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Home My WebLink About17337 (10) �x,P�,�-��1 Ci"I'Y OF DIAMOND BAR �'' DEPARTIv1ENT OF CC1h�UEtJNiTY&.DEVEL4PMENT SBRVICES l 21825 E.Copley Lhive (909)860-3195 Faac(909)861-3117 PRESS ` `%y�' BUILDINGFERMITAPPLICATION FIRMLY � JdBSITE . � � APPUCATION--��( '��PERMIT __/�J�P/C ADDRESS�� fi.��-��'��'�1��_��.��._�1 .,,,._� DATE � 4 _�1NUMBER � �i o� -- � —�r� ISSUE TYPE OOC APN LQT TRACT s _, DATE CONST. GROUP p OWNER PuCte Homes o ADDRESS T8403 Von Karman Ste 200 ZOtVING s�TBacxs � GITY !rvltl@ Z!P_.�,�3�EL 9��7�74�FOI} FRQNT __ RW C) � APPLICANT �, TEL. REAR �� SlDEi51QE BTREET RW _ L1 z � CONTRACTOR` SAME _ SIpE _ �i � ADDRESS -- pROPOSED USE� -�� Q GITY ZIP TEL. w ARCH/ENG/ z DESIGNER Have Desir�n NO.DWEL NO. NO. a ADpRESS -Z�FIf�I@W,f�dPt Center � UNITB STC}RtES BEDROQMS � ctTv Newnart B¢�t�26_B(kE�. 9►}976�Q$1 � " DESGRIPTi4N SQ.FT. FACTOR PSF ADJ.AREANALUATION p'� 4WNER-BUILDER DECLARATION SFFifADpfREM O I NEREBY AFFIHM UNDER PENAL7V Of PERJURV THAT I AM EXEMPT FROM TNE CONTRA�TORS LI- G8r8Qe/C3fPOIt W GENSEUWFORTNEFOLLOWINGREASON(SEC.7037.58USWESSAYOPROFESSIONSCOQE:ANYCITYQR (f) � COtXVTYWHICHREWiRESAPERMRTt5CaJ5TAVCT,AiTSR,RAFROVE,0EM�4i5t4,ORR'cPA7RANYSTRUG W P8110/DECI( w TURE,PRIOR TO ITS ISSW�NCE,AL50 REOUIRES iHE AppLICAhT FOR SUCH pERMl7 TO FILE A SIGNEU W 5TATEMEM THAT HE OR SHE!S LICENSED PURSUANT TO 7HE PROY4SIONS OF THE CONfRAC7URS!i� � CENSE lAW(CHAPTEP 9(<OMM6NqNG wITH SECTION 100oi oF DIVISH3N 3 Uf THE BUSMESS AN�PRO� � PDOUSpB FESSN7NSCODE�OFTHATtiEORSHEI9EXEMPTTHEREFROMpNDTHEBA5ISFORTHEALI.EGE�E%EMp� (3 � 71�NN.ANYYKKATIONOFSEGT74Y7431.56YANYAPFCtGANTFQRAFEF�IITSUBJEGTSTHERPPtlCANTTO z Re-Roof M A CIYIL PENALTY OF NOT M�RE THAN FIVE MUNDFiED OOLUIRS(f500�.�: � � C71,ASONMEAOFTHF:PROPERTY.ORMVEMPLOYEESWITNWAGESASiHFIRSOLEC4MPENSATION, � �Otiltii8tC1'dl WILL�7ME WOPoC,AMO tHE STFiUCTURE IS NOT INTEMOEO bR 6FFEREO FOR SAIE{SEC.7044,eU9i- J � NESS AND PROFESSIONS CODE:THE CON-RAC70pS LICENSE LAW UOES N6T APPLY TO AN OWNER OF � PROPERTV 4YHO BUIL0.5 4FI IMPROVES THEREON,AND WNO DOES SUCH WORK HIMSELF OH HEftSELF Oft C[ TNROUGH HIS OR HEROWN EAAPLOYEES,PROVIDED TiiAT St1CH�MPROVEMEN'SAqE NOT MTENDED OR m � OFFERFOFOqSALE.IF,HOWEVER,THEBUILDINGOFIMPROVEMENTIS50LDWITHINONEYEAROFCOMPLE� � TION,THE OWNER-BUtLDER WIU.HA4E THE BURDEN OF PA�YING THA7 HE QR SHE DID NOT BUIlO O% � IMPR4VEFOpTHEPVRPf?.�EOFSALE). W ❑I,AS4WNEROFTHI:PR6PERTY,AMEXGLU5IVELVCONTRACTINGWITHLICEN5EDCONTRACTORS � TO CAMSTRVCT TNE PROJGCT{SEG��Ad,BU5INESS AND PROFESSlQNS CODE:THE CONTRACTORS Li� Veit18ti0t1 ADJ.AREA W CENSELAWDOESNOTAPPLYTQANOWNEFpFApROPERTYWHOBUILDSORIMPRGIVESTNERE4N,ANp � WHOCONTRACTSFORSUC�IPRO.IECTSWITHACONTRACTOR(S�LlCF4SEDPURSUAN7TOTHECONTRAG- Q{�AM1lTITY DESCRIPTION FEE - Y TORS IiCENS€tAW.j. ... � ❑1 AM E%EMPT 11NbER SEC. ., .,,__B.