The URL can be used to link to this page

Home My WebLink About10954� _ ---�-- CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT _ 21660 E.Copley Drive Suite 190 PRESS � (909)860-3195 Fax(909)861-3117 �'��' BUILDING PERMIT APPLICATION FIRMLY � JOBSITE /�, APPLICATIO PERMIT P/C o ADDRESS �a�l 6 l�V� �S -� � './ DATE � — NUMBER � I # o ISSUE TYPE OCC °D APN LO TRACT DATE CONST. GROUP °C OWNER ��OL2'<--Pi O ADDRESS � � ZONING SETBACKS Z CITY � ZIP TEL. FRONT RW ❑ � APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ z Q CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE /� � CITY ZIP TEL. c £ '••-,� , o ARCH/ENG/ � z DESIGNER NO.DWEL. NO. NO. f � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION I � O OWNER-BI:ILDER DECLARATION SFR/ADD/REM p I HEREBY AFFIRM UNDER PENALTV OF PERJUAY THAT I AM EXEMPT FROM 7HE CON7RAC70RS LI- GefBJP,/CBfpOR W CENSE LAW FOR 7HE FOILOWING REASON(SEC.7o37.5 BUSINESSAND PROFESSIONS CADE:ANV CITV OR (n U COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W Patio/Deck Z TURE,PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPLICANT FOF SUCH PERMIT TO FILE A SIGNED w STA7EMENT THAY HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON7RACTORS LI- � � CENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� LL' OUSPB 0 FESSIONS CODE)OR THA7 HE OR SHE IS EXEMP7 THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- � TION.ANY VIOU710N OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMI7 SU&IEC7S THE APPLICANT T0 Z Re-Roof � A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f5oo).): � ❑I,ASOWNEROFTHEPROPERN,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COmmCfCidl - Z WILL DO 7HE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7004,BUSI- J , NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF ' � PiiOPERTYNMOBUILDSORIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSEIFORHERSELFOR � [[ THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OH m 'I � OFFEREDFORSALE.IF,HOWEVERTNEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THA7 HE OH SHE DID NOT BUILD OR � � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPFOPERTV,AME%CLUSIVELVCONTRACTINGWITHLICENSEDCONTRACTORS � TO CONSTRUCT THE PROJECT(SEC.7044,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V8IU8IlOf1 � a�J ADJ.AREA W CENSE LAW DOES NOTAPPIY TO AN OWNER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITHACONTRAC70R(5)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM E%EMPT UNDER SEC. 8.d P.C.FOR THIS REASON Q � � � " �""L O s� � ,�� DATE � OWNER '�1 � Z U W � LICENSED CONTRACTORS D RATION w ¢ � I HEREBY AFFIHM UN�ER PENAL7V OF PERJURV THAT I AM LICENSE�UNDER PROVISIONS OF CHAPTER � � � e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND Z - 'X MY LICENSE IS IN FULL FORCEAND EFFECT. m . /J �`G� �., � �^ O � � Nr L }� �.�� LICENSE CLASS LIC.NO. � � � w DATE CONTRACTOR 0- �� S S^ � r� WORKERS'COMPENSATION DECLARATION J � Q � U � I HEREBV AFFIRM UNDER PENALTY OF PERJURV ONE OFTHE FOLLOWING DECLAHATIONS: Z � I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELf-INSURE FOR WORKERS' _ � COMPENSATION,ASPROVIDEDBYSECTION37000FTMEUBORCODE,fORTHEPERFORMANCE U �d �� / ¢ OFTHE WORK FOR WHICH 7HIS PERMIT IS ISSUED. � � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE.AS REOUIRED BV SECTION Q 370o OF THE LABOR CODE,FOFi THE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS / x g S'� � ISSUED.MY WORKERS'CAMPENSATION INSURlWCE CARRIER AND POIICY NUMBER ARE: CONSTRUCTION � Q > CARRIER PLAN REVIEW i � POLICY NUMBER ELECTRIC Z '�� Q (� 0 (i}i455ECf10NNE�NOTBENMPLEfEDOFTHEPEW�UTISFORONEHU1�DFiEDDOILARS(i100)ORLESS). 'PLUMBING � ( • Y•s W 1N Z I CERTIFV THAT IN TFIE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PEFMIT IS ISSUED,I MECHANICAL ��( •�'v .(.�} SHALL NOT EMPLOY ANV PEASON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � � WORKERS'COMPENSATION LAWS OF CALIFOflNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE SU&IECT TO THE WORKERS'COMPENSATION PFOVISIONS OF SECTION 37000F THE UBOR 0 CJ� � CADE,I SHALL FORTHWITH COMPLY WITH TNOSE PROVISIONS. �SSUANCE p DATE: APPLICANT: SMIP � I J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C � SU&IECTAN EMPLOYEATO CRIMINAL PENALTIES AND CIVIL FWES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(5700.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � J SECTION 3708 Of THE LABOR CADE,INTEHEST,AND ATTORNEV'S FEES. RETENTION FEE: � � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDEH PENALTV OF PERIURY THAT THERE IS A CONSTRUCTION LENDING AGENCY �- FOR 7HE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W 2 LENDER'S NAME � � LENDER'SADDFiESS � I CERTIFY THAT I HAVE HEAD THIS APPLICATION AND STATE THAT TNE ABOVE WFORMATION IS CORflECT. TOTAL FE ES �� G'S w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS FELATINCa TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTAT�VES OF THIS COUNTV TO ENTER UPON THE � �y ZABOVE-MENTIONED PROPER7Y FOq INSPECTION PURPOSES. COM '� `�� /� � ' �t ? ��'� _ �t V U'1�- C�j��.C� / ¢ PE MI AME(PRINT) ' � � �V � � � 'N SIG R OF ERMITTEE DATE ' = RECPT.NO. O PAID BY � VALIDATION ~ WHITE—Depa ment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy , . . . �, , , . � , .�.;.. . � , . •.�.>- . ;>, y ., �._.. . 1� ..,, , . ; �,...} .�..,' ... CITY OF DIAMOrvD �/a►R IfdSPECTIOI� REC�F��9 � � ' � � � o � � � � . � e i • i ■ SET BACK � � FLOOR JOIST ' FTGS/FORMS/STEEL. FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUGT • , . GROUND PLUMBING UNDER FLOOR CUt�IDUIT SLAB GRADE ' FIREPLACE FOUNDATION TEMP POWER - FIREPLACE BOND BEAM WATER SEflVICE t � - � MID HT. BOND BEAM R(OOF SHEATHING �. � �• . ' 8 F7. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENGHING ROUGH ELEC,TRIC�;,� ROUGH GRADING ROUGH PLUIviBING FINISH GRADING SHOWER/TiI,:�B�EST'.�'�'"j , POOL ELECTRIC EXT. LATH751DING � POOL FENCING . WALL IN5ULATION POOL FINAL • CEILING INSULATION OFF SITE IMPS. 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'D,EPT. FINAL : :. . � � � , t��; ., , FINAL HEATING HEALTH DEPT. FINAL � � � . FINAL ELECTRIC QEV. FEES�PAID ' .,. FINAL PLUMBING , ENERGY: � _ . _ _ • � • O COMMEiVTS � . � , �'��i�,� �-,�� SEPTIC TANK SIZE 1lg�f ;� ; �f"��:�� SEEP PIT/U SIZE . - : , - : . ',., � �, - ='� . . � . ,, , , - s� - ' -. � • � ' � ^ �'� j ,� � /I / (