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Home My WebLink About10-835 (5) • � ' CITY OF DIAI"iOND BAR � , � �'- ��--�� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES `� � 21825 Copley Drive,Diamond Bar,cA 9i��s PRESS '� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 4��r BUILDING PERMIT APPLICATION FIRMLY � JOBSITE � APPUCATION � PERMIT O�� P!C o ApDRES�IG{�3?� � PD�T GT• DATE �� NUMBER # ISSUE TYPE ��J OCC � APN$�_ LOT Q�� TRACT d2 OATE � CONST.�!IJG��GROUP � p OWNER d � W� � ZONING SETBACKS o ADDRESS D T WdN� � Z cirr �WMOND Q,p,rZ ziP TEL. � FRONT RW ❑ TEL. SA-�1�1� 7 REAR ❑ g APPLICANT --�— SIDEJSIDE STREET RW ❑ � CONTRACTOR �� T S�DE ❑ � � ADDRESS PROPOSED USE � � crrv ziP TEL.�Uq qTZC��T w ARCH/ENG/. z DESIGNER � NO.DWEL. NO. NO. � .ADDRESS , UNITS STORIES BEDROOMS � CITY,. . , ZIP TEL. � DESCRIPTION S�.FT. FACTOR PSF AD,I.AREANA�UATION I � � OWNER-BUILDER DECLARATION SF AD EM O I HEREBY AFFIRM UNDER PENALTY OF PERJVRV THAT I AM E%EMPT FROM THE CONTRACTORS LI- � G0f8gB/Cef�10R W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCITYOR (n U CAUNTYWHICHRC-0UIRESAPERMITTOCON5T0.UCT,ALTEP,IMPRaVE,OEMOUSFl,ORREPAIRANVSTqUC� �jJ py�10/DBCK wTURE,PR10H TO ITS ISSUANCE,AL50 REOUIRES TNE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w � STATEMENT THAT HE OR SHE IS 110EN5ED PURSUANT TO THE PROVISIONS OF THE CONTRAGTORS LI- � , CENSE UM��CHAPTEA o�COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSVNE55 AND PRO- � PooUSpa � FE5SION5CODE)OR7HATHEORSHEISEXEMPTTHEREFROMAN�THEBASISFOFTHEALLEOEDE%EMP- ' TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PEAMIT SUBJEC75 THE APPUCANT TO ' Z Re-Roof � A CML VENALTV OF NOT MORE THAN GNE HUNDRED DOLLARS(fboo)J: � ❑I,ASOWNEROFTHE7ROPERTY.ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION,, � COrtIfTl6lCIeI � Z VALI DO THE WORK,AND THE STRl1CTURE tS NOT INTEN�ED OP OFFE0.ED FOR SALE.(SEC.70N,0U51- J (' � NESS AND PROFESSION9 CODE:7ME CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF m n�ad `� PROPERTV NMO BUILOS OR IMPROVES TMEREON,AND WHO DOES SUCN WORK HIMSELF OR HERSELF OR' Q iHpOU0Y1 MIS OR HER OWN EMPLOVEES.PROVIDED THAT SUCH�MPROVEMENTS AFE NOT INTENDED OR - W OFFEHEDWRSrLEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITMINONEYEAROFCOMPLE- � TtON,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINQ TFUT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE VURPOSE OF SALE). - _ ❑I.AS OWNER OF TME PROPER7V,AM E%CLUSNELV CANTRACTINO WfTN UCENSED CONTRACTORS Q TO CONSTRUCT THE PR0.fECT(SEC.70N,BUSINESS M10 PROFESSIONS COOE:1}/E CONTMCTORS LI� ��V81U81�Of1 ADJ.AREA � CENSE LAW DOES NOT MPLV TOAN OWNER OF A PROPERTV NR10 BUILDS OR IMPROVES THERC-0N.AND W/qCONTRACTSFORSUCHPR0.IECTSWITHACONTMC1aR�S�LICENSEDPURSUANTTOTHECONTPAC- QUANTITY DESCFiIPTION FEE � TOHS UCENSE LAW J. `� /'� O ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON � I ^ J� � a . , v LL DATE OWNER ~ Z W � LICENSED CONTAACTORS DECLARATION w � I HEREBYAFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSEO UNDER PROVISfONS OF CHAPTEH �r � d B(COMMENCING WITM SECTION 7000)OF DIVIS�ON 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z X AIY LICENSE IS IN FUL�FOFCE AN�EFFECT. m � LICENSE CIASS �� LIC.NO.��T��t" � � V DATE ��+�� CONTRACTOR �' ^. n- W • � WORKERS'COMPENSATION DECLARATION Q�. � I HEHEOY AFFIRM UNDER GENAITY OF VERJUFlV ONE OF THE FOLLOWING DECUMTIONS� U . ., ' ' ' � ' ' � ' . � Z Q � I HAYE AND WILL MAINTAIN A CERTIFICATE OG CONSENT TO SEIF�WSURE FOR WORKERS' 2 ,' � COAI7ENSATION,AS PROVI�ED BV SEGTION 37000FTHE LABOR CODE,FOR THE PEFFORMANCE w OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED. � � . / W V 1 HAVEAND WILL MAINTAIN WOR)(ERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370o OF THE UBOR CODE,FOR THE PERFORMANCE OF THE WORN f-0R WNICH THIS PEHMIT IS ��0 ISSUED.MV WORKERS'CAMPENSATION INSURANCE C�AR1RIER AND POLICY NUMBERAAE: ONSTRUCTIO j CAaRIER ��Y'�F'—� �i).'1,l].. PLAN REVIEW /'�^ ' � _POLICY NUMBER QQ U��Q��\Q ELECTFIC '1P►✓- z ¢ � (MLSSECf10NNE�NDTBEOJAFt.ETEDOFiFkPERV(TiSFORONEIM�DRE�DOLLli�S(i�OD)ORLFSS} PLUMBING . Z I CERTIFV hiAT IN TNE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUEO,I MECHANICAL � � SHALLNOT EMPLOYANV�ERSON IN ANV MANNER SOAS TO BEC-0ME SU&IECT TOTFiE � WORKERS'COMPENSATION lAWS OF CALIFORNIA AN�AGREE THAT IF I SHOULD BECAME INSPECTION FEE � S SU&IELT TO THE WORKERS'COA/PENSATION PROVISIONS OF SECTION 770a OF THE UBOR �SSUA CE � COOE.I SHALL FORTFIWITH COMPLV WITN THOSE