The URL can be used to link to this page

Home My WebLink About17044 CITY OF DIAMOND BAR ��I�� ^----��`--- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 1 21825 E.Copley Drive ��N 1� � - (909)860-3195 Fax(909)861-3117 PRESS ��'%y�� BUILDING PERMIT APPLICATION FIRMLY o DDRESS�O� S i �p�, R;LJe�2 IUV DATE CATION l�� NUMBER�� #/C � ISSUE TYPE OCC I APN LOT TRACT DATE CONST. GROUP p OWNER�. CDeDOV �1' o ADDRESS .51�_ �(,94 ZONING SETBACKS FRONT qyy ❑ Z CITY ZIP 1 TEL. ��i�'3�.2c� � o APPLICANT TEL. S DE/SIDE STREET RW ❑ z Q CONTRACTOR C R�f'6�M-C Rtly SIDE ❑ ADDRESS L��O M A-G � 'T � CITY��ptl� 691A�t ZIP Q�A�'I.� TEL .S3 4'2 �� PROPOSED USE o ARCH/ENG/ v �z DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I M1 E%EMPT FROM THE CONTRACTORS LI- Gdf8J0/CBfPOh W CENSELAWFORTHEFOLLOWINGPEASON(SEC.7031.SBUSINESSAN�PROFESSIONSCODE:ANYCITYOR (n C-� COUNTVWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIHANVSTRUC� � w TURE.PRIOR TO ITS ISSUANCE,ALSO REDUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STA7EMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CANTRACTORS LI� � � CENSE LAW(CHAPTER B(COMMENCING WI7H SECTION 7000)OF DIVISION 3 OF THE BUSWESS AND PRO� POOUSpB � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof A CNIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLLARS(S500J.): Z~ ❑I,ASOVMEROFTHEPROPERN,ORMVEMPLOYEESWI7HWAGESASTHEIRSOLECAMPENSATION, WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7014,BUSI- � Commercial - � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW OOES NOT APPLY TO AN OWNER OF � — PROPERTVNM1iOBUILDSOFIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR � 7HROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSAPENO71N7ENDEDOR � m w OFFEREDFORSALE.IFHOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWI7HINONEYEAROFCOMPLE� 0 710N,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DI�NOT BUILD OFi Z IMPROVE FOH THE PURPOSE OF SALE). � ❑I,ASOWNEROFTHEPROPERTV,AME%CLUSIVELVCAN7RAC71NGWITHLICENSEDCAN7RACTORS W � TO CANSTRUCT THE PRQIECT(SEC.7oa4,BUSINESS AND PROFESSIONS CADE:THE CON7RACTORS LI- V81U8fIOf1 ADJ.AREA W CENSE UW DOES NOTAPPLY 70 AN ON?JER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON,AND � WHOCANTRACTSFORSUCHPPQIECTSWITHACON7RAC70R(5)LICENSEDPURSUAN7TOTHECANTRAC- QUANTITY DESCRIPTION FEE 70RS LICENSE UWJ. / � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q (�J j� � Z � � � U � Q — DATE OWNER H � w � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENPLTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAP7ER � a, B(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PROFESSIONS CODE,AND Z ' �i X MY UCENSE IS IN FULL FORCE A^ND`EFFECL I � LICENSE CLASS � - " LIC.NO. �7 J� 6 � � �-a�-�. J V DATE___ CONTRACTOR n- W � WORKERS'COMPENSATION DECLARATION � � a �1�4i �OO t�B� �1°—�✓ � I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF 7HE FOLLOWING DECLARATIONS: Z � � �� n�w RJ Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF-INSURE FOfl WORKERS' _ , Q CAMPENSATION,AS PROVIDED BY SECTION 37000FTHE LABOR CODE.FOR THE PERFORMANCE U OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. w � � Ow _I HAVE AND WILI MAMTAIN WORKERS'COMPENSA710N INSURANCE,AS REOUIRED BV SEC710N 37ooOF7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEHMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CAHRIER AND POUCV NUMBER ARE: CONSTRUCTION J j CARRIEF PLAN REVIEW � POLICY NUMBER ELECTRIC Z Q � (iHISSECIIONNE�NOTBE00MPLETEDOFTHEPEFA4TISFORONEHUhDREDOq1MS�E100)ORLESS). PLUMBING Z I CERTIGV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL n---+�u-.