The URL can be used to link to this page

Home My WebLink About25065C 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 H'BUILDING PERMIT APPLICATION FIRMLY JOBSITE APPLICATION PERMIT nc p/CoADDRESSjD DATE NUMBER t' # ISSUE 2 TYPE OCC APN LOT TRACT DATE J S CONST.GROUP p OWNER ADD ESS t ZONING SETBACKS Z CITY T ZIP TEL.iZ Z jj a FRONT R ly p APPLICANT TEL. SIDE/SIDE STREET RW CONTRACTOR SIDE ADDRESS • u CITY .,,K- ZIP i TEL. PROPOSED USE G/ q. w ARCH/ENG/ z DESIGNER w NO.DWEL. NO.NO. a ADDRESS CITY ZIP TEL. UNITS STORIES BEDROOMS n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p OWNER-BUILDER DECLARATION SFR/ADD/REMO p I HEREBV AFFIRM UNDEfi PENAL7V OF PERJURV THAT I AM EXEMPT FROM 7HE CONTRACTORS LI- Gdf8g0/CefPOAWCENSELAWFORTHEFOLLOWINGREASON(SEC.7o31.5BUSINESSANDPROFESSIONSCODE:ANYCITVOR (nUCOUNryWHICHRE0U1RE5APERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTiiUC- w TURE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOH SUCH PERMIT TO FILE A SIGNED w Patio/DeckSTATEMENT7HA7HEORSHEISLICENSEDPURSUAN7TOTHEPROVISIONSOFTHECON7RAC70RSLI CENSE LAW(CHAPTER G(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- PooUSpa FESSIONSCODE)ORTHATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALLEGEDEXEMP ( TION.ANVVIOUTIONOFSECTION7031.SBVANYAPPLICAN7FORAPERMITSU&IECTSTHEAPPLICAN7T0 Z Re-RoofACIVILPENALTYOFNO7MORETHANFIVEHUNDREDDOLLARS(f5oo).): Z I,ASONMEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, COrt1rtIBfCl81 WILL DO THE WORK,AND THE STHUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70 1,BU51- J N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPER7V WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HEH OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMEN75 ARE NOT INTENDED OP m OFFERE FORSALEIFHOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE- Z TION,THE OWNER BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF S/LE). W I,AS OWNER OF THE PROPER7V,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC ORS TO CONSTRUCT THE PRQIEC7(SEC.70a,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- V81U8f1011 ADJ.AREAWCENSEUWDOESNOTAPPLYTOANONMEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND WHOCANTRACTSFORSUCHPR0.1EC7SWITHACONTRACTOR S LICENSEDPURSUAN7TOTHECONTRAC- QUANTITY DESCRIPTION FEE Y 70RS LICENSE LAW.). Q J O I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON QU LL DATE OWNER Z w LICENSED CONTAACTORS DECLARATION W 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER d D(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PPOFESSIONS CODE,AND ZXAIYIICENSEISINFULLFORCEANDEFFEC7, mL1JG LICENSE CLASS C R LIC.NO.L 1 j V DATE I D-O[. CONTRACTOR d W WORKERS'COMPENSATION DECLARATION Q NI HEREBY AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWING DECURA710N5: Z I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF INSURE FOR WORKERS' Q CAMPENSATION,AS PfiOVIDED BV SECTION 37o00F 7HE LABOR CODE,FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w I HAVE AND WILI MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370o OF THE LABOR CADE,FOR THE PERFORMANCE OF THE WOPK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS' MP NSATION INSURANCE CA RIER AND POLICV NUMBERARE: CONSTRUCTION Q CARRIER "S 7 4--.ln _ PLANREVIEW Z POLICYNUMBER (!i 'i'I D ELECTRIC lZJiHISSECf10NNENOTBEOOMPI.EfEDOFTHEPEMYTISFORONEFNPDREDOp1ARS(5100)ORLESS? PLUMBING Z 1 CER7IFV THA7 IN THE PERFORMANCE OF THE WORN FOR WHICH 7HIS PERMIT IS ISSUED,I MECHANICAL SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECAME SUBJECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF 1 SHOULD BECAME INSPECTION FEE SU9IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37000F THE LABOfi CADE,ISHALLFORTHWITHCOMPLYWI7HTHOSEP OVISIqy ISSUANCE V SMIP p DATE:16-L 1-v[ APPLICANT: J WARNING:FAILURE TO SECURE WORKERS'COMP NSATION COVE AGE IS UNLAWFUL,AND SHALL BE ENERGY P/C SU&IECTANEMPLOVEHTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMITDOLLARS(S70o,o00,IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN 1,SECTION37a80FTHELABOFCODE,INTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: I bv a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O I HEREBV AFFIFM UNDER PENALTV OF PERJURY THAT THERE IS A CONS7RUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.. ZW LENDER'S NAME F— LENDER'SADDRESS TOTALFEESICERTIFYTHA71HAVEREADTHISAPPLICATIONANDSTA7ETHATTHEABOVEINFORMATIONISCARRECT. JwIAGREETOCOMPLVWITHALLCITVANDCOUN7VORDINANCESANDSTA7ELAWSRELA7INGTOBUILDINGv ' CANSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATNES OF THIS COUNTV TO ENTER UPON THE ZABOVE-MENTIONED 7HOPERTV FOR INSPECTION PURPOSES. Q COMMENTS m PERMI77EE NAME(PRINT) a G6 N SIGNATUFE OF PERMI E DATE RECPT.N0. PAID BY VALIDATION WHITE—DepaRment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENRO File Copy,GREEN—Applicant's Copy V 9 f d I$ I Sf['0 I l l Oa 3pf G400GYJ DGJ4G O pC CC 40Q Oa PCC 40C7a DGJ4C ..DGrI ..a_ tfi 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 HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE MPS. 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 DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY o COMMEIVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a i7 C