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Home My WebLink About10-1038 � �'�� ¢-- 3�- �95� �`_ 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 Q ADDRESS I3 7O � ��S } . APPLICATION. D �O NU BE q/C�4� O p DATE � APN LOT�_ TRACT DATE ��7'� f D ONST. j�ROUP p OWNER � e o ADDRESS J ZONING SETBACKS oCITY ZIP S�TEL. � REART RW ❑ APPLICANT TE�. ❑ �d SIDE/SIDE STREET qyy p CONTRACTOR '-f � SIDE p Q ADDRESS '� �K � CITY �r� ��_ ZIP gZ�O/ TEL Z/Lf��6 PROPOSED USE w ARCWENG/ L iz DESIGNER �Ldr.o �iv T�/'�f NO.DWEL. NO. NO. a ADDRESS �n UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PER0.IRV THAT I NA EXEMPT FROM THE CONTRACTORS LI� G8(8gB/C81POR W CENSE LAW FOR THE FOLLOWINO REASON(SEC.7031.6 BUSINESSAND PROFESSIONS CODE:NIV CITV OR (n � U COUNTyWHICHREWIRESAPERMIT7000NS7RUCT,ALTER,IMPROVE,DEAIOLISH,ORREP/URANVSTRUC- W TUHE.PRIOR TO ITS ISSUANCE.ALSO REW IRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w Patlo/Deck � STATEMEM 7HAT HE OR SHE IS LICENSED PUFSUANT TO THE PROVISIONS OF THE CANTRACTORS LI� � CENSE LAW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS ANO PRO- � POOUSPB FESSIONSCODE)OR?HATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORiHEALLEOEDE%EMP• (� TION.ANY VIOUTION OF SECTION 7031.5 BY ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO Z Re-Roof A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLURS(i500).): � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COrtIfTIBICI9I Z WILL DO THE WORK,M1D THE STRUCNRE IS NOT INTENDED OR OFFEFEO FOR SALE(SEC.70u,BUSI- J � NESS AND PROFESSIONS CODE:THE CONTMCTORS UCENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPEHTV WHO BUILDS OR IMPROVES TNEREON.AND WHO DOES SUCH WORK HIMSEIF OR HERSELF OR wTHROUGH NIS OR HEH ONM EMPLOVEES,PHOVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMRE� Z TION,TME OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). � w ❑I.AS OWNER OF 7HE PROPERTV,AM E%CIUSIVELV CONTRACTMG WITH LICENSED CONTRACTORS [[ TO CONSTRUCT THE PR0.IECT(SEC.70U,BUSINESS AND PROFESSIONS CODE:TME CONTRACTORS LI� V8IU8SIOn� ADJ.AREA W CENSEUWDOESNOTAP7LVTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � NM1IOCONTRACTSFORSUCHPRQlECTSWITHACONTRACTOR(S)IICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION TORS LICENSE LAWJ. FEE � � ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q / 3 U � DATE OWNER H Z U � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIHAI UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � � o(COMMENCINO WITN SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS COOE,AND Z �� MY LICENSE IS IN NLL FORCE AND EFFECT. m �, LICENSE CLAS �IC.NO. � . V DATE O CONTRACTOR d W � WORKERS'COMPENSATION DE RATION Q N U � 1 HEREBY AFFIqM UNDEF PENALTV OF PERNRV ONE OF THE FOLLOWING DECLARATIONS: Z � • • �Z _I MAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SEIF�INSURE FOR WORKERS' a Q COMPENSATION,AS PROVIDED BV SECTION 370o OFTHE LABOR CODE,FOH 7HE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � Qw I HAVE AND WILL MAINTAIN WOR)(ERS'CAMPENSATION INSURANCE,AS REWIRED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOq WHICH THIS PERMIT IS ISSUED.MY WO RS'CAMPENS/A�J_C�N INSURA/Nc�LC�a RI/Eq.w�POIICV NUMBER ARE: ONST UCTIO jCARRIER �/,+aI//�'��fL .J/�C.fl.� PLAN REVIEVJ � POLICYNUMBER �7L707/y.�C7 � �/I__.L_Cl_ 0 (INISSECIIONNE�NOTBEWRIPLE7mOFhEPEqATrISFOHpNEFiIA�DqEppqlppgKlOD)ORLFSS} .LU W _�� .„w. Z I CERTIFV 71