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Home My WebLink About17342 i / �� CITY OF DIAMOND BAR � �� DEPARTIv1ENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive i�� (909)860-3195 Fax(909)861-3117 PRESS �%»�' � BUILDING PERMIT APPLICATION FIRMLY � JOBSITE /� l / ' APPLICATION � � PERMIT I�� P/C ¢ ADDRESS_ �� Q� �, ^��►+� �-� � � ` ]�'�� J�� o DATE _� - NUMBER ��_L�LLL_ °� APN LOT TRA T __ ISSUE TYPE OCC p OWNER Pul�te Homes DATE CONST. GROUP o ADDRESS 184i�1 Von_ Karman Ste 2�0 ZONING SETBACKS z cirr I rvine ziP 92612rE�. 9497974400 FRONT RW ❑ � APPLICANT _ TEL.__. REAR � z SIDE/SIDE STREET RW ❑ ¢ CONTRACTOR_ SAME SIDE � ADDRESS � CITY ZIP TEL. PROPOSED USE (� ;� 0 w ARCWENG/ �z DESIGNER HOV�e D2S_1g�fl NO.DWEL. NO. NO. d ADDRESS �1� @N wpor�Z,en er P. � CITY NLW_��B(�1p 9266QTEL. 9l497GOOH�2 UNITS STORIES BEDROOMS � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/AOD/REM O � I HEREBV AFFIRM UMDER PENALTV OF PERJUHV THAT I AM E%EMPT FROM THE CONTRACTORS LI- G8f0CJB/CBfPOh W CENSEL4WFOPTHEFOLLOWINGREASON(SEC.]031.SBUSMESSA�DPflOFE5510N5CODE:ANYGTVOR (n U COUNTYNhiICHRE�UIRE£APERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANY57RUG wTURE.PRIOR 70 ITS ISSU4NCE,PLSO REOUIRES TME APPLICANT FOR SUCH PERMIT TO FIIE A SIGNED w Patio/Deck � STATEMENT TMAT HE OR:iHE IS LICENSED PURSUANT TO'HE PROVISIONS OF THE CONTRACTORS U- � CENSE LAW(CMAPTER 9�COMMENCING WITH SECTION 7000)OF�IVISION 30F THE BUSINESSAND PRO- � POOI/Sp3 � FESSIONSCADE)ORTHATHEOflSHEISEXEMPTTHEREFROMANDTHEBA515FORTHEALLEGEDE%EMP� (� U TION.ANVVIOLATIONOFSECTION7031.SBYANYA?PLICANTFORAPERMITSU&IECTS?NEAPPIICANTTO Z RB-R001 A CIVIL PENALTV OF NOT AIORE THAN FIVE Hl1N�RED�OLLARS(SSa�).)� � f71.A50WNEROFTHEPROPERN,ORMVEMGLOVEESWITHWAGESASTHEIR50LECOMPENSATION, � COff1R18fC18I Z Wlll DO THE WORK,AND iHE STRUCTUR'e IS NO'INTENDED OR OFFEREO FOFl SALE(SEC.70a4,BU51� _J � NESS rWD PROFESSIONS A�E:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � — PROPERTYWHOBUILDSORIMPROVESTHEFEON,ANDWHODOESSUGHWORKHIMSELFORHERSELFOR W THROU6HHISORNEROWNEMPLOYEES,PqOVI�EOTHATSVGMIMPROVEMENTSARENOTINTENDE�OR m � OFFERE�FORSPLE.IF,HO�NEVER,THEBUILDINGORIMPROVEMENTISSOIDWITHINONEYEAROFCOMPLE� Z TION,THE OWNEF-9UIL�ER WILL HAVE THE BURDEN OF PROVING TNAT HE OR SHE DI�NOT BUILD OR � IMPROVE FOR 7HE PURPOSE OF SAIE). . w ❑I,ASOWNEROFTHEPROPERTV,AMEXCLUSIVELYCONTRACTINGWITHLICENSE�CONT(7ACTORS � TO CANSTRUCT THE PRQIECT(SEC.7064.BUSINESS AND PROFESSIONS CO�E:THE CONTRACTORS LI- V8IU2110f1 ADJ.AREA W CENSELAWDOESNOTAPVLV70ANOWNEROFAVROPERTVWHOBUILDSORIMPROVESTHEREON,AND = NMOCANTRACTSFORSUCHPqOJECTSWITHACONTRACTOR(5)LICENSEDPUHSUANTTOTHECONTRAP FEE � roasucENSEuw.�. QUANTITY DESCRIPTION � ❑I AM EXEMPT UNDE�.R SEG B.8 P.C.FOR THIS FEASON Q ?j U � DATE OWNER 1– Z U � LICENSED CONTRACTORS DECLARATION W ¢ � I HEREBY AFFIqM UNDER FENALTY OF PERJURV THAi I AM LICENSED UNDER PROVISIONS OF CHAP7ER � d 9(COMMENdNG WITH SECTIIXJ 7000)OF DIVISION 30F THE BUSINESSA.YD PROFESSIONS GOOE.AN� Z LX MY LICENSE IS IN FULL FORCE AND EFFEGT m 4� .S O � LICENSECLASS �1 ��.No_ 517593 � V DATE_�� 9/30/O 1 CONTRACiOR Pu I te a w � WORKERS'COMPENSATION