The URL can be used to link to this page

Home My WebLink About17966 (25) _ s ` CITY OF DIAMOND BAR �'"' - --�F�'— DEPARTMENT OF COIvA�IUNITY&DEVELOPIvIENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS �"%�� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE APPLICATIO PERMIT i/� P/C ADDRESS DATE � �2' NUMBER (a�� # � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER o ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT qyy ❑ g APP,LICANT TEL. REAR ❑ zQ SIDE/SIDE STREET RW ❑ � CONTRACTOR ^ SIDE p ADDRESS�r�,t6� � �� ,!)f-- o� PROPOSED USE CITY ��,� ZI _��_ TEL. w ARCH/ENG/ cY pe-d�i ��d�L�-��-^�.�t� �' z DESIGNER � � � a ADDRESS NO.DWEL. NO. NO. v� UNITS STORIES BEDROOMS � CITY ZIP TEL. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADD/REM p I HEREBV AFFlRM UNDER PENAL7Y OF PERRIRV TFIAT I AM EXEMPT FROM THE CONTRACTORS LI- G0f89B/CBfPOft W CENSEUWFORTHEFOLLOWIN6REASON�SEC.7031.68USINESSMIDPHOFESSIONSCODEANYCITVOR (n U (p�JpJn'W�{ICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLJSH,ORREPAIRANYSTqUC- w � w NRE,PRIOR TO ITS ISSUANCE.ALSO REWIRES THE APPLICANT f-0H SUCN PERMIT TO FILE A SIGNED W P8110/DBCK � STATEMENT THAT HE OR SHE IS LICENSEO PURSUANT TO THE PROVISIONS OF THE CANTRACTORS LI- g CENSE UW(CHAPTER B(CAMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO- u" PooUSpa ^ FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREFROMMIDTHEBASISFORTHEALLEQEDE%EMP� � V TION.ANVVpLATIONOFSECTION7071.5BVANVAPPLICANTFORAPEFiMITSU&IECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENALT/OF NOT MORE THAN FIVE HUNDRED DOLURS(f500).): � ❑I,ASONRJEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATKKJ, � COff1rt16fC18I Z WILL DO THE WORK,AND THE STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.70a,BU51- J � N NESS AND PROFESSIONS CODE:THE CONTfiACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � �' PROPEHTV NMO BUILDS OR IMPROVES TNEFEON,M!D WHO DOES SUCH WORK HIMSEIF OR HERSELF OR Q THROUGH HIS OR HER ONTI EMPLOVEES,PHOVIDED 7HAT SUCH IMPqOVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVER7HEBUILDINGOfiIMPROVEMENTI550LDWITHINONEYEAROFCOMPLE� . Z TION,hIE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). ' w ❑I,ASOWNEROFTHEPROPEHTV,AME%CIUSIVELVfANTRACTINOWfTHLICENSEDCONTMCTORS Q 70 CANSTRUCT THE PR0.IECT(SEC.701/,BUSINESS AND PROFESSIONS CODE:THE CAMRAC70RS ll- V01U8�iOn � �� ADJ.AREA W CENSELAWDOESNOTAPPLVTOANONTJEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND � WHOCONTMCTSFORSUC}IPR0.IECTSWITHACONTRACTOR(S)UCENSEDPURSUANTTOTHECONTRAG QUANTITY DESCFIPTION � roas ucENSE uw.�. FEE � ❑I AM IXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U LL" DATE OWNER F— Z U � LICENSED CONTRACTORS DECLAAATION w � � I HEREBYAFFIRM UNDEH PEN�LTV OF PERIURV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � d B(COMMENqMO WITH SECTION 7oao)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE.AND Z ' X MY LICENSE IS W FULL FORCE/V!D EFFECT. m � LLI � LICENSE CLASS � LIC.NO. O � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION C� � U � I HEREBV AFFlRM UNDER PEN�LTV OF PERIUqY ONE OF THE FOLLOWINO DECLARATIONS: Z �Z I NAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' ¢ Q = COMPENSATION,AS PROVIOED BV SEC710N 370o OF THE IABOR CADE,FOR THE PERFORMANCE U OF THE WOR)(FOR WHICH THIS PERMIT IS ISSUED. W � � QW _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REWIRED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ��J�(� ISSUED.MV WORKERS'COMPENSATION INSUMNCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION / j CARRIEH Cf�t�� PLAN REVIEW ' POLICY NUMBEH /.T� l.�I.�- � � ^�� , ELECTRIC ¢ —+-�v � (1FOSSECTK7NNE�NO78EOCf.1PLEfIDOFT}EPERMfT6FOqONEMR�DHEDDOUARS(E100)ORLfSS} PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE MlORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL C7 SHALL NOT EMPLOY ANY PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE N WORKERS'COMPENSATION LAWS OF CALIFORNIA AND AGHEE THAT IF I SHWLD BECOME INSPECTION FEE S SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION3�OOOFTHELABOR I �xY f�_�\ ' I ,� CODE,I SHALL FORTHWIhI COMPLV WITH THOSE PROVISIONS. ISSUANCE '" �,./ O p DATE: a�,_;�`_n,PpLICANT �` SMIP I „ I p w ENERGY P/C � ( � � I J WARNIN�:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS NUWFUL,AND SHALL BE J � f �y SUBJECTMI EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TMOUSMID ENERGY PERMIT ' DOLLAAS(f100.000).W ApD1ilON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � J SECTION 37oB OF THE LABOR CODE,INTEREST,AND ATfORNEV'S FEES. �V' I / w RETENTION FEE: O CONSTRUCTION LENDING AGENCY ---- � PRE•ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS ACONSTRUCTION LENDING AOENCY FOR THE PERf-0RMANCE OF THE WORK FOR WHICH THIS PEFMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME H LENDERSADORE55 w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CARRECT. TOTAL F E ES I �'+�' �� I AQREE i0 COA/PLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING �J � CANSTRUCTION,AND HEREBV AUTHOFIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS � � �/ N� _ �YT�C — 1�t v-'�% m PERMITTEENAME(PRINn � �'�\� � ��r-1t � 6� 6�3� � SION R �RM� DATE � RECPT.NO. PAID BY VALIDATION WHITE—Depertmen[Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy ' ��'( �(�r ��GR�f�i��1QD ��ff$ �6��f�GC��B.2�(�I ��C�� ° �`ir ' C� DD GJ t� �� 0[��PC�G�tr� o �`tt� ° � o > 5ET BACK FLOQR JaIST, ' FfGS1FORMSlSTEEL � FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT ' GROUND PLUMBING __ i UNQER FLOOR CUMDUIT SLAB GRADE FIREPLACE FOUNDATION � TEMP POWER FIREPLACE BONQ BEAM WATER SERVICE � MID HT. E30ND BEAM ROOF SHEATHIPVG 7 �J' � 8 FT. B�ND BEAM � � ' FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER �J/ _ Z�� PRE-GRADING , ROUGN HEATIIVG � BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUIVIBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRiC EXT. LATH/SIDING POOL FENCING � WALL INSULATIOiV POOL FINAL CEILING INSULATION OFF S!TE IMPS. DRYWALL NAILIPVG DEQICATIONS SEWER FIiVAI ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP P!T/LL. ON S17E IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. G!RE DEPT. FINA'_ FINAL HEATING • HEALTH DEPT. FINA� FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING I ENERGY � C�Gi�t,OOG� o �o _ .___. .�� __.-----�__ _-- - ---� � - — -- _ ___1..: _ . _ COi�IiViE�l1`S SEPTIC TAIVK SIZE SEEP PIT/U SIZE � r�l� ` a. � , � . _ , .