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Home My WebLink About10-892 ��_ CTTY OF DIAMOND BAR 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 �''°"'• BUILDING PERMIT APPLICATION FIRMLY y�, JOBSITE 7 Q Q�� (,C�L�) �J� �� APPLICATION PERMIT p/C � o ADDRESS Y O �C�'�� r DATE � /g,(0 NUMBER��.q�Q— R'9'� � � ISSUE /,/� `, TYPE OCC APN LOT T�IACT DATE_ L V'��`�� p OWNER �� .��c j� o CONST. • GROUP p ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT qyy � g APPLICANT TE (� REAR � � SIDE/SIDE STREET pyy ❑ I a� CONTRACTOR SIDE p � ADDRESS ��F�' f` �N n � o PROPOSED USE X �� CITY ZIP TEL. � �� oARCH/ENG/ r� )�,r ��r � �� (,�,�.L� z DESIGNER l �V YI � � w � NO.DWEL. NO. � ADDRESS�� NO. � CITY � ZIP� E r— UNITS STORIES Z BEDROOMS� � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION ' p� OWNER-BUILDEA DECLARATION p SF AD EM p I HEREBV AFFlRM UNDER PEN�L7Y OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� G8f9A0/CBfPOR W CENSELAWFORTHEFOLLOWINOREASON(SEC.7031.68USINESSANDPROFESSIONSCODE:ANVqTVOR (f� U COUNTVNRi1CHRE0UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORiiEPAIRANYSTRUG W patlo/Deck• w TURE,PRIOR TO ITS ISSUANCE,AL50 RC-0UIRES THE APPIICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI• � CENSE UW(CHAPTER e(COMMENCWO WITH SECTION 70oa)OF DIVISIOtJ 3 OF THE 9USINESS AND PRO- � POOUSPB , � FESSIONS CODE)OR 7HAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLE6ED E%EMP- � TION.ANY VIO�ATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof � ACIVIL PENALiY OF NOT MORE h1/V!FIVE HUNDRED DOLURS(f5a0).): � ❑I.ASOWNEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COR1ffIBfC18I Z WIIL DO THE WORK,AND THE STRUC7URE IS NOT IN7ENDED oq OFFERED FOH SALE(SEC.7a1,BUSI� J � NESS AND PROFESSIONS COOE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF ? A� ViiOPEHTV Vh10 BUILDS OR IMPROVES THEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR '� w THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH W PROVEMENTS AqE NOT INTENDED OR m Q OFFEREDFORSALEIF,FIOWEVER,7HEBUILDINCaORIMPROVEMENTIS50lDWITHINONEVEAROFCOMPLE- Z TION,TNE OWNERAUILDEfl WILL HAVE THE BURDEN OF PqOVWO THAT HE OR SHE DID NOT BUILD Oq � MPROVE FOR THE 7URPOSE OF SAL�. W ❑I.AS OWNER OF THE PROPEf�V,AM EXq.USIVELY CqNTRACTINO WITH LICENSED CONTRACTORS [[ TO CANSTHUCT THE PR0.IECT(SEC.7oN,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTOqS LI- V8111fii1Of1 qp,�_qqEq W CENSEIAWDOESNOTAPPLVTOANON7JEROFAPROPERTVWHOBUIlD50RIMPflOVESTHEREON,AND � Y/FIOCANTMCTSFOFSUCHPROJECTSWITHACONTMCTOF(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY D CRIPTION ioas ucENSE uw.>. FEE > � ❑I AA/E%EMPT UNDER SEC. B.d P.C.FOR THIS REASON � � �? U LL' DATE OWNER � /� G� S � LICENSED CONTRACTORS DECLARATION w '� � I HEREBY AFFIRM UNDER PENAI.TY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �, ,�/ e � 0(OOMMENCINO WRH SECTIDN 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AN� Z G _ I/�'� (./ � LV �UCENSE IS IN FULI FORCE AND EFFECT. m � UCENSE CI.ASS LIC.NO. � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION � � I HEREBY AFFIHM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECUMTIONS: � � Z � _I NAVE AND WILL MAMTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ Q COMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERAIIT IS ISSUED. w � � � _I HAVEAND WILL MAINTAIN WOFlKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE.FOR THE PEfiFORMANCE OF THE WORK FOR WHICH THIS PERMR IS � �/� ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBERAAE: NSTRUCTIO �V � CARRIER LAN REVIEW Z POLICV NUMBER C IC Q � (i1115SECt10NNE�NOTBEO7A1Fl.ETmOF7FIEPEPAYiISFOHONEF#N�DHEDOOIIJ�H51i100)ORLESSl W Z I CERTIFV THAT IN THE PERFORMANCE OF THE M/OR)(FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C} SHAIL NOT EMPLOY ANV PERSON IN ANY MANNER 50 AS TO BECOME SU&IECT TO THE (/� WORNERS'CAMPENSATION LAWS OF CALIFORNI/�AND AQREE THAT IF I SHOULD BECOME INSPECTION FEE SUBJECT TO THE WOqKERS'COMPENSATION PROVISIONS OF SECTION 37oa OF THE LABOR �SS D O CODE,I SHALL FOFTHWITH COMPLY WITH THOSE PpOVI510NS. . ISSUANCE p DATE: APPLICANT: MIP �` � W J WARNINO:FAILURE TO SECURE WORNERS'COMPENSATION CAVERAOE IS UNLAWFUL,AND SHAIL BE ENERGY P/C � J � SU6IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOILARS(f100.o00).IN�DDITION TO THE COST OF COMPENSATqN,DAMhGES AS PROVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. NTI FE : .�� OCONSTRUCTION LENDING AGENCY p -AL � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AOENCV � a- FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.C.�. Z W � LENDEFYS NAME F— LENDER'SADDRESS � ICERTIFVTHATIHAVEREADTHISAPP�ICATIONANDSTATETHATTHEABOVEWFORMATKKJISCORRECT. TOTAL FEES � 2 �2 �g / /� `� W I AOREE TO CAMPLV WITH ALL CITY AND COUNTV OqDINANCES AND STATE LAWS RELATINQ TO BUILDINO � d � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CAUNTV TO EMER UPON THE )/ ' �j Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS �•O Y�`��(a�Yx` �. ^ �J O 0 J � m PERMITTEE NAME(PR1Nn ' . Q � � SIGNATUREOFPERMITTEE DATE 2 RECPT.NO. � PAID BV VALIDATION - F WHITE—Department Copy,YELLOW—Flnence Copy,PINK—Assessor Capy,GOLDENROD—File Copy,GREEN—Applicant's Copy CYYV O� DI�,NiOND �,�R If�Sf�ECI'IORI RECORD . n �M - _ . - I1 ��,�} �, �'�I�IYGC��ItUln'J �' B ' �� R� 0 '�� v�''�G'J��:..iv.�` �yr��, � L�t,�x�'" -�, � , o ' ��._ _ . .� � � , T BACK FLOOR JOIST FTGS/FORMS/STEEL � FHA REOMTS ELECTRIC GROUND UNDER FLOOR DUCT � GROUND PLUMBiNG UNDER 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-GRAD�NG ROUGH HEATING ' ' BENCHING ROUGH ELECTRIC ROUGH GRAD►NG ROUGH PLUMBING !I FINISH GRADING SHOWER/TUB TEST • POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION � POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING /7�i(! 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 7�// � DEV. FEES PAID FINAL PLUMBING ENERGY C�f��Co'X�` COMIVIEI�ITS 51as,.�. ��e z/,o SEPTIC TANK SIZE SEEP PIT/U SIZE a � ` � _ . _ �