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Home My WebLink About16511 � CITY OF DIAMOND BAR �� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ^� 21660 E.Copley Drive Suite 190 (909)86Q3195 Faz(909)861-3117 PRES$ ��'� BUII.DING PERMIT APPLICATION FIRMLY o� JOBSITE. �2�Q D G� .C/�G � APPLICATION � r-1 Q-(�1, NUMB R J l #/C ADDRESS 7 DATE O � ISSUE " '' TYPE'^�'" • OCC -- APN LOT TRACT �z DATE CONST. GROUP q� OWNER pADDRESS L� ZONING SETBACKS�.•"-��`...,, .y.'^ ; '� � CITY � ZI Z�TEL. REART. _. � � ' ,RW p❑ APPLI ANT TEL. SIDE/SIDE STREEf RW ❑ � CONTRACTOR 1 ' d . �/^ SIDE � C'DTMDRESS Q- ZIP � TEL. PROPOSED USE � ARCH/ENG/ RA,q�� / �.�+ � DESIGNER /�'!/N�i� _ �� V- N�SOG • NO.DWEL. NO. NO. ADDRESS �,CS�� S� UNfTS STORIES BEDROOMS � CI ZI � TEL. ti �n DESCRIPTION SG1.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM � � O � I HER�V AFFIFW UNDEfi PENALT'OF PEFLIURV THAT I MI E%EMPT FROM THE CONTRACTORS ll- G9fH96/C9fF10fS CENSEUWFORTHEFOLLOWINORFA40N(SEC.703t.6BUSIHESSANDPROFE5510NSCODEANYCI7VOR (n COUNTYWWp1REWIRESAPERMRTOCONSTRUCT,KTERIMPROVE.DEMOLJSH,ORREPNRANYSTRUC- W Patio/Deck TURE,PRqR TO ITS 159UANCE,KSO REW IRES hIE MPLICANT FOR SUCH PEfU11T TO FILE A SIGNEO w � STATEMENT T}UT HE OR SHE IS LICENSED PURSUAN7 70 7NE PHOVISIONS OF THE CONTMCTORS LI- � C CBISE UW(CHAPTER Y(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOYSPB . iF FE5910N5 COO�ORTTIAT HE OR SHE IS E](EMPT7HEREFROM AND THE BASIS FOR THE ALLEOED EXEMP- V TqN.AHVVqLATqNOFSECTION7031.6BVANYAPPLICANTFORAPERMITSU6IECTSTHEMPLICANTTO Z Re-Roof � A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLURS(f5o0).): . � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESVATHWAOESASTHEIRSOLECOMPENSATION, � COmrtl9fClfl1 . ., � WILL DO iHE WORK,AND THE STRUCNRE IS NOT IMENDED OR OFFERED FOR SALE(SEC.70U,BUSF J N NESS AND PROFESSIdiS CODE TME CONTRACTORS LICEHSE Uw DOES NOT MPLY 70 AN OWNER OF � � _ , PiqPEHiY W/10 BUYDS OR IMPROVES hIEREON,AND Wlq DOES SUCH WORK HIMSELF OR HERSELF OR - ' - � T/Qt7U�H HI90R HER OWN EMPIOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT WTENDED OR m , , - - . . ., Q ,OFFEREDFORSALEIF./10WEVERTHEBUlDP1�ORIMPROVEMEHTISSOLDWIh11NONEYEAROFCOMRE- �'� Z 'TqN,THE OWNERAUILDER VALL HAVE 7HE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUIID OR . � pAPHOVE FOR 7HE PURPOSE OF SAIEI �JJ ❑4��WNEROFTHEPROPEHTv,AA1IXClUSNELVCONTMCTIN(iWIhIIICENSEDCONTRACTOR3 � [C �aDNBTRUCT THE PRQIECT(SEC.)0/1,BUSINESS MID PROFE5910N5 CODE:THE CONTRACTORS U- V8IU8�lOf1 ADJ.AREA l� CENSE UW DOES NOTMPLY TO AN OWNER OF A PROPEfl7V Vh10 BUttDS OR IlAPROVES 7HEREON,AND - MRqCONTMCT5FOR3UCHPRO,IECTSWITNACOHTMCTOR(S)LICENSEDPURSUAHTTOTHECONTRAG pUANTITY DESCRIPTION FEE � Y 70fi3l10ENSE UWJ. ^ O I MI EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON � I Y U S � u" DA7E ONMER � Z w � LICENSED CONTRACTORS DECLARATION W � 1 HEAEBV AFFIRM UNDER PEIUL7Y OF PE0.IURY THAT I MI LICENSED UNDER PROVISIONS OF CHAPTER U. � Y(COMMENCWO WI7H SECTION)000)OF DNISION 3 OF 7HE BUSINESS M!D PROFESSIONS CODE,AND Z ' �� W LICENSE IS IN FULL FORCE EFFECT. m � IICENSE CIASS LIC.NO. � . � V DATE��lS�,CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION a N1 HEREB AFFIRM UHDER PENKTV OF PERIURY ONE OF hiE FOLLOWINO DECLARATIONS: Z � I HAVE AND WILL MABiTM1 A CERTIFlGTE OF CONSENT TO SElFNSURE FOH NOHKERS' _ Q COMPENSATION,AS VROVIDED BV SECTION 37000F THE LABOfi COOE,FOR TME PERFORAIANCE �U Q OF THE WORN FOR WHICH TH�3 PERMIT IS ISSUFD. � I HAVE AND WILL MAIMAIN WORKERS'COMPENSATION INSURANCE,AS REOUIPED BV SECT1qJ Q 37000F THE LABOR CODE.FOii TNE PERFORMANCE OF TNE WORK WR WHlpij1iIS PERMR IS �^,f�„ �/� ISSUED.MY ERS'COMPENSATION IN RANCE CARRIER AND POLICY Nl1Y(AER ME: CONSTRUCTION ��F�i'��' � /�/ � CAHRIER G� - �%Q- PLAN REVIEW � Yr�uueER ` ELECTRIC � "��r�ID �Eoor.r�r�oFnfaEw�iswaor�funr�ooa.w�sit+aolaa�ss� PLUMBING � ,�_ Z I CERTIFY THAT W hIE PERFORMANCE OF 7HE WOR!(FOF MMICH 7HI5 PERMR IS ISSUED,I MECHANICAL (J SHALL NOT EMPLOV M1V PERSON W ANV MANNER SO AS TO BECOME SUBJECT TO THE � (n WOR7(ERS COMPENSATION LAWS OF CALIFORNI/�AND AGREE THAT IF 1 511IX1LO BECAME INSPECTION FEE S SUBIECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR caoE.i sr�ui rvanrv�nn�ca,�p�v winr T e rqov�sroNs. ISSUANCE � �/� �'�^ SMIP , p DATE:»�T�APPLICANT. V I/dG w ENERGY P/C � WAANINO:FA0.URE TO SECURE VAFlKERS'CAMPENSATION COVERAOE IS UNLAWFUL,AND SHALL BE � SLlaIECTANEMPLOVER70CRIAIPULPENALTIESANDCMLFINESUPTOONEHUNDREDhWUSAND ENERGYPERMIT DOLLARS(i100,000�,W PDDITION TO THE CAST OF COMPENSATION,OAMAQES AS PHOVIDED FOR IN � SECilON370EOFTMELABORCODE,INTEREST,ANDATfORNEV5FEE5. ' RETENTIONFEE: d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � 1 HERFBV AFFIqM UNDER PENAL7Y OF PERIURY THAT THERE IS ACONSTRUCTION LENDWG AGENCV . ' � FOR THE PERFORMANCE OF THE WORK FOR WHI TH/IS�PEFMR IS ISSU (SEC.30Y7,CIV.C.). Z �� Ov�� w � LENDER'S NAME . � � F- I.ENDEH'SADDRESS � t CERTIFV THAT I HAVE READ 7HI5 MPLICATION AND STATE THAT TME ABOVE WFORMATION IS CORAECL TOTAL FE ES W I AOREE TO COMPLY N7TH ALl CITY AND COUNTY ORDINANCES AND STATE UWS REUTINO TO BU0.01N0 � � CONSTRUCTION,N1D MEREBV AU7HORI E REPRESENTATIVES OF h115 COUNTV TO EMER UPON THE ' � S� ABOVE�MEN710NE0 PROPEFTY f-0R I PECTION PURPOSES. COMMENTS � � J � PERMI77 NAME(PRI � �, 3 Zr'-/--�/- � Sq RE OF PERA1 DA7E � � RECPT.NO. PAID BY VALIDATION WHITE—Depertment Copy,YELLOW�Inence Copy,PINK—Assesaor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy �9'�'V �� DA�6aP�� aV� .. ' � - IP1��C�'94�� RE�ORIL� r � e� . . , . _ �; � � �� ,, ,- � ; ,� � k. .a. e � ,. . ' �� "e� �� 4 � : . .