&P C.FOft THIS flEA50N Q � —... � � � OA7E � OWNER F � � V w � �l�ENSED GOEVTRACTQftS DEGtAiiAz10N W "^C -- CC IMEREBYAFFIRMUNOERPI:NALTYOFPER�URYTHATIAMLICEN4EDUNDERPROVISIONSOGCHAPTER � j� $(COMMfNGM}G WITH SECTION TOGO}OF DIVi5iON 3 OF THE BUSINESS AND PROFESuiONS CODE,AND Z W MY LICENSE IS IN FULL FORCE AND EFFECT m C�� j#� .5fl � UCENSEC4ASS_ A /��(�*LIC.NO.�[�� i7ATE_�,R�J_3y_(SJ,.�3CONTRACTOR P(lI'tP. a �� W � WORKERS'GdMPENSATk4N DECLARATtON � Q cn U � 1 HEREBYAffIRM UNDER PENALTY Of PEftJURV 04J^OF iHE FOl.i.O'MNC�6ECF,ARATIONS: Z � I HAVE ANp WILL MAINTAIN A CENTIFICATE OF CONSENT Tp SELF-INSl1RE FOR WONKEPS' $ �CAMPEF75A710N,ASPR6VIDE08YSEC7I6N37oDOF7FtEtAeOACODE,FOfiTNEPERFORMANCC C3 � OF THE WORK FOR 1NHICH THiS PERMIT IS ISSUEp. � � � _IHAVEANDW�LLMA�MAINWOFNERS'COMPENSATIONINSURANCE,ASREOUIREDBVSECTION � a]oo OFTHE LAB4RCO0E,FOfl THE pERFORMANCE OF TME WORK FOR WHICH'NlS PEflMITIS FSSVED.lJY W6RKEI�S'CANFENSATION INSURANCE CAftPoEP AND P�LICY M1RIMBER ARE-. CONSTRUCTION . a �ARa,ER _ Pac�ipf�(iC{['y E� m)� p/� Inps, Co. Qu�HREview . ^ � POLIGVNUMBER�_�,�t[_�1L.,"73U��07A ELECTRIC ,,, -� 41 .5 0 d (MIS6ECT4NNEEbNOTBE�77h1Gt.ETEDOFTHEPEWr9TI5FOHIXJEHUWRE��01.L.AR5�5100)ORLESS), PLUMBING � Z t CEfl(IFY THAT 7N TNE PERFORMANCE OF THE WORK FOKt WH CH THI5 PERAIIT IS ISSUED,i MECHANICA(_ , („}' SHALLNOiEMPLpYANYPERSONINANYMANNFRSOASTOB6COME5�BJECTTOTHE �/j WORKERS'COMPENSATION LAWS OF CALIFOfiN1A,AND AGiiEE THAT IF i SH4ULD 6ECCMc lMSPECTIQN FEE � SUBlECTiOiHEWURKERS'COMIPENSATIpNPRO'fISiONSOFSECTiON3]00t7FTHEtABpR u_��— � COOE,I SHALL FdRTHWITH COMPLV WITH tHOSE PROV1510N5. �SSUANC.E „ � DATE:_, �-��!'-4lFPLICANT�. _P�...� I IVIT�eS SMIP o - W ENERGY PJC �,�j WAANING:FAILt1RE TO SECURE WORKERS'GOMPENSATqN COVERAGE IS UNLAWFUL,ANp SHALL BE - � SUBJECTAN EMPLL]YERTQ f.RIMINAL PENALTIES ANp CIVIL FWES UP TQ ONE HUNDRED THOUSAND ENERGY PEF{MIT � � [X1L.AftS{St0U,�0o}.!N AObi'"ION TOTtfE GOS7 OE COMPENSATIpN.OAMAGES AS PftpYiDED FORltt �� — J SECTION3�OBOfTHLLA60FlCOpE,iNT€qE5T,ANDATTOftNEY'5FEE5. RETENTIONFEE: � _. � CONSTRUCTION t ENDING AGENCV PRE•ALT FEE: O � !HEftEBY AFFIftM UNDeA PE21AlTV�F PERlUftY THAT THEftE IS ACO{JSTRUCTtON LENDING AGENGY a- FOii tHE PERFORMANCE OL THE WORK WR WMCH THiS PCRMIT IS ISSUE�(3EC.309�,CIV C.J. "—"�'— W �,^.,�` (� .} � IENDEFtS NhME�. '�y�C.t(�,.�....['U�Le, .. �.�. .. . h- �EMDER'SADORESS� _.,, �. ._ �� TOTALFEES � 1 CERTIFY�HAT 1 HAYE READ THIS APPLIC.AT1pN AND STAiE THAT THEABQYE MfQAMATiON IS CAftftfGT E/� 4 �AGREE TO COAAPI Y WI7N Al_CITV ANp COUNTv ORDtNANCES AND STATE IAWS RELA7ING TO BU�LOING 66�J V � CONSTRUCtI[}N,ANUHEREBYAUTHORIZEREPRES[NTATIVESOFTHISCOUNTYTOENTERUi'�N1NE � ABOYE-MENTIONE6 FP6?ER'fY FClR�NSPECiiON PURPOSES. COMMENTS,_,_.,,,,,_...._. . � � ,.