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Home My WebLink About14391 (873)r 0 i� w 17 UJ O CC_ O (ZB W TW F LL O GO 0 WFz F-- �Qz d 0 W z E7 to s O W 11 J Ei O Cr LL 0 co coN J CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21660 E. Copley Drive Suitt 190 (909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION JOSSITE A DRESS ir 31/S Sc� _V --e It'& APN LOT TRACT OWNER ADDRESS CITY ZIP TEL APPLICANT TEL CONTRACTOR �✓+� A ADDRESS CITY f pn'I(� ZI P V.PZ TEI �i�( �1 •( F `7 X�Y ARCWENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFUPERJURY IM UNDER PENALTY OF PERRY THAT 1 AM EXEMPT FROM THE CONTRACTORS U. CENSELAW FOR THE FOLLOWING REASON (SEC. 7031.6 BUSINESS AND PROFESSIONS CODE ANY CITY OR COUNTY WHICH REOIARESAPERMITTO CONSTPUCTALTER IMPROVE DEMOLISH. OR REPNRANY STRUG TURF PRIOR TO ITS ISSUANCE. ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE UW (CHAPTER P (COMMENCING WITH SECTION 7000) OF DIVISION 7 OF THE BUSINESS AND PRO- FESSIONSCODE) ORTHATHEOR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TON.ANY VXXJITI N OF SECTION 7001.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANTTO A CML FENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS USOO).X CI L AS OWNER OFTHE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WALL DO THE WON(, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE ISEC. 7044, BUSI- NESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE UW DOES NOTAPPLY TO AN OWNER OF WHO HO BUILDS OR IMPROVES THEREON. AND WINO DOES SUCH WORK HIMSELFOR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IR IIOWEVERTHE BUILDING ORIMPROVEMENTIS SOLOWITHIN ONEYEAR OF COMPLE• TION, THE OWNER BUILDER WALL HAVE THE BURDEN OF PROVING THAT HE OR SHE DO NOT BUILD OR IMPROVE FORTHE PURPOSE OF SALE). 0 L AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WTTH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U. CENSE LAW GOES NOTAPPLY TO All OWNER OF A PROPERTY M40 BUILDS OR IMPROVES THEREON. AND WHOCONTRACTS FOR SUCH PROJECTS WITH A 001,17RACTOR(S) LICENSED PURSUANTTO THE CONTRAG TORS LICENSE LAW.). O IMI EXEMPT UNDER SEG S. 6 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEPEBYAFFPRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER P (COMMENCING WITH SECTION ?ODD) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND W LICENSE IS N FLU FORCE AND EFFECT. LICENSE CUSS ` _ l UC. NO. yy / .DATr U _ d _cowpuu=o WORKERS'COMPENSATIONDECLARATION tVICAKERS'7 1 NEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOUDWING DECD —I HAVE AND LNLL MAINTAIN ACERTIFlCATf OF CONSEMTO SELNNSURE ORCOMPENSATION.AS PFK)VIDED BY S[CTICN 37DTGF THELABOR WDEF OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REQUIRED§Y' CTDN 3700 OF THE LADOR COOT, FOR THE PERFORMANCE OF THE WORK FOR WHICH TOS PERMIT IS ISSUED. MY WORKERW COMPENSA.TIIONN INSURANCE CARRIER AND POLICY UMBER ARE. CARRIER s"7k l"�tN[i1 j POLICY NUMBER ` (ITIS SECTION NEED NOT BE OCM"XrEDOFTFE PERLST IS FOR RED OOLIJAS Gt U)ORLFSS). I CERTIFY THAT LATHE PERFORMANCE OF THE WORK FOR W CH THIS PERMIT IS ISSUED.I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO TO COME SUBJECT TO THE WORK'cRT COMPENSATION LAWS OF CALIFORNIA,A ACRE THAT IF BECOME SUSJECTTO THE WORKERS'COMPENSATION IONS OF CTION37 FTHE LAB CODE I SHALL FORTHWITH COMPLY WITH RO IONs. DATE: � APPLICANT: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL SE S'_ UIECTAN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS 100,000), N ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THATTHERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC 3007, CN. C.). LENDERS NAME LENDERS ADDRESS 1 CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CRY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCT ION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INS PECTIN PURPOSES. Xmle 4,1,G PERMITTEEN NT) SKINATUR&OF PERMITTEE ATE EXP1F;1.-U SEP 14 PRESS FIRMLY APPLICATION PERMIT P/C U I DATE NUMBER / M ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ Lj SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/REM CD Garage/Carport UJ Patlo/Deck LU LL PooUSpe Z Re -Root Commercial - 5 In Valuation ADJ.AREA OUANTITY DESCRIPTION FEE 177 5U .5 Wu,, /rkTr l LU z J 9 a' i UCT N 'C P REV' LECT BING r ECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES COMMENTS RECPT NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW--Finance Copy. PINK—Assessor Copy, GOLDENROD—File Copy, GREEN—Applicant's Copy CITY OF DIANIIOND.BAR INSPECTION'RECORD 1►� �;�= cl ri,e i� to F_� SET BACK ;. i Il�r = c �+ n iok-9�itfM 0. FLOOR JOIST �. . ;FIGS/FORMS/STEEL- - ,ELECTRIC GROUND GROUND PLUMBING FHA REOMTS UNDER FLOOR DUCT UWER FLOOR CO;,+,)JIT SLAB GRADE - - - FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE - MID HT. BOND BEAMi !ROOFSHEATHING 8 FT. BOND.BEAly1 ` FRAM!NGNENTILIATION - FINAL BOND BEAM' ;ROOF COVER PRE -GRADING 'ROUGH HEATING BENCHING ROUGH ELECTRIC_ _ ROUGH GRADING ,ROUGH PLUMBING FINISH GRADING TEST POOL ELECTRIC Ea=r. LATH,SIDING- iii------4--^JAL+ POOL FENCING INSULATION --,- - POOL•FINAL - - E CsEILiNS INSULATIONi OFF SITE IMPS. dE YtJt�I,L_NAiLING - DEDICATIONS, L1eER - FINAL ENG. ? :3� P . iC TANK LANDSCAPE/IRRIG. _ ';T/L.L. ON SITE IMPS. _ ,7-<,Ia' 1 EST FINAL -ZONING ''= r• ::;•�,; IST. -' FIRE DEPT. FINAL IAEATING _ HEALTH DEPT. FINAL -ELECTRI ; DEV. FEES PAID - `PLUMBING ENERGY � r I ,SEPTIC TANK SIZE- IZCSEEP PIT/U SIZE :SEEP - —