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Home My WebLink About17911 �x�� CITY OF DIAMOND BAR ------��--- DEPARTMENT OF COMIvIUNITY&DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS "-�� BUILDING PERMIT APPLICATION FIRMLY QJOBSITE � Z[f�/! �<r�.-�AL�/C� � � DATECATIONI (G� NU BER�� #/�_ ¢ ADDRESS � 'r < <=�-r- ;, °r APN LOT�� TRACT ISSUE ,/� TYPE OCC p OWNER _��,��LlTi C'�yFI�� DATE �� 'U� CONST. GROUP p ADDRESS 'z_Z��f �G6�Cff1'�J'L OR, ZONING SETBACKS Z CITY�.�,�{l ZIP TEL. FRONT RW ❑ � APPLICANT TE . � L' REAR ❑ Z �'^d��`�_ SIDE/SIDE STREET RW ❑ Q CONTRACTOR _ SIDE ❑ ADDRESS L8�'d 1[� • � CITY S k��f� ZIP /�� TEL9'77 'S ZS PROPOSED USE oARCH/ENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS co cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBY AFFIRM UNDER PENAL7V OF PERJURV THAT I AM E%EMPT FROM 7HE CONTRACTORS LI- G8f896/CBfpOR W CENSELAWFORTHEFOLLOWINGREASON(SEC.7o31.5BUSINESSANDPROFES510N5CODE:ANVCITVOR (n U COUNTYWHICHREOUIHESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� - w TURE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES 7HE APPLICANT FOFi SUCH PERMIT TO FILE A SIGNED w Patio/Deck STA7EMENT THAT HE OR SHE IS LICENSED PUFSUAN7 TO 7HE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHAP7ER 8(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSpB � FESSIONSCODE)ORTHATHEOHSHEISEXEMP77HEREFROMANDTHEBASISFORTHEALLEGEDE%EMF� (!f V TION.ANV VIOLATION OF SECTION 7031.5 BY ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re•Root � A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5500).): Z ❑I,ASOWNEROFTHEPROPERTV,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 Commercial - WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7o�d,BUSI� J � NESS AND GROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIMSELF OR HERSELF OR � THROUGH HIS OH HER OWN EMPLOYEES,PpOVIDED 7HAT SUCH IMPROVEMEN75 ARE NOT INTENDED OR m w OFFEREDFORSPLE.IF,HOWEVER711EBUIL�WGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE� � TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PqOVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR 7HE PURPOSE OF SALE). _ ❑I,ASOWNEROFTHEPROPERTV,AMEXCWSIVELVCONTRAC7INGWITHLICENSEDCON7RAC70RS W Q TO CANSTRUCT THE PROJECT(SEC.70l4,BUSINESS AND PROFESSIONS CODE:7HE CONTRACTORS LI� ValUO�lOf1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPfiOPER7VWHO8UILDSORIMPROVESTHEREON,AND � NMOCONTHACTSFORSUCHPRQIECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � J 0 ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � � U � ¢ DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION w � t HEHEBV AFFIRM UNDER PENALTY OF PERJURV THA71 AM LICENSED UNDER PROVISIONS OF CHAP7ER � � e(COMMENCING WITH SECTION 7000)OF DIVISION 30FTHE BUSINESS AND PROFESSIONS CODE,AND Z X MY LICENSE IS IN FULL FOFCE AND EFFEC7. - /5 y Q (`'� � � � LICENSE CLASS ` Z � LIC.NO. �. Z /c.� � V DATE y� I��B Z CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION ¢ � I HEREBY AFFIRM UNDER PENAL7Y OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z Q Z _I HAVE AND WILI MAINTAIN A CERTIFICATE OF CANSENT TO SELF-INSURE FOR WOHKERS' _ Q CAMPENSATION,AS PROVIDED BY SECTION 37o00F THE LABOR CODE,FOF THE PERFORMANCE w Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � Qw _I HAVEAND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION 3700 OF THE LABOR CADE,FOR THE PERFORMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUE�.