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Home My WebLink About15562 (656)r'" CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 851-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS_ 51 S' APN LOT TRACT OWNER kO7k U U:; G k' Y ADDRESS5=� CITY Diam A. 5" ZIP 71317([�f$e TEL APPLICANT � '_3C fit 5-1:211 CONTRACTOR 3 _ ADDR SS1_1$%% 5- wa CITY ZIP CIDZI4EL. IL 515-131 ARCHIENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIPAL UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS I.J. CENSE LAW FOR THE FOLLOWING REASON (SEC. 7071.6 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHCH REOUIRESA PERMIT TO CONSTRUCT,ALTER. IMPROVE. DEMOLISH, OR REPAIRANY STRUC- LURE, PRIOR TO RS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS U. CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DMSION S OF THC BUSINESS AND PRP FESSIONS CODE)ORTHAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION.ANY VX ATON OF SECTION 7071.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (ISDO).): O LAS OWN ER OF THE PROPERTY OR MY EMPLOYEES WITH WAG ES AS THEIR SOLE COMPENSATION, WILL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSK NESS AND PROFESSIONS CODE: THE CONTPACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERIYVA40 BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HS OR HER OWN EMPLOYEES, PFICMDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE i HOWEVER, THE BUILDING OR IMPFIDVEMENTIS SOLD WITHIN ONE YEAROF COUPLE. O -0 TN, THE OWNER -BUILDER WLL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O L AS OVINER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTNO WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U. CENSE LAW DOES NOTAPPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPPIOVES THEREON. ANO WIHOCONTRACTS FOR SUCH PROJECTS WITHA CONTRACTOR(S)LICENSED PURSUANTTO THE CONTRAC TORS LICENSE LAW). O IAM EXEMPTUNDER SEC B. & P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER I (COMMENCING NTH 5ECTI N 70001 OF DMSKON S OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE 15 N FULL FORCE AND EFFECT. LICENSE CLASS 6. G- 3 (x *C... DATE =I f-0 0 CONTRACTOR fjOtIOrlCi WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION. AS PROVIDED BY BECTON 7700 OFTHE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERT COMPENSATI N INSURANCE, AS REQUIRED BY SECTION 07000F THE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR NHICH THIS PERMIT IS :SUED. MY WORK R/5�C\\d��1PEN5ATION INSURANC CARRIER AND PQK:V NUMBER ARE: CARRIER � IL rZ; POLICY NIIIASER 2' z"! (IMSEC ION NEED NOT BE COMS7ETEDOF THE PERMIT IS FORGIVE H.MIHPJ DOLLARS (111001 OR LESSI 1 CERTIFY THAT N THE PERFORMANCE OF THE WORM FOR WHICH THIS PERMIT IS ISSUED.I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BCCOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 7700 OF THE LABOR CODE.I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT. WARNING: FAILURE 70 SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL. AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S 100.0M). N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 7097. CV C). LENDERS NAME LENDERS ADDRESS I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THC ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOYE.MENTONED PROPERTY FOR INSPECTION PURPOSES. P TEE E NTI NA 4 E A ---) ne)v PRESS FIRMLY I �'1 DATEAPPLI ` J NUMBER�� ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ.AREANALUATION SFR/ADD/REM Garage/Carport W Patio/Do(* LI- Pool/Spa 0 Z Re -Roof 0 Commercial - m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J Q U cc H U W W z r ,r fjL m J 0- � Z Q 2 U W CONSTRUCTION PLAN REVIEW ELECTRIC PL�yUr',pl?ICr� MECHANICAL INSPECTION FEES ISSUANCE SMTP gong - ENERGY P/C qIT 1' 1 lY 'ON A 1 ENERGY PERµll RETENTION F : PRE -ALT FEE: TOTAL FEES -22 U 5 COMMENTS RECPT. NO. PAID BY VALIDATION WHITE—Depanment Copy, YELLOW—Finance, Copy, PINK—Assessor Copy, GOLDENROD—Fib Copy, GREEN—Applicant's copy CITY OF DIAMOND BAR INSPECTION RECORD' to ki SETBACK = I I 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 HT. BOND BEAM' ROOF SHEATHING s FT. BOND BEAM FRAMIN GNENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING -- BENCHING -ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERITUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. .SEPTIC TANK LANDSCAPE/]RRIG. 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 .... , '104 ; ENERGY COMMENTS _( O=C�►Qrcc�,ss—�_c�c�{_ SEPTIC TANK SIZE SEEP PIT/U SIZE