+�� y�� } SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECAME SUBJECT TO THE ' //� � � � � ' N WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FE�/�-"�� •��"� � SUBJECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOR � t nl CODE,I SFIALL FORTHWITH COMPLV T SE PROVISIONS. ISSUANCE �v`� p DATE: ��_ APPLICANT:NN�"W"�" SMIP qi i r , � I � J WARNING:FAILURE TO SECUHE WOHKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � J � SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TMOUSAND ENERGY PERMIT r DO�URS(i100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PflOVIDED FOR IN I�Y. � SEC710N 3708 OF THE LABOR CODE,MTEREST,AND ATfORNEY'S FEES. _.,._.=...,-��^--�-"— RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIfiM UNDER PENALTV OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.�. . Z W � LENDER'S NAME � LENDER'SADDRE55 � TOTAL FEES I �� I CERTIFY TI1AT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPIV WITH ALL qTV AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORRE REPRESENTATIVES OF THIS COUNTV TO EMER UPON THE � A��MENTIONED PROPERTY FOR INSPECTION PURPOSES. Z COMMENTS � , ��.P�c 3�cc QPERMITTEE N (PRIN7) � � �1 s,,� ��3�—a � � SIGNA7URE OT�PERMF�E DA7E = RECPT.NO. PAID BY VALIDATION ~ WHITE—De aAment Co YELLOW—Finance Co PINK—Assessor Co GOLDEN OD—File Co GREEN—A IicanYs o P PY� PY. PY� PY, PP PY C�B�� '�� i�iI��1C� �1�1� 0�1��[��`�O�r� f�C�C.��G�[� o��c�oa oa� c�c� , oa��c�o� a �a� m. o�a�b�. � ��u —_ �Y-----=� � .�. SET BACK i �— , FLOOR JOIST ; _ _ _._ -- --- ; � ----____.. FTGS/FORMS/STEEL _ ; FHA REQMTS - -- _..___.. ._ ...... _._____ __ _._ ...____ —__-- ELECTRIC GROUND ' � UNDER FLOOR DUCT -i-- -- GROUND PI.UMBING ---_ � �_--- � U�1DER fLOOR CU��7UIT____� f --- SLAB GRADE � _� FlREPLACE FOU(VDATION �_ _ TEMP POWER _ I __ � FIREPLACE BC?ND BEAM _ ___� _._ --.--_a.....___ _ ____ — ____—_..______._ WATER SERVICE � MID HT. BOM1Id BEAPvt ' — -- -- --- -- ROOF SHEATHING ___^ 8 FT. BOND BEAM_ � . —_--;----- -- - ._-- ..___�___ _._ _..__..._. FRAMINGNENTI�IATIOtJ � FINAL B�ND BEAM _ j _ ROOF COVER � _ PRE-GFiADING _�_� ____ ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRAdING _... __---- -_..._.._._-----_....___.__ .—_ �_ ._......---- ROUGH PLUMBING FINISH GRADING ___ SHOWER/TUB TEST i POOL ELECTRIC ��_ ____ ___� _ _�___........_--------- EXT. LATH/SIDING POOL FENCING ____ W,4LL IiVSULATION __ i POOL FINAL . _ _._ �__--- --___..--- CEILING INSULATION �FF SITE IMPS. __ DRYWALL NAIUIVG I _.�__ dEDICA710NS � - _-__---__-_ __________� SEWER FINAL ENG. SEPTIC TAIVK LANDSCAPE/iRRIG. ----.� -------- --- --.__.-- SEEP PIT/LL ON SITE 1MPS. GAS AIR TEST , FINAL ZONING _ _ __ _ FII�AL CONST. ` � F�RE DEP7. FiNAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC � DEV. FEES PAED - -- FlNAL PLUMBING , ENERGY __ ----.� __...-------__--�— -----._.__. � � C�I�t OO(�O(�o _ l __.____ COMfViENTS � SEPTIC TANK SIZE SEEP PIT/U SIZE __.�_____ -----..._.._.____�_ __-.-- � -- --- � � _ ------- � � �� '� � � _