PROYISIONS. O DATE:�L�y�APPLICANT: _ � SMIP � - — � r �w ENERGY P/C WARNINO:FAILURE TO SECURE WORKEAS' PENSATION CAVERAOE IS UNLAWFlIL,ANO SHAI.L BE � SU&IECT AN EMPLOVER TO CRIM WAL PENALTIES AN�CIVIL FW ES UP TO�NE NUN00.E0 THWSMlO NERGY PE �� DOLLARS(S10D,000).W�DDITION TO THE COST OF COMPENSATqN,DAMAGES�5 PHOVIDED FOR IN �D O ¢ SECTION�708 OF THE LABOH COOE,INTEREST,AND ATTOFNE'f5 FEES. RETENTIO w CONSTRUCTION LENDING AGENCY PRE-ALT E: � O n� � I HEREBY AFFIqM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV �f �� FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS oERM1T IS ISSUED(SEC.308�.CIV.CJ. o-'� Z W � LENDER'S NAME � F- LENDER'SAODRESS C ) /) � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT TME ABOVE INFORMATqN IS CORRECT. TOTAL F C ES / � �. � � " �� I AGREE TO COMPLV WITH ALl CITY AND CAUN'fY ORDINANCES AND STATE lAWS REUTINO TO BUILDINO � � CONSTRUCTION,AND HEREBY AUTHOFIZE REPRESENTA71VE5 OF THIS COUNTV TO ENTER UPON THE ZABOVE-MENTqNED PROPEATV FOR INSPECTbN PUflPOSES. COMMENTS ' � J � � m PERMITTEE NAME(PRINT), � ¢ v , a � � SIGNATUREOFPERMITT DATE RECPT.NO. PAID BY VALIDATION F=— WHITE—Depertment Copy,YELLOW—F�nance Copy,PINK—Aasessor Copy,GOLDENROD—File Copy.GREEN—Appl Ys Copy CITY O� DlAiVi�ND �AR �� . , , . ,�, . ,.� Ii�S�'�C�'GOf� �3ECOR� _. " • ��]�3G�C�C�400� ��o � .��[�LC��G� ��:�`�' �l�G��C��```tt'0�';�. �GJ�a�'�',�- :�I�[� o � . _ _ -� . __ , . SET BACK FLOOR JOIST ' FTGS/FORMS/STEEL �� FHA REQMTS ' ELECTRIC GROUND UNDER FLOOR DUCT.� . - � GROUND PLUMBING UNDER FLOOR CONDUIT 5LA6 GRADE FIREPLACE FOUNDATION i , TEMP POWER FIREPLACE BOND BEAM WATER SERVECE MID NT BOND BEAM � � ROOF SHEATHING 8 FT. BOND BEAM ' FRAMINGNENTILATION 2 FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING � �S �� POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION � OFF SiTE IMPS. DRYWALL NAILING /� • DEDiCATIONS SEWER FINAL ENG. SEPTIC TANK . � LANDSCAPElIRRIG. SEEP P!T/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINALCONST. ' -�-/� �' � ' FIRE DEPT. FINAL FINAL HEATING � � � HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY C��o � COIVIMEIVTS��7,��,,��.,�� -E'vv� �' o w�� c l W�. tZ �� ' � � �o _ � . . �1 c -(��b�L c, I/z,s t t � �� , i z� SEPTIC TANK SIZE SEEP PIT/U SIZE a . c� � ;,, �� ..:� h ' . � _ S 4�+ � -. _ �. _ _ — I ' . � ��, '�F�_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICE5 " 21825 Copley Drive,Diamond Bar,CA 91765 ` � (909)839-7020 Fax(909)861-311? Building Inspection Hotline(909)839-7027 PRESS � � ��'� SUILDING PERMIT APPLICATION FIRMLY �� JOBSITE 1 11�� P�� G f DATE CATION NUMBEF�(/� !C ADDRESS � � � ISSUE /� TYPE OCC APN�� LOT e�I-� TRACT �ZS�i DATE �V-D� �/ CONST. GROUP p OWNER _�'1�lIC.`-! P(�i 51ffM� WA��- GLA�Wt'� o ADDRESS�'�+2��p�'r GT ZONING FRONT KS RW ❑ Z CITY ZIP TEL. REAfa ❑ � APPLICANT f� WR�/Il(j- TEL. p SIDE/SIDE STREET RW ❑ � CONTRACTOR_1J[R�_T ��z SIDE ❑ � ADDRESS PROPOSED USE � C�Ty ZIP TEL. w ARCWENG/ � DESIGNER a ADDRESS NO.DWEL. NO. NO. UNITS STORIES BE�ROOMS � C�T( ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O 0 I HEREBY AFFIRM UNDER PENALTV OF PERJURV TMAT I AM EXEMPT FROM THE CANTRACTORS LI� GBfegB/CBfpOff W CENSEUWFORTHEf-0LLOWINOREASON(SEC.7031.SBUSWESSANDPROFESSIONSCODE:ANVCITYOR (n U COVNTYwNICHHEOUIRE5n7EFlM1TTOCANSTRUC7,ALTER.IMPROYE,OEMOLISH,ORREPNPANVSTRUG w paUo/peck Z TURE,PRIOR TO ITS ISSUANCE,ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED STATEMENT T{AT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW�QUPTER i(CAAIMENCINC3 V11TH SECTION�000)OF�IV1510N 3 OF THE BUSINESS AND PRO- u' POOVSPB � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMAND7HEBASISFORTHEALIEOEDE%EMP� � � TION.ANV VIOLATION OF SECTION 703t.5 BV ANY APPLICANT FOR A PENA�T SUBJECTS THE APPIICANT TO Z Re-Roof � A CML PEW�17'�OF NOT MOAE TMAN FIVE HUNDRED DOLIARS�f500).): � ❑I,ASOWNEROFTHEPROPERT',ORIAVEMPLOVEESWIiHM1AQESASTNEIRSOLEWMPENSATqN, � Commercial WII,L DO THE WOAK,M1D THE S7RUC7URE IS NO7 1NTENOEO oR OFFEqED FOR SALE(SEC.7a�,BU51- J NE55 AND PROFESSIONS CODE:TNE CONTMCTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERYV WFIO BUILOS OR IMPROVES THEREON,AND NMO OOES SUCH WORK HIMSELF OR HERSELF OR � Q T/4ROU6H HIS OF HER OWN EMPLOVEES,PROVIDED THAT SUCN 4MPROVEMENTS ARE NOT INTENDED OR m w OFFERE�FORS�LEIF,FIOWEVER,7HEBUILAINGORIMPROVEMENTISSOLDWITHINpNEYEAROFCOMPLE- � TION,THE OWNER-BUIL�ER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DIO NOT Bl11LD OR Z IAIVROVEFORTHEWRPOSEOFSALE). _ ❑I,AS OWNEROF