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Home My WebLink About11242 �.. � — CITY OF DIAMOND BAR � COMMUNITY DEVELOPMENT DEPARTMENT .,,.¢ . 21660 E.Copley Drive Suite 190 pRESS ' (909)8fiQ-3195 Fax(909)861-3i 17 '""°, BUILDINGPERMITAPPLICATION � � FIRMLY N JOBSITE '']�(� �/�' APP�ICATION 0 ADDRESS ��v 1 R�K� �� ' DATE ~ NUMB R # � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER • O LI � ADDRESS� 1 / ZONING SETBACKS Z CITY � ZIP TEL. FRONT RW ❑ g APPLICANT o TEL. ^L REAR ❑ Z SIDFJSIDE STREET RW CI � CONTRACT�R itX�o SIOE C Q ADDRESS � � CITY �—la • ZIP 4 TEL. �! PAOPOSED USE Q ARCWENG/ w DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OYVNER-BI:ILDER OECLARATION SFFUADDlREM O [] I HEflE9Y AFFIRM UNDER 7ENILLTY OF PERJURY TFIAT I AM EXEMP7 FROM THE CONTRACiORS LI- G9l8Q8/C8�011 W CENSEIAWFONTMEFOLLOWINGRFASON(SEC.7037.5BUSINESSANOPROFESS�ONSCODE:ANYCITYOR (/� zCOUNTYWHIp1RE0UIRE5APERMITTOCDNSTRUC'�hLTER,IMPROVE,DEMOLISH,ORREPAIFANYSTRUG W PeIlO/D6CIC TURE.PRIOR TO ITS ISSUANCE.ALS�NEOUIRES THE APPLICANT FOR SUCH PERI�IIT TO FILE A eIGNEO W � STAiEMENf THAT HE OR SNE IS UCENSED PURSUANT TO TNE PROVISIONS OF lHE�ONTRACTORS U- � GENSE I.�W�CFIAPTEF 9�COMMENGING WITH SEGTION 7000�OF�IVI910N]OF THE BUSINE55 ANO PRO� POOU$Dd FESSIONS CO�E)OR TI1AT HE OR SHE IS E%EMPT THEFEFROM ANO THE 6A515 FOFl THEALLEGE�E1fEMP� V TION.ANYVIOLATIONOFSECTIqJ7091.6BYANVAPPUCANTFORAPERMITSUBJECi51HEAPPLICMiTT[1 Z Re-Roof � ACIVILOENALTYOFNOTMORETWWFNEHUNDREDDOLUH5�S500).�: � ❑I,ASOWNENOGTHEPiiOPERTY.ORMVEMPLOVEESLNTHWAOESAS7HEIRSOLECOMPENSATON, � Commercial WILL DO THE WORK,AN�THE 6TRVCTURE IS NOT INTENOED OR OFFERED FOR 6ALE(SEC.70H.BU51- J N NE55 AND PROFESSIONS CODE:THE CANTRACTORS IICENSE LAW DOES NOT APPIY TO AN pWNEH OF = PROPERTY MfF10 BUItAS OR IMPROVES THEREON,AND WHO�OES SUCH WORN HIMSELF OR HERSELF OR (� THROV�HHISORHEROWNEMVLOVEES,PqOVI�EDTHATSUCHIMPROVEMEMSARENOTWTENDEDOR m OOFFEREDFORSALE.IF,FIOWEYER7MEBUtlIDIN(70RIMPHOVEMENTISSOLDWITHNONEYFAqOiCDMPLE� Z TION,h1E OWNER�BUROER WILL HAVE 7HE 9UqDEN OF PROVIN6 THAT HE Oq SNE DID NOT BURD OR = IMPROVEFOR7FIEFURPOSEOFSALE). �y,� CI.ASOWNEflOfTHEFflOPERiY.AMEX0.U51VElYCONTRACTINGWITHLICENSEDCONTPA[:TORS � TO CONSTqUCT 7HE PROJECT(SEC.7ou,fiUSINESS AND OROFESSIONS CO�E'TI/E CANTRACTORS U� VfilUetl011 A�J.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTYWHOBUKDSORIMPROYESTHEREON,ANU � WHOCONTRACTSFORSUCHPHQIECTSWITHACONTRACTOR(S�UCENSEDPURSUNJTTOTHECONTRAG QUANTITY DESCRIPTION FEE � TOFS LICENSE LAW.), J � ❑I AM EXEMPT UNDEH SEC. B.6 P.C.FOq THIS RE�SON q � U LL" DATE OWNER � Z W ¢ LICENSED CANTRACTORS DEGLAAATION W � 1 MEREBY AFFIRM UNDER PENALTY Of PERJURY 7HAT IAM LICENSED UNDEfl PflOY1SIONS OF CXAP7ER � L 1�l C ,, d 9(COMMENCING WITH SECTIDN 7aoa)OF DIVISION J OF THE 6USINESS ANU PHOFESS�ONS WDE,MID Z TG�i X MY LICENSE IS IN FULL FORCEAND EFFECT. � m LlJ / � LICENSE CIA55 *�� LIG.NO. � j V OATE L CONTRACTOq __ d lL 3�� WORKERS'COMPENSATION DECLARATION ¢ � INEREBYAFFIRMUNDERPENPLTYOfPERJURYONEOFTHEFOLLO'MNGOECLARATIONS: Z Z _IHRVEANUWILIMAINTAINACERfIFICJI7EOFCAN5ENT705ELF-INSUNEFORWORKERS' _ Q COMPENSATION,A9 PPOVI�ED