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Home My WebLink About17336 �x��, �� --� �� CITY OF DIAMOND BAR � � DEPARTMENT OF CONIIvtUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive ' '""� (909)860-3195 Fax(909)861-3117 PRESS "-.��' BUILDING PERMIT APPLICATION FIRMLY � JOBSITE �� "�' APPLICATION PERMIT �I P/C o ADDRESS ��}'` � r�. �' �'�-rr � 1 DATE_ � '� �� NUMBER `� p o ISSUE TYPE OCC I °^ APN LOT � TRACT_.y � _ DATE CONST. GROUP p OWNER Pl.l�t� Homes `L ADDRESS 1840� VOII Karman St@ Z�� ZONING SETBACKS Z CITY �YVIIIP ziP 92612rE�. 9497974400 FRONT RW ❑ � APPUCANT _ TEL. REAR ❑ o SIDElSIDE STREET RW ❑ ¢ CONTRACTOR_ SAME SIDE ❑ � ADDRESS PROPOSED USE �_ � CITY ZIP TEL _ 0 w ARCHJENG/ z DESIGNERHOV@ Desi ►1 NO.DWEL. NO. NO. a ADDRESS Z40 ewaort en 2Y f". UNITS STORIES BEDROOMS � C�Tv NPwnnrt RG#tp q76&OTE�. 9497600812 � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � O OWNER-BUILDER DECLARATION SFR/ADD/REM � I HEREBV AFFIRM UNDER PENALTY OF PEHJURV THAT I AM EXEMPT FROM THE CONTRACTOflS LI- � Garage/Carport W GENSELAWFORTHEFOLLOWINGREASON�SEC.I031.SBUSINESSANOPROFESSIONSCODE:ANYGITYOR U CWNTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMVROVE,DEMOLISH,ORREPAIRANYSTRUG W PatIO/DBCI( Z TURE.PRIOfl TO ITS ISSUANCE,ALSO REdUIFES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNEJ w W STATEMENT THAT HE OR SHE IS LICENSED PUR5UANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHAPTER 9(COMA/ENCING WITH SECTION 7000)OF DIVISION 9 OF THE BUSINESS AND Pft0- LL' POOUSP2 � FESSIONSCOOE�ORTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGE7EXEIAP- � � TION.ANYVIOLATIONOFSE�:CTION7031.5BYANVAGPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z R2-ROOf � ACIVILPENALTVOFNOTMOpE7HANFNEHUNDREDDOLLARS(S50o;�.): O ❑I,ASOYMEROFTHE�.PROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, ❑ GOfIlf118fCIflI Z WILL DO THE WORK,AN�l HE STRUCTURE IS NOT INTEN�ED OR OFFEflED FOR SALE(SEG.�ooa,BU51- J NE55 AND PROFESSIONS CODE:THE CON'RACTOflS LIGENSE LAW OOES NOT APPLY TO AN OWNER OF � PROPERTYMhiOBUILD50RIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHEflSELFOR m � THROUGHHISORHEqOWNEMPLOYEES,PqOVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR WQ OFFEREDFORSALE.IF,HOWEVERTHEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAFOFCAMPLE- Z TION,THE OWNER�BUILDEN WILL HAVE THE BUR�EN OF PROVING THAT HE OR SHE�I�NOT BUILD OR � IMPROVE FOR THE PURPO!:E OF SALE). ❑I,AS OWNER OF THI_PROPERTV,AM E%CLUSIVEIY CONiRACTING WITH LICENSED CONTRACTORS � TO CANSTRUCT THE PRQIECT(SEC.]044,BUSINE55 ANO PROFESSIONS CODE THE CONTPACTOFS LI- VdIU8SI0f1 A�J.AREA W GENSEUWDOESNOTRPF'LYTOAIJOWNEROFAPROPENTVWHOBUILOSORIMPROVESTHEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITMAGONTRqCTOR(5)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE TORS LICENSE LAW.). � Q �IAM E%EMPTUNDER SEC._ B.8 P.C.FORTHIS REASON � � � � �ATE OWNER F Z <") W � LICENSED CONTRACTORS DECLARATION w ¢ CL IHEflEBYAFFlRMUN�ERPENALTYOFPERJURYTHATIAMLI�ENSEDUNDERPROVI510N50FGHAPTER � d 9(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESSAND PFOFESSIONS COOE,nN� 1 X MY LICENSE IS IN FULL FORCEAND EFFECT m (1� .5O L1J � LICENSECLASS A ��.Na_ 517593 � V DATE� 9/3(1/01 CqVTRAGTOR Pu I te a