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Home My WebLink About16946 (25) CTI'Y OF DIAMOND BAR v(;�S lL� 3�(�. � -----��— DEPARTMENT OF COMT�IUNTI'Y&DEVELOPIv1ENT SERVICES � 21825 E.Copley Drive (909)860.3195 Faac(909)861-3117 PRESS ��<�� BUILDING PERNIIT APPLICATION FIRMLY o� JOBSITE i�.p APPLICATION _� �,� ERMIT �I _� P/C ADDRESS � LJ DATE UMBER �� # � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER i o ADDRES Y ZONING SETBACKS ' Z CITY ZIP 'Z TE . FRONT qyy p o APPLICA T TEL. REAR � � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE ❑ ADDRESS � CITY ZIP TEL. PROPOSED USE >, oARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION S0.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERJURV hUT I AM E%EMPT FROM THE CONTRACTORS LI� Gef890/C9fPOR W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANVCITYOR (n U COUNTVWHICHREWIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEAqLISH,ORREPAIRANVSTRUC- w NRE,PRIOR TO ITS ISSUANCE,ALSO FEQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w Pai10/D6CI( �, � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PqOVISIONS OF THE CONTRACTORS LI- � � CENSE IAW(piAPTER G(COMMENCING WITH SECTKKJ 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- PaoUSpe � FESSIONSCOD�Oq7HATHEORSHEISEXEMPTTHEREFROMANDTHEBA5ISFORiHEALLEOEDE%EMP� (!� TION.ANV VqLAT10N OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT T0 Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLLARS(f500).): p ❑4�OWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 CpmmBfC18I Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BU51� J � ' � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIAISELF OR HERSELF OR � TNROUGH HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m ' � OFFEREDFORS/�LEIF,HOWEYERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z TION,THE OWNERAUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W ❑I,AS ONRJEROFTHE PROPEHTY,AM E%CIUSIVELV fANTRACTINO WRH UCENSED CONTRACTORS � TO CONSTRUCT THE PR0.IECT(SEC.70/1,BUSINESS M1D PROFESSfONS CADE:THE CONTRACTOPS LI� V01U01i0f1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEROFAPROPERTVM?70BUILDSORIMPROVESTHEPEON,AND � WNOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTMC� QUANTITY DESCRIPTION FEE Y 70R5 LICENSE LAW.). � ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ?� U � DATE OWNER � Z U � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENALTV OF PERIUPV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � �(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CADE,AND Z �' X" MV LICENSE IS IN FULL FORCE M1D EFFECT. m LLI � LICENSE CLASS LIC.NO. � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION � N U N I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWINO DECLARATqNS: Z �Z _I MAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' ¢ Q COMPENSATpN,AS PROVIDED BV SECTION 3�0o OF THE LABOR CADE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � , � _I HAVE AND WILL MAMTAIN WORNERS'COMPENSATION INSURANCE,AS REOUIHED BV SECTION Q 3�00 OF THE UHOR CODE.FOR THE PERFORMANCE OF THE WORK f-0R NM1iICH 7HI5 PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION J j CAFiRIER PLAN REVIEW � POLICY NUMBER Z ELECTRIC ¢ � 0 (hUSSEc110NNE�N07BEODAPLE7IDOFnfaEaAttISFOROrvEt4.lOREDDq1�Rs(S7m)ORLEsS} PLUMBING i w e.�..- Z I CERTIFY THAT W THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL L}' SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE (n WORKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR S CODE,I SH�LL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � p DATE: APPLICANT: SMIP W J WARNIN�:FAILURE TO SECURE WORKERS'COMPENSATqN COVERAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C J � SU&IECTANEMPLOVERTOCqIMINALPENALTIESANOCIVILFINESUPTOONEHUNDREDTF70U5AND ENERGYPERMIT DOLURS(5100,000).IN ADDI710N TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 370B OF THE LABOH CODE,INTEREST,AND ATTORNE'f5 FEES. OC RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PEFiJURV THAT THERE IS A CONSTRUCTION LENDWG AGENCV ' FOR THE PERFORMANCE OF THE WORN FOR NRiICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME � LENDER'SADDRESS w ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETFIATTHEABOVEINFORMATIONISCOFHECT. TOTAL FEES ��O � I AOREE TO COMPLV WITH ALL G7V AN�COUNTY ORDINANCES AND S7A7E LAWS RELATING 70 BUILDINQ V � CONSTRUCTION,AND HEREBV AUTHORIZE RESENTATIVES OF THIS COUN7V TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTV FOR IN PE ior+vuaaosEs. COMMENTS � 0 r = J m PERMfTTEE N E(Pfil `` C/) � / � � SICNATU ERMfTTEE DATE � � = RECPT.NO. PAID BY VALIDATION ~ WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—AppllcanYs Copy �p�"�f ��' �Q��R� �/R16� �h�9��(�t�'�'64�G�N ff�f�c�C�ff�� [��trDC�l ° '� ��[� �� DQ� � � o ' SET SACK FLOOR JOIST FfGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR QUCT GROUND PLUMBING UNQER FLOOR CC)�IdUIT SLAB GRADE FIREPL'ACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BONd BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILiATtON FINAL BOND BEAM ROOF COVER PRE-GRADfNG ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PIUNiBING FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT. lATH/SIDING P�OL FENCING WALL INSULATION PO�L FINAL GEII.ING INSULATION OFF SITE IMPS. DRYWALL NAIUNG DEDICATIONS SEWER �L�y�,� FINAL ENG. SEPTIC TANK LANDSCAPE/tRRIG. SEEP PIT/L.L, ON SITE IMPS. GAS AIR TEST FINAL Z�N1fVG FINAL CONST. F1RE DEPT. FINAL FINAL HEATiNG HEALTH DEPT. �INAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ;3l /( � � ENERGY C�G t�OG o < o COi1�iViENTS SEPTIC TAiVK SIZE SEEP PIT/U SIZE � � � ° � � � � . , , -