� - � � � ... '�'';_,, � � D � .+�� . . . . _ . . .. ;� :`;:, .�y� ` �;;`� SET BACK , � '�' FLOOR JOIST �- FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND . UNDER FLOOR DUCT - GRC3UND PLUMBING (p ...p ' UNDER,ELOOR COMQUIT� . , SLAB GRAQE �wL FIREPLAGE'FO�INDATION ` ' TEMP POWER � FIREPLACE BOND EiEAM WATER SERVICE ' MID HT. BOND BEAM ROOF SHEATHlNG i �' . ' � � 8 FT. BONQ BEAM ' FRAMINGNENTiLIATION • - FINAL BOND BEAM ' ROOF COVFR PRE-GRADING " ' � . � � ROUGH HEATiNG BENCHI�VG.,. ; ;. , � ROUGH ELECTRlC ROUGH GRADING ' RCIUGH PLUNIBING FINISH GRADING SNOWERlTUB TEST POOL ELECTRIC EXT. �,4TH/SIDING �•- `'Ci POOL FENCING � WALL INSULATION . POOL FINAL � GEILING INSULATI�N OFF SITE IMPS. � - DRYWALI NAlLING _�� _�j DEDICATIONS � SEWER ENG. � SrPT1C TANK LANDSCAPE/IRRtG. � SEEP P!T/L.L. ON SITE iMPS. GAS AtR TEST FINAL ZONING FINAL C�NST. FlRE DEPT. FINAL Fl�VAL i-iEATING NEAL7N DEPT. �INAL � FiNAL ELECTFIIC - YJ/ DEV. FEES FAID � �=;i�1AL PLUMBWG ENERGY : � � . _ . .- -• f- n� ..��- � �� ' � � CO�UIM��lTS � � � SEPTIC TANK SiZ� . SEEP PIT/U SIZE �� , L, � ' . � � �� ",.� . _ — ��-- �t�'°� � ��" a?�t��,�#��. . .. .�� .� s 2 a " . . . _ ��:�,�� ^�'� s�^'� „'„ � `"^� $;'b � '�w.� �A�`& °�r K�"`z� _ . � , ,�, "�� a mg"� n� r�r�_,.�,�.�a:° , � . � g�_:.�C� ��`�d`��y�SC`. `�. . . . . � �Y tk^N �'Y Q��ri' ty'�'y�� [nx�W t , � �. !w b..i• �3.F.� -. � . • , .w�l�"��9y�i.i�9 tqy �i�� . , . �A B� . f o$�� S'Y `�r . - � � . ' . . _i . ..( i _ � �_ � ' I , � � CITY OF DIAMOND BAR .� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � -w 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS ��^�'� B ILDING PERMTr APPLICATION � � FIRMLY o DDRIESS v��D� � � � DATE CATION S �� NUMB R �� #/C V'�1��J � ISSUE , TYPE `� � OCC APN LOT TRACT , � DATE CONST. GROUP g OWNER , " ADDRESS ZONING SE'TBACKS Z CITY � ZI TE,p LFC,/ FRONT� " - RW ❑ g APPLICANT TEL�� ?47 � REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE ❑ � ADDRESS � CITY ZI � TEL PROPOSED USE B ARCH/ENG/ � DESIGNER S � SOG- , , NO.DWE�. NO. NO. � ADDRESS - UNITS STORIES BEDROOMS � CITY ZI�TEL�'i//C�11 Ci J v� DESCRIPTION SQ.FT. ACTOR PSF ADJ.ARE LUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM I O � I HER�Y AFFlRM UNDER PBJALTV OF PERRIRV THAT I AM IXEMPT FROM 7HE CONTMCTORS LI- G8f89B/CBfPOR O I W CENSEUWFORTHEFOLLOWPIOREASOH(SEC.7031.6BUSINESSANDPROFESSIONSCODEMIVGTVOR (n C..7 COUNTYNT9(71qEpUIRE3APERMfT7000NS7HUCT,AL7ER.WPROVE,DEAqLISH,ORRE7/JRANVSTAUG W Z TURE.PR10R TO 1T9 IS9UANCE,AL50 REWIHES THE MPLICANT FOH SUCH PERMIT TO FIIE A 51(iNED PatlO/DBCk �� STA7EMENT THAT HE OR SHE IS LICENSED VURSUMlT TO THE PROVISIONS OF hiE CONiRAC70A5 U- w � CENSE UW(CNAPTER Y(COMMENCIN(i WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO- � POOUSpa � � FESSIONS COOE)OR THAT HE OR SHE IS E%EMPT 7HEREFROM AND T/E BAS1S f-0R THE ALLEOED EXEMP- TION.ANYVIOLATIONOFSECTION7031.68VANVMPLICMlTFORAPERMITSU&IECTS7HEAPPLICANTTO Z Re-Root � A CML PENALTY OF NOT MORE TNAN FNE HUNDRED OOILARS(fbao).): _ � ❑I,ASONR�EROFTHEPROPER7Y,ORMVEMPLOVEESWITHWAOESASTHEIHSOLECOMPENSATION, 0 COrtITBfCIBI -� YALL DO 7HE WORIC�ND THE STRUCNRE IS NOT INTENDm OR OFFERED FOH SALE(SEC.70u,BUSF J � NE59 AND PqOFE5510N5 CODE THE CONTAACTORS LICEHSE UW DOES NOT APPLY TO AN OWNER OF � � O PROPEATYVAIOBURDSORIMPROVESTHEREON,ANDNh10DOES5Up1WORKHIMSELFORHERSELFOR m � � 7YIHOUO/1 HIS OR HER ONM EMPLOVEES,PROVIDm THAT SUGi IMPROVEMENT9 ARE NOT WTENDED OR � � OFFERm W R SALE IF,F10WEVER 71�E BU0.DIN0 OR IMPROVEMBfT IS SOLD WITHIN oNE YEAR OF COMPIE- �TION,THE OWHERAUILDEH MALL HAVE THE BURDEN OF PROVW�THAT HE OH SHE DID NOT BUILD Ofi �O � WPROVE FOR THE PURP0.SE OF 9ALE). � v � � ❑1,hSOWNER OF TME PROPERTV,AM EXCLUSNELV CONTRACTINO WffH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC.70/1,BUSINESS AND PROFESSIONS CODE THE CONTMCTOqS LI- V8IU9lI0fl ADJ.AREA C@/SE UW DOES NOTMPLV TO AN OMMER OF A PROPERTY WFiO BUpDS OR IMPROVES THEREON,M1D � WFqCONTAACTSFORSUCHVR0.IECTSW17H11CONTRACTOR(5)LICENSEDPURSUANTTOTHECONTMG pUANTITY DESCRIPTION FEE � TORS LICQISE UW.). � Q ❑1 AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON U 3 � 2 �. ,l' . DATE OWNER � � LICENSED CONTRACTORS DECLARATION W �` Q V CC I HEqEBY AFFIRM UNDER PENALTY OF PEiLIURY THAT I AM UCENSED UNDER PROVI910NS OF CHAPTER � � d Y(COYMENCPIO N7TT/SECTION 7000)OF DNISION J OF THE BUSINE55 M!D PROFESSIONS COOE,AND Z � � X YY IICENSE IS IN FUIL fORCE EFFECT. m LLJ Q � � LICENSE CIASS LIC.NO. � J � �nre� coriraacToa a � WORKERS'COMPENSATION DECLARATION � � . � I HEREp/y PFFlRM UNDER PENALTY OF PERIUfiY ONE OF THE FOLLOWINO DECURATIONS: Z ,��!'yA . , i /J J/ Q 7/ f�fG � �IHAVEANDWILIMIJNTAINACERTIFICATEOFCANSENTTOSELF-INSUflEFORVKIRNFRS' _ , !1('\ Q COMPENSATION,AS PROVIDED BV SECTION 3�o00F THE LABOR CODE,FOR THE PERFORAIANCE W V�J Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � - 1 HAVE AND VALL MNNTNN WORKERS'COMPENSATION INSURANCE,AS HEOUIRED BV SECTION Q 370o OF 7HE LABOR ODDE,FOH iHE PERFORMANCE OF THE WOfU(FOR WHICH THIS PERMIT IS ISSUED.MV KERS'�Q,OMPE�SATIONINSUR/WC CARRIERANDPOLICV MBERARE CONSTRUCTION jCAFiRIER G S- PL4N REVIEW 0 �cY Nu►�eER � � ELECTRIC � ��r+orsemiatFrIDacnEa�rsFoqor��a�nt�Enpalqas�siroloq�ss} PLUMBING �.j\ � Z I CERTIFY THAT P!THE PERF-0RMANCE OF THE WORK FOR WHICH THIS PERMI715 ISSUED,I MECHANICAL W � SHALL NOT EMPLOY ANV PERSON Ml ANY MANNER SO AS TO BECOME SU&lEC7 TO THE (� WORKERS'COMPENSATION UWS OF CALIFORNII�AND AOHEE THAT IF I SHOULD BECOME INSPECTION FEE � SU&IECT TO THE M/ORNERS'COMPENSATqN PROVISIONS OF SECTION 370o OF TME LABOR S CODE.