DECLARATION a � I HEREBY AFFIRM UNDER CENALTY OF PERJUFV ONE OFTHE FOLLOWING DECLARATIONS� z � _I HAVEAND WILL MAINTAIN ACERT.FICATE OF CONSEN7T0 SELF-INSURE FOR WORKEFS' a 2 COMPENSATION,AS PROV'DED BV SECTION 3�0o OF THE LABOR CODE,FOR THE PERFOqMANCE U OF THE WORK FOFI WHIGH THIS PERMIT IS ISSUEO. w � � w I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOIIIRED 8v SECTION Q3]DOOFTHELABO3COOE,FORTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBERARE CONSTRUCTION j CARRIER Pacific Emp Ins�7. CO. PLANREVIEW Z POLICV NUMBER_ W O R L4 3 D��H/A ELECTRIC Q � (i}iISSECiIONNEELNOTBE�AREfEDOFTNEPERMlTISFORONEHUI�REDDIXI.AiLS(5100;ORLESS). PLUMBING � .SO W Z I CERTIFY THAT IN IHE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUE�,I MECHANICAL C�J SHALLNOTEMP�CVANYPERSONINANYMlWNEFSOASTOBECOMESUBJEGTTOTHE [n WORKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIfISMOULDBECOME INSPECTIONFEE ? SUBJECT TO THE�JORKERS'COMPENSATION PROVISIONS OF SECTION 31000F THE LABOR COOE,I SHALL FOfiTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE p DATE: S–�C�_l1p�PLICANT Pulte Homes SMIP W J WFRNING:FAILVRE TO SEGVflE WORKERS'COMPENSFTION GOVEHAGE IS UNLAWFUL,AND SHALL BE ENERGY P!C J � SV9JEGTANEMPLOYERTOCRIMINALPENAlTIESANDCIVILFINESUPTOONEHUNDRE�THOUSAND ENERGYPERMIT DOLLARS�S10o.o00).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3108 OF THE LABOR CODE,INTEREST,AN�ATTORNFV'S FEES. � RETENTION FEE: w —__ O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNOER FENALTV OF PERJURV THAT THERE IS ACONSTRUCTION�ENOING AGENCY � � FORTHE PERFOFMANCE OFTHE WORK FOR WHICH THIS PERMI�IS ISSUED(SEL.3o97,CIV CJ. �� Z j`i' None (Pulte) LEN�ER'S NAME � F– LEN[lER'SAD�RE55 � � IGEFiIFVTHATIHAVERE/.DTHISAPPLICATIONANDSTATET4ATTHEABOVEINFORMATIONISCORRECT TOTAL FEES VV.SO w I AGREE TO COMPLY WITH 4LLCITY AND COUNTV ORDINANCESAND STATE LAWS RELATING TO BUILDING � CONSTRUCTION,AND HER=OVAUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UGON THE � ABOVE�MENTIONED PROPI:PTY FOF INSPECTION PURPOSES. Z COMMENTS 0 J � m PERMITTEE NAME(PRINT) Q � ', � SIGNATUFEOFPERMITTEE DATE � - '� � RECPT.NO. . J PAID BY � VALIDATION WHITE—DepaRment Gopy,YELLOW—Finance Copy,PINK—Assessor Copy,GOL ENROD—File Copy.GFEEN—ApplicanPs Copy a mrr- ��; �� ;�i�a� '; �� ""b,�� a �� i �, �g��i yi�. � ��"� g��' � �� . a.,= . . . . . . , �°��i��i� �' ' , 9'�sf�� /�� , � _ _ _ ... .� a ... __ . . . . ... .. . .. .. .... ....... ...... __. . . �' J ' ., .. . .. . .... ... ��an �� r�'�v ��`.,' � —a G 4 . .. .. . . ... . . ... _ ... �i'�,�ti��'i��'��t� �� .. E' i°� uq i . �a ' � � '� �� : - ... . . � � � i� r � . ��s;��i"€ �� i i �' .�u..� E '�� >: .. ... . . . .. .. ... _. zai„- n� s�� ¢Ap �;4m� , � 7"I�,� �3�' 'e'�� J .,,.;;�'`-�t� I _..... � , . ... ... . .. . .. ..... . ..... ... ... ,, .a . ._. .. 4 g r s � ��" . . ._ .. '. � n I i � � ' y t� `@' .a ��:r° �' " . .. . . ... .. .... . .. . ... ._. . .. .. .... _. . .. '. x m ��. � � � + s��' ' � �,,dy4 i��,��i '.! ��,��:.g�h�� s-'' : ...[:. ... � .