BV SECTION 3i00 OF TNE LABOR COOE,FOR THE PERFOWAMICE W Of/7HE WORK FOR WHICH THIS 7ERMIT IS ISSUEO. � W vIHAYEANDVlILLMAINTAINWORKERS'GOMPENSATIONINSURANCE,ASHEWIREDBYSECTION O 97000F TFIE LABOF CO�E,FOR THE PERFOii�MNCE OF THE WORK WR WHICH THIS PERMIT IS ISSUED.MY WORNERS'COMPENSATION INSURANCE CARRIER ANO POLIGY NUMBER ARE: CONSTRUCTION J j cnaaiEA _ PLAN REVIEW Z POLICYNUMBER � ELECTRIC Q 0 (MISSECIIONNEmNO78ECOMPIE'fE�OFhEPERhttISPORONEFU/�DREDDOLWiSRi aa ssG PLUMBING � � C W Z �CERTIFY ThNT IN TME PERFORMANCE OF TME WOPK FOR WMICM 7MI5 PERMIT 1$I55UED,I MECHANICAL (�} SHALLHOTEMPLOYANYPERSONINANYMANNERSOASTOBECAMESl1BJECTTOTHE y WORKERS'COMPENSAiqNLAW50FCAUFORNIA,MIDAGREETHATIFtSMWLDBEfAME INSPECTIONFEE SUBJECTTO TME WORKERS'COMPENSATION PROWSIONS OF SECTION 37o00F TNE IABOR � s CODE,1 �ALL RTHWITN CDMCLV WITHTHOSE VROVIS ISSUANCE ` r �� O � j p DATE � AVPLICANT __ � WARNINO:FAILURE TO SECUAE WORNERS'C01APENSATION COVERAGE IS UNUWFIII,µ0 SHALL BE ENERGY P/C � SUBJECTIWEMPLAYEATOCRIMINALPENALTIESANDCIVILFMESUPTOONEHUNDNEDTIWSMlD ENEFGYPERMIT DOLLAflS(i100.000�.IN ADOITION TO THE COST OF COfdPENSFTION.DAMAGES�S PflOVIDED FOR IN � SECTION370BOFTHELABORCODE,WTEREST,ANDATfORNEY5FEE3. RETENTIONFEE: ow_. CONSTRUCTION LEND�NG AGENCY PFE-ALT FEE: O � IHEREBVAFFIRMl1NDERPENALTYOFPERIURVTHATiHEREISACONSTRl1CTIONLEN0INGAGENCV FOq THE PERFORMpNCE OF THE WORK FOR WHICH TNIS PERMIT IS i5SUE0(SEC.]OW,CIV.G�. Z W � IENDER'S NAME F-' lEN0ER5ADORE55 Q 1 CERTIFY THAT I HAVE READ THIS APP�IC�TbN AND STATE THAT h1E ABOVE INFORMATION IS CORRECL TOTAL FEES �� W IAGqEE TO COMPLY 1MTM ALL GTY AND CAUNTV ORDINANCES AN�STATE UWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBYAUTF70RIZE REPRESENT TIVES OF TMIS COUMY TO ENTER UPON THE d�� . y � I� Z ABOVEdAENTIONE�PROPERTY FOR INSPECTIDN 7URP E5. COMMENTS`j�,`[7�, D vT D� K�I�� "'L M � ¢ PERMITTEE NMI�yQ � � �Y G � SIGNATUREOFPERMITTEE ORTE = HECPT.NO. PAID BY VALIDATIO ~ WHITE—Deper6neM Copy,VELLOW--Finance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,6REEN—ApplicanPs Copy . , . ... . . . n, . -' . . .. . �.. . .. .r . . . . .. . . . . . . . .. .. . �. . .. �ly' > .. . .. � . . . i , . , .�.,. � . . . CITY OF DIAMOI�D BAR ; � �ye�t ��INSPECTION RECORD � . �v • e � , . � . . � � , . � . • SET BACK � FtOOR JOIST FfGSJFORMS/STEEL I FHA REGIMTS ELECTRIC GROUND UNDER FLOQR dUCT � GROUND PLUMBiNG UNDER F�bOR CFJMDUIT � � � SLAB GRADE FIREPLACE FOUNDATION - � TEMP POWER � � FIREPLACE BOND BEAM �- WATER SERVICE ' � MID HT. BOND BEAM � � ROOF SHEATHING 8 FT. BOND BEAM FRAMING/VENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING • ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING ; FINISH GRADING SHOWER/TU6 TEST � POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEIIING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/tRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZON�NG FINAL CONST. � FIRE DEPT. FINAL FINAL HERTtNG HEALTH DEPT. FINAL FIN�,L ELECTRIC . I - DEV. FEES PAID FINAL PLUMBING i ENERGY � � * r COMMENTS • �•.. ,a : ---- • � , , , � � SEPTIC TANK SIZE SEEP P17/U SIZE � ''I,; �,jll �, � ' ;� �,P' ' �. : .