TME PROPEHTV,AM EXClU51VELV CANTMCTIN�WfTFI LICENSED CONTRACTORS Q TO CONSTRUCT THE PR0.IECT(SEC.70W,BUSINESS ANO 7ROFESSIONS CO�E:THE CONTRAGTOR9 LI- V8IU81�Ofi ADJ.AREA W CENSEUWDOESNOTMPLVTOANOWNEROFAPROFERTVWMOBUIlD50RIMPPOVESTHEREON.AND � NTIOCANTRACTSFORSUCHPROJECTSWITHACONYRACTOP(S)LICENSEDPURSUANTTOTHELOMRAG ' QUANTITY DESCRIPTION FEE . � Y 70fi5 LICENSE LAW.). � O I AM EXEMPT UNDER SEC. B.8 P.G FOf1 THIS REASON Q � C u_� � oc ' � 2.2 DV � DATE OWNER U ,,, . N t f N � LICENSED CONTRACTORS DECIARATION . W a O � 1 HEREBY AFFIFlM UNOER PENALTV OF PERJURV THA71 AM UCENSED UNDER PROVISIONS OF CHAPTER Ur . � i(COMMENGNO WITM SEC7ION 1000)OF DfVI510P1 3 OF THE BUSINE55 AND PROFESSKKJS CODE.AND Z • �� IAY LICENSE IS IN FULL FORCE AND EFFECT. h � .LI L � UCENSE CLASS J _ LIC.NO. U V / �� _ F' , '� / '� J V pp7E�J� CONTRACTOR n- iyr "�1r'�' 1_ � WORKERS'COMPENSAT�ON DECLARATION U t � 1 MEREBY AFFIRM UNDER PENALTY OF PE0.IURY ONE OF RiE FOILOWIN6 DECUiiAT10N5�. Z C E N O Q � _I NAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WOPNERS' = QT .!�y � COAIPENSATION,AS PFOVIDED BV SECTION 3�00 OF THE LABOR CODE.FOR 7HE PER WRMANCE U � ,! �� OF THE WORK FOF WHICH THIS PERMIT IS ISSUED. � / � ✓�J s"P� 0 w �I HAVE IND WILL MAINTAIN WORKERS'C(MAPENSATION INSURANCE,AS RE9UIRED BY SECTION H Q J7ou OF THE LABOR CODE,FOR THE PERFORMANCE OF TNE WORK FOR WHICH NIS PEpM1T IS " �� f'� ISSUED.MV WORKERS'COA/PENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: ONS CTION �.� _ � CARRIER �T�R'TL FV�� PLAN REVIEW � y� � POLICV NUMBER � LEC �� + Q � (IFLLSSE(.'TIONNE�NDTBENAPIFfEDOF'fFEPEFL.YT6FOA01�1E�DDCLLAR4(5100)ORLESS} PLUMBING �('� W ��7 V Z I CERTIFV THAT IN TNE PEFFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I C A C} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE . � WORI(ERS'COMPENSATION LAWS OF CA�IFORNIA AND AGREE 7HAT IF I SHOULD BECOME INSPECTION FEE /� SU&IECTTOTHEWORKERS'CAM7ENSATIONPROVISIONSOFSECTION37000FTNELABOP ANCE • � CADE,I H ORiHWITH COMPLV WITH(HOSE PROVISIONS. O �p ..7. :�� p OATE: �� APPLICANT. . W • ENERGY P/C J WARNING��FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFIJL.AND 5HA1.L BE � SUBJECT AN EMPLOV[H TO CRIMINAL PENALTIES AND CML FINES UP 70�NE NUNOREO THOUSAND ENERGY PEAMIT DOLLARS(5700,000).IN ADDITION TO THE COST OF CAMPENSATKKJ.DAMAGES AS PROVf�ED FOR IN A N � SECTION 3708 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES E ION � `� � � i O . CONSTRUCTION LENDING AGENCY P E-ALT FEE• � I HEREBV AFFIRM UNDER PENALN OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AOENCV �� ir�'� F-0H THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3007.CIV.C.). Z W � LENDER'S NAME � LENDER5ADDRESS Il � 1 CERTIFY THAT 1 HAVE READ THIS APPIICATION AND STATE THAT 7HE ABOVE INFORMATION IS CORRECT. TO�AL FE ES �/ v w I AGREE TO CW/PLV W1711 ALL CITV AND COUNTV OROINlWCES AN�STATE LAWS RELATINO TO WILDINO �/.�� /1^ � CqNSTRUCTION.ANDHEREBVAUTHORIZEREPRESENTATIVE50FTHI5CWNTVTOENiERUPONTHE � �T . `�• ZABOVE-MENTqNED 7ROPERn'FOR INSPECTION PUFPOSES. COMMENTS 0 �J � � � Q PERMITTEE NAME(PqINT) ,� C!J � � SIONA7URE OF PERMITTEE � DAT RECPT.NO. PAID B VAUOATION 2 ~ WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Gopy,GOLDENROD—File Capy,GREEN--Applicant's Copy � CVl'V O� DI,�►fi�ON� ��,R , ,` / + s+ • Id�SPECTlO� RECORD .� �, " � � _. . �._ . ��.; ,,; �.�[��p�C�00G� .:,:o . :� O�PC�C�4�Q ' ` 0(�1�QC��40C�f�E�� '; o �'� ,�`w'=�� o ;, ,_� SET BACK - FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOQR DUGT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRAOE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H7. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATlON FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEII.ING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATfONS SEWER FINAL ENG. SEPTIC TANK lANDSCAPE/IRRIG. SEEP P!T/L.L. ON SITE IMPS. GAS AIR TEST , FINAL ZONING FINAL CONST. V� FIRE DEPT. FINAL FINAL HEATING a) HEALTH DEPT. FINAL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUMBING � ENERGY • ' C�,'l��o � ; COMMENTS SEPTIC TANK SIZE . SEEP PiT/U SIZE a . � a r + Y ' .. i_. ; r:` ' ' Dd� ... . � �� • . . .. .- . .r �. � �. .. . C . l" > � �y � � ' _�� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 PRESS �'9N'� BUILDING PERMIT APPLICATION FIRMLY } JOBSITE � i APPLICATION PERMfT p/C F'12 ¢ ADDRESS� /4�3 RI�OPOS� l � T SSUE �a� a� /�" NUMBER=SS�.I��#_ \O^ \�'-�Q� � APN LOT TRACT DATE t/�"� � I ONST. GROUP p OWNER F�E�AlQ�( 1.