The URL can be used to link to this page

Home My WebLink About11-426 (5)� _�,� _ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES > 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS �'"�'� BUILDING PERMIT APPLICATION FIRMLY QJOBSITE�f �/ �LC�/L C.CI �U/c DATE CATI� { PERMIT 1�J �P/C P�2 ¢ ADDRESti7� I'7�U S, I ��'I � � NUMBER /� #_ �� '}'1.� � APN LOT TRACT �SSUE TYPE y� OCC Q � DATE �� CONST. / C� GROUP !v p OWNE�f2ES ��'�'� p ADDRESS � � S RGEV/C� ZONING SETBACKS gcirv A� K�f�N ZIP��'fEL. FRONT qyy � APPLICANT iLL Da./Lvr.l TEL.7� - O�-�J(q� REAR p � — SIDE/SIDE STREET RW ❑ � CONTRAC OR. SIDE � � ADDRESS y n � CITY ZIP TEL. PROPOSED USE�_� /'¢TI C� Cr0 U�l� w ARCWENG�, �r �'-T�� z DESIGNER/� ' � C-G�u / A6.S �,lJC w � NO.DWEL. NO. �- NO. n. ADDRESS C Ckl - uiTG./DO /9lP STORIES � � CITY�/ �LL6 ZIPQ �' TEL � ' Od, UNITS BEDROOMS � — - � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBY AFFIRM UNDER PENALTY OF PERIURV THAT I AM EXEMPT FROM THE CANTRACTORS LI� G8le9B/COf�Mft W CENSEIAWf-0H7HEFOLLOWINOREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:MIVCITVOR (f� U COUNTVNTIICNREOUIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- w Z TURE.PRIOR TO ITS ISSUANCE,AL50 REW IRES hiE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Petl BCk X w STATEMENT THAT HE OR SHE IS LJCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTOR9 LI� 0� CENSE UW(CHAPTER e(CAMMENCINO WITH SECTION 7oaa)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPe FESSIONSCODE)ORhIATHEORSHEISEXEMPTTHEHEFROMANOTHEBA515FORTHEALLEGEDE%EMP- (� � U TION•ANY VIOlAT10N OF SECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO Z Re-Roof � A CIVIL VENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f50D).): � ❑�,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAOESASTHEIRSOLECAMPENSATION, � CORIR18fCI7I WILL DO THE WORK,AND THE STHUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7M�,BUSI� J N NESS AND PROFESSIONS CODE:THE CONTRACTORS UCENSE LAW OOES NOT APPLV TO AN OWNER OF ? GROPEfiTY NM1IO BUILDS OR IMPROVES TMEREON,M1D WHO DOES SUCH WORK HIMSELF OR HERSELF OR w THROUON HIS OR MER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMEMS ARE NOT INTENDED OR m Q OFFEREDFORS�LEIF,FIOWEVERTMEBUILDINOORIMPROVEMENTISSOLDWITMNONEVEAROFCOMPLE- , Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO THA7 HE OR SHE DID NOT BUIID OP � UIPROVE FOR THE PURPOSE OF SALE�. �y,� ❑I,AS ONMER OF THE PROPEHTV,AM E%CLUSIVELV CqNTMCTINO WITH LICENSED CONTRACTORS = [[ TO CONSTRUCT THE PR0.IECT(SEC.7011,BUSINE55 ANO PqOFE5510N5 CADE:THE CONTRACTORS LI� V8IU8IlOf1 ADJ.AREA W CENSEIAWDOESNOTAPPLYTOANOWNEROFAPROPERTYWHOBUILD50RIMPROVESTHEi7EON,AND � � M/HOCONTRACTSFORSUq1PqOJECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECON7RAC� QUANTITY DESCRIPTION TORS LICENSE UW.). FEE � ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � DA7E OWNER F- Z U � LICENSED CONTRACTORS DECLARATION W � I HEREBV AfFIRAI UNDEH PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTEH � � G(COMMENCINO Wlhl SECTbtJ 