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Home My WebLink About11-1453 _ _ _ . I ^ �� CITY OF DIAMOND BAR V I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �4''�"+W BUILDING PERMIT APPLICATION FIRMLY N JOBSITE Q-'�) / �j�U�� /' DATE CATION l� �I NUMBE q/C ¢ ADDRESS C..� y (Q � � ��s� o —�r— -�—� � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER o ADDRESS ZONING SETBACKS ' z CITY ZIP TEL. FRONT qyy � � APPLICANT TEL. REAR p ¢ SIDE/SIDE STREET RW ❑ � � CONTRACTOR SIDE p ADDRE r � CITY 'ZIP 4_1-97'? TE� PROPOSED USE o ARCH/ENG/ � �� z DESIGNER � ADDRESS NO.DWEL. NO. NO. cn UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O 0 I HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTOFS LI� .G8feg0/COtPOR W CENSELAWFORTHEFOLLOWINOREASON(SEC.7031.58USINESSANDPROFESSIONSCODE:ANVCITYOR (f� C-� COUNTYNRiICHRE�UIRESAPERMITTOCONSTRUCT,ALTERIA/PROVE,DEMOLISH,ORFEPAIRANYSTRUG w w TURE,PRqR TO ITS ISSUANCE.ALSO FEQUIHES THE APPLICANT F-0R SUCH PERMIT TO FILE A SIONED W PafIO/D6CI( g STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF hIE CONTRACTORS LI� � CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PR0. � POOUSPe FESSIONS CODE�OR 7HAT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR THE ALLEOED EXEMP- C7 TION.ANY VIOLATION OF SECTION 7071.6 BV ANV APPLICANT F-0R A PERMIT SU&IECTS THE APPLICANT TO Z RaRoof A CML PENALT'OF NOT MORE THAN FNE HUNDRED DOLURS(f500).): Q ❑I.ASOWNEROFTHEPROPEPTV,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � CORIffIBfClal Z WILL DO THE WORI(,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W�,BUSI� J - N NESS M1D PROFESSIONS CODE:THE CONTMC70R5 LICENSE LAW DOES NO7 APPLV To AN OWNER OF � PqOPEFTV NMO BUILOS OR IMPROVES THEREON.AND NM110 DOES SUCH WORK HIMSELF OR HERSELF OR w THROUOl7 NIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,FIOWEVER,7HEBUIIAINGORIMPROVEMENTIS50LDWITHINONEVEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL MAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OP � IAIPROVE FOR THE PURPOSE OF SALE). W ❑I,ASOMMEROFTHEPROPEf7�',AMEXQUSNELYCONTRACTINGWfTHLICENSEDCON7FACTORS Q TO CONSTRUCT TME PHOJECT(SEC.701�,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- V8IU8110 qp�,qqEq W CENSE UW DOES NOT APPLV TO AN OVINER OF A PROPERTV WHO BUILDS Ofl IA/PROVES THEREON,MID � W/iOCONTRACTSFORSUCHPR0.1ECT5WITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTflAC- QUANTITV DESCRIPTION rau ucENSE uw.�. FEE � Q ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � U � DATE OWNER ¢ Z U � LICENSED CONTRACTORS DECLARATION w � � 1 HEREBY AFFIRM UNOER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � 9(COMMENCINO WRH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSKKJS CADE,AND Z OMY LICENSE IS P!FULL FORCE ANO EFFECT. �� LICENSE CLAS � LIC.NO. � . V DATE CONTRACTO d W � � WORKERS'COMPENSATION DECLARATION � � U � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z � _I HAVE AND WILL MAINTAIN ACERTIFICATE OF CONSENTTO SELF-INSURE FOR WORKERS' a 2 Q COIAPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOF CODE,FOR THE PERFORMhNCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � W � � Qw _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTKKJ 370o OF THE LABOF CADE,FOR THE PERFORMA CE OF THE WOFK FOR WHICH THIS PERMIT IS �,/.y �� ISSUED.MV ( S'COMPEN N INSURA CE CARRI AND POLICY N MB a na• CONSTRUCTION /L � CARqIER � PLAN REVIEW �fj �� 0 POLICV NUMBE Zd ELECTRIC � (fFB55ECr10NNFIDNOTBEOOMR.EfEDOFTYfrPERlMISFORONEFiIN�OFmpOU.pRS(f10D)ORLESS} PLUMBING W Z I CERTIFV THAT IN THE PERFOPMANCE OF THE WOR1C FOH WHICH THIS PERMIT IS ISSUED,1 MECHANICAL C� SHALL NOT EMPLOY ANV PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE (n WORKERS'COMPENSATIONLAWSOfCALIFORNI0.ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE = SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR / CODE,I SHALL FORTHWITH COMPLV WITH THOSE P{iOVIS10N5. ISSUANCE ___ � 0 p DATE: APPLICANT. SMIP p W J WARNINO:FAfLURE TO SECURE WORNEFS'COMPENSATION CAVERAOE IS UNLAWFUL,AND SHAILBE ENERGY P/C � J � SU&IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FWES U7 TOONE HUNDRED THOUSAND ENERGY PEFMIT OOLURS(f 100.oa0),IN�DDI710N TO THE COST OF CAMPENSATION,DAAIAGES AS PROVIDED FOR IN J SEGTION 3�08 OF THE LABOR CODE.WTEREST,AND ATTORNEY'S FEES. w RETENTION FEE: O CONSTRUCTION LENDING AGENCY P - T FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDINO AOENCV � FOR THE PERFORMANCE OF THE WORK FOR WNICH THIS PEflM1T IS ISSUED(SEC.30G7,CIV.C.�. Z W � LENDER'S NAAIE � LENDER'SADDRESS � � I CERTIFV iHAT I HAVE READ THIS APPLICATION AND STATE THAT 7HE ABOVE INFOfU/ATqN IS CORRECT. TOTAL F E ES d w I AGREE TO COMPLV WITH ALL CfTV AND COUNTV ORDINMICES AND STATE UWS RELATWO TO BUILDINO (F>�/ �/ � � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF THIS COUNTV TO ENTER UPON THE /J // /'� �y[ (� ` ` Z ABOVE�MEMIONED 7ROPERTV FOR INSP PU ES. //�/7 // ( J/, e1 _� /�'\ � y�7_�� 0 .'uG�'✓/ZC� J �� D COMMENTS[lCbS.�/�w��v� R� vc•� � � m PERM E NAME(PRINn Q �,� N 10 A FE OF PERMITTEE DA7E � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Flnence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanPs Copy CI�'V OF DIAiViOND �AR I�lS�ECTIOft! �ECORD � �. . �. (1�J�pL�C�400GrJ1 ' o �� ::` ' 0�[�C�'�p ,. . Oa�PLC�QOU�I . DG�4�.- . DG�I G�� f� �, SET BACK • FLOOR JOIST FTGS/FORMS/STEEL FHA REC�MTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. B�ND BEAM ROOF SHEATHING � 8 FT. BOND BEAM � - FRAMINGNENTILATION ' _ �� G��_ FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CE�LING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. - GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINA�PLUMBING ENERGY C�,�OC�o � . C011�MEIVTS . SEPTIC TANK SIZE SEEP PIT/U SIZE G] GrI G �