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Home My WebLink About10-1064� _f�` CITY 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 i �'9^'� BUILDING PERMIT APPLICATION FIRMLY ¢ DDRESS O� � " Y DATEICATION/O !/y C^/O NUMBEFi/�IO p/C � ISSUE 'L J TYPE OCC APN LOT TRACT DATE p OWNER CONST T��ROUP � ADDR SS CL ZONING SETBACKS 0 z CITY ZIP TEL. FRONT qyy � i � APPLICANT TEL. REAR � ¢ SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE � ADDRESS _/ r`/� ��` � CITY ZIP TEL. PROPOSED USE �e'F'Q�flT/�-A wK.l� ��J 2"'CJ o ARCWENG/ � DESIGNER NO.DWEL. NO. NO. a ADDRESS u� UNITS STORIES BEDROOMS � CITY ZIP TEL. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION p SFR/ADD/REM � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT I M/E%EMPT FROM THE CONtRACTORS LI- G8f8 0/Ce OA W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANYCITYOR (f� 9 � U COUNryWHICHREWIRESAPERMITTOCONSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANVSTRUG W TURE,PRIOR 70ITS ISSUANCE,ALSO REWIRES THE AFPLICANT FOR SUCH PERMIT TO FILE A SI6NED w Patio/Deck � STATEMENT THAT HE OR SHE IS IJCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LF � CENSE UW(CHAPTER D(COMMENCINO WITH SECTION]000)OF DIVISION 3 OF THE BUSINESS AND PRO� � POOUSPO FESSIONSCODE)ORTHA7HEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� TION.ANV VIOI.ATION OF SECTION 703t.5 BV ANV APPLICAM FOR A PERMIT SU&IECTS THE APPUCANT TO Z Re-Roat A C�NALTY OF NpT MOqE THAN FIVE HUNORED DOLUAS(i500).): �0 ASONMEROFTHEPROPEFTV,OHMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COlfIfIIBfCIaI Z WILI THE WORK�ND THE S7RUC7URE IS NOT INTEN�ED OR OFFERED FOR SALE(SEC.7ou,BU51- J � NESS AND PiiOFESSIONS CODE:THE CONTRACTORS IICENSE LAW DOES NOT APPLV TO AN OWNER OF � � PROPERTY Nh10 BUILAS OR IMVROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q TMROUGHHISORHEROWNEMPLOVEES,7ROVIDEDTHATSUq11MPROVEMENTSAqENOTINTENDEDOR m 0 OFFEREDFORSALEIF,FIOWEVER,THEBUILAINOORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPIE� Z TION,THE OWNER$UILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUItD OR � IMPHOVE FOR THE PURPOSE OF SAL�. O I,AS OWNER OF THE PROPEHTV,AM EXq.U51VELY CANTRACTINO W ITH LICENSED CONTRACTORS TO CONSTRUCT TME PRQIECT(SEC.70a1,BUSINESS AND PHOFESSIONS CODE:TME CONTRACTORS LI- VBIIIdIIOf1 ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEROFAPROPERTYWHOBUILASORIMPROVESTHEREON.AND � NM1IOCONTRACTSFORSUCNPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION io�,s ucENse uw.�. FEE � ❑I AM EXEMPT UNDER SEC. 8,d P.C.FOR THIS REASON Q � U � DATE OWNER F— Z U �¢ LICENSED CONTRACTORS DECLARATION W 2 I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CFiAPTER � � 8(COMMENCINO WITH SECTION 70ao)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z X• 4V LICENSE IS IN FULI FORCE AND EFFECT. m llJ � UCENSE CLASS LIC.NO. � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION � � U N I HEREBV AFFIRM UNDER VENALIY OF PEqJURV ONE OF THE FOIIOWING DECLARATIONS: Z • � � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORNERS' _ , COMPENSATION,AS PROVIDEO BV SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMMICE U OF THE WORK FOR NMICH THIS PERMIT IS ISSUED. W � � Qw _I HAVE M1D WILL MAINTAIN WORI(ERS'CAMPENSATION INSUHANCE,AS REQUIRED BV SECTqN 370o OF THE LABOR CODE,FOR THE PERFORAIANCE OF THE WORN FOR WHICH THIS PERMIT IS O ISSUED.MV WOR)(ERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: TRUCTIO jCMRIER PLAN REVIE � � POLICv NUMBER ZQ ELECTRIC � (fFO55ECT10NNE�NDTBE00MPLFfIDOFTHEPERI.Y�ISFORpNEhll.lDRmOpi/��t10%ORIESS} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHA C�S SH�LL NOT EMPLOV ANV PERSON IN M!Y MANNER 50 AS TO BECOME SU&IECT TO THE (/� wORKERS'COMPENSA710N LAWS OF CALIFORNIA NdD AOREE THAT IF I SHOULD BECAME N � SU&IECT TO THE WORKERS'COMPENSATION GROVISIONS OF SECTION 77000F THE LABOR ,Q� � CODE.1 SHALL FORTHY/ITH COAIPLV WITH THOSE PROVISIONS. AN '�— � 1� DATE: APPLICANT: MIP W � WARNINO:FAILURE TO SECURE WORNERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECT AN EMPLOVER TO CHIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERG� DOLLARS(f10o.oao),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVI�ED FOR IN � SECTIDN 370E OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. TEN ION F �(� O � , CONSTRUCTION LENDING AGENCY P ALT FEE• � � I HEREBY AFFIRM UNDER PENhLTY OF PERJURV THAT THERE IS A CONSTNUCTION LENDINO AGENCV ZFOR THE PERFORMANCE OF THE WORK FOR WHICN THIS FERMIT IS ISSUED(SEC.3087,CIV.CJ. - � � W . � LENDER'S NAME � LENDERSADDRESS � TOTAL FEES v� ��•S�oZ � I CEFTIFY THAT I HAVE READ THIS APPLICATpN qHD STATE THAT THE ABOVE INFOqMATqN IS CORRECT. w 1 AGREE TO CAMPIV WITH ALL CfTV AND CWN7V ORDINANCES AND STATE UWS REUTING TO BUILDING d � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF 7HI5 COUNTY TO ENTEq UVON THE Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � � � 7i�LC� (��e' . � m PERMI7TEE NAME RI � ` � � ¢ � �� AV �O � N SIONATURE F ERM EE DATE �.` � � RECPT.NO. PAID BYC..JC_+ VALIDATION WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy CITV OF D9�aiViOND �AR � , I�SP�C�90�1 �3�CORD - - � �: , � �� ,; � o - �=� �.,z- . . , � � � � �G�J�P�.�'J�I�� ° '., . ��. �� ° , . � _ `r _ ' .�J�pCC�`u�O[►�.. ; '�JG�: ��. ��PCC. t�� .;.:,.. . ° � SET BACK , FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION � TEMP POWER FIREPLACE BOND BEAM ' WATER SERVICE MID HT. BOND BEAM , ROOF SHEATHING 8 FT. BOND BEAM � FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HE,4TING BENCHING ROUGH ELECTR�C 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. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. � SEPTIC TANK LANDSCAPEJIRRIG. 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 ENERGY C��o � . COMMENTS �v�--�_l. ��.�.. 90 ��"7 ou l2 � s�aa. SEPTIC TANK SIZE SEEP PIT/U SIZE a :� � .�ti,, w.,. ;��, � , - y� � . .