSPECTION PURPOSES. COMMENTS � � ..�-N�� - ;� a�� m PERM'fTTFi Rl1AE(PR� � �� ¢ � f�- a � � SIQ TUREOFPERMfTTEE DATE � RECPT.NO. PfUD BY VALIDATION WHITE—Department Copy,VELLOW�inence Copy,PINK—Aasessor Capy,GOLDENROD—File Copy,GREEN—Applicant's Copy co�v o� oo��o�� ►� . i�s��c�oo��co�� . , oa�p�c�400a oc�a� oa�p��a oa�p��oc�a �a�� 'oa��c� � . -.�:�: SET BACK FLOOR JOIST FTGS/FORMS/STEEL 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 FT. BOND BEAM � FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlfUB TEST POOL ELECTRIC EXT. LATH/SIDING POQL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING �� ENERGY C��o � COMMEfVTS - ~, SEPTIC TANK SIZE SEEP PIT/U SIZE a � � - �� Q.