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Home My WebLink About16907 (25) _--�� ---_ CITY OF DIAMOND BAR EX p I R E D DEPARTIv�NT OF COMMiJNITY&DEVELOPIvIENT SERVICES 21825 E.Copley Drive I � '�"� (909)860-3195 Fax(909)861-3117 J U N 19 2002 PRESS "'��'� BUILIDING PERMIT APPLICATION FIRMLY I } JOBSITE �`� ` R `,, APPLICATION PERMIT �� P/C o ADDRESS��Iv V I� V1, �S�• DATE NUMBER # � ISSUE TYPE OCC APN LOT TRAC DATE I CONST. � GROUP p OWNER S . I�F��Z��°- o ADD SS ZONING SETBACKS Z CITY�( ZIP . TEL. FRONT RW ❑ o APPLICANT TEL. S DE/SIDE STREET RW ❑ z m CONTRACTOR C� SIDE p ¢ ADDR,�t�S /� ' � CITY IV� ZIP TEL N PROPOSED USE I oARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS cn cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBV AFFIRM UNDER PENAL7Y OF PERJURV THA71 AM EXEMPT FROM THE CONTRAC70RS LI� Gef8J0/CBfPOR W CENSEUWFOR7HEFOLLOWINGREASON(SEC.7o37.5BUSINESSANDPROFESSIONSCODE:ANVCITVOR (n U CAUNTVWHICHREQUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,OHqEPAIRANYSTRUC- W TURE.PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck S7ATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTORS LI- � CENSE LAW(CHAPTER B(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSWE55 AND PRO� u" PooUSpa � FESSIONS CADE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR THE ALLEGED E%EMP- (�J V TION.ANYVIOLA710NOFSEC710N7o31.5BVANVAPPLICANTFORAPERMITSUBJECTS7HEAPPLICANTTO Z Re-Roof A CIVIL�ENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f5o0).): ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOVEESWI7HWAGESAS7HEIRSOLECAMPENSA710N, � Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.704I,BU51- J COrtIrtIOfClel - � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WOHK HIMSELF OR HERSELF OR Q THROUGHHISORHEROWNEMPLOVEES.PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m � OFFEREDFORSALEIF,HOWEVER7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING 7HAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w O I,ASONRJEROFTHE PROPERTV,AM EXCLUSNELV CON7RAC71NG WITH UCENSED CONTRAC70R5 � TO CANSTRUC7 THE PR0.IECT(SEC.70�a,BUSINESS AND PROFESSIONS CADE:THE CONTRAC70R5 LI� VelU0ll0n ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPER7YWHOBUILDSOHIMPROVESTHEREON,AND � WHOCONTRAC7SFORSUCHPROJEC7SWITHACON7RACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.d P.C.FOR THIS REASON Q ' � U � � DATE OWNER U Z W � LICENSED CONTRACTORS DECLARATION W Q � I HEHEBY AFFIRM UNDER PENALTY OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d e(COMMENCING WITH SECTION 700o)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �X MY LICENSE IS IN FULL PORCE AND EFFEC7. m - � IICENSE CLASS LIC.NO. D j �, J U DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENALTV OF PERIURY ONE OF 7HE FOILOWING�ECLARATIONS: Z Z _IHAVEANDWILLMAINTAINACERTIFICATEOFCANSENTTOSELF-INSUREFOfiWORKERS' _ a CAMPENSA710N,AS PROVIDED BY SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE w Q OF THE WORN FOR WHICH THIS PEFMIT IS ISSUED. � W ��HAVEAND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS RE�UIRED BV SECTION Q 370o OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSU NC C RIER AND POLICY NUMBER ARE: CONSTRUCTION J � CARRIER PLAN REVIEW Z POLICV NUMBER ELECTRIC ¢ 0 � • � � (fHLSSECTIONNEmNOTBEOJMPLEfFDOFh1EPERMfTISFORONEHUI�DfiED001.LAR5(E10o�ORLESS} PLUMBING _ W Z I CERTIFY THAT IN THE PERFOflMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (,'} SHALL NOT EMPLOY ANV 7ERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE _ = SUBJECT TO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 37oa OF THE LABOR - � CODE,1 HALL ORTHWITH COMPL�(, OS ROVISIONS. ISSUANCE . 1 � SMIP p DATE: � APPLICANT � J WARNING:FAILURE TO SECURE WORKERS'COMPENSA710N COVEFAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJECTAN EMPLOYER TO CRIMINAL PENAL71E5 AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOH IN � SECTION 3708 OF THE LABOF CODE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: �. � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PEFiJURY THAT THERE IS A CONSTRUCTION LENDING AGENCV , FOR THE PERFORMANCE OFTHE WORN FOR WHICH THIS PEFMIT IS ISSUE�(SEC.30B7,CIV.C.�. Z W � LENDER'S NAME � LENDER'SADDRE55 � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFOFMATION IS CORRECT. TOTAL FE ES � r�� w I AGREE TO COMPLV WITH ALL CITV ANO COUNTV OFDINANCES AND STATE UWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHOR2E REPRESEN7A71VE5 OF THIS COUNTV TO ENTER UPON THE ZABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENT$ � � � � n m ITTEE N (PRINT) � � � � � ) � N SIGNATURE MITTEE T � = RECPT.NO. �, �PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy . .. . . . . .. . . . . . , . ... . . . �.. � . .� . . �f ..s �t'� � ... ' . . . ' . , . �Ylll� Il �II ✓��UUY\%�ll�! 11r�/I111� ��9��{� I��1� ��Q�� QC7��[JO[c� DQ r� 0�� O�C�i JOG� DGJ`� � 0� � o � �. SET BACK F�OOR JOIST FTGS/FORMS/STEEL � FHA REQMTS � ' ' - -�------ : ----- r --{--- _._..__ ELECTRIC GROUND � _ � j UNDER FLOOR DUCT - --- ----_ —..._..�------- ! __..-- GROUND PLUMBING ' UNDER FLOOR CU�iDUIl" i _______ SLAB c?uRADE FIREPLACE FdUNDATION ____ TEMP POWER ! ___i_ _FIREPLACE_BOND BEAM ' W,4TER SERVICE ! � M1D HT. B�ND BEAM � � ROOF SHEATHING ' 8 Ff. BOND BERM' � FRAMINGNENTILIATION FINAL BOP�D BEAM i _ _._,.____ ...--- —------.__._� —�_.._.---- ROOF COVER PRE-GRADING I � ROUGH HEA7WG BENCHING ROUGH ELECTRIC ROUGH GRADING -- � ...___ __.----- — -----.____. ROUGH PLUMBING ; FINISH GRADING SHOWER/TUB TEST ; POOL ELECTRI� EXT. IATH/SIDING ' POOL FENCING WALL I�lSULATIOiV POOL FINAL i CEILIPEG INSULATION OFF SITE 1MPS. ! � DRYWALL fVAILING DEDIG,4TIONS — -.. - ------__� SEWER FINAL ENG. � SEPTIC TANK LAPJDSCAPE/IRRIG. SEEP PIT/I�.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL COfVST. � �!RE DEPT. FI�lAL FINAL HEATlNG ! HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING � ENERGY � � --..._ C��G,�l!'O��o ' ° -..-- C�NiiViEfVTS SEPTIC TAYJK SIZE SEEP PIT/U SIZE --- �^ � __..._----- � � ------ � ', .