� � .._ . .�._.. m PERMITTEE NAME(PRINT) Q ..__..__.._._ . � . {,n SIGNATUREOFPERMITiEE DASE z RECPT.Nd. <' PA��BY _ VALIDATiON � WHfTE-Department Copy,YELLQW-Finance Copy,PINK-Assessor Copy,64�DENRQC?-File Copy,GREEN-ApplicanYs Gopy ' � �b.'�+��"' �,u�.i�.�� "'F s �� .�� `'�•�t��' _ e � a,, @�� i�, 3�� m.��,.�5,�".. ... .� ._ , . ... . . . . , . �_ ��: .. .. _. _..._ ._. . . . .... . . .. .. .. . . .... . . .. �� .. ._ _ � , .. -n ,.�.w.. . . ._ .. . , ,, ! . .. _ ... . .. " � + ..�'' , _ ... .... _. , � _ i a ��w�t � � i �� 6 N� .. . . _ . _ . . . .. . . .�� a� �oy �t . � �. fi,��.,�� § r ,:_ �i 3�'§,�.d w-` .. ... . . . .... . .... .. . . . .. . . . .. . _.. ._. .. _. 5 8 ' 1 ��..� ti. .a+ 1, g " . . . � i . � ... ... .. ... . . ... . ..... .. .. �'_= 5 �l. a�La,.t ` . . .... . . . .. . . ... . , " s��,, � ��, �. .,� � �r �,n a�* ?��:� �m s;.� � -� . .. . . .. .. ... . ._ .. .. - .-. - y[ '��. ... .. . . .. .'' r - " r -! '"�� .. . . ... . . ._ . ..... .. . ... .. ... .. . .. -. - '.. � �; ._ �, .... i ': 1 % . "9's t 1� z-`�� .... � ' �z` ��96��i� „ � _ .� r . �r r p . «e.''� .e ,y v.�. . ... ... .. .. �— .. . . � DIAMOND DAR JOBSITE y G, ADDRESS V-v'�-kJ-) APN�OT TRACT OWNER Pulte Homes ADDRESS 18401 Von Karman Ste 200 CITY Irvine zIP 92612E�.9497974400 APPLICANT TE�. CONTRACTOR SAME ADDRESS CITY ZIP TE�. ARCH/ENG/ DESIGNER Hove Design ADDRESS 21U Newport n ter Dr. CITY Newport BOLD 97660E�.949760081 OWNER-BUI�DER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE t_AW FOR THE FO��OWING REASON(SEC.7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT,A�TER,IMPROVE, DEMOI.ISH,OR REPAIR ANY STRUC- TURE, PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APP�ICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRP,CTORS LI- CENSE IAW(CHAPTER 9(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 A�LEGED EXEMP. TION.ANY VIOLATION OF SECTION 7031.5 BY ANY APP�ICANT FOR A PERMIT SUBJECTS THE APP�ICANT TO A CIVIL PENA�TY OF NOT MORE THAN FIVE HUNDRED DO��ARS(5500).): ^I,AS OWNER OF THE: PROPERTY,OR MV EMP�OYEES WITH WAGES AS THEIR SO�E COMPENSATION, WI�L DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SAI.E(SEC. 7044, BUSI- NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE�AW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUI�DS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR 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 COMPLE- TION,THE OWNER-BUI�DER WIL�HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUI�D OR IMPROVE FOR THE PURPOSE OF SALE). ^I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTING WITH �ICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- CENSE IAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUI�DS OR IMPROVES THEREON,AND WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S) LICENSED PURSUANI�'0 THE CONTRAG TORS�ICENSE tAW.). ^I AM EXEMPT UNDER SEC. B.