`. . '- s. -� .... . ._. ... .... . .. . .._ . . .. . _..... . _._ ..... ... . .. DIAMOND JOBSITE ADDRESS APN LOT TRA T OWNER Pulte Homes ADDRESS 18401 Von Karman Ste 000 CITY Irvine zip 92612rEL. 9497974400 APPLICANT TEL. CONTRACTOR_SAME ADDRESS CITY ZIP TEL. ARCWENG/ DESIGNER Hove Design ADDRESS 2TI F Newport Center Dr. CITY Newport R p 92660TEL.9497600812 OWNER-BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE:ANY CITY OR COUNTY WHICH REQUIRES A PERMITTO CONSTRUCT,ALTER. IMPROVE, DEMOLISH,OR REPAIR ANY STRUC- TURE. PRK)R TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PRO. FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION.ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS($500).): ^ I,AS OWNER OF TH E PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044,BUSK NESS AND PROFESSIONS :ODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS 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-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ^ I.AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTlNG WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044, BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON.AND WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S)LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). ^ I AM EXEMPT UNDER SEC. B. &P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND MY LICENSE IS IN FULL FORCE AND EFFECT LICENSE CLASS A LIC. NO 517593 DATE xp 9130/O1 CONTRACTOR Pulte WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS' -1 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 FOFI 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 Emp In CARRIER Pacific s.Co. r� e POLICYNUMBER-WORL4301187A (THIS SECTION NEEC NOT BE COMPLETED OF THE PERMIT IS FOR ONE HUNDRED DOLLARS($100)OR LESS). IC E RTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT 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 LABOR CODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: 5-10-(PLICANT: Pulte Homes WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 LABOR CODE,INTEREST,AND ATTORNEY'S FEES. CONSTRUCTlON LENDING AGENCY I HEREBY AFFIRM UNDER FENALTY OF PERJURY 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 I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT I AGREE TO COMPLY WITH 4LL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HER-BY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE. MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMITTEE NAME(PRINT) SIGNATURE OF PERMITTEE: DATE CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION PRESS FIRMLY APPLICATION PERMIT 1 ; \P/C LICATION 1 - DAT NUMBER 3 q t7y� ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ^ REAR ^ SIDE/SIDE STREET RW ^ SIDE ^ PROPOSED USE (r 4rCA_V N0. DWEL. N0. N0. UNITS STORIES BEDROOMS DESCRIPTION S0. FT. FACTOR PSF ADJ.AREA/VALUATION SFR/ADD/REM Garage/Carport co - W Patio/Deck LL PooL/Spa 0 Z Re-Roof 9 Commercial 5 Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J U U W W (.7 Z 41.50 -J Z 2 0 W CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING 41.50 MECHANICAL INSPECTION FEE ISSUANCE ' SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES 66.50 COMMENTS RECPT N0. ' PAID BY VALIDATION WHITE-Department Copy,YELLOW-Finance Copy, PIN