The URL can be used to link to this page

Home My WebLink About10-1273 �!_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 � (909)839-7020 Fax(909)86]-3117 Building Inspection Hotline(909)839-7027 PRESS "'"' BUILDING PERMIT APPLICATION FIRMLY } JOBSITE � � APPLICATION PERMIT p/C � ADDRESS DATE NUMBER # � ISSUE TYPE OCC APN LOT TRACT DATE � � CONST. ��qpUP p OWNER � �` ADDRESS �- y ZONING SETBACKS 0 FFiONT g CITY IAVY�L?l1Gt Q>G1✓Z ( TEL REAR RW � APPLICANT TEL. SIDE/SIDE STREEi Ryy p � CONTRACTO ` SIDE � ADDRESS ' � CITY ZI _�_ TEL. PROPOSED USE (JF1` o ARCWENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. u� UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION p SFR/ADD/REM � I HEREBV AFFIRAI UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CANTRACTORS LI- G218g0/CBfpOR W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.68USMESSANDPROFESSIONSCODE:ANVCITYOR (n U CIXJNTyWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- w � Z NRE,PRIOR TO RS ISSUANCE,ALSO{iEW IRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONE� w Petio/Deck W STATEMENT TNAT HE OR SHE IS LICENSED PURSUANT TO THE GROVISIONS OF THE CONTRACTORS U� , 0� CENSE UW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooUSpe FESSIONS CODE)OR THAT HE OR SHE IS E%EAIPT THEREFROM AND THE BA515 FOR THE ALLEGED E%EMP- (� V TION.ANV VIOIATION OF SECTION 7031.5 BV ANV APPUCANT FOR A PERMIT SUBJECTS THE APPLICANT TO Z Re-Roof � A CML PEN/�LTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f500).): � ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAOESASTHEIRSOLECOMPENSATION, � COR1rtIBfC18i WILL DO THE WORI(,AND THE STRUCTURE IS NOT INTENOED OR OFFERED f-0R SALE(SEC.7W�,BU51� J � NESS AND PROFESSIONS CADE:THE CONTRACTORS LICENSE LAW DOES NOT A7PLV TO AN OWNER OF � PROPERTV NhiO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w THROU(iH HIS OR HER OWN EMGLOYEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m � OFFFAEDFORSOlEIF,HOWEVER,7HE8UILAINGORIAIPROVEMINTI550LDWITHINONEVEAAOFCAMVLE- T�ON,THE OWNEF-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE F-0R7FIE PURPQSE OF SALE). W ❑I.AS ONMER OF THE PROPERIV,M1 E7(CLUSNELY CANTRACTINO WRH LICENSED CONTRACTORS � TO CONSTRUCT THE PR0.IECT(SEC.70U,BUSINES9 ANO PqOFESSIONS CODE:THE CONTRACTORS LI- VBIUef10l1 ADJ.AREA W CENSE LAW DOES NOTAPPLV TOAN OWNER OF A PROPERTV WHO BUILDS OR IMPROVES TMEREON,M!D � NM1/OCOMRACTSFORSUp1PR0.1ECT9WITHACqNTRACTOR(S)LICENSEDPURSUANTTOTHECANTRAG QUANTITY DESCRIPTION Y 70R5 LICENSE UW.). FEE �J ♦ �, Q ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q Q �� U � oae OWNER � Z U �Q LICENSED CONTRACTORS DECLARATION W ¢ 1 HEREBY AFFIRM UNDER PEN�LTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � (t��e � �(COMMENCINC3 WITH SECTION 7oa0)OF DIVISION J OF THE BUSINE55 AND PROFESSKKJS CADE.AND Z V !/\� �'C 1/Y LICENSE IS IN FULL FORCE EFFECT. m V � �3 (065 � ICENSE CLAS LIC.NO. � V ATE CONTRAGTOR d W � ORKERS'COMPENSATION DECLARATION � � I HEREBV AFFIRM UNDER PENALTV OF PEfUURV ONE OF THE FOLLOWING DECLARATqNS: U � Z � _INAVEANDWILIMAWTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORNERS' ¢ 2 Q COMPENSATION,AS PROVIDED BY SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE U OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � w _1 HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 37W OF THE LABOR CODE,FOR THE PERFORMMICE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'CAMPENSATION I URANCE CARRIER AND POLICV NUMBERAAE: CONSTRUCTION jCARFIER_�O� �^� PLAN REVIEW � � POLICV NUMBER_(�Lt��=/�A�� .ncq� Q � ��i � (i}�SSEC�IONNE�NO7BEOCMPLETEDOFTIEPEW.TTISFORONEF�0.1�DFiEDDq1M5(t100IORLESS} U ,�5� W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C} SNALL NOT EMPLOV ANV PEHSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE (/� WORNERS'CAMPENSATION LAWS OF CALIFORNIA M1D A�REE THAT IF I SHOULD BECAME INSPECTION FEE SUBJECTTOTHEWOHKERS'COMPENSATIONPROVISIONSOFSECTION97000FTHELABOR ` �^ O CODE.I SHALL FORTHWITH COMPLV WITH THOSE PFOVISIONS. ISSU CE J �V p DATE: APPLICANT: SMIP W � WARNMG FAILURE TO SECURE WORKEFS'COMPENSATION CAVERAOE IS UNLAWFUL,AND SHALL BE ENERGY P/C � � SU&IECTAN EMPLOVER TO CHIMIN�L PENAITIES AND CIVIL FWES UP TOONE HUNDRED THWSAND ENERGY PERMIT DOLLARS(tloo.oao),IN ADDITION TO THE COST OF COMPENSATKKJ,DMAA�ES AS PROVfDED FOR IN � � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. ETENTI E: r� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT THEfiE IS A CONSTRUCTION LENDING ACENCY FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.�. Z W � LENDEfYS NAME I'— LENDER'SADDRE55 w I CERTIFV THAT I HAVE READ THIS APPIICATION AND STATE TNAT THE ABOVE WFORMATpN IS CORRECT. TOTAL FE ES / � � I AGREE TO COMPLV WITH ALL CITY AND COUNTY ORDINANCES M10 STATE LAWS REUTINO TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF 7HI5 COUNTV TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS ' 0 �(\ (� � `1�V�( 1 m PERMITTEE NAME(P � � Q ^ � J � SIONANRE OF PERMITTEE ATE � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Flnance Copy,PINK—Assessor Copy,GOLDENFOD--FIIe Copy,GREEN—Appl t's Co PY cs�v o� �a��o�� ►� i�s��c�oo� ��co�� °�; ��p�c�ooa ��p4� e�° oa�P��4oa oa�p�ao� �a4� oa�p�c��a �° �- SET BACK F.LOOR JOIST ' FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UN�ER FLOOR DUCT- GROUND PLUMBING UfJDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION � TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING � ' 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE—GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC �' :r;;.'r'.� � ROUGH GRADING ROUGH PLUMBING �� iD FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. I.ATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST a FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY C��o � COMMEfVTS ��-:�; ��:f-.e�..� 'f;,.;�`T. �.�(~- �� SEPTIC TANK SIZE SEEP PIT/U SIZE a ;� �� F� Q'.