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Home My WebLink About11-1426 _ _�� 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)839-70 7 PRESS �'9N'� BUILDING PERMIT APPLICATION �- FIRMLY o� JOBSITE APPLICATION I PERMIT J� p/C ADDRESS DATE_ ��/ NUMBER /' /! # � � APN�QT TRACT ISSUE ,r� / 7ypE /� �C � DATE v / CONST._�,/�GROUP p OWNER �V"� o ADDRESS ZONING SETBACKS w FRONT � CI ZI TEL. RW ❑ APPLICANT TEL REAR � � SIDE/SIDE STREET RW ❑ � CONTRACTOR SIDE � ADDRESS o � CITY Z TEL. PROPOSED USE o ARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. v� UNITS STORIES BEDROOMS � CITY ZIP TEL. I � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECIARATION p SFR/ADD/REM p 1 HEREBV AFFlRAI UNDER PENALTV OF PEfLR1RV THAT 1 AM E%EMPT FROM THE CONTRACTORS LI- GHfB B/Ce OR W CENSE UW FOH THE FOLLOWINO REASON(SEC.7031.5 BUSW ESSAND PROFESSIONS CODE:ANV CITY OR (n 9 � C-� COUNTVWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER.IMPROVE.DEMOLISH,ORREPAIRANVSTRUC� w w NRE.PRqR TO ITS ISSUANCE,AL50 REW IRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w Patlo/Deck � STATEMENT TFUT HE OR SHE IS LICENSED WRSUANT TO THE PROVISIONS OF THE CONTRACTOR$LI� � CENSE LAW(CHAPTER D(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF TFIE BUSINESS AND PRO� � POOUSPB FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE/�LLEGED E%EMP- (� TION.ANY VIOLATION OF SECTION 7037.6 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO Z Re-Roof � A CML PENALTV OF NOT MOFiE THAN FIVE HUNDRED DOlLARS(f500)J: � ❑I,ASONMEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOIECOMPENSATION, COrtIrtI0fC18I WILL DO THE WORK,AND 7HE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7oM,BUSI� � � NESS AND VROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NO7 APPLV TO AN OWNER OF � PROPEHTV WHO BUILOS OR IMPROVES THEREON,AND NM110 DOES SUCH WORN HIMSELF OR HERSELF OR CL TMROUGH HIS OR HER ONRJ EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT IMENDED OR m 0 OFFEREDFORSALEIF,VpWEVERTFiEBUILDINOORIMPROVEMENTIS50LDWRHINONEVEAROFCAMPLE- Z TION,THE OWNER�BUILDER WILL HAVE 7HE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUIID Oq � IMPROVEFORTHEWRPOSEOFSALE). W O I,AS ONRIER OF THE PROPERTV,AM EXCLUSNELY CONTRACTINO WITH LICENSED CONTRACTOflS Q TO CONSTRUCT THE PRQIECT(SEC.70U,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� V9IU8tlOf1 ADJ.AREA ' W CENSE lAW OOES NOT APPLV TO AN ONMER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � WFIOCONTRACTSFORSUCHPRQIECTSWITHACANTqACTOR(S�LICENSEDPlJqSUMfTTOTHECONTRAG pUANTITY DESCRIPTION�� ' � rau ucENSE uw.�. FEE Q ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q ' � U � DA7E OWNEp F- Z U � LICENSED CONTFACTORS DECLARATION W � I HEREBY AFFIRM UNDEH PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCIN6 WITH SECTqN 7000)OF DNISION 3 0F THE BUSINESS AND PROFESSIONS CODE,AND Z �� MY LICENSE IS W FULL FORCE AND EFFECT. m � LICENSQ GLASS �IC.NO. � �� / U DA� CONTRA OR d w . � � WOAKERS'COMPENSA � � I HEREBY AFFIRM UNDER PENALTY OF PERIURY ONE OF FOLLOWING DECLARATIONS: � � Z �Z I AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF-INSURE FOR WORKERS' a ' Q PENSATION,AS PROVIDED BV SECTION 37000F TNE LABOR CODE.FOR THE PERFORMANCE ' U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. • W - � � � I HAVE AND WILL MAINTAW WORKERS'COMPENSATION INSURANCE,AS REWIRED BV SECTqN . Q 3700 OF THE IABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS ISSUED.MY WORN/Egs'�•COMPpENS�ATION IN �ryAy7CyE�C��RRIER AND POLICV NUMBER ARE: CONSTRUCTION j CAARIER /�-yO9Jt�K�: �.��!'��!'L^ - � PLAN REVIEW ZPOLICV NUMBER_ �� /!i ' 2_ � ELECTRIC ¢ p' (hil5SEC110NNE�NOTBE07MRETE�OF7HEPERMfTISFOFiONEFiIF�OREDDOUMS(t1a0)ORLESS} PLUMBING �j W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WOR)(FOR WHICH THIS PER MECHANICAL C'} SHAIL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECOM ECT TO TH (/� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND A�REE E�' �� INSPECTION FEE = SU&IECTTOTHEWORKERS'COMPENSATION I 5 S OFT OR CADE.I SHALL FORTHWI7N COMPLV WI OSE P 10 . ISSUANCE / I � p DAT � � APPLICA -SMIP w ENERGY P/C J WAFiNINO:FAILURE TO SECURE WORKERS'CAMPE 10 A UL,AND SHALL BE J � SU&IECTANEMPIOVERTOCRIMINALPENAL7IES D TOONEHUNDREDTHOUSAND ENERGYPEFMIT DOLURS(5100.000),IN�ODITION TO THE COS F COMPENSATION,DAMAOES AS PROVIDED FOR IN J SECTqN 3�OB OF THE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. w RETENTION FEE: O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: . � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDINO AGENCV a- FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.308�,CIV.CJ. Z W � LENDER'S NAIAE . I— LENDER'SADDRESS � ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT. TOTAL FEES o � �� I A6REE TO COMPLV N7TH ALL GTV AND COUNTY ORDINANCES M1D STATE LAWS RELATINO TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE R P SENTATI ES OF THIS COUNTV TO ENTER UPON THE � Z ABOVE-MENTq ED P ERTV FOR INSP URVO s. COMMENTS � � J � m PERMITTE AME I � Q C/� N SIONAN O�� I E DA7E � RECPT.NO. PAID B VALIDATION ITE—Department Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD—Ftle Copy,GREEN—Applk;anfs Copy CITV O� DIAiVdtJND ��,R IR�S�EC�'EOi� R�CORD .. �= :�a�p�c�400a ac�a� oa�pc�c��oa oa�p��ooa� �a4�:: ��: �t�� ... � SET BACK FLOOR JOIST FTGS/FQRMS/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 H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBIPIG 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 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 I`� �� ENERGY C��OC�� COMMENTS _ ac�f1'—��1=�— � SEPTIC TANK SIZE SEEP PIT/U SIZE a � � �