✓AMf' p ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT pyy � o APPUCANT �( � C�142K TEL. T/�i C�2.�}(,04( REAR O zd _v SIDE/SIDE STREET qyy � CONTRACTOr� SIDE � ADDRESS . c � �/ � CITY ZIP ,��C,�C c�� PROPOSED USEA � 6�({2 K'�F NG � o ARCWENG/ --��L I�(6�� ADD ESS � `�� NO.DWEL. N . NO. � CITY _ TEL. UNITS STORIES BEDROOMS � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADD/REM � I HEREBY AFFIRM UNDER PENPLTV OF PERIURV THAT I AM EXEMPT FROM THE CANTRACTORS LI� G8f3 B/C8 W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.5BUSINE55ANDPROFESSIONSCODE:ANYCITVOR (n g �� ZCAUNTVNTiIpIRE0UIRESAPERMITTOCONSTRUCT,�ITERIMPROVE,DEMOLISH,ORREPAIRMIYSTRUG W patio/Deck w NRE,PRpR TO RS ISSUANCE,/�L50 RE-0UIRES THE APPLICANT FOH SUpi PERMIT TO FILE A SI6NED W � STATEMENT THAT HE OR SHE IS t10EN5ED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE UW(CHAPTER B(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � POOVSPB FESSIONSCODE)OR7HATHEORSHEISEJ(EMPTTHEREFROMAND7HEBASISFORTHEALLEGEDE%EMP- (� TION.ANV VIOLATION OF SECTION 7031.6 BV ANV APPLICAN7 FOR A PERMIT SU&lECTS THE APPLICANT TO Z B-ROO� Q� � A CIVIL PENALT/OF NOT A/ORE TMAN FIVE HUNDRED DOlLARS(f500).): � �I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECAMPENSATION, � COrt1rtIBfC18I WtLL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFEFED FOR SALE(SEC.7M�,BUSI- J N NESS M!D PROFESSIONS CODE:THE CANTMCTORS LICENSE LAW DOES NOT A7PLV TO AN OWNER OF � PROPEHTY NM1iO BUILOS OR IMPROVES THEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFEREDFORSALEIF,HOWEVERTIEBUILDINGORIMPROVEMENTISSOLDWITHWONEVEAROFCOMVLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE 7URPOSE OF SAL�. w OI,ASOWNEROFTHEPROPERTV,AMEXCLUSNELYCONTRACTINOWITHUCENSEDCONTRACTORS � TO CANSTRUCT THE PRQIECT(SEC.7041,BUSINESS AND PqOFES510N5 CODE:THE CONTRACTORS LI- V81U8110f1 ADJ.AREA W CENSE UW DOES NOTAPPLV TOAN OWNER OFA PROPERTV WHO WILDS OR IMPROVES THEREON,MID � WHOCONTRACTSFORSUCHPqQ1ECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECON7RAG QUANTITY OESCRIPTION FEE Y TORS LICENSE IAWJ. 0 ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON JQ � U LL DATE OWNER H � LICENSED CONTRACTORS DECLARATION W � 1 NEREBY AFFIHAI UNDER PENALTV OF PERIURY TNAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d 9(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X MV UCENSE IS IN FUL�FORCE AND EFFECT. m LLJ �j � �UCENSE CLASS .'` LIC.NO.��_��s� � 1- , S- , V ATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OFTHE FOLLOWING DECLARATIONS: U � Z � � _I HAVE AND WILL MAMTAIN A CERTIFICATE OF CqNSENT TO SELFINSURE FOR WORNERS' _ Q COMPENSATION,AS PROVIOED BY SECTION�3700 OF 7HE I.ABOR CODE,FOR THE PERF-0RMANCE U � OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHIp1 THIS PERMIT IS �� 'Q ISSUED.MV WORKERS'COMPENSATION INSUHANCE CAPRIER AND POLICY NUMBERAAE; CONSTRUCTION jCARRIER �o �V� PLAN REVIEW G�g`•CO� � X POLICVNUMBER ��,0� -�\1 � ELECTRIC Z Q 0 (iHISSEC�IONNEIDNOTBE001.AE7mOFi1-IEPEIM(tSFOqpNEµXd)qEDpq.ypq3(ylpp)pqLESS� PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C�S SHALL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE (n WORKERS'CAMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I SHOULD BECAME INSPECTION FEE SU&1ECT TO THE WORNERS'CAMPENSATqN PROVISIONS OF SECTION 370o OF THE UBOR �� O CODE,ISHALLFORTHWITHCOMPLVWITHTFIOSEPROVISIONS. ISSUANCE p DATE:�� APPLICANT: SMIP � S`-� w ENERGY P/C J WAANINO:FAILURE TO SECURE WORKERS'COMPENSATqN CAVEOAGE IS UN WNL,AND SHALL BE J � SU&IECTANEMPIOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOILARS(f 100.000),IN/�DDITION TO THE COST OF COMPENSATION,�AMAGES AS PROVIDED FOR IN w SECTqN3�OeOFTHELABORCADE.INTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: 1� -� O CONSTRUCTION LENDING AGENCV PRE-ALT FE�E±: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS ACONSTRUCTION LENDINO AOENCY �H r , � FOq THE PERFORAIANCE OF THE WORK FOq WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.C.). Z W � LENDER'S NAME , � LENDER'SADDRE55 w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT TME ABOVE INFORMATqN IS CARRECT. TOTAL FE ES �� ` 1 S „ OS � I AGREE TO COMPLV WI7H ALL GTV AND CAUNTY ORDINANCES AND STATE LAWS RELATINO TO BUILDINO � CONSTRUCTION,AND HEREBV AU�FfORIZE REPRESENIATIVES OF THIS COUNTV TO EMER UPON THE Z ABOVE-MENTqNED PROPERTY FOR INSPECTION PURPOSES. COMMENTS ' � � L�A]Y J m P RMITTEE NAME P � . ¢ � � 1 c 4� 3 � N SIONATUREO E ATE � RECPT.NO.