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Home My WebLink About10-1053 (5) ^� �� CITY OF DIAMOND BAR . �/ " DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ` 21825 Copley Drive,Diamond Bar,CA 91765 I ' (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS � �'^�'� BUILDING PERMIT APPLICATION FIRMLY y JOBSITE 'r,�' ^� ��"'�� PpLICATION PERMIT p/C o ADDRESS �KO SLLNs�T�CZvssr�oG, cD �--A. yt�� DATE NUMBEFj! � �3 # � ISSUE ? �7 _ /'� TYPE pCC APN LOT TRACT DATE �O - A`-�✓"'��l CONST._�L��GROUP p OWNER �}��b H,�1.S�\� p ADDRESS A ZONING SETBACKS I Z CITY w �ZIP I7�.�TEL. O9 FRONT qyy � g APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ � CONTFIACTOR 'SIDE p o CDDRESS ZIP TEL. PROPOSED USE � o ARCWENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS �. ti � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFlRM UNDER PENAL7Y OF PERri1RV THAT I AM E%EMPT FROM THE CONTMCTORS LI- G8f2gB/CefP011 W CENSEUWFORTHEFOLLOWINOREASON(SEC.70.31.6BUSINESSANDPROFESSIONSCODE:ANVCITYOq (n U COUNryWHICHRC-0UIRESAPEFMITTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORREPNRMIVSTRUC- W P0�I0/DBCK � NRE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOq SUCH PERMIT TO FILE A SIGNED w � STATEMENT TNAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF TME CANTRACTORS L4 � � CENSE UW(CHAVTER 0(COMMENCINCi WITH SECTKKJ 7000)OF DIVISION 7 OF 7HE BUSINESS M1D PRO� POOUSP2 � FESSIONSCOOE)OR7}IA7MEORSHEISEXEMPTTHEREFROMMlDTHEBASISf-0RTHEALIEGEDEXEMP- (� TqN.ANY VIOLATION OF SECTION 7031.6 BV ANV APPUCANT FOR A PERMIT SU&lECTS THE APPLICANT TO Z Re-Roof � A CIVIL PENAL7V OF NOT MORE THAN FIVE HUNDRED DOLURS(5500).): p ❑I,ASONRJEROFTHEPROPERTV,ORMYEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � CORIrtIBfCl81 Z WILL DO THE WORK,AND 7HE STRUCTURE IS NO7 INTENDED OR OFFERED FOR SALE(SEC.7011,BUSI� J � NE55 AND PROFESSIONS CODE:THE COMMCTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q TH1id10H HIS OR HER OWN EMVLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORUAPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z TqN,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERTV,AMEXq.U51VELYCONTRACTINOWITHIICENSEDCONTRACTO{i5 � TO CONSTRUCT THE PHOJECT(SEC.7oN,BUSINESS AND PROFESSIONS CODE:THE CONTRACTOR9 LI� V8IU8(IOfI ADJ.AREA W CENSELAWDOESNOTAPPLVTOANONRJEROFAPROPERTYWHOBUILDSORIMPROVE57HEREON.AND � NTIOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S)IICENSEDPURSUANTTOTHECANTqAP QUANTITY DESCRIPTION � rau ucENse�nw.�. FEE � q I MI E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � 11(?/ , ) U � DATE � OWNER �� F— . �OO �. Z U � LICENSED CONTRACTORS DECLARAT�ON w � I HEREBY AFFIRM UNDER PENALTY OF PE0.IURY THAT 1 AM LICENSED UNDER PqOVI510NS OF CHAPTER � � e(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z � �� MV UCENSE IS W NLL FORCE AND EFFECT. m � IICENSE CLASS LIC.NO. � V DATE COKTRACTOR d W � WORKERS'COMPENSATION DECLARATION a � U � I HEREBV AFFIRM UNDER PENALTV OF PERtt1RV ONE OF THE FOLLOWING DECLARATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF�INSURE FOR WORKERS' a S � COMPENSATION,AS PROVIDED BV SECTION 3�OOOF THE LABOR CODE,FOR THE PERFORMANCE W Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w _I HAVE AND WILL MAINTAIN WORNERS'CAMPENSATION INSURANCE.AS REOUIRED BV SECTION Q370o OF THE UBOR CO�E,FOF THE PERFORMANCE OF THE WORK FOR WHICH TFIIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION � CAARIER PLAN REVIEW � POLICV NUMBER Z¢ E C S�i� � (IHISSECTqNNEIDND78ECO1.q.ETEDOFTiEPEq1.T�15FpqOr¢HU.pqEpppUspg(S1pp1�LFS5�. PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL GS SHAIL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SU&IECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORN10.AND AOREE THAT IF I SHOULD BECAME INSPECTION FEE � SUBJECT TO THE WORI(ERS'COMPENSATION PROVISqNS OF SECTION 37o00F THE UBOR OCODE.I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. NCE p DATE: APPLICANT: SMIP W � WARNING:FAILURE TO SECURE WOHKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFWESUPTOONEMUNDREDTNOUSAND ENERGYP� DOILARS(5100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED f-0R IN � � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RE � OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBY AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDINQ AOENCV � FOR THE 7ERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oe7,CIV.C.�. Z W � LENDER'S NAME F— LENDER'SADORESS g W I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATqN IS CARRECT. TOTAL FE ES ' �'� � 1 A(3REE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STnTE LAWS REUTINO TO BULLDIN6 � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UVON THE Z ABOVE�MEMIONED PR07ERTV FOR INSPECTION PURPOSES. COMMENTS � � I• �7� m PERMITTEE NAME(PRI ' ' Q � � N SN3NANRE OF P DATE � RECPT.NO. ' Q PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Aasessor Copy,GOLDENROD—File Copy,GREEN—Appl(cant's Copy CITV O� D9AfV�OND ��4R , II�S�ECTBC)6� R�CORD z.��a�pc�c�400a Da� .. . oa�p�c�4oa . , oa�p�c�0o�`} o �� n da�p�C��.-�� 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 H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC !3 t 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 C��o { : COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � � .. , � _ .