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z �� MY LICENSE IS M FULL FORCE AND EFFECT. m � LICENSE CLASS �IC.NO. � U DATE CONTRACTOR d W � WORKEfiS'COMPENSATION DECLARATION � N I HEREBV AFFIRM UNDER PENALTY OF PERIURV O7JE OF THE FOLLOWING DECLARATIONS: V � Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' ¢ S COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE 7ERFORMANCE U OF THE WORK FOR NM171CH TNIS PERMIT IS ISSUED. W � � w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,A9 REWIRED BY SECTION Q 3700 OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �� ISSUED.MV WORKERS'CAMPENSATION INSURlWCE CARqIER AND POLICY NUMBERARE: CONSTRUCTION � . CMRIER PLAN REVIEW ��\. 3p Z POLICV NUMBER ELECTAIC Q p (i}IISSECiIONNE�NOTBECOAJPLEfEDOFhEPER4iri5FpqpNEF0.ADFiEDDOLLARS(t100)ORIESS} PLUMBING W Z I CERTIFV THAT IN TliE PERFORMANCE OF THE WORN FOR WHlqi THIS PERMIT IS ISSUED,I MECHANICAL C} SHAIL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO 9ECOME SU&IECT TO THE (/j WORKERS'COMPENSATION LAWS OF CALIFORNI/�AND AGREE THAT IF I SHWLD BECAME INSPECTION FEE SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTqN 3700 0F THE UBOq �� O CODE,I SHALL FORTHWITH COMPLV WIhI THOSE PROVI510N5, ISSUANCE � � p DATE: APPLICANT. SMIP �� W J WARNINO:FAILURE TO SECURE M/ORKERS'COMPENSATION CAVERAOE IS UNUWFUL.AND SHALL BE ENERGY P/C � J � SU6IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOlLARS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOFi IN J SECTION 3708 OF THE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. w RETENTION FEE: O CONSTRUCTION LENDING AGENCY PF�-ALT FEE; � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THATTHEFE IS A CONSTRUCTION LENDING AOENCV ��+L'1-1 f! ^ FOR THE PEFFOfiMANCE OF THE WORK FOq WHICH TMIS PERMIT IS ISSUED(SEC.30D7,CIV.C.). /r//17Jv V Z ' W � LENDEF'S NAME � LENDER'SADDRESS w I CERTIFV THAT I HAVE READ THIS APPUCATqN AND STATE TiAT THE ABOVE INFOR7AATION IS CORRECT. TOTAL FE ES �� ' � ' /• ��f � 1 AGREE TO CAMPLV WITH ALL CI7V AND COUNTV ORDINANCES AN�STATE UWS FEUTINO TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CWNTV TO ENTER UPoN THE Z ABOVE-MEMIONED PR07ER wsPECTioN Puaroses. COMMENTS � � G FS o J � m PERMITTEE NAME( ' � � y �� -�r - � SI NA RE OF PE DATE ' — RECPT.NO. PAID BY ALIDATION ~ WHITE—Departmant Copy,YELLOW�inance Copy,PINK—Assessa Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy CE.�V O� DIAf1�OND �AR I�S�EC�IOi� �3ECORD �r � : ry- D�I�PGC�i DOG} DGJS�C�°.;.�`� OG�pGQ u OG3� 0{�l�C��i 0.0[�, DGJ4G 0[�l�pC�C�4QG3.�. SET BACK " FLOOR JOIST � FTGS/FORMS/STEEL S 1 • FHA REQMTS • ELECTRIC GROUND UN�ER FLOOR DUCT � GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE B�ND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION S 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/SIDING POOL FENCING WALL INSULATION 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 DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY fi �� . COMMEIVTS SEPTIC TANK SIZE SEEP PIT/U SIZE�. a c� a � ,.� ��. � n . -