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Home My WebLink About10744CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21660 E. Copley Drive Suite 190 (909) 86D-3195 Fax (909) 861.3117 BUILDING PERMIT APPLICATION ADDRITE SS ID�_fii 146 APN LOT T�T OWNER ES K ADDRESS OO NL L/:/ CITY #54&ZIP T _ 1W 916 .i APPLICANT T l CR ACTO ADDRESS CITY ZIP TEL 5T,9 -7_k,' ARCWENGI DESIGNER ADDRESS CTTY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM TINDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LF CENSE LAW FOR THE FOLLOWING REASON (SEC. 70.91.8 BUSINESS AND PROFESSIONS CODE: ANYCITYOR COUNTYNMIW REOUIRESAPERMRTO CONSTRUCT,ALTER. IMPROVE. DEMOLISH. ORREPAIR _STRUC- TURE. PRIOR 70 ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IN LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LL CENSE LAW (LTUPTER P (COMMENCWG WITH SECTION 7000) OF CNISgN 7 OF THE BUSINESS AND PRO - SHE OOOE) OR TNIATHE Oil SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7071.6 BY ANY APPLICANT FOR APERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FINE HUNDRED DOLLARS ($600).): O LASOMEROFTHE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WILL 00 THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY W!IO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELFOR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF OOMPLE- TION, THE OV NER$ULDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O 1, AS OWNEROFTHE PROPERTY.AM EXCLUSIVELYCONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7041, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TORN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FDR SUCH PROJECTS WITH ACONTRACTOR(SI LICENSED PURSUANT TO THE OONTRAC- TORS LICENSE LAW.L O 1 AM EXEMPT UNDER SEC. B. a P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED TINDER PROVISIONS OF CHAPTER P (COMMENCING WITH SECTION MW) OF DIVISION 7 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS N FULL FORCE AND EFFECT. w LICENSE CLASS 0 LIC. 710. J6 LATE "�G - 5". CONTRACTOR WORKERSCOMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: IIHHAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR MARKERS' COMPENSATION, AS PROVIDED BY BECTON 77DO OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR VAN ICH THIS PERMIT la ISSUED. I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REWIRED BY SECTION 7700 OF THE LABOR CODE, FOR THE PERFORLIANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS, Ir P SATION� IG R!r CARRIER AND POLICY NUMBER ARE: CARRIER L�C/��Y POLICY NUMBERIF 7 OMSECMWZ)NOTBECOMRZ=OFTFEFEWNFORCNEILFLIRED a,OD)ORL;bf 1 CERTIFY THAT N ME PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALLNOT EMPLOY ANY PERSON N ANY MANNER BOAS TO BECOME SUBJECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA AND AGREETH FI SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION P=1DONS OF 6 ION TOOOF THE LABOR CODE,I HALLF HVRTH COMPLY MATH TFIOB PROVISIONS LATE; APPLICANT: WARNING: FAILURE SECURE WORKERSCOMPENSATION COVERAGE IS UNIAW'FU.. AND SHALLSE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U' TOONE HUNDRED THOUSAND DOLLARS (8100,ONI). N ADDITION TO THE COSTOF COMPENSATION. DAMAGES AS PROVIDED FOR IN BECTON 7704 OFTHE LABOR CODE. WTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. SOT. CV. C.), LENDER'S NAME LENDER'SAMMSS 1 CERTIFY THAT I HAVE READ THISAPPLICATION AND STATETHAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITHNA AN N ALL CITY ACOUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMITTEE E P 81GNATUREOF PERMRTE DATE EXPIRED NOV 0120 PRESS FIRMLY APPLICATION f ��C( PERMIT 1�� O lC DATE_ NUMBER r ISSUE TYPE OCC DATE CONST, GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM W Gara9alCarporl W POWJDeck LL Pool/Spa ZRD-Rooi 0 Commercial m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE tFY U W Ed 1 L7 Z m L) L) al caO DA? C U W CONSTRUCTION PLAN REVIEW ELECTRIC PLU �ECHANICA CSREE ISSUANCE SMIP SEPP 16 IM ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES COMMENTS RECIPE NO. PAID BY VAI IDATIO WHITE—Department Copy. YELLOW—Finencs Copy, PINK—Assessor Copy. GOLDENROD— 118 COW GREEN—Applicant's COPY (1 1� CITY OF DIAMOND BAR � . . U��K�E_CTION RECORD SETBACK ELECTRIC GROUND GROUND PLUMBING SLAB GRADE TEMP POWER WATER SERVICE ROOF SHEATHING ROOF COVER ROUGH HEATING ROUGH ELECTRIC --'----------`-- ROUGH PLUMBING _ SHOvYEnnugTEST EXTL4TH/S/D|NG WALL INSULATION CEILING INSULATION DRYWALL NAILIN� SEWER SEPTIC TANK GAS AIR TEST FINAL HEATING FINAL PLUMBING ' COMMENTS_______ FLO()R JOIST UNDtR FLOOR DUCT | /POOL ELECT FIRFPLACE FOUNDATION FIREPLACE BOND BEAM 1HMID POOL. FINAL HT. -BOND BEAM j PRE -GRADING DEDICATIONS FINAL ENG ROUGH GRADING FINISH GRADING | /POOL ELECT POOL FENCING POOL. FINAL DEDICATIONS FINAL ENG FINAL ZONING FIRE DEPT FINAL DEV. FEES PAID � -�-��---'� - ----'--'--------- ( _'...... ..... -------| �-�' -' -- ��-----'---'-------- | ' -'--'---' ------'-------------------- ' SEPTIC TANK SIZE _�_ � '- '� - --_--_--�_---�-_-_----_-__-_-_ ------ ' ------------'--'------- - | �