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Home My WebLink About12790 ' � , k �� CITY OF DIAMOND BAR �^PInE • DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 M 9 2003 (909)860-3195 Faz(909)861-3117 PRESS ��. BUILDING PERMTT APPLICATION FIRMLY � JOBSITE � l ` APPLICATION y✓ -� PERMIT �� P/C o ADDRESS DATE NUMBER # � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP °C OWNER O " ADDRESS ZONING SETBACKS z CITY � ZIP��[�'�TEL: REART RW ❑ g APPLICANT TEL. SIDE/SIDE STREET RW ❑ � � CONTRACTO SIDE ❑ � ADDRESS �' � CITY ZIR��Q TEL. PROPOSED USE w ARCH/EN / � � iz DESIGNER NO.DWEL. NO. a ADDRESS UNITS STORIES EDROOMS � CITY " ZIP TEL. � � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O , � I HEREBV AFFlRM UNDER PENALTV OF PERNRV 7HAT 1 MI EXEMPT FROM THE CONTRACTORS LI- G8�9gB/CefPOft W CENSEUWFOHTHEFOIIOWINGREASON(SEC.7031.68USINESSANOPHOFESSqNSCODE:ANYCITYOR (n 1 U COUNryWHIq1REpUIRESAPERMRTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W P8110/DBCk Z TURE.PRpR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI• W c CENSE UW(CHAPTER Y(COMMENCINO WITM SECTION 7000)OF�IVISION 3 OF THE BUSINESS AND PRO- LL PooVSpa � FESSIONSCODE)OHTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFOH7HEALLEOEDEXEMP• V TION.ANY VIOI.ATpN OF SECTION 7091.5 BV ANY APPUCANT FOR A PERMIT SU&IECTS THE APPLICANT TO z Re-Raof SS � ACIVIL PENALTY OF NOT MORE THAN FNE HUNORED DOLURS(i5ao).): � ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, ❑ COrtIfIIBfCld1 l MIILL DO THE MIORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.704/,BUSI- J � NESS AVD VROFESSIONS COOE:THE CONTRACTORS LICENSE UW DOES NO7 APPLY TO AN OWNER OF ? PROPEHfY NR1D BUttDS OR IMPROVES THEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR � 7HROU(Yi HIS OR MER ONM EMPLOYEES,VROVIDED THAT SUp1 IMPROVEMENTS ARE NOT INTENDED OR m Q ,OFFERmFOHSALEIFHOWEVERIHEBUILDINGORIMPROVEMENTISSOLDWfTHINONEVEAROFCOMRE- Z 'TION,THE OWNERAUILDER WILL HAVE THE BURDEN OF PROVING 7HAT HE OR SHE DID NOT BUILD OR � UAPROVE FOH TME VURPOSE OF SALE). W ❑I,ASOMMEROFTHEPROPEfiTY,AMEXCLUSIVEIYCANTRACTINGWfTHLICENSEDCONTRAC70RS � TO CONSTRUCT THE PRQIECT(SEC.70H,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS U- 21118f1Of1 O ADJ.AREA �� .j W CENSE LAW DOES NOTAPPLV TOAN OWNER OF A PROPER7V WHO BUILDS OR IMPROVES 7HEREON,AND - - � M1fOCOMMCTSWRSUCHPRQIECTSWIhIACON7RAC70R(S)LICENSEDPURSUANTTOTHECONiMG QUANTITY DESCRIPTION � ,EE � 7C%LS LICENSE UW.). ❑1 AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q 3 � � �� DATE OWNER w � �f' F UCENSED CONTRACTORS OECLARATION w � �""` � I HEREBYAFFIRAI UNDER PENALN OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � , d Y(COMMEHCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND.7ROFESSIONS CADE.AND X MY UCENSE IS IN NLL FOfiCE AND EFFECT. Z '�M LL1 �/ c� � � UCENSE CLASS � LIC.N0. (✓ J � V DATE CONTRACTOR d W � WOHKERS'COMPENSATION DECLARATION Q �' � I HEFEBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE WLLOWING DECLARATIONS: U VJ a � I HAVE AND WILL MAINTNN A CERTIFICATE OF CANSENT TO SELF-INSURE FOH WORKEF75' _ � COMPENSATION.AS PROVIOED BV SECTION 37000F 7ME LA80R CADE,FOR THE PERFORMANCE �U OF 7HE WOHK FOR NR11CH THIS PERMIT IS ISSUED. � � 0 w I HAVE IWD WILL MAIHTAIN WORKERS'COMPENSATION INSURANCE.AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS � � ISSUED.MY WO CER COMPENSAT INSUR CE CARRIER POIICY NUMBER ARE: CONSTRUCTIO � � CARRIER��',.