� �O�� PAID BY VALIDATION � WHITE—DepaAment Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENFiOD--File Copy,GREEN—AppliranYs Copy CITV OF DEAfViOND ��,R y � . , , �, � � � . I�SP�CY90�1 R�CORD T ' � ' ., +• •. . O o �.....- p ` . �' • � ��1�3pCC�400f�� , �D�5 F. 0�1�3PC�C�4� � Q{��pf�G400G1 DLQ4G D�f�pG�G;I��°�", 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'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM' � FRAMINGNENTILATION � FINAL BQND BEAM ROOF C�VER ��4',�j�' O PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING d� �d POOL FENCING WALL INSULATION • POOL FINAL CEILING INSULATION � OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTtC TANK LANDSCAPEIlRRIG. SEEP P!T/L.L. ON SlTE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. F1RE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY (c�"I �o c - , COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a. �? ��; ��- �� a � �. : : � � � � . . n� � � � � ' � � _.��_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 PRESS ''^"� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE t � G'.,�- APPLICATION ; PERMIT �Fl/��y p/C o ADDRESS 1� DATE NUMBER ��'la"�-� � ISSUE ��i/_// TYpE OCC APN LOT TRACT DATE�/ `f� p OWNER 11 ti{/�� CONST. GROUP o ADDRESS ZONING SETBACKS Z CITY ZIP TEL. � FRONT pyy � g APPLICANT TEL. SI�SIDE STREET RW ❑ � CONTRACT R �� P SIDE ❑ O ADDRESS � �' PROPOSED USE TCR �I ��G yN�h{Pif� � CITY ZIP f�� TEL. w ARCH/E G/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CIN ZIP TEL. UNITS STORIES BEDROOMS � I N DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION p SFR/ADD/REM � I HEREBV AFFIRM UNDER PENALIY OF PEfL1URV THAT I AM E%EMPT FROM THE CONTRACTORS LI- GafBgB/CBfpOff W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANYCITYOR (n U COUNTYWH�CHREOUIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPPJRANVSTHUC- w w NRE,PRIOR TO ITS ISSUANCE,ALSO REW IRES hIE APPUCANT FOR SUCH PERMIT TO FILE A SIONED w P8�I0/DBCI( g STATEMENT THAT HE OR SHE IS LICENSEO PURSUANT TO THE PROVISIONS OF THE CQNTRACTORS L4 � CENSE UW(CHAPTEfl G(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED E%EMP- 710N.ANV VIOlAT10N OF SECTION 7031.5 BV ANY APPUCANT FOR A PERMIT SUBJECTS THE APPLVCANT TO Z Re-Roof � � A CML PENALT/OF NpT MORE THAN FIVE HUNORED DOLLARS(5600)J: � ❑I,ASONRJEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COR1rtIBfC18I . WILL DO 7HE WORI(,AND THE STRUCTUFE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BUSI- J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROVEHTY WHO BUILDS OR IMPROVES THEREON,AND NM110 DOES SUCH WORN HIMSELF OR HERSELF OR w THROUGH HIS OR HER OWN EMGLOVEES,PROVIDED THAT SUCN W PROVEMENTS ARE NOT INTENDED OR m Q OFFEREOFORSALEIF,HOWEVER,7HEBUILDINOORIMPROVEMENTISSOLDWITHINONEVFAROFCOMPLE- Z TpN,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W ❑I,ASOWNEROFTHEPROPERTV,AME%CLUSNELVCONTRACTINOWfTHLICENSEDCONTMCTORS � TO CqNSTRUCT THE PRQIECT(SEC,)ON,BUSINESS AND PROFESSIONS CADE THE CONTRACTOFS U- V81U01iOf1 �� qDJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPERTVWIfOBUILD50RIMPROVESTHEREON,/WD � WHOCONTRACTSFORSUpiPRQ1ECT9WITHACANTRACTOR�S)LICENSEDPURSUMITTOTHECONTRAG QUANTITY DESCRIPTION TORS LICENSE UW.). FEE � O I AM EXEMPT UNDEq SEC. B.8 P.C.FOR THIS REASON � � U LL DATE OMRlER ¢ Z U � LICENSED CONTRACTORS DECLARATION W � I HEfiEBY AFFIRM UNDER PENALN OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d, e(COMMENCWOWITHSECTION7000)OFDIVISION3OFTHEBUSINE55AN�PROFESSIONSCODE.AND Z X MY IICENSE IS M FULI FORCE AND EFFECT, m � LICENSE CLASS � I� LIC.NO. �� U DATE �I��'� CONTRACTOR � I d �l� Y � 'WORKERS'COMPENSATION DECLARATION � � I HEREBY AFFIRM UNDER PENALTY OF PERIUfiY ONE OF THE FOLLOWING DECIARATIONS: U � Z � _IHAVEANOWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' _ Q COMPENSATION,AS PROVIDED BV SECTION 370o OF THE LABOR CODE,FOR THE PERFORMMICE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w 0 � � _I HAVE AND WILI MAINTAIN WORKERS'COMPENSATION INSUHANCE,AS REOUIRED BV SECTION Q 37000F THE U1BOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS //�(� O/ ISSUED.MV WORKERS'COMPENSATION INTSUR�ANCE CARRIER AND POLICV NUMBER AAE: CONSTR CTIO ,�t! jCARRIER S��YHI'I� PLAN REVIEW ZPOLICY NUMBER_��b'�■^� !