The URL can be used to link to this page

Home My WebLink About17938 �� _ CITY OF DIAMOND BAR ' DEPARTIv�NT OF COMMUNTI'Y&DEVELOPMENT SERVICES 21825 E.Copley Drive I (909)860-3195 Fa�c(909)861-3117 PR E$$ ��'<�� BUILDING PERNIIT APPLICATION FIRMLY o� JOBSITE ? / Q�Q �� A/�!, /p ,/{J APPLICATION� � �UMBER�� #/C✓ ADDRESS �� v �� `Y�� `� DATE � ISSUE n � b�_TYPE pCC APN LOT TRACT .DATE �� CONST. GROUP p OWNER p ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT pyy ❑ � APPLICANT TEL. REAR p �� SIDE/SIDE STREET RW ❑ CONTRACTOR !f c� U SIDE p ADDRESS i d � CITY O�-AN�/t • ZIP TEL. `�Z-/� � PROPOSED USE oARCWENG/ � z DESIGNER w NO.DWEL. � NO. Z— NO. � ADDRESS 3 � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM U O p I HEREBV AFFIRM UNDER PENALTY OF PEFWRV THAT I AM E%EMPT FROM THE CONTRACTORS LI� Gflf9QB/CBfPOf1 W CENSEUWFORTHEFOLLOWINGREASON(SEC.7ai1.sBUSINESSANDPROFESSIONSCODE:ANYCITVOR (n U CqJMJYyMICHREWIRESAPERMITTOCON57AUCT,ALTER,IMPROVE.DEMOUSH,ORREPAIRANYSTRUC- W patio/Deck Z NRE,PRIOH 70 ITS ISSUANCE,/�150 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w �w STATEMENT THAT HE OR SHE IS LICENSEO PURSUAN7 TO THE PROVISIONS OF THE CONTMCTORS LI- CENSE UW(CHAPTER 9(COMMENCINO WITH SECTqN 7000)OF DIVISION 3 OF THE BUSINESS Ml�PR0. � PooUSpa ^ FESSIONSCODE)OR7}LITHEORSHEISEXEMPTTHEREFROMANDiHEBA515FORTHEALLEOEDE%EMP� (� � TION.ANYVpLAT10NOF5ECTION7031.6BVANVAPPLICANTFORAPERMITSU&lECT57HEAPPLICANTTO Z qe-Roof A CIVIL PENALTV OF NOT MORE TIAN FNE HUNDRED DOLURS(5500�.): � ❑I,ASONMEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIFiSOLECOMPENSATION, � COR1rtI0fCl8� � Z WILL DO THE WORK�D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SPLE(SEC.704s,BUSI- J � NE55 AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � Pi70PERTV WHO BUILDS OR IMPROVES 7HEREON,AND WHO DOES SUCH WOqK HIMSELF OR HERSELF OR wTHROU(iFIHI50RHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPqOVEMENTSARENOTINTENDEDOR m 0 OFFEREDWRSALEIF,FIOWEVERPIEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUIID OR � � UAFROVE FOR THE PURPOSE OF SALE�. w ❑I,AS ON7JER OF THE PROPERTV.AM EXCLUSIVELV CANTRACTINO WRH LICENSED CONTMCTORS . � TO CONSTRUCT THE PRQIECT(SEC.7011,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� VeIl18fIOf1 G G� qDJ.AREA W CENSEUWDOESNOTAPPLVTOMIOWNEROFAPpOPERTYWHOBUILDSORIMPqOVESTHERC-0N,AND � WHOCANTRACTSFORSUG1PRQlECTSWITHACONTRACTOR(S)LICENSEDPURSUMITTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS UCENSE UW.). � ❑I AA1 EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q /�C� 'CG � � T G . � DATE OWNER ~ �r�U`� � LICENSED CONTRACTORS DECLARATION w R [,� �� 4 i � � I HEREBY AFFIRM UNDEH PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � � D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS COOE,AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT. ' / m , Y C. /( 3 J � LICENSE CLASS C^� 1 LIC.NO. �1 �� V DATE Y� T��'C�^ CONTRACTOR ��. d C W _ � WORKERS'COMPENSATION DECLARATION Q U � I HEREBYAFFIRM UNDER PENALTV OF PERJURV ONE OFTHE