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Home My WebLink About11-237� 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 `°"' BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE APPLICATION PERMIT p/C ADDRESS ��'�'� ST�� - pf2- • DATE �� << NUMBER� # � ISSUE TYPE . OCC APN LOT TRACT DATE p OWNER � �SID�NG� CONST. GROUP o ADDRESS Sier�� ZONING SETBACKS z CITY ZIP TEL. FRONT qyy � o APPLICANT �(�/5N16{� �yK TEL.71�-'709 30?3 REAR p z¢ SIDE/SIDE STREET q�l p � CONTRACTOR � � Go �r�a� SIDE � � ADDRESS 11� O C�T. sp�,n��t S PROPOSED USE LJ i�A I I ��P� S{n,ic�o„c�(,.�Q,��-�c 'Z, �Gru62ZIP��n TEL.S(,�-4o7-53So � � p�F ��tiL .T � �n ; lbs w ARCH/ENG/ -�-5 � � z DESIGNER /q,�- • '�'m`�-+� T�� la q.� 16t w NO DWEL. � � NO. ' Np. a ADDRESS N UNITS � STORIES � BEDROOMS N CITY - - ZIP TEL. � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDEA DECLARATION p SFR/ADD/REM p I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CONTRACTORS LI- Gaf99B/C81POR W CENSEUWFORTHEFOLLOWINOREASON(SEC.7a31.5BU51NE5SANDPROFESSION9CODE:ANYCITYOF (n C� COUNTVWHICHREWIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE.OEMOLISH,ORREPAIRANVSTHUG PB�IOID6CI( W NRE.PRqR TO RS ISSUANCE.ALSO REQUIRES THE APPLICANT FOR SUCN PERMIT TO FILE A SIONED W � STATEMENT 7HAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF hIE CONTRACTORS U- � � CENSE UW(piAPTER e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS ANO PRO- � PooUSpa FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� (� TION.ANYVIOLATIONOFSECTION7031.6BVANVA7PLICANTFORAPERMITSU&lECTShIEAPPLICANTTO Z Re-Roof � A CML PEN�LTV OF NOT MOFE THAN FIVE HUNDRED DOLLARS(i500).): Z ❑I,ASONrtJEROFTHEPROPERTV,ORMVEMPLOVEESWI7HWA0ESASTHEIR50LECOMPENSATKKJ, � CpmmBfC181 WILI DO THE WORK�N�71iE STRUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC,7aa,BU51- J � NESS AND PROFESSIONS CADE:THE CANTRACTORS UCENSE LAW DOES NOT APPLV TO AN OWNER OF � G PROPER7Y WFiO BUILDS OR IMPROVES THEREON,AND VhlO DOES SUCH WORK HIMSELF OR HERSELF OR w THROUGH HIS OR HEF OWN EMPLOVEES,7ROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVER,7�{EBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAAOFCOMPLE- Z TION,THE OWNER�UILDER WILL HAVE THE BURDEN OF PqOVINO THAT HE OR SHE DID NOT BUILD OR � IMPpOVE FOR THE PURPOSE OF SALE). �� a W ❑1,1150WNEROFTHEPROPERTV,AME%CIUSIVELYCONTRACTINOWRMLICENSEDCONiRACTORS ' � TO CONSTRUCT THE PR0.IECT(SEC.7014,BUSINE55 ANO PROFESSIONS CODE:THE CONTRACTORS LI- V8IU0fI0f1 T Ti�� L qp,�.qqEq � CENSE LAW DOES NOTAPPIV TOAN OWNER OFA PROPERTV WHO BUILDS OR IMPROVES THERE-0N,AND WFiOCONTMCTSFONSUCHPRQIECTSWITHACANTqACTOH(SJLICENSEDPURSUANTTOTHECONTMG ou�wnrv DESCRIPTION Y roas ucENSE uw.�. FEE Q ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � U � DATE ONMER F�- � LICENSED CONTFACTORS DECLARATION w � I HEREBY AFFI{UA UNDER PENALTV OF PERri1RV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � � G�COMMENCINO WRH SECTION 7000)OF DIVISqN 3 OF 7HE BUSINESS AND PROFESSIONS CODE,AND Z ' �� MV LICENSE IS IN FULL FORCE AND EFFECT. m � UCENSE CLASS �^�.