— ELECTRIC � Q �"1 0 (1FESSECTqNNE�NOTBE00MPLEfmOFAEPE{Y.i�15FOqpNEF4,�DqEDOq1ARSK100)ORLESSy PLUMBING W Z 1 CERTIFY THAT IN THE PEi7FORMANCE OF THE WORN FOH WHIp/THIS PERMIT IS ISSUED,I MECHANICAL CJ SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE [/� WOFKERS'COMPENSATION LAWS Of CALIFORNIA,AND AGREE THAT IF I SHOULO BECAME INSPECTION FEE SU&IECTTO THE WORKERS'COMPENSATION 7ROVISIONS OF SECTION 37000F THE IABOR � O CODE.I SHA4L FORTHWITH COMPLY WITH LTHOSE PROVISIONS. �l I U __ p DATE:1�O � I APPLICANT: �7iV�47 A��M� fW�'��Y SMIP �� w ENERGY P/C J WARNINO:FPJLURE TO SECURE WORNERS'COMPENSATtON CAVERAQE IS UNLAWFUL,AND SHALL BE � SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOLLAAS(5100,oao),IN ADDITION TO THE COST OF CAMPENSATIOtJ,DAMAGES AS PROVIDED FOR IN � � V v � SECTION 3]OB OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. TE F O CONSTAUCTION LENDING AGENCY qF-vi T FE� � P %%��J � � 1 HEREBV AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDINQ AOENCY � FOP THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oB7,CIV.C.). Z W � LENDER'S NAME � LENDEIYSADDRE55 W I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORAIATION IS CORRECT. TOTAL F E ES � /`�� I AOREE TO COMPLV WITH ALL GTV AND COUNTY ORDINANCES AND STATE lAWS PEUTING TO BUILDINO � CONSTRUCTION,AN�HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTEFi U70N THE ' Z ABOVE�MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS ' 0 J � m �ERMI77EE NAME(PRINn � � Q � � SIONANREOFPERMITTEE DATE � RECPT.NO. PAID BY V/WDATION WHITE—Department Copy,YELLOW—Flnance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy CITY O� DIAi1�OND �AR . . . , , . : . IftlSPEC�'IOi� 64ECORD � :UI�J�Ir��U ll�� , 0 ' -��U�J, &'�`�^� �-�� + "+ A �� '� . __,- _ _. ., SET BACK � , FLOOR JOIST ' FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIFiEPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING i� ' 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERri'UB TEST POOL ELECTRIC EXT.LATH/SIDING P�OL FENCItVG WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK s� 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 =o .o - COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE �` a . �:- - _ � t :c� ;t� �:: ;;r ��.{' � �", �; � �� ".�",�,�� , � • �� ' �,� . ' , ��_ CITY OF DIAMOND BAR /' ' � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES f/ 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �'9�"'� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE i APPLICATION { PERMIT P� � o ADDRESS (,�-�� C�C`�C�\'�' DATE /� NUMBER I C�� 01.'�� pl10' �� ISSUE TYPE � OCC APN LOT TRACT DATE � CONSI��O GROUP p OWNER p ADDRESS l<►��?, c�c�z'�'� ZONING SETBACKS z CITY l�►Z7c'\or\ �c�t� ZIP��TEL. FRONT qyy � � APPLICANT TEL. REAR � ¢ SIDE/SIDE STREET RW ❑ � CONTRACTOR �.�P � RCil1�iC�r SIDE p ADDRESS � CI7Y�i(�`�''�o�c�i PROPOSED USE�C\ C2��r-�� (��-- ZIP rE�.4.i�99�9Z �� " �� '�-S.�.ra.�� 2� o ARCWENG/ � ---�-�-.p� �^ aDESIGNER � L.�r�c+ ADDRESS �"�� NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES Z BEDROOMS S � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O Q I HEREBV AFFIRAI UNDER PENALTY OF PERIURV THAT I AM EXEA/PT FHOM THE CONTRACTORS U� G0f8 0/C8 fl W CENSEUWFORTHEFOLIOWINOREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITYOR (n 9 � V COUNTYVh11CHRE0UIRESAPEHMITTOCANSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANV3TRUC- w w NRE,PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPUCANT FOR SUpi PERMIT TO FIIE A SIONED W Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF TNE CONTRACTORS LI� � CENSE UW(CHAPTER e(COMMENCWO Wlhl SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooUSpe . FESSIONSCODE)ORTHATHEOFSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP� (� TION.ANY VIOLATION OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof A CML VENALTV OF NOT MORE hlMl FIVE HUNDRED DOIURS(f5o0).�: � ❑I,ASONRJEROFTHEPROPER7Y,ORMYEMPIOVEE5W17HWAOESASTHEIRSOLECOMPENSATION, � COffIRIBfC10I Z WILL DO THE WORK,AND THE STRUCTURE IS NOT IN7ENDED OP OFFERED FOR SALE(SEC.7a1,BUSI- J � NESS M!D PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROVERTY N?10 BUtLDS OR IMPROVES TMEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR 2 THROU(3H HIS OR HER ONTI EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERNEBUIL�IN�ORIMPROVEMENTISSOLDWfTHINONEVEAROFCOMPLE- Z TION,THE OWNEREUILDER WILL NAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUIID OR � MPROVE FOR THE WRPOSE OF SALE). W ❑I.AS ONMER OF THE PROPERTV,AM E%CLUSIVELV CANTRACTINO WITH LICENSED CONTRACTORS p�c'` � TO CONSTRUCT THE PR0.IECT(SEC.7Wa,BUSINE55 AND PROFESSIONS CODE:THE CON7RACTORS LI- V8IUe110f1 _`Fi��J�1� Ap�.AREA W CENSE LAW OOES NOTAPPLV TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES TMEREON,AND � WFIOCANTMCTSFORSUCHPRQIECTSWIh1ACANTRACTOR(S)LICENSEDFURSUMlTTOTHECONTRAG QUANTITY DESCRIPTION TORS LICENSE UWJ. FEE Q ❑1 AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON � ?� U � DATE OWNER H Z U � LICENSED CONTRACTORS DECLARATION w I � �HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � i(COMMENCIN(3 WITH SECTqN 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT. m � LICENSEt C`LASS� LIC.NO._Ob��S� � V DATE�(� II,�{1 CONTRAGTOR � W � WORKERS'COMPENSATION DECLARATION � � U N I HEREBV AFFIRM UNDER VENALTY OF PERIURY ONE OF THE FOLLOWING DECLARATIONS: Z �Z _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' a Q COMPENSATION,AS VROVIOED BV SECTION 370o OF THE LABOR CODE,FOR THE 7EF W RMANCE U OF THE WOPK FOR WHICH THIS PERMIT IS ISSUED. � W Y�HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS PEWIRED BV SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMI115 � ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION '��', � � CARRIER LAN R IE 0 POLICY NUMBER Zd ELECTRIC � (nassEcnor�r��rq7ee�rFooFn-�EaEw�rrsFoaor+E�roqEoppunasgim�oq�ss} � PLUMBING .. w Z �CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUEO,I MECHANICAL � C!S SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE (/� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I SHOULD BECAME INSPECTION FEE SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE UBOq ^�. �5 O C1OD'E,ISHALLFORTHWITHCOMPLVWI7HTHOSEPROVISIONS. ISSUANCE � a� p OATE:��-1��/�� APPLICANE �SMIP S� W � WARNINO:FAILURE TO SECURE WORKERS'COMPENSA CAVERAGE IS UN ,AND SHALL BE ENERGY P/C � � SUBJECTMIEMPLOVERTOCRIMINALPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(f 1ao.o0o),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS FROVIDED FOR IN J SECTqN 3708 OF THE LABOR CODE,INTEREST,MlD ATTORNEV'S FEES. �O`�O w RETENTION FEE: O CONSTRUCTION LENDING AGENCY P.�yRE-�ALT�FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT THERE IS A CANSTRUCTION LENDING AGENCV �y�� 1 � a- fOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERAIIT IS ISSUED(SEC.JOe�,CIV.CJ. Z W � LENDER'S NAME F— LENDER'SADDRESS }�`,� w I CERTIFY TMAT I HAVE READ THIS AP7LICATION AND STATE THAT 7HE ABOVE INFORMATIOfJ IS CARAECT. TOTAL FE ES / , I�� -�G ' ,`S � I A(3FEE TO CAMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE UWS REUTING TO BUILOIN6 - . Z CONSTFUCTION,AND HEREBV AUT}IORIZE REPRESENTATNES OF THIS COUNTV TO ENTER UPON THE / �`/ �� /�/� ABOVE�MEMIONED PROPERTV FOF INSPECTION PURPOSES. /,. c> bc ru� 0 COMMENTS 1.(! �017'"`� J X ��1.��c- � PERMITTEE NAME RINn ' � � � � � SKiNATURE OF �y�- � RECPT.NO. �U�.�s PAID BY 01.�J WWDATION WHI — epartment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,OOLDENRO�File Copy,GREEN—Appllcanl's Copy CE�Y OF DIAf�Of�D �AR . � ' ,� ; , ,� � Ift�S�(EC�'E0�9 �tECORD � ��c��=� , aa�p�c�sooa � ��,�i�a��:�'� f � �� h, oa�p�c�ooa o �� -, � 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'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM ' FRAMINGNENTILATION FINAL BOND BEAM ' ROOF COVER PRE-GRADING ROUGH HEATING BENCHIfVG ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL 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. Zy'�M FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY C�'n��o e .' . COMMENTS SEPTIC TANK SIZE SEEP PITlU SIZE a �.� �� t�.. � � _: _ , �� _,; �� n; ��_ �,� . . : . .: = -.�:,_ � ' . .' +� ' �� 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 �;`g 1 ��5� APPLICATION PERMIT �� p/C o ADDRESS '�%7 DATE_ �l�Cr�ll� NUMBER ��' $`� # ��- � APN LOT TRACT ISSUE TYPE OCC DATE �I a l�� CONST. GROUP p OWNE�HEtN`QY �Ff�f1� p ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT qyy � o APPLICANT LH Lr/�' � TEL.�O � REAR � � SIDE/SIDE STREET RW ❑ � CONTRACTO / �dl�� SIDE p o CDYRESS Z�P O'11C EL.