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Home My WebLink About18139 CITY OF DIAMOND BAR '�/ `----�� -- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21825 E.Copley Drive - (909)860-3195 Fax(909)861-3117 � PRE$S ��"%�� BUILDING PERMIT APPLICATION FIRMLY ¢ ADDRESSr ��7� ��RG�C� �� .i APPLICATION " y GZ PERMIT /��S �P/C o DATE NUMBER / � ISSUE TYPE OCC APN LOT TRACT DATE y G Z CONST. GROUP p OWNERf p ADDRESS� 2. C ZONING SETBACKS z CITY e� � ZIP TEL. FRONT Ryy p o APPLICANT TEL. REAR p z SIDE/SIDE STREET RW ❑ � CONTRACTOR�' � SIDE p ADDRESS/ i � o CITY i �D�f�iFf! ZIP CA-�/��T�L. /,� PROPOSED USE✓� , I �G o ARCH/ENG/ � ' _ u ' z DESIGNER � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION p SFR/ADD/REM I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT�AM EXEMPT FROM THE CONTRACTORS LI- GBfeJB/CefPOR W CENSELAWFORTHEFOLLOWIN�REASON(SEC.7031.SBUSINESSANDPROFESSIONSCADE:ANYCITYOR (n C� COUNTVNT11p1RE0UIRE5APERMITTOCONSTRUCT,ALTER.IMPFOVE,DEMOLISH,ORREPAIRANVSTRUC- w w NRE,PRqR TO ITS ISSUANCE,�LSO RC-0UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w P8�10/DBGC � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(GIAPTER B(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS/WD PRO- � POOUSPB Q FESSqNS COOE)OR 7HA7 HE OR SHE IS EXEMP7 THEREFPOM AND TME BA515 FOR THE ALLEOED EXEMP- Z 30 V TION.ANV VIOLATqN OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO Re-Roof A CML PENALTY OF NOT MORE THAN FNE HUNDRED OOLLAAS(f5ao).): � ❑I.ASOWNEROFTHEPROPERTV.ORMVEMPLOVEESWITH:WAGESASTHEIRSOLECOMPENSATION, . � COR11f1BfC181 Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70a,BUSI- J � � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PqOPEHTY WHO BUILDS OR IMPqOVES THEREON,AND WHO DOES SUCH WORK HIMSEIF OR HERSELF OR wTMROUGH HIS OR HEF OWN EMPLOVEES,PROVIDED 7}UT SUCH IMPROVEMENTS ARE MOT INTENDED OR m � OFFEREDFORSPLEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION.THE OWNERAUILDER WILL HAVE THE BUFDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURP0.5E OF SALE). w ❑I,AS ONTJER OF 7HE PROPERTV.AA1 E%CLUSIVELV CONTRACTING WITH UCENSED CONTRACTORS � TO CONSTRUCT 7HE PRQIECT(SEC.7014,BUSINESS AND PROFESSIONS CODE:1HE CONTRACTORS LI� V01U8t1Of1 ADJ.AREA W CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPERTVWFIOBUILDSORIMPROVESiHEF7EON,AND � WFqCONTRACTSFOR5Uq1PRQlECTSWIhIACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAC� QUANTITY DESCRIPTION FEE Y 70RSL10ENSELAw.). 0 ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � � U � DATE OWNER H Z U � LICENSED CONTRACTORS DECLARATION W , � 1 HEREBY AFFIRM UNDEF7 PEWLLTV OF PER1UFiV TFIAT I AM LICENSED UNDER PFiOVI510N5 OF CHAPTER � � 9(COMMENCINOWITHSECTION7oao)OFDIVISION30FTHEBUSINESSANDPROFESSIONSCODE,AND Z LLI MV UCENSE IS IN FULL FORCE AND EFFECT, �i m � UCENSE)CLASS C_�� LIC.NQ��v. � V DATE O"�' U�- CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � U N I HEREBY AFFIRM UNDER PENALTY OF PERIURV ONE OF hIE FOLLOWING DECLAMTqNS: Z 0Z _I HAVE ANO WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WOqKERS' ¢ Q COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERAl1T IS ISSUED. W � � Qw _I HAVE AND WILL MAINTAIN WORKEf75'COMPENSATION INSURANCE,AS REOUIRED BV SECTION 3700 OF h1E LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS / � [l �6 J ISSUED.MY WORNERS'CPNPENSATION INSURANCE C�RRIER AND POLICY NUMBER AAE: CONSTRUCTION �� j CARRIER�� Nf� PLANREVIEW Z POLICVNUMBER L�Of ELECTRIC Q � (1MSSECiKxJNE�MOTeEm.�LET�OFTHEaEa1MISFOROMEF0.1rDqEppqlqqS(Stm)ORLEss} PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOq WHICH THIS PERA/1T IS ISSUED,I MECHANICAL C.�} SHAIL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE (n WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SFIOULD BECOME INSPECTION FEE � SU&IECTTO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 37oa OF THE L/�BOR � CO�E,I SHALL FORTHWI7N COMPLV WITH THOSE PROVISIONS. ISSUANCE _ � p DATE:✓ - ��Z qpp�ICANT� SMIP b� � W J WARNIN6:FAILURE TO SECURE WORKERS'COMPENSATION COVEqAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C J � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHWSAND ENERGYPERMIT DOLLARS(5100.000�,IN PDDITION TO THE COST OF COMPENSATqN,DAMAGES AS PROVIDED FOR IN 'L- J SECTION370BOFTHELABORCODE,INTEREST,ANDATTORNEI"SFEES. OC RETENTION FEE: � OCONSTRUCTION LENDING AGENCY ' PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTFUC710N LENDINO AGENCY � FOR THE PERFORMANCE OFTNE WORK FOR WHICH TNIS PERMIT IS ISSUED�SEC.3087,CIV.C.). Z W � LENDERS NAME F- LENDER'SADDRESS w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE WFORMATION IS CARRECT. TOTAL F E ES /� ' / � 1 AGREE i0 CAMPLV N7TH ALL CITV AND COUNTV ORDINANCES AND STATE LAWS RELATINO TO BUILDING � CANSTRUCTION,AND HEREBV AUTHOqIZE REPRESENTATIVES OF THIS CWNTV TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTY FOR INSPECTION PUR705E5. COMMENTS � / � , ��l�7 m PERMITTE AME(PRI ) � ,� � 6-u-oZ � SIONATUFIEOFPEflMITTE DATE y � RECPT.NO. PAID BY L VAIIDATION WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—ApplicanCs Copy �0�'� �➢(� ��t�i��f(�9�➢ (�� p�� i�[�� oa�� c�a� � � � � . ,_�� oa�p� �o a �. � � o�� c�a SET BACK FLOUR JOIST FTGSlFORMS/STEEL t=HA REaMTS ELECTRIC GROUND � UNDER FLOQR QUCT GROUNQ PLUMBING ' � UNDER FLOOR GUt�IDUIT � SLAB GR,4QE FIREPLACE FOUNDATION TEMP POWER ~ FIREPLACE BOND BEAM WATER SERVICE / MID HT. BOND BEAM ROOF SHEATHItJG ��OL 8 FT. BONQ BEAM _ ^`_ � FRAMINGNENTIL�ATtON FiNAL BaND BEAM ROOF COVER PRE-GRAQlNG ROUGH HEATlNG BENCHING ROUGH ELECTRIC ROUGN CRADING ROUGH PLUNIBING FINISH ^vRADiNG � SHOWER/TUB TEST P�OL ELECTRIC EXT. tATH/SIDING POO�FENCING WAL�INSULATION POOL FINAL CElLIP1G I�lBULATION OFF SlTE IMPS. DRYWALL NAIUNG DEDICATIONS SEWER i FI�iAL ENG. SEPTIC TAM1lK .` lANDSCAPE/IRRIG. SEEP PIT/L.L. � ON SlTE IMPS. GAS A!R TEST FINAL ZOfVING FINAL CONST. �' _(��p2 FIRE DEPT. FINAL FIPVAL HEATING HEAL7H DEPT. FINAL FINA�ELECTRIC �^ DEV. FEES PAID FINAL PLUMBING ENERGY - • �OGa t � � COiVIfViEIVTS SEPTIC TANK SIZE SEEP PIT/U SIZE � �l " � � — �