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Home My WebLink About11-1450 ��` CITY OF DIAMOND BAR ✓ DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES / 21825 Copley Drive,Diamond Bar,CA 91765 � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7 � PRESS �''�"� BUILDING PERMIT APPLICATION ,� FIRMLY o� JOBSITE , I�� ` APPL�CATION PERMIT /p/C ADDRESS� �� DATE NUMBER I"� (/p � ISSUE ^� , �C APN LOT TRACT DATE � �-/ � CONST. GROUP p OWNER ��V��f� �?� �'1 - o ADDRESS ZONING S qCKS FRONT Z CITY Z P TEL. RW ❑ � APPLICANT • TEL. b REAR � SIDE/SIDE STREET RW ❑ � CONTRAC OR i . SIDE � ADD E S O PROPOSED USE o CITY ZIP TEL. / ?�I �- G �i w ARCWENG/, � � z DESIGNER � � � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBV AFFIRM UNDER PENALTV OF PERri1RV THAT I AM EJ(EMPT FAOM THE CANTRACTORS LI� G8l800/COfPOR W CENSEIAWFORTHEFOILOWINOREASON(SEC.7031.6BUSINESSANDPROFESSION9CODE:ANVCITVOR (f� U CpUry7yWHICHRC-0UIRESAPEqMITTOCANSTRUCT,ALTER,I/APROVE,DEMOLISH,ORREPAIRANVSTRUC- w NRE,PRqR TO ITS ISSUANCE,AL50 qEQUIRES THE APPUCANT FOR SUqi PERMIT TO FILE A SIGNED w Patlo/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTOR9 LI� C CENSE UW(CHAPTER B(COMMENCWO WI7N SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PR0. � Pool/Spe `l FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALlEOED E%EMP� � V TION.ANYVIOLATIONOFSECTION7o31.5BVANVAPPLICANTFORAPERMITSU&IECTS7HEAPPLICANTTO qe..qpp} /�� A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(f500�.): Z � {/r/ Q OI,ASOWNEROF7HEPROPERTV,ORMVEMPIOVEESWITHWAGESASTHEIR50LECOMPEN5AT10N, � COrtITBfCIBI � Z VALI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W1,BUSI- J � � � HE59 M1D PROFESSIONS CADE:THE CONTRACTORS UCEN9E LAW DOES NOT APPLY TO AN OWNER OF j PROPERTY MR10 BUILDS OR IMPROVES THEREON.M1D WHO OOES SUCH WORK HIMSEIF OR HERSELF OR , w THliC%lOH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPqOVEMENTS ANE NOT INTENDED OR m Q OFFEREDFORSALEIF,FqWEVER,THEBUILDINdORIMPROVEAIENTI550LDWITHINONEYEAROFCOMPLE� Z TION,7HE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING TMAT HE OR SHE DID NOT BUILD OF = IMPROVEFORTHEPURPOSEOFSALE). , �yJ ❑4��NNER OF THE PROPER7Y,AM E%CLUSIVELY CANTRACTINO WITH LICENSED CONTRACTORS Q TO CONSTRUCT THE PRQIECT(SEC.7W1,BUSINE55 ANO PROFESSIONS CODE:7HE CONTRACTORS LI- V8IU9�lOf1 ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN ONMER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION Y Toas uc�sE uw.�. FEE Q ❑I AM E%EMPT UNDER SEC. B.6 P.C.FOR THIS REASON � � ,lJ ?� U . � DA7E OWNER H Z U F LICENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PENALTY OF PERNRV THAT I AM LICENSED UNDEfl PROVISIONS OF CHAPTER � � 9(COMMENCIN(i WIiH SECTION 7000)OF DIVISION J OF THE BUSINESS AND PROFES510N5 CODE,AND Z � �� MY UCENSE IS W FULI FORCE AND EFFECT. m � LICENSE CLASS LIC.NO. �� V DATE CONTRACTOR . d W � WORKERS'COMPENSATION DECLARATION Q � U N I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECURATIONS: Z � � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSEM TO SELF-INSURE FOR WORKERS' a . S Q COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE VERWRMMICE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � W ' � � w I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE.AS REWIRED BV SECTION Q 3700 OF THE LABOR CADE,FOR THE PERf-0RMANCE OF THE WORK FOR WHICH THIS PERMIT IS /��/'�� /q � ISSUED.MV WOR S' PENS TION INSURANCE D POLIC UMBER ARE� CONSTRUCTION ��•� IC�d�� jCAARIER �� l��Ce pLAN REVIEW ZaoucvNun+eEa " ELECTRIC -�j ,3 ¢ . p (iHISSECi%7JNE�NOTBEWMREfIDOFh$PERAYTISFORONEFIA�DREDDOLI}AS�t1ao)ORLESS} PLUMBING W Z 1 CERTIFV THAT IN TF7E PERFOHMANCE OF THE WOfUC FOR WHICN THIS PERMIT IS ISSUEO.1 MECHANICAL LJ' SHAIL NOT EMPLOV PNV PERSON IN ANY MANNER AS TO ME SU&IECT TO THE (/� WORKERS'COMPENSATqN LAWS OF CALIFORNI D AO E AT IF I SF/OULD BECOME INSPECTION FEE SU&IECT TO THE WORNERS'COMPEN N P ISIONS F TION 370o OF THE LABOR � O CODE,1 SHA FOR TH COMPIY ITH M IS N ISSUANCE �/ \ � p DATE: " — '� APPLICAN.. SMIP �� W J WARNINQ:FAILUFE TO SECURE WORKERS'CA NS ION CAVE UNLAWFUL,AND SHALL BE ENERGY P/C � J � SU&IECTANEMPLOVERTOCRIMIN�LPENALTIE AND IVILFWES P �ONENUNDREDTHOUSAND ENERGYPERMIT DOLURS(5100,000),IN PDDITION TO THE COST CA PENSATION,DAMAOES AS PROVIDED FOR IN J SECTION 3708 OF THE IABOR CODE,MTEREST,A ORNEV'S FEES. � w RETENTION FEE: O CONSTRUCTION LENDING AGENCY pR�E:^ _ � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCY `�� `�� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERAl1T IS ISSUED(SEC.3oG7,CIV.C.�. Z W � LENDER'S NAME F— IENDER5AD�RESS w I CERTIFV THAT 1 HAVE READ THIS APPIICATION AND STATE THAT THE ABOVE INFORA/ATION IS CARRECT. TOTAL F E ES � ,��O i 9 � I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS HELATING TO BUILDINO . � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNE OFTHIS CWNTV TO ENTER UPON THE Z ABOVE-MENTqNED FROPERTV FOR INSPECTION PURPOSE COMMENTS ' � J � . m I E(PRl ' . _ I O� v � � SI(1 M EE ' , DATE � RECPT.NO. O PAID BY O VALIDATION WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy C9TV O� DIA6VdOND ��R INSIPEC�'90N R�COFtD ' o <�C��'�r�� ' � � x�G]�3G?GC�QOQa 'l�.�a.`� ��.l�G?GC�4QQ �� DG]�CC�C�I �.. �i ;'. .f,.. . SET BACK FLOaR 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 H'T. BOND BEAM ROOF SHEATHING ` f� '�j v 8 FT. BOND BEAM FRAMINGNENTIL'ATION 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/SIDI(VG POO�FENCING WALL INSULATION � i� POOL FINA� CEILING INSULATION OFF SITE IMPS. DRYWA�L 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 f COMMEfVTS _ — �2- �` SEPTIC TANK SIZE SEEP PIT/U SIZE , a � � ;� ,r �� a