�� PROPOSED USE /�N�'T �/�/' 'T��G(rl o ARC NG/ � DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDEH PENALTV OF PERIUFV THAT I AM E%EMPT FROM THE CONTRACTORS LI- G8feg0/CBfPOh W CENSELAWFORTFIEFOLLOWINOREASON(SEC.70.31.6BUSINESSANDPROFESSION9COOE:ANVCfTVOq (n C� COUMVWMCHREOUIRESAPERMRTOCONSTRUCT,/�LTER�PROVE,DEMOLISH,ORREPAIRANYSTRUG Z NRE.PRIOR TO ITS ISSUANCE,ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W PO�1O/D9CI( w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS L4 w I � CENSE LAW(CHAPTER B(CAMMENCING WITH SECTqN]000)OF ONISION 3 OF TFIE BUSINESS AND PRO� � POOUSP9 , Q FESSIONSCODE)ORiNATHEORSHEISEXEMPTTHEREFROMAflDTHEBASISFORTHEALLEOEDE7CEMP- (� V TION.ANV VIOLATION OF SECTION 7031.6 BY ANV APPLICANT FOR A PERMIT SU6IECTS THE APPLICANT T0 Z Re-Rool A CMI.PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLAqS(f600)J: � ❑I.ASONRJEROFTHEPROPERTV,ORMYEMPLOVEESWITHWA6ESASTHEIRSOLECOMGENSAiION, � CORIRIBfCIeI Z WILL DO THE WORK AND THE STRUCTURE IS NOT IMEN�ED OR OFFERED FOR SALE(SEC.70N,BU51� J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT A7PLV TO AN OWNER OF •S �O PqOPERTYWH00UILD50RIMPROVESTHEREON,ANDWHODOE55UCHWORNHIMSELFORHERSELFOR � CC THROU(1H HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUpi IMPROVEMENTS ARE NOT INTENDED Oq m . � OFFEREDFORS�LEIF,FqWEVER7}1EBUILOWOORIMPROVEMENTISSOIDWITHINONEYEAROFCOMPLE- Z TION,THE OWNERAUILDER WILL HAVE iHE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR `1�� ' �O � IAIPROVE f-0R THE PURPOSE OF SALE. w ❑I,ASOWNEROFTHEPROPEHTV,AME%CLUSNELVCANTqACTINOWRHLICENSEDCONTRACTORS � TO CONSTRUCT THE PRQIECT(SEC.7014,BUSINESS AND PROFESSIONS CODE:TNE CONTRACTORS LI- V8IU2fIOf1 ADJ.AREA W CENSE UW DOES NOTAPPLV TO AN ONTJER OFA PROPERTY WHO BUILDS OR IMPROVES TMERE-0N,AND � WFIOCONTRACTSFORSUCHPRQIECTSWITHACANTRACTOR�S�LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION Y TORS LICENSE LAW.). FEE Q ❑I AM E%EMPT UNDEH SEC. B.6 P.C.FOR THIS REASON Q '� �i U � �� ' .� . � DATE OWNER ~ Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTV OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z � �� MV UCENSE IS W FULL FORCE AND EFFECT. m � ICENSE CLASS ` LIC.NO. `1G l.�J�k' _ � w ATE �Z ! ' 1 CONTqACTOR�'��'� I�CC� a � WOAKERS'COMPENSATION DECIARATION Q , U N I HEHEBY AFFIRM UNDER PENALIY OF PERIURV ONE OF THE FOLLOWING DECLAFUTIONS: Z �Z _INAVEANDWILLMAINTAINACERTIFlCATEOFCONSEMTOSELF-INSUFEFORWORNERS' a Q COMPENSATION,AS 7ROVI�ED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U OF TME WOR1C FOR WHIC}I THIS PERMIT IS ISSUED. W � � _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REaIJIPED BY SECTqN Q 3700 OF THE LPBOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS � ISSUED.MY WORNERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION �� • 9 0 ] CAARIER �T�'� ��'� PLAN FEVIEW � . o—� 0Z POLICYNUMBER 7��—�Calis�,� ELECTRIC Q 0 (MISSECiIONNE�NO7BE�f.�7EpOFT�'�PEMYTSFOR�NEFIIN�ORFD�OLLARS(5100)OqLESS} PLUMBING ' W Z I CERTIFV 7HAT IN THE PERFORMANCE OG THE WOR)(FOR WHICH THIS PEFUAIT IS ISSUED,1 MECHANICAL C,'} SHALL NOT EMPLOV ANV PEHSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE (/j WORKERS'COAIPENSATIONLAWSOFCALIFORN10.ANDAaREETHATIFISHOULDBECOME INSPECTIONFEE SUBJECTTOTHEWORNERS'COMPENSATIONPROVISIONSOFSECTION77000FTHELABOR �^ � O CODE,I SHALL FORTHWITH COMPLV W17H THOSE PFOVISIONS. ISSUANCE � p DATE: Z � APPLICANT: SMIP - SO W / � WARNINO:FAIIURE TO SECURE WOAHERS'COMPENSATION COV2RAOE IS UNLA FUL,AND SHALL BE ENERGY P/C � � SU&IECTAN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLURS(f100.o00�.IN ADDI710N TO TNE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN J SECTION 3]OB OF THE LABOH CODE,INTEREST,AND ATTORNEVS FEES. u ` OQ w AETENTION FEE: T O CONSTRUCTION LENDING AGENCY . PRE-`ALT�FEE: ' � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AOENCV �o�.�� ,� � Z� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). W � LENDEP'S NAME H LENDER'SADDRE55 w 1 CERTIFY 7HAT I HAVE READ THIS APPLICATION AND STATE iliAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES �� F.��. 'T�� I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS REUTINO TO BUILDINO � CANSTRUCTION,AND HEREBV AUT/qRRE REPRESENTATIVES OF THIS CWNTV TO EN7ER UPON THE � Z ABOVE�MENTIONED VROPERTV FOR INSPECTION PURPOSES.. COMMENTS ' � � ��e l�s'`C` m PERMITTEE NAME(PRINn ' � � � 1( ��_-� �Z /1 \ � SIONATUR EE DAT � RECPT.NO. � Co3J�C�pAID BY� ��O� VALIDATION� WHITE—Depertment Copy,YELLOW—Flnence Copy,PINK—Assessar Copy,GOLDENROD—Flle Copy,GREEN—Applk;ant's Copy � 5 CITV OIF D8A,f1iiOND B,4Fi � � � ' .' .'� ,�� .� � Ii�SP�CT9t3i� RECORD ��a�pc��ooa o��} ��c� o �s�t� :n o�,��'ao�'` ��.p . �� ,�,� � � , � . , 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 HT. BOND BEAM ROOF SHEATHING 8.FT. BOND BEAM FRAMINGNENTILAT�ON FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPElIRRIG. SEEP PIT/L.L. � ON S1TE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. �",��1 FIRE DEPT.fINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY ' �� COIVIMEIVTS SEPTIC TANK SIZE SEEP PIT/U SIZE �I - �. � 1��r' <<'. ,: � - ��« .=�.�,�. .� �[ �6� -'�a 'y��y„E.� . r�'k.L'r�-F _ �"�}� �,��s.