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION J � CARRIER PLAN REVIEW ZPOLICY NUMBER ELECTRIC ¢ �� (�HISSEGTIONNEmNOTBECOMPLEfEDOFiHEPERMfTISFORONEHUI�DREDDOILARS(5100)ORLESS). PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C7 SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE � SU&IECTTO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 37oa OF 7HE LABOR ' CADE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � � _y�� I��O� SMIP p DATE: PPLICANT: J WARNING;FAILURE TO SECUHE WOfiKERS'CAMPENSATION COVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C � SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PEFMIT DOLLARS(f100.000j,IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN � . � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE: � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBYAFFIRM UNDER PENALTY OF PERJURV THATTHERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WOR "R/'W/HICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z �/1 f I I W � LENDER'S NAME � LENDER'SADORESS � � TOTAL FEES . � � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPLV WITH ALL CITY AND COUNTY ORDINANCES AND STATE L4WS RELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUN7Y TO ENTER UPON THE � ABOVE�MENTIONED PROPERN FOR INSPECTION PURPOSES. Z � COMMENTS � ��_ � , m PERMI77 E(PR T) Q � � SIGNATUREOFPERM DATE = RECPT.NO. PAID BY VALIDATION � ~ WHITE—De aAment Copy,YELLOW—Finance Co PtNK—Assessor Copy,GOLDENRO�File Co GREEN—A licant's Co P PY� PY. PP PY . ^ _ . , . . . . . . � � �� (� �ig�6�� Q� D�I�G'��9C�(�' 1�3��C�1�3� 01�.1�� D��.� OGJ�G�� OG� tr o� DGJ`� OG� o,p SET BACK FLOOR JOIST j ---- , --- -- -- --------T— ----------.._— FTGS/FORMS/STEEL _ F FHA REt�MTS _ ___.._ ' __... ,.. ._--- --__ -- � ___ __--_� _----- ELECTFi{C GROUND � � � UNDEH FLOOR DUCT ----... — _..- -- � ------ GROUND PLUMBING '^�2� ; UNDER F�OOR CU�IDUIT � ___ SLAB GRADE , � FIREPLACE FOUPUDATION _ TEMP POWER ,_ I � FIREPLACE BOND BEAM — _. _. ----------- -----------....__ WATER SERVICE � MID HT. Bt7iVD BEANi - ---�- - -----._----- ---- ROOF SHEATHIIVG ; 8�� B��a B�A� i _. FRAMIiVG/VENTILIATION I FItJAL BOND BEAM _ i __ ROOF�OVER PRE-GRADING _____ _ _______ ROUGH HEATING BENCHING _ ROUGH ELECTRIC ROUGH GRADING __ ___ ROUGH PLUNIBING ! FINISH GRADING _ _ SHOWER/TUB TEST I POOL ELECTRIC � _ _ _ _._.--- -- . . EXT. LATH/SIDING ; i POOL FENCING ------- -..___�_.� _.�__ ___�.�_---._____ � WALL INSULATIOh! � POOL FINAL � CEILING INSULATIO(V � OF� F SITE IN�PS. - � --- DRYWALL NAILING ' DEDICATIONS SEWER ` FINAL ENG. ----___.._ SEPTIC TAIVK LANDSCAPE/IRRIG. ---__�_._....__ ______ _ SEEP PIT/�.L. ON SITE IMPS. ' GAS AIR TEST _2 �L I FINAL ZO(VING _ FINAL CO(�ST. —� —� F!R— E DC i-FINAL ^ FINAL HEATING i HEAL.TH DEPT. FINAL FIPJAL ELECTRIC ; DEV. FEES PAID FIiVAL PLUfVIBING ; ENERGY __.._.__._. _ � , � � — ---- -- ____� - --- C�G�� -------�- --- e C�IVIIVI�Itl�S SEPTIC TANK SIZE SEEP PIT/U SIZE - , � - __ __----- ---------- �G�l � � �..._ �.-- -----.___._ �