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Home My WebLink About18384 (40) CITY OF DIAMOND BAR �� --�� ---� DEPARTME?�.T'T OF CONIIviUNI'I'Y&�DEVELOPIv�NT SERVICES I „ z�82s E.co ie ��e 0 C T 0 9 2002 P Y (909)860-3195 Fax(909)861-3117 PRESS "`%.��` BUILDING PERMIT APPLICATION FIRMLY } JOBSITE •1+�� I a �n � � APPLICATION � 2�� 'Z PERMIT i�� p/C a ADDRESS i��1� v`� �/ o e � DATE NUMBER # � ISSUE /r-,� TYPE OCC ¢ WNER LOGT TRACT _ DATE ��D�v" CONST. GROUP I O o ADDRES ZONING SETBACKS Z CITY ZIP TEL. FRONT q�/y , ❑ � APPLIC NT � TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ z Q CONTRACTOR � � �I� ��S I ` SIDE �❑ PROPOSED USE � CIT`( S ZIP G TEL � � ��PG Y/C ��Z1 ! w ARCH/ENG/ ` z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP__ TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM • O I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI- G8f8QB/C2(pOfl W CENSE LAW FOR THE FOLIOWING REASON(SEC.7031.5 BUSINESS AND PROFESSIONS rODE:ANV CITV OR (n U COUNTYNh11CHRE0UIRESAPERMITTOCONSTRUCT,ALTER,IM?ROVE,DEMOLISM,ORREPAIRANVSTRUG W py�lO/DBCk w TUHE,PHIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FlLE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- . � CENSE LAW(CHAPTER e(CAMMENCING WITH SEC710N 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO- � PooUSpa . O FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND TME BA515 FOR THE ALIEGED E%EMP- � U TION.ANV VIOLATION OF SECTION 70J7.5 BY ANY APFUCAN,-FON A PERMIT SU9JEC'f5 THE APPLICANT TO Z Re-Roof . A CIVIL 7ENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(f5oo).): � Z~ ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWi7HWAGE5A51HEIR50LECOMPENSATiON, WILL DO THE WOqK,AND THE STRUCTUHE IS NOT INTEND[D OR OFFERED FOH SALE(SEC.70N,BUSI- � COffIfflOfCldl � NESS AND PROFESSIONS CADE:THE CONTRACTOiiS LICENSE UW DO'cS NO'APPLV 10 AN OWNER OF � PROPERTV WHO BUILDS OR IMPHOVES THEREON,AND WHO DOES SUCH WORN HIMSELF OR MERSELF OR 2 THROUGH HIS OR HER OWN EMPIOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NO7INTENDED OR m QOFFEREOFORSALEIF,HOWEVERTHEBUILDINGOPIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� Z 710N,7HE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING'.HA7 HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PUfiPOSE OF SALE�. W ❑I,ASOWNEROFTHEPROPERTY,AMEXCLUSNELVCONTRACTINGWITHLICENSEDCANTRACTORS Q TO CONSTRUCT iHE PRQIECT(SECJOa�,BUSINE55 AND PROFESSIONS CODE:THE CONTRAC70R5 LI- VelUetlO� � ADJ.AREA W CENSEUWDOESNOTAPPLYTOANONMEROFAPROPERTVWFiOdUII.�SORIMPROVESTHEREON,AND � NTIOCANTRACTSFORSUCHPRQIECTSWITHACON7RAC70R(S�I.ICENSEDPURSUAN770THECONTFAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE UW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � � U Y, � — Q N L DA7E OWNER _ � Z w � LICENSED CONTRACTORS DECLARATION w � I HEREBYAFFIRM UNDER PENA�TV OF PERIURV THAT IAM LICENSED UNDER PROVISIONS OF CHA7TER � d e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PP.OFESSiONS COOE.AND Z `X MV LICENSE IS IN FJU�LL FORC AND EFFECT. � m � LICENSE�A S v�o�� IIC.NO. "� j � �[ J V DATE V • CONTRACTO d W � WORKERS'COMPENSATION DECLARATIO Q '�� I HEREBV AFFIRM UNDER PENAL7V OF PEFLIURV ONE OF THE FOLLOWING DECURATIONS: Z � I HAVE AND WILL MAINTAIN A CERTIfICATE OF CONSENT 70 SELF�INSURE FOR WORNERS' _ � ¢ COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE W OF THE WORN FOR WHICH THIS PEFMIT IS ISSUED. � � w I HAVE AND WILI MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 37000F THE LABOR CODE,FOR THE PERFORMANCE OF 7HE WORK FOR WHICH 7HI5 PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION J � CARRIER PLAN REVIEW - Z POLICV NUMBER ELECTRIC Q � (fHISSECTIONNE�N0T6E�AIPLETEDOFTHEPERAYTISPoFONEHU1.OfiEDDOILPAS(f700)ORLESS). PLU w HANICA Z AA��11 I CERTIFv 7HAT IN THE PERFORMANCE