�r � � LIC.NO. � > � , ~ DATE Z��'�/�1 J ' " V cor�ranc7oa d w � WORKERS'COMPENSATION DECLARATION � I N I HEREBV AFFIRM UNDER 7ENAL7Y OF PERJURV ONE OF THE FOLLOWING DECUAATIONS: U J � Z 0Z _I HAVE M1D WILL MAINTPJN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WOqKERS' a Q COAIPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U O WORK FOR WHICH THIS PERMIT IS ISSUED. W � � W I HAVE AND WILI MAINTAIN WOR)(ERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370D OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERA/1T IS /�y� /� ISSUED.MV WORKEFS'COMPENSATION INSU,RA•NCE CARRIER AND POLICY NUMBER ME: CONSTRUCTION �� CARqIER �T-�Fr� TN ND PLAN REVIEW 0 POLICv NUMBEF � � ELECTRIC � (iHI55ECilONNE�NOTBECOA4LEfFDOFTI$PERI�MISFOqpNEFRN�HEDDp1FAS(f10D)ORLESS} PLUMBING W Z I CEfiTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C,'} SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECAME SUBJECT TO THE (/j WORNERS'COMPENSATION LAWS OF CALIFORNIA AND AOREE THAT IF I SHOULD BECOME INSPECTION FEE SU&IECTTOTHEWORKERS'COMPENSA NPROVISIONSOFSECTION37000FTHELABOR O COD ,1 SH FORTHWITH COMPLY T PROVISIONS. ISSUANCE 1p DATE: �"` I I APPLICAN. ' . _ SMIP �8� J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION COVERAQE IS UNLAWFUL,AND SHALL BE ENERGY P/C � J �y SU&IECTANEMPLOVERTOCRIMINALPENALTIESAN�CIVILFINESUPTOONEHUNDREDTHWSAND ENERGYPERMIT DOLURS(5100,000),IN�DDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEVS FEES. J� w RETENTtON FEE: �� CONSTRUCTION LENDING AGENCY pqE�qLT FEE� � I HEREBV AFFIRA/UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AOENCY ��4 d � da FOR THE PERFOqMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.C.). �l r�� Z W � LENDER'S NAAIE F– LENDERSADORESS w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFOqMAT10N IS CORRECT. TOTAL FE ES f �� I AOREE TO CAMPLY N7TH ALL CITY AND COUNTY ORDINANCES AND STATE UWS RELATING TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CAUNTV TO ENTER UVON THE Z ABOVE-MENTIONED PROPERTV FOR INSPECTqN PURPOSES. COMMENTS � �v�G ✓ � m P I NAME( r r ¢ � 1 1 U� � SIGNA OF PERMITTEE p�7 � RECPT.N0. PAID BY VALIDATION WHITE—Oepartment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy � J CITY O� DI�►f�fiOftlD �AR INS��Y9�� V��CORD . , .� �la�p[�C�4Q0� D�4C a4,�� d[��pGC�40G3 . Oa�QLC�T40�1i�: : DGJ4C :Da�pLC�40G3'� SET BACK 'v, 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 HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FIfVISH 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 LANDSCAPE/IRRIG. SEEP PIT/L.l. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH QEPT. FINAL FINAL ELECTRIC �r DEV. FEES PAID FINAL PLUMBING ENERGY ��'�: COMMENTS " " �a�S"_lf�j� �x� s r �:ti�- �,��-► �-S ,3��'�, � SEPTIC TANK SIZE SEEP PIT/U SIZE � a -`� � .t? �i� Yc 1 . �.i. . �t} Q` ',JR. .