FOLLOWINO DECLARATIONS: Z Z� _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKEFS' a Q COMPENSATION,AS PFOVIDED BV SECTION 370o OF 7HE L1BOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � Qw �I HAVE AND WILL MAIMAW WORNERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTKKJ 370a OF iHE LABOR CODE,FOR 7HE PERFORMANCE OF TH WORK FOR WHICH THIS PERMIT IS '�I �� ISSUED.MV WOR�ERS/'COMP SAT10N INS RANCE CA R AItlD POLICV NUMBER ARE: CONSTRUCTION � CARRIER /v '� � �� PLAN REVIEW ZPOLICV NUMBER G ELECTRIC Q � (iHISSECf10NNE�NOTBE00MPLETEDOFTHEPERMfTISFORCNEFM�DqEppOlWiS(flpp)pqLESS} PLUMBING w Z �CERTIFV THAT W THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (} SHALL NOi EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE (,/J WORKERS'CAMPENSATION lAWS OF CALIFORNIA,AND AGREE TMAT IF I SHWLD BECOME INSPECTION FEE = SU&IECTTO THE WORNERS'COMPENSATqN PROVISKKJS OF SECTION 37000F THE LABOR CODE,I SHALL FORTHWI7H COMPLV W{�iSY�QVI510NS ISSUANCE � p DATE: r-a�r��-_�APPLICANT: SMIP ( W J WARNINO:FAILURE TO SECURE WORKERS'CONPENSATION COVEAAOE IS UNLAWFUL,AND SHALLBE ENERGY P/C J � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDqVILFINESUPTOONEHUNDREDT1i0USAND ENERGYPERMIT DOLLARS(f100.o00),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR COOE,INTEREST,AND ATTORNEV'S FEES. � oC RETENTION FEE: OCONSTRUCTION LENDING AGENCV PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS ACANSTRUCTION LENOINO AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH TMIS PERMIT IS ISSUED(SEC.3oel,CIV.C.). Z W � LENDER'S NAME � LENDER'SADDRE55 w I CERTIGY THAT I HAVE REAO THIS APPLICATIOfJ AND STATE THAT THE ABOVE INFORMATION IS CORFECT. TOTAL FE ES 1 2� •q � � I A6REE TO CAMPLV WITH ALL CITV!WD CAUNTV ORDINANCES ANO STATE LAWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHOFIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE�MENTIONED PROPERTV FOR INSPECT RPOSES. COMMENTS � � �� /.�'�� m PERMITTEE N E(PRINn � /, � � / ��\.7 � SIONATURE OF PER ---� DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Co GREEN— py, Appli t'S Copy �011`� �9f� [�U��l�li��t [��1ff� DI�SG�[��8�-�l �[�t��l�i� �� DQ r� - OG�°�G�[� � �C� DD Q`t� 01� ' o � SET BACK FLOOR JQIST FTGS/FORMS(STEEL � FHA REaMT5 ELECTRIC GROUND �UNQER FLO�R DUCT GROUND P�UMBING UNCJER FLOOR CU�IDUIT A SLAB GRADE FIREPLACE FOUNDATI�N TEh/IP POWER FIREPLAGE BOND BEAM � WATER SERVICE MID HT. BOND BEAM ROOF SHEATHIfVG ��jy 8 FT. BQND BEA(v9 FRAMIiVGNENTILIATiOfV FINA�BOND BEAM ROOF COVER 3,oz- PRE-GRADlNG ROUGH HEATING BENCHlNG RUUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWEFirfUB TEST ' POOL ELECTRIC EXT. LATH/SIDING P(JOL FENCING WALL INSULATION POOL FINAL � CEILING INSULATION OF�SITE IMPS. DRYWALI�NAILING DEDICATI�NS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. , FlRE DEPT. FINA� FINAL F{EATING HEAL7H DEPT. FfNAL �� FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBIMG ENERGY — �� CONiNiENTS �'�r�G�- __�� 4;/�n� �J7�L� G�� K=� � _ ' i , � SEPTIC TANK SIZE SEEP PIT/U SIZE � � � ` � , � , ,