F T E WOHK FOR WHICH THIS PERMIT IS ISSUED,I (} �HALL NOT EMPLOV ANV PERSON IN A MA NER S AS TO BECO SU CT TO THE � WORNERS'COMPENSATION LAWS OF LIF NIA, D AGREE TH I S ULD BEC N FEE U&IECT TO THE WORKERS'COMPEN ATIO ROV IONS SE I N�3 TH OR � y ALLF HWITHCOMPLV TMT E VI510 . SUAN E � � S p DATE: APPLICANT: J WARNING:FAILURE TO SECURE WORNERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(f 100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PflOVI�ED FOR IN J SECTION37080FTHELABORCODE.INTEREST,ANDATfORNEV'SFEES. RET,ENTIONFEE: � � CONSTRUCTION LENDING AGENCY P LT E: �_ O � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCV � FOR TME PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30B7,CIV.C.). Z W � LENDER'S NAME F— LENDEfi'SADDRESS � I CERTIFV THAT I HAVE READ TMIS APPUCATION AND SiATE THAT THE ABOVE W FORMATION IS CORRECT. TOTAL F ,n�; \� w I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � ' �{� V � CONSTRUCTION,AND HEREBV AUTHOFiIZE REPRESENTATNES OF THIS COUNTV TO ENTER UPqN THE , � OVE�MENTIONEDPROPERTVF INSPECTION PURPOSES. Z / A COMMENTS o �S . �` v � m 1 NAME(P NT) ¢ �-o� � � � U ER E DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Depanment Copy,YELI.OW—Finance Copy,PINK—Assessor Copy,GOLDENR D—File Copy,GREEN—Applicant's Copy �� Bi��'p4�� I�� ' � . I3 � �... �Q � r� .� �� .,��,�� ,� p� � , �.�': , .�f ��- .,. . - ; , . ,: e . , . ' SET BACK � � ; f LC�QR Jt�IST � � __- ---- -,.. _ _ _ . _ -- ...__r._. _. -- - -I ._... _ __._.--- --- FTGS/FORMS/STEEL � � I FHA REQMTS i � --- - -- - -; _ _ - j _._ ELECTRIC GROUND � UNDEF� FLQOR DUCT � � ; _.____ _ _._ _.___— __ _..--- - ------ -_ ._ __._ _� .. ..--- -- GROUNQ PLUMBING �__. UNDr� FLOOR CUt�it7UIT , I _ , � -- _� � _ -- ; — --- --- -- S�AB GRADE � � FIRFPLACE F�UNDATION_ � - ' -- -..-- --.... . _ ----.. _..------ � --___. TEMP POWER � j i�IREFLACE BC1ND BEAM _ � � --- -- . _. . ___. . ..- WATER SERVICE_ __ j ; � MID HT, �OND E3EAM � - — ------- ----- - ROOF SHEATHING ____�__ .i 7 8 FT_B�N� 6�AM � . .� _...._..� _........"'._..�.�.�.�._.,__...i �.��.�._ .._,__ ......___ ...___.�.�. ._`�._.`. .. FRAMINGNENTIUATION�_ _____ ,_FINAL E30NQ BEAM _ — --- _...- _._ __------ - --- --- ROOF COVER j PRE-GRADING ' -- --- ------_....�-------_._.._.- ---;- � ----------.... ROUGH HEATING _ ______� BENC'r-fiNG ! -- — _.___._.._..--- -..__. ROUGH ELECTRIC , � ROUGH GRAQlNG � _._...--- -- --- ' __.._.._..--'- ---...._.__-- ------------ — ROUGH PLUMBING ! F FINISH �aRADING --- - ___ _ __._...----____- .. �__�.._.. - ------- ------------ -_.._ _...... SHOWER/TUB TEST � POOL E�ECT'RIC __ -- - ----- ------ EXT. LATH/51DING � ' POOL FENCING ! . ___ __ ---------- ._�_—r, .__.. ------._._ _.. _�--- .___ WALL INSULATION L POOL FiNAL _ � ___ CEILING INSULATION I OFF S{TE IMPS. ___.._------ --.- ---- ---------- DRYWALL NAILiNG j � [�EDICI�TIONS � , - ---------.__........_.-�---------..._._-----------�--------...------ ---- SEWER _ _1 F{NAL ENG. - - ------ ---- �-- SEPTIC TANK __`^_�---- .._ _- -� I_LANDSCAPE/IRRIG. .__ i � __ ..__.._- -.--��__....._.__- SEEP PIT/L.L. I r C7N SiTF_ IMPS. �--�- --i�-._._...- -------- GAS AIR TEST ,; FINAL Z�NIhlG -- _._------�-_.__.... ---.----�- -------- �lNAL CONST. � 1 � � �! E FlRE L�EPT. FINAL _ —+------ ;....,.._ ._..�.�_ -------- ----- FINAL HEATING _ � ; HEALTFI DEP"(. FINAL �------------ FiNAL ELECTRIC � ; ; DGV. F�ES PA1D � - ---------�----.__...--��_._:___....--...______�_.__..__ _...------ � ------....---------- FINAL PLUMBING ; _ _ ; ': ENERGY -- ----- � ------ __ ' --- - � _�_ -- � — ------- 0 . � �ra��' �, � ._.— C U Ni iVi E iV TS _.- ____�----_.�._ __._ �_--- SEPTIG TANK SIZE SEER PIT/U SIZE ---- --__ __---- ----------- ------- � � -- -------, _._....--- ------ ------ '� � �� — ----- -- ----- , .. ..'� ,�.:h�i. ... �o AeGo --