&P.0 FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DEC�ARATION I HEREBY AFFIRM UNDER PENA�TY OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND MY�ICENSE IS IN FUL�FORCE AND EFFECT. A LICENSE CLASS L(C. N0. 517593 DATEEX$9/3010 1 CONTRACTOR Pu I to WORKERS'COMPENSATION DECLARP,TION I HEREBY AFFIRM UNDER PENA�TY OF PER]URY ONE OF THE FO�LOWING DECLARATIONS: I HAVE AND WIL�MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' COMPENSATION.AS PROVIDED BY SECTION 3700 OF THE IABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WIL�MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION 3700 OF THE IABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: Emp Ins.Co. CARRIER Pacific N� POLICYNUMBER_WOR�4301187A {!-HIS SECTION NEED NOT BE COMPLETED OF THE PERMIT IS FOR ONE HUNDRED DO�LARS($100)OR LESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHAL�NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUB]ECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE tABOR CODE,I SHAL�FORTHWITH COMPLY WITH THOSE PROVISIONS. 5-1 0-QF D T T Pulte Homes A E: LICAN WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERP,GE IS UN�AWFUL,AND SHAL�BE SUBJECT AN EMPLOYER TO CRIMINA�PENALTIES AND CIVI�FINES UP TO ONE HUNDRED THOUSAND DOL�ARS($100,000),IN ADDI""ION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOFI CODE,INTEREST,AND Al"CORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENA�TY OF PERJURY THAT THERE IS ACONSTRUCTION �ENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC 3097,CIV.C.). LENDER'S NAME None(Pulte) LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH AL_CITY AND COUNTY ORDINANCES AND STATE�AWS RE(ATING TO BUI�DING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMIITEE NAME(PRINT) SIGNATURE OF PERMITfEE DATE CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVE�OPMENT SERVICES 21825 E.Copiey Drive (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION PRESS FIRM�Y APP�ICATION I PERMIT P/C V DATE NUMBER# ISSUE TYPE OCC DATE CONST GROUP ZONING SETBACKS FRONT RW^ REAR^ SIDE/SIDE STREET RW O SIDE^ PROPOSED USE-z-cA N0. DWE�. N0. NO. UNITS STORIES BEDROOMS DESCRIPTION SQ. Ff. FACTOR PSF AD7.AREAIVALUATION SFR/ADD/REM CI) GarageJCarport W Patio/Deck LL PooVSpa 0 Re-Roof Z Commercial 5 Valuation AD.I.AREA QUANTITY DESCRIPTION FEE ] Q U U W -] Z 41.50 J a Q U Z Q S U W CONSTRUCTION PLAN REVIEW E�ECTRIC PLUMBING 41.50 MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENER6Y PERMIT RETENTION FEE: PRE-ALT FEE: TOTA�FEES 66.50 COMMENTS RECPT NO, PAID BY VA�IDATION WHITE-Department Copy,YE�LOW-Finance Copy, PINK-Assessor Copy,GO�DENROD-File Copy,GREEN-Applicant's Copy