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Home My WebLink About10817CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT ..• C 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 '""' BUILDING PERMIT APPLICATION TE ADDRIESS 2 3 4 c- /i 1 24ELf IEE AP. APN LOT TRACT OWNER A4w-rkn kutiTYrQRo ADDRESS 39 W1LLOWj'A'V0X 6 CITY Pe,,M00A ZIP 9174C TEL. APPLICANT 4,,,.d,,Q/tq-i2e&o/riWjYid4 TIE L - CONTRACTOR CE. /Air . ADDRESS r��Yf S'" Er44aYf��YE . CITY _ N✓6i�,BN�7/6L. ZIP , _Y77,9 TELI66Z,03.72-91�.� ARCFVENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESSAND PROFESSIONS CODE: ANY CITYOR COUNTY WHICH REQUIRESAPERMITTO CONSTRUCT, ALTER, IMPROVE, DEMOLISH,OR REPAIR ANY STRUC. TURE. PRIOR TO ITS ISSUANCE. ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS 0 - CENSE LAW (CHAPTER I (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO. FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEOAP- TION. ANY VIOLATION OF SECTION 7031.5 BYANY APPLICANT FOR A PERMIT SUSUECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (8500).): ❑ 1, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES ASTHEIR SOLE COMPENSATION. WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEG 7044, BUSI- NESS AND PROFESSIONS CODE. THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WOK) 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 BUILDINGOR IMPROVEMENT IS SOLD WITHINONE YEAR OFCOMPLE- TION. THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). C I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U- CENSE LAW DOES NOTAPPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHDCONTRACTS FOR SUCH PROJECTS WITHACONTRACTOR(S) LICENSED PURSUANT TOTHE ODNTRSC- TORS LICENSE LAW.). ❑ I AM EXEMPTUNDER SEC. B. A P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURYTHAT IAM LICENSED UNDER PROVISIONS OF CHAPTER I (COMMENCING WITH SECTION 7000) OF DIVISION 3OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULLFORCE AND EFFECT. LICENSE CLASS C.20 UC. N0. 4 DATE 44 CONTRACTD WORKERS' COMPENSATION C RATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER "_ POLICY NUMBER (THIS SECTION NEEDNOT BECOMPLIFTED OFTFE PERMIT IS FOR ONE HJJDFED DOLLARS (SI 00 Rl $1 I CERTIFY THAT N ERMIT THE PERFORMANCE OF THE WORK FOR WHICH THIS PIA IS I D, I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO SECOME SUBJECT TOITHE WORKERS' COMPENSATION U1W5 OF CALIFORNIA, AND AGREE THAT IF I SHOUID BECOME SUBJECTTO THE WORKERS' COMPENSATION PROVISO SNS OF SECTION 3700 OF THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH TO10 ' P ISIONS. DATE: /r-_ 47 APPLI WARNING: FAILURE TO SECURE WORKERS' ENSATION NCUNLAWFUL, ANO SHALLBE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES CNIL FINESU GONE HUNDRED THOUSAND DOLLARS (8100.000), IN ADDITION TO THE COST OF CO SAT AM. S AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBYAFFIRM UNDER PENALTYOF PERJURY THAT THERE IS ACONSTRUCTION LENONG AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 5087, CIV. C.). LENDER'S NAME LENDER'S ADDRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THATTHE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTONED PROPERTY FOR INSPECTION PURPOSES. IF. a. A11t- &,V.41r/o411Af 5 /N#C. ��a ena.✓ <JeN��y PERMITTEE NAME (PRINT) SIGNATURE OF T TE / b Q 7 PRESS FIRMLY APPLICATION PERMIT Jj(j P/C DATE & -3 — 97 NUMBER v� # ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDEISIDE STREET RW ❑ SIDE ❑ PROPOSED USE t yA n n NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFRIADD/REM U) Garapa/Carport W PatkdDeck LL POOUSpa Z Re -Roof ' Commercial M 0 CT 0 .11997 Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J Q U H U Ul 2 an J a a k c 6sproBg ww Mly-Al ;u Roo* X -X A";r STFiefS. CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE ilrz: SMTP ENERGY PIC ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES COMMENTS RECPT NO. PAID BY VALIDATION wnI I t—yABpanment copy, YbLLOW--••Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD 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 FRAMING/VENTILIATION 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 E° : ' '" 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. FIRE DEPT. FINAL FINAL HEATING /r HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY OMNQENTS COMMENTS'- SEPTIC TANK SIZE SEPTIC SEEP PIT/U SIZE