�SHALL FOR7HWITH CAM7LV WITH e cqovisions. ISSUANCE OO•O I � �p DATE:��-4/APPLICANL /�� -SMIP 2_ � WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAQE IS UNUWFUL,AND SHALL BE ENERGY P/C � � SU&IECTANEMPLOYERTOCAIMWALPENAL7IESAN�CIVILFINESUP700NEHUNDREDTFfOUSAND ENERGYPERMIT � � DOLLARS(5100,000).IN ADDITION TO THE COST OF COMPENSATKKJ,DAMAOES AS PHOVIDEO f-0R IN �/ � sECT10Na7oeOFTHELA80RCODE.INiERE57,ANDATTORNEI"SFEES. qE7ENTIONFEE: �\L� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT hIERE IS A CONSTRUCTION LENDWG AOENCV FOR THE PERFORMANCE OF 7HE WOPK FOR 7H15 PERMfT IS SSUED(SEC.70Y7,CIV.C.). � Z w /l/''oA/r� �v/T� . � LENDERS NM/E 1— LENDER'SADDRE55 � ICERTIF`/7TIATIHAVEHFIDTIIISAPPLICATIONANDSTATETHATTHEABOVEMFORMATIONISCORRECT. TOTALFEES � ) a�� w 1 AGREE TO CAMPLV WITH ALL CRV M1D COUNTV ORDINMICES AND STATE LAWS RELATINO TO BUILOINO � CONSTRUCTION,AND HEREBV AUT/10RRE flEPRESEMATNES OF THIS COUNTY TO ENTER UPON THE ' ZABOVE-MEMKINED PROPERTV FOfl W Ecrar�vuavosEs. COMMENTS � � 0 J I = Q PERMITTE NP1dE(PRI � � �/• � SIO OF PERMfTTE DATE AECPL NO. PAID BY � WWDATION � WHITE—Department Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—ApplicanPs Copy �O�Y �� U�f��'D��9 ��ff� . � � 6��s6��CT'6�� &�� :;,�":.�(��u�n}(;f�' � � D�� -i� �" � ' _t� �°-�i'. �� , p a p ,�. � �o ' �� _.�{ s:6VJ�' SET BACK . FLOOR�lOIST - , • FTGS/FORMS/STEEL � � ` �',,,��- HA REQMTS ELECTRIC GROUND „4z�_� /� UNDER FLOOR DUCT � GFiOUND PWMB(!VG _ -("J ,. .��-�-r"" UNDER�•FLOOR.CUMDUIT SLAB GRADE FIREPLACE•�F(7UNDF�TION ' 7EMP POWER FIREPLACE BOND BEAM � WATER SERVICE MIQ HT. BOND BEAM • RnOF SHEATHlNG 8 FT. BOND BEAM � FRAMINGNENTILtATiON FWAL BOND BEAM ROdF COVF_R PRE-GRAdING . . ROUGH H'EATING BE�VCHlNG. . • � ` ' . S . ROUGH ELECTRIC " ROUGH GRADING � ROUGH PLUIVIBIiVG . ' FINISH GFiADING SHOWERRUB TEST � POOL ELECTRIC EXT. LATHlSIDING ��„`'�-j -cA, POOL FENCING WALL INSULATION '' ' L FINAL CEiLlNG INSULATION �,,,. � �_p OFF SITE IMPS. - DRYWALL�JAILING p.� � �' , . �; � -DEDICATIONS , � �~ SEWER ' ,ti FINAL ENG. SEPTIC TANK ,��• . •LANDSCAPE/IRRIG. SEEt PiT/LL. ,� � � ON SlTE IMPS. GAS AIFt TEST ,.�� FlNAL ZONlNG ��FINAL CONST. � • ,,�! ,�� +�� IRE nEPT. FINAL FIN.4L HERTING � - HEALTH DFPT. FINAL �i�iAL-ELECTFtIC p �.:t� . `�V. FEES PAID - ; ',=f;-i.�L'PL'Ui�hBINC�� ?�-�j•-�b - , � ENERGY ^_. — - ,I ;_.__.. �• ' , o � _� �.'� — �---- _ � � . ' t �, �•, ;�. , _ , , . . -- ��G�1�'Ii1��lT� � � - I''�,� �I �. �.r. .. � ` � .�—�_--- '" � , ' . . c SEPTIC T/�NK'S{ZE SEEf' PITIU SIZE a ;�,:.� �� r �; ,��s� _ _, � ,, ro �> . ---_ �' � ��_ ` y ,� , �; �: � ,� r � � . ,,,�� ,� � ::> ��:��. . � �: �o_ ;,:'1JL/ ��" dz-��. � .._@� . . , . _ . 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