w � WORKEFS'COMPENSATION DECLARATION � � a � U � I HEREBY AFFIRM UNDER PENALN OF PERJl1FV ONE OFTHE FOLLOWING DECLARATIONS: Z Q 0 I HAYE AND WILL MAINTAIN A CERTIFICATE OF CONSENT i0 SELFINSURE FOR WORKERS' _ CAMPENSATION,ASPqOVIDE�BVSEGTION3IaoOFTHELABORCODE,FORTHEPERFORMANCE U ¢ OF THE WORK FOfI WHICH THIS PERMIT IS ISSUED. � � w I HAYE AND WILL NAMTAIN WOFKERS'COMPENSATION INSURANCE,AS REOLIIRFD BV SECTION Q 37ooOFTHELABORCODE,FORTNEPERFORMANCEO�THEWORKFOFWHICHTHISPERMITIS ISSUED.MY WORKERS'GOMPENSATION INSURANCE CAARIER AN�POLICY NUMBER ARE�. CONSTRUCTION � oARR,ER PaCifiC Em1, p Ins. Co. PLANREVIEW z POLIGVNUMBER. W�RLY�O��R7A ELECTRIC ¢ (fHISSECTKKJNEQ�NOTBEOJMPIEfEDOFh1EPERMRISFOFONEHU�[N7EODOI.I.ARS�EIOC�ORLESS). PLUMBING � � W MECHANICAL Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHIGH THIS PERMI?IS ISSUED,I ('} SHALL NOT EMPLOY ANY PERSON IN ANY MANNEH 50 AS TO BEGOME SUBJECT TO THE � WORKERS'COMPI:NSATION LAWS OF CAUFORNIA,ANO AGREE TMAT IF I SHOUL�6ECOME INSPECTION FEE � SU&IECTTOTHEINORNERS'COMPENSATIOVPROVISIONSOFSECTION97ooOFTHELABOR • � CODE,i SHALL FOaTHWITN COMP'_Y WITH THOSE PROVISIONS. ISSUANCE � DATE: S—�V—IArPLICANT Pulte Homes $MIP .. . . .. Q ._ _-- __ ._.._.._..__..... .. ......._'___.. — W ENERGY P/C J WARNINGFAILURETOSE�Uf7EWOflKERS'COMPENSATIONCOVERAGEISUNLAWFUL,ANDSHALLBE J StJ&IECTANEMPLOVERTOCFIMWALPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOUSAND � DOLLARS(f1oD,om),IN AODITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN ENERGY PERMIT J SECTION31aBOFTHELAEORCODE,INTEREST,ANOATTORNEV'SfEES. RETENTIONFEE: � � CONSTRUGTION LENDING AGENCY pRE-ALT FEE: � I HEREBVAFFIRM UNDER�ENALTV OF PERJURY THATTHERE IS ACONSTRUCTION LENDING AGENCV � FOR THE PERFORMANCE�JFTHE WORK FOR WHICH THIS 7ERMIT IS ISSUED(SEC.3097,CIV.C.). Z � LENDER'SNAME NnnP �P�ItP� F— LENOER'SADDRESS � ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEWFORMATIONISCORRECi. TOTALFEES VV�SO w I AGREE TO COMPLV WITF��ALL CITV AND COUNTV OROINANCES AND STATE LAWS RELATING TC BUILDING � CONSTRUCTI�N,ANO HEREBV AUTHORIZ�REPRESENTA7WES OFTHIS COUNTV TO ENTER UPON THE ZABOVE-MENTIONEO 7ROVERTV FOR INSPECTION PURPOSES. GOMMENTS � J � m PEAMITTEE NAME(PRINTi Q � � SIGNA'UHE OF PERMITTFE DAT'c 7� = RECPT.NO. PAID BY V� VALIDATION �� ~ WHITE—De a�ment Go YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN—A licanfs Co P PY� PY, PY, PY� PP PY �'� � �+, �i T ��`-"��r�e.,�� °�"�", '� "�`�... , �.'�a �, _ �,�;u,�� _,��'��k�N �� `, N��" _ �ir� � � �,� �3 7: �';.�k 5 .. .. .. .. ... .. . .. ... .. . . .. . ... . , , . ... .. .. ...... . ..... .. .._ . a � . .:�, �r� ��, �"w,=_ .. . . . . � . ... . :. .'�, �ia E .__:, ... ..._ ... .. .. ..... .. .... . . . .. .... ..... .. . . . .... . ... . .. . .. . ._ . . ... ... . .. .._. . .._ .. .... .. _.. ...�.. �. . . . . . ... . . . . . .... . ....... .... . . . .._. ..._ . ._.. .� � � ' .... . . .. .... . . ... .. . .... .. : , � � +�� 4 Y e � .