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Home My WebLink About16920 (25) � ' CITY OF DIAMOND BAR ��-- -� — DEPARTIvIENT OF COIvA�UNITY&DEVELOPMENT SERVICES ��p��ED '' 21825 E.Copley Drive '� (909)860-3195 Fax(909)861-3117 PRESS �'"-��'w BUILDING��R1Vf[ITAPPLICATION JUN 191002 FIRMLY � JOBSITE 1 �7 ,( h�qM�nd p,q1 APPLICATION Q� , / ^O I PERMIT /�4�� /C o ADDRESSz%�D TrQSqC'O ��• � �/ f/ DATE �� NUMBER � l ISSUE TYPE OCC r° APN G LOT 1"b. TRACT DATE CONST. GROUP p OWNER � � ADDRESS O ZONING SETBACKS Z CITY �A O ZIP tl TEL. �I - S FRONT Ryy ❑ � APPLICANT TEL. REAR ❑ Z SIDE/SIDE STREET RW ❑ ¢ CONTRACTOR � G O I �YI S�I'N C �01�) � 'I fl G. SIDE ❑ o ADDRESS � PROPOSED USE __ � ` �C �vY�CS �1.�'� , o CITY ZIP TEL. - I o ARCH/ENG/ z DESIGNER ' w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- GBfflQB/C2fPOfI W CENSELAWFORTHEFOLLOWINGREASON(SEC.7o31.5BUSINESSAN�PROFESSIONSCADE:ANVCITVOR (J) U COUNTYWHICHHE�UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOUSH,ORREPAIRANVSTRUC- � � . w TURE,PFIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPLICANT FOR SUCH PEFiM1T TO FILE A SIGNED w Patio/Deck � STATEMENT 7HAT HE OR SHE IS LICENSED PURSUANT TO 7HE PROVISIONS OF THE CON7RAC70RS LI� � � CENSE LAW(CHAP7ER B(COMMENCING WI7H SECTION 7000)OF DIVISION 3 OF THE BUSINESS AN�PRO- POOUSPB � � FESSIONSCADE)ORTHATHEORSHEISEXEMPTTHEREFqOMANDTHEBASISFORTHEALLEGEDEXEMP� (� V TION.ANVVIOLqTIONOFSECTION7031.58YANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � A CIVIL PENALTV OF NOT MOFiE THAN FIVE HUNORED DOLURS(f500).�: Z ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COffIfflBfCl81 - WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7041,BU51� J � NESS AND PROFESSIONS CODE:THE CON7RAC70RS IICENSE UW DOES NOT APPLV 70 AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIMSELF OR HERSELF OR � THROUGH HIS OR HEH OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEREDFORSALE.�F,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWI7HINONEYEAROFCAMPLE- � TtON,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). p ❑I,AS OWNER OF THE PROPERTV.AM ERCLl1SIVELY CON7RAC71NG W ITH LICENSED CONTRAC70RS � TO CANSTRUCT THE PRQIEC7(SEC.7011,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI� VelUe�lOfl � ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEflOFAPROPEFTVWHOBUILDSORIMPROVESTHEREON,AND � � WHOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S�LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCR�PTION ' FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.d P.C.FOR THIS REASON Q � U � � DATE OWNER � Z w � LICENSED CONTAACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � �� d D(COMMENCING WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X MY LICENSE IS IN FULL FOHCE AND EFFECT. q ^ � LICENSE CLASS��I��q n 1 G LIC.NO. �v�`� y�c j V DATE $'�b/�I CONTRACTORkG�hD�I ��,IA�' � d W � WORKERS'COMPENSATIONDECLARATION =nC• Q � I HEREBY AFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: Z � 1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SE�F-INSURE FOR WORKERS' _ � Q CAMPENSATION,AS PROVIDED BY SECTION 37000F THE UBOR CODE.FOR THE PERFORMANCE w Q OF THE WORK FOR WHICH THIS PEiiM1T IS ISSUED. � � �I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIPED BY SEC710N ))), //y � Q 37000FTHELABORCODE.FORTHEPERFORMANCEOFTHEWOflKFORWHICHTHISPERMITIS /y%' � ISSUED.MY WORNERS'C1pMPENSATION INSURANCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION / I.1! j �1 e FVr)d PLAN REVIEW CARRIER Z POLICV NUMBER�f 4T��G�_OI ELECTRIC Q � (fHI55ECT10NNE�NOTBE00MREfEDOFTFIEPEFUNTISFORONEHUPDREDDOLLFFiS�5100)ORLESS). PLUMBING - Z I CERTIFV THAT INTHE PERFORMANCE OF THE WORK FOfl WHIC MIT IS ISSUED,I MECHANICAL ��\ �i � L (•} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BE ME UB ECT TO THE � WORKERS'CAMPENSATIONUW ORNIA, NDAGRE HATI IS OULDBECOME INSPECTIONFEE � = SU&IECTTOTHEWORKERS' .ENS 10 RO SIO OF EC71 3700F7HE R 5 � CADE,I SHALL FORTHWITH COMPLV WI TH SE� OVI ION. ISSUANCE I O DATE: �7 d APPLICANT. ' SMIP I r 0 �p JENERGY P/C -U I WARNING:FAILURE TO SECURE WORKERS'C PENSATION COVERAGE IS UNLAWFUL, D SHALLBE _ � � SUBJECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRE HOUSAND ENERGY PERMIT - ' "' DOLURS(5100.000),IN ADDITION TO THE COST OF COMPENSA710N,�AMAGES AS PRO 1 ED FOH IN � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: pw_, CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W � LENDER'S NAME H LENDER'SADDRESS � � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES /l� �• � w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE UWS REIATING TO BUILDING � CONSTRUC710N,AND HEREBY AU7HORIZE REPRESENTATIVES OF THIS COUNTV 70 ENTER UPON THE � ABOVE-MENTIONED PROPERTV FOR INSPEC7ION PURPOSES. Z COMMENTS � d n vn m EE NAME(PRI 7) ¢ � � � � SIGNA REOF PM E DATE = RECPT.NO. PAID BY VALIDATION ~ W E—De a ment Copy,YELLOW—Finance Co PINK—Assessor Co GOLDENRO�File Co GREEN—A licant's Co PY. PY, PY. PP PY , . . � .. . ' • � � ' .. �'.0 . v��.:. . . . . -\�:� .:e!-'�. . . . .. . .. . . . , , �� Il �� 4i11fVV�9V� tVJIN� � ��`-�' 11 ��Y V U It�WO�b[U 4� '♦ oU�JC'JlT LSLJ��J�U DQ I� O� U Q oU�.1�J�r l� ��I DQ� oU�7�N u p o SET BACK FLOOR JQIST- "�'� ' � ' ' '. . FTGSlFORMS/STEEL I; FHA REQMTS ___ ELECTRIC GROUND ; UNaEFt FLO�R QUCT _ _. -:- -_ 1-- . � GROUND PLUMBING ' UNDER FLOOR CUf�IDUiT � ' � � TEMP POWER FIREPLAt�E BOND ' --__-__._...__. -- ------ . : ., SLAB GRADE __ ___ FIREPLA�E FOUNDATION � � --- --�T.� __..... ; � BEAM WA7ER�SERVICE --- � — _�_ MID HT f3�ND�[iEAM ' -- - -�- �- —, � --- __ ---- -- ' " ' _ .. _ .___ _..— �—-- �----F -_..__ ROOF SHEATHING _ $ �� Q��M ' __ � ' ___ FRAMING/VENTILIATION FINAL B�ND BEAM _ ___ ROOF COVER PRE-GRADING ROUGH HE,4TING • BENCHlNG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUNIBIiVG FINISH GRADING SHOWERlTUB TEST POOL E�ECTRIC EXT. LATHlSIDIfJG POOL FENClNG WALL INSULATIOIV POOL FINA� CEILING INSULATION OFF SITE IMPS. I DRYWALL NAILING DEDICATIONS SEWER FINAL E�1G. -- -----._-- ------ SEPTIC TANK LANDSGAP�/IRRIG. -�-------- �� SEEP PIUL.L. ON SITE iMPS. � GAS AIR TEST FINAL ZONING FINAL CONST. FlRE QEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTAIC DEV. FEES PAID FIfVAL PLUMBING ENERGY I — C�Gt�OO[� o < , . � , . , - CONifVIENTS . , � , � . , . SEPTIC TAfVK SIZE SEEP PIT/U SIZE - --- --- � . __� _ ___.. , i�i/ C� ------ � � �