� PLAN REVIEW � � POLICY NUMBER�U`7�Q � ELECTRIC /� 0 (1}flSSECfKINNEIDNOTBEOprPLEfmOFiHEPERMTISFi�RONEMADREDDOIAMS(5100)ORLESS� PLUMBING ./ W MECHANICAL Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I (} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SOAS TO BECAME SUBJECT TO THE � WORKERS'COMFENSATION lAWS OF CALIFORNIA M1D AGHEE THAT IF I SHOULD BECAME INSPECTION FEE S SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 7700 OF THE UBOR � conE,i sHu�coRrr+win+coMa�r Mnn�n�osE raovisioris. ISSUANCE � SMIP �g p DATE: APRICANT: . � ENERGY P/C ��T��FETY WARNING:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNUWFUL,AND SHALL BE � SU&IECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(iloo,000).IN ADDITION TO 7HE COST OF COMPENSATION,DAMAGES AS PROVIDED FOH IN J SECTION 370e OF hiE U180R CODE,INTERES7,AND ATTOflNEY'S FEES. ' RETENTION FEE: � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENOING AGENCV FOR THE 7ERFORMANCE OF THE WORK FOR WHICH THIS PERMI715 ISSUED(SEC.30V7,CIV.C.�. Z W � LENDER'S NAME F— LENDER'SADDRESS � ICERTIFYTHATIHAVEREADhIISAPPLICATIONANDSTATE7HATTHEABOVEINFORMATIONISCARRECL TOTAL FEES � W I AGREE TO COMPLV WITH ALl CT'AND COUNTY ORDINANCES AND STATE UWS REU71N0 70 BUILDING � CONSTRUCTION,AND HEREBV AU7HORI2E REVRESENTATI OF T CAUN7Y TO EMER UPON THE � ZABOVE-MEHTIONED PROPERTV FOR INSPEC7qN PURP COMMENTS � O � J � m NAME(PRINn . Q � ?/�/ .� � � SIONANRE OF PERMITTEE DATE � RECPT.NO. PAID BY VALIDATION WHITE—DepeAment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy ` . . , . . . , .. .. / . v .. . . . . � . . , ... . . .. , � . �'.:�'_'i�.,�u,�,�: �i0�� 01�� ' , - FL��: �:,:' ��'. �f�S�f��'GOBN FiECO(�� . . � : ,. � � � u -.- �� o j��u o n � :�t � � r� , . e m � .� � , . . _: _ �: . � .� � , „ ,P.,., _. .r � � ��.� �SET BACK � � � FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNdER FLOOR DUCT �' ' GROUND PLUMBING UNDER FLOOR CU�IDUIT SL46 GRADE FIREPLACE FOUNDATION - - � - TEMP POWER FIREPLAEE BOND BEAM - WATER SERVICE • - MID HT. BOND BEAM• ---• • • - - -� • � - ROOF SfiEATHING - 2 � 8 FC'BOND BEAM_ . � � � FRAMIN.G/V�NTI�IATION._ .. . FINAL BOND BEAM ROOF COVER � . PRE-GRADING - ROUGH HEATING BENCHING � ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING ; 'SHOWER/TUB TEST POOL ELECTRIC � EXT. LATH/SIDWG POOL FENCING �� WALL INSULATION POOL FINAL " CEIUNG INSULATION OFF SITE IMPS: DRYWALL NAILWG DEDICATIONS SEWER FINAL ENG. � _ SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L..L. � - ON SITE IMPS.. GAS AIR TEST FINAL ZONING FIIVAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FIMAL ELECTRIC ' DEV. FEES PAID FINAL PLUMBING ENERGY �m � �� ,„ �.�m� � . «`� �� COMMEfVTS ,.�. .. , . ,.�� . . - -.- - _ . • _1 ". :y: ' :t: ';�.. - ,_,.;+f _ _. '^r: _. . , _,,:. . .. ,'�::.... _. SEPTIC TANK SI�E SEEP PIT/U SiZE ��• r� �� — Y"`, i� i ; ,��, � � ': . � �r f��, � K��,�: � . - . . _ . . , `�a��°' �.�. ��',.,�� f . }