� a �i"� 9ltq .. .. . . . . .. .. _ .. ... . ._. . __. . ...._ . .... � ir �'" ��ct+'�rYis �� . — ,. „"' a .. i =;� � .. , . � � , . . . ._ . _ .. . .. .. .. . . ..._ _ .. _... . .... . __ .. � � ' , , r . . ... ... . .. . ... . . . . ._ .. . .... ... ._. . �. �-�, — 5�Y a� . _ �s� 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 JOBSITE } L)-\ te ADDRESS APN LOT TRACT__ OWNER Pulte Homes ADDRESS 18401 Von Karman Ste 200 CITY Irvine zIP 92612TE�.9497974400 APPLICANT TE�. CONTRACTOR_SAME ADDRESS CITY ZIP TE�. ARCH/ENG/ DESIGNER Hove Desi n ADDRESS 240 WD t Center Dr. CITY Newport Rc4tp C12166 TEL.9497600812 OWNER-BUI�DER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE�AW FOR THE FOL�OWING REASON(SEC.7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT.A�TER,IMPROVE, DEMO�ISH,OR REPAIR ANY STRUG 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 t_AW(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 DOL�ARS($500).): ^ I.AS OWNER OF THE PROPERTY.OR MY EMP�OYEES WITH WAGES AS THEIR SOLE COMPENSATION, WI�L DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SA�E(SEC. 7044, BUSI- NESS AND PROFESSIONS(:ODE:THE CONTRACTORS�ICENSE LAW DOES NOT APP�Y 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 PRO)ECTS WITH ACONTRACTOR(S)�ICENSED PURSUANT TO THE CONTRAC- TORS LICENSE�AW.). o I AM EXEMPT UNDER SEC. B.&P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DEC�ARATION I HEREBY AFFIRM UNDER PENA�TY OF PER7URY 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 LIC. NO. 517593 LICENSE CLASS Y� DATE Exp q/3n/Oi CONTRACTOR PuIto WORKERS'COMPENSATION DECLARA,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�ABOR 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 IJ�BOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER Pacific Emp Ins. Co. POLICY NUMBER W O R 43(111187A (THIS SECTION NEED NOT BE COMPLETED OF THE PERMIT IS FOR ONE HUNDRED DO�LARS($100)OR�ESS}. I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUB]ECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE 1NORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE�ABOR CODE,I SHALL FOSTHWITH COMP�Y WITH THOSE PROVISIONS. DATE: 5-1 0-WPLICANT: Pulte Homes WARNING FAILURE TO SETURE WORKERS'COMPENSATION COVERAGE IS UN�AWFU�,AND SHAL�BE SUBJECT AN EMPLOYER TO CRIMINA�PENALTIES AND CIVI�FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LAE.OR CODE,INTEREST.AND Al"I'ORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENA�TY OF PER]URY THAT THERE IS A CONSTRUCTION LENDING 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 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. AGREE TO COMPLY WIT)A�L CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMIITEE NAME(PRINT) SIGNATURE OF PERMITi'E:E DATE 0 W 0 0 w O 0 w w CO CO O W U W 0 U O CO 0 LL O W 0 w A CO CO M Z 0 W 0 J 0 0 W C.D CO APPLICATION PERMIT P/C 3� 1 1_y «cttt--- J # DATE NUMBER ISSUE TYPE OCC DATE CONST GROUP ZONING SETBACKS FRONT RW^ REAR^ SIDE/SIDE STREET RW^ SIDE^ PROPOSED USE N0. DWE�. N0. NO. UNITS STORIES BEDROOMS DESCRIPTION SQ. Ff. FACTOR PSF ADJ.AREANA�UATION SFR/ADD/REM CO Garage/Carport w Patio/Deck L�' Poo(ISpa 0 Z Re-Roof Commercial M Valuation AD.I.AREA QUANTITY DESCRIPTION FEE ] U cc U W J W z Z 41.50 J CL U Z 2 0 W CONSTRUCTION PLAN REVIEW E�ECTRIC P�UMBING MECHANICAL INSPECTION FEE 25 00 ISSUANCE SMIP ENERGY P/C ENER6Y PERMIT RETENTION FEE: PRE-ALT FEE: TOTA�FEES 66.50 COMMENTS RECPT NO. PAID BY V VA�IDATION WHITE-Department Copy,YE�LOW-Finance Copy, PINK-Assessor Copy,GO�DENROD-File Copy,GREEN-Applicant's Copy