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Home My WebLink About12487 _�� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES y 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS ��TM'� � BUILDING PERMIT APPLICATION � FIF�MLY N JOBSITE -� APPLICATIONr J� ✓ PERMIT /C o ADDRESS � � � DATE 1�!� � NUMBER C� � c� ISSUE NPE " OCC APN LOT TRACT DATE CONST. GROUP °C OWNE��42W- Rh�'4�U o . p ADDRESS Z� 'Z'L�I �I CIG Yk ZONING SETBACKS W CITY ' � Z TEL FRONT RW ❑ � APPLICANT � �lN-� TEL.�jl�[U'`/S� REAR ❑ SIDE/SIDE STREEf RW ❑ � CONTRACTOR � � SIDE ❑ Q ADDRESS��L'�� ROPOSED USE o CITY�(�t S ZIP TEL. w ARCH/ENG/ W DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBY AFFlRAI UNDER PENALTY OF PERNRY THA7 I AM EXEMPT FROM THE CONTRACTOHS LI- G8f89B/CefPOfi W CENSELAWFORTTiEFOILOWINOREASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANYCITYOR (n U COUHT`/WHIp1RE0UIRESAPERMRTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIHANYSTRUC- W patio/Deck W NRE,PRIOR TO ITS ISSUANCE,ALSO HEDUIHES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS 110EN5E0 PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PHO- � PooVSpa FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR THE ALLEOED EXEMP• TION.AHVVIOLATpNOFSECTION7031.6BYAHYAPPLICANTFOHAPERMITSU&IECTSTHEAPPLICANTTO � Z Re-Root � A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLURS(i5o0).): � ❑I,ASONMEROFTHEf'ROPERTY,ORMYEMPLOYEESWITHWAGESASTHEIRSO�ECOMPENSATION, � COrtIR1BfCl81 � YALL 00 THE WOFiI(,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70��,BUSI- J NESS ANO PROFESSIONS CODE:THE CONTMCTOfiS LICEHSE lAW DOES NOT APPLY TO AN OWNER OF N PROPEHfYVh10BU1LDSORIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFOHHERSELFOR � Q THiqUGH HIS OR HER OWN ELIPLOVEES,PROVIDED THAT SUp11MPROVEMENTS ARE NOT INTENDED OR m 0 OFFERmWRSALEIF,f10WEVERTMEBUIIDINQORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z �'TIOH,iHE OWNER-0UIL�ER WILL HAVE T1E BURDEN OF PROVINO 7HAT HE OR SHE DID NOT BUILD OR � IMPROVE FOF THE PURPOSE OF SALE). ' W aI,ASONMEROF7HEPROPEHTY,AMIXCLUSNELYCONTMCTINOWfTNLICENSEDCONTMCTORS � TO CONSTRUCf THE PRQIECT(SEC.7041,BUS�NESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V01UHllOf1 ADJ.AREA W CENSEUWOOESNOTMPLYTOANOWNEROFAPROPERTVHRIOBUILDSORIMPROVES7HEREON,AND � VAfOCOMMCTSFORSUp1PR0.1ECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTO7HECONTRAG pUANTITY � DESCRIPTION FEE � � lORS UCENSE UW.). 0 ❑I AM IXEIAFT UNDER SEC. B.8 P.C.FOR THIS REASON � 3 � � DATE ONMER f" U w F LICENSED CONTRACTORS DECLARATION W � 1 HEREBY AFFIRM UNDER PENALTY OF PERIURV 7HAT 1 AM LICENSEU UNDER PROVISIONS OF CHAPTER � ' . � Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF T1E BUSINESS AND PROFESSIONS CADE,AND Z X MY LICENSE IS IN FULL FORCE AND EFFECT. L1J m O � � LICENSE C S �f LIC.NO. � J V pp7E L U CONTflACTOR d W 1 2J� � WORKERS'COMPENSATION DECLARATION� �,/v � � J ¢ � 1 HEREBY AFFIRM UNDER PEN/�LTV OF PERIUM ONE OF THE FOLLDWING DECUMTIONS: � N Z � _I HAVE AND WILL MAIN7AIN ACERfIFlCATE OF CONSENT TO SELF•INSURE FOR WORKERS' _ COMPENSATION,ASPROVIDEDBYSECTIONJ7000FTHEUBORCODE,FORTHEPERFORMANCE U Q �E WORK FOR WHICH THIS PERMIT iS ISSUED. � � W 1 HAVE AND WILL MAIMAIN WORKERS'COMGENSATION INSURANCE,AS RE�UIRED BY SECTION � Q 9700 OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INSURANC CARRIER AND POLICY NUMBER ARE: CONSTRUCTION � � CARRIER � � v PLAN REVIEW � POLICY NUMBER � ELECTRIC Q � � (1H6SE(,'fqNNE�NOT8E00APLEfIDOF7FfrPERMTISFOROMEHINDREDD011lAS(S10D�q� } PLUMBING Z I CERTIFV THAT IN THE PERFOfiMANCE OF THE WORK FOR WHICH THIS PERMI7IS ISSUED,I MECHANICAL (� SHALL NOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE � WORNERS'COMPENSATION UWS OF CALIFORNIA,AND AGREE THAT IF 1 SHOUL�BECOME INSPECTION FEE � � SUBJECT TO THE WORNERS'COMPENSATION PROVISIONS OF SECTIO THE LABOR � COOE,1 S ALL F TH COMPLV WI7H�,T,HO/SE PRy�c�en ISSUANCE � � ''✓ SMIP DATE: O � �SAPRICANT: p+ w ENERGY P/C �,GT�'1 �QQR e � WARNINO:FAILURE TO SECURE WORKEHS'COMPENSA710N CAVERAGE IS UNUWFUL,AND SHALL BE � SUBJECT AN EMPLOVER TO CRIMINAL PENAL7IES PND CIVII FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT DOLURS(f1o0,o00),IN ADDI710N TOTHE CAST OF COMPENSATpN,OAMAGES AS PROVIDED FOR IN J SECTION 370E OF THE LABOR CODE,MTEREST,AND ATTORNEI^5 FEES. RETENTION FE�'.�I�nF T1T A MnNT1 A A� Q OCONSTRUCTIONLENDINGAGENCY PRE-ALTFEE: BUTT T1TN(: ANT1 CA�RRTV � I HEREBV AFFIRM UNDER PENALTY OF PER1UfiV iHAT THERE IS A CONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.90Y7.CIV.C.�. Z W � LENDER'S NAME F— LENDER'SAD�RESS � I CERTIFY THAT I HAVE READ THIS APPLICA710N AND STATE THA7 THE RBOVE INFORMA710N IS CORRECT. TOTAL FEES � � I AGRF'TO COMPLY WITH ALL CITV AND COUNTV ORDINANCES AND STATE UWS REUTING TO BUILDING � CONSTRUCTION,AND HEREBY AUTFIORIZE REPRESENTATIVES OF THIS COUN7V 70 ENTER UPON THE ,�/ /�.r"�� /� /�� . ZABOVE•MENTIONED PROVER7Y FOR INS7EC710N PURPOSES. COM E TS O !✓ LF�J (/ O/`� /� o � U � 3 � � _ m V RMITTEE E INn ' /_1 � � � �� y SNiNANREOFVERMfTTEE ATE RECPT.NO. PAIDBY VALIDATION ZO � WHITE—Depertment Copy,YELLOW�inance Copy,PINK—Assessor Capy,GOLDENROD--File Copy,GREEN—ApplicanYs Copy � , ,, .. . . , :. , ,... r�n , „ ,� , .. , . . . , .. . p . , � � ,��.' ' . � . `rt COTY OF DIAiViOBVD B�►R . . Of�9S�EC�'IOQV REC0�=8D . ' � ,.... . � - - � F, . r � e tci ,�:, � �� +�`�.;,�1 0'.. � � � � � �� P ��.� � � 1 � , ti, - ' ., � o .P :� ...� .�� .�� > � .57 ,� .��, ..;.,�,:,..�".."� �:� .-: �..y,. �. _ . SET BACK ' ' � . , . FLOOR JOIST :" i � FTGS/FORMS/STEEL FHA REQMTS � ` ELECTRIC GROUND ' UNDER FLOOR DUCT • GROUND PLUMBING UNDER FLOOR CU�IDUIT _ _ SLAB GRADE FIREPLACE FOUNDATION - - � TEMP POWER FIREPLACE BOND BEAM -- - � � WATER SERVICE MID HT. BOND BEAM� - - • ROOF SHEATHING 8 FT. BOND BEAM � ' ! FRAMINGNENTILIATION FINAL BOND BEAM ; ROOF C�VER PRE-GRADING � f ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING FIOUGH PLUMBING FINISH GRADING ' SHOWERlTUB TEST POOL ELECTRIC � EXT. LATH/SIDING POOL FENCING � WALL INSULATION POOL FINAL . _ CEILING INSULATION OFF SITE IMPS. DRYWALL NAILWG DEDICATIONS SEWER FINAL ENG. SEPTIC TAMK LANDSCAPEIIRRIG. SEEP PIT/l.L. ON SITE IMPS. GAS AIR TEST �..,,¢.,f,::;�-r��;;��. FINAL ZONING FINAL CONST. " "' '•` '� ` FIRE DEPT. FINAL FINA�HEATING ,r.; G7 F* ':i�,+� HEALTH DEPT. FINAL � FINAL ELECTRIC � '' DEV, FEES PAID FINAL PLUMBING ENERGY � �� 4 i - '�SPc, ��i�';�' COMiViEiVTS . , - - - �' !"�� 'ti;�`', . 41' '�'A :.7 - . . . . �� yi� SEPTIC TANK SIZE� ','� .' ' .;�,�.r�.lC1'�f�; y.'l'(:� � . SEEP PIT/U SIZE ��:.--�_�::I;,?,'.:t.?�'!i�")::(fi.1F� - � ' .. . _ ; . , �. :� . ` :i � . , �� , � ' ' � � � • i ; ; � , .