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Home My WebLink About14984 (20)P. 5f¢2 O n Fn I 0 Q ze W z Cv C0 S O IL cc J w O d �TS } 1. 4 a 03 F CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES . y 21660 E. Copley Drive Suite 190 (909)860-3193 Fax(909)961-3117 ^N" f BUILDING PERMIT APPLICATION OBSITE t50 a DRESS APN LOT TRACT OWNER -" ADD ESS V CITY TEL. R PPLICANT TEL. CONTRACTOR J ADDR CITY � ZIPG(l irl� EL ARCWENG DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS Ll - CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.6 BUSINESSAND PROFESSIONS CODE:ANYCITYOR COUNTY WIBCH REOUIRESA PERMRTOCONSTRUCT,ALTER IMPROVE DEMOLISH, OR REPNRANY BTRVC- TURE. PRIOR 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 LAV! (CHAPTERS (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE SLIMNESS AND PRO- FESSIQNS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION MI.B BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS O L ASOWNER OF THE 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. BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO WLDSOR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR 14 FOR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT IMNOEOOR OFFERED FOR SALE IF.HOWEaR. THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE- TION. THE OWNERSDE ULR WILL HAVE THE BURDEN OF PROVINGSH THAT HE OR E DD NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE), 0 L AS OWNER OF THE PROPERTY. AM EXCLUSIVELY WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSK)NS CODE: THE CONTRACTORS U - CENSE LAW DOES NOTAPPLY TORN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHOCONTRACTS FOR SUCH PROJECTS WITHACONTRACTOR(S) LICENSED PURSUANT70THE CONTRAC. TORS LICENSE LAW:). O 1 AM EXEMPTUNDER SEC. S. A P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFSLA UNDER PENALTY OF PERJURY THAT IAM LICENSED y)NDER PROVISIONS OF CHAPTER a (COLUAENCING WITH BECTON 7000)AFONISIOR 3OFTHE'BUMNESS ANOPRi3FESSKWS.C`DE, AND MY LICENSE IS N FULLE LWPE07:-•-�.------•••—•-�- LICENSE CUSS 111 .LJO,.NO:,; DATE CONTRACTOR ORKERS' COMPENSATION DECLARATION _ r I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARAT S. —I NAVE AND WILLMAINTAIN ACERTIOCATE OF OONSBNTTO SELFINSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY ON 37000E THE LIBOR CODE, FOR THE PERFORMANCE OFTHE WORK FOR WHICH PERI�a ISSUED. MY WORKERS' COMPd_ S�ITIpN INSU CABBIE AND POLICY SERA : CARRIER C./L1V v POLICY NUIMSER (TIaSsec" NEED NOT BEOOAPLETFDOF7VE P[IYATLi FOR 19 HUNDI (L100)ORUiSS) 1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 5 D. 1 SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT H WORKERS COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOU SUBJECT TO THE WORKERS'OOMPENSATION PROVISIONS OF SECTION 37000 OR OWE, 1 SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT, WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3057, CIV. C.), LENDERS NAME LENDERSADORESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION 15 CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING OONSTRUCTION, AND HERESYAUINORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPE FOR INSPECTION PURPOSES PE ITTEE (PRINT) SKLNATUR OFPERMITTEE DATE .lam PRESS FIRMLY APPLICATION /LMPERMIT P/CVV . DATE NUMBER k VV 1ISSUE11 TYPE. OCC DATECONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE m17 is NO. DWEL. NO. NO. 11, UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADO/REM Garage/Carport co WPatioMeck LL PoovSpa � Re•RaDf 0 Commercial 5 1r7% Valuation ADJ.AREA CILIANTITf OES RIPTION FEE [L �' J� W 0 2 Z ILLI \ J O O STRUCTION / PLA REVIEW 1� •� E CTRIC PLUMBING MECHANICAL INSPECTION FEE Min ISSUANCE SMIP t 1 ENERGY PIC MAY T� A ENERGY PERMIT Cn!� 0- F DI A A OD�OT�R� AR RETENTION FEE: RT TTr E)R1iT ,Ct111T) Y SI�rF'H P LT FEE' TOTALC/F�EES COMMENTS" v RECPT. N0. PAID BY VALIDATION WHITE --Department Copy, YELLOW—finance Copy. PINK—ABsmsor Copy, GOLDENROD—file Copy, GREEN—Appllcam's Copy CITY OF DIAMOND BAR INSPECTION RECORD SET BACK KUM,, FLOOR JOIST FIGS/FORMS/STEEL-[3 T L FF 7 FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT. - SLAB GRADE i FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND, BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMNONENTILIATION 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 CEILING INSULATION OFF SITE IMPS. -FDEDICATIONS DRYWALL NAILING SEWER FINAL ENG. SEPTIC TANK LANDSCAPEARRIG. 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 FINAL PLUMBING I ENERGY COMMENTS A c ZZ -4 SEPTIC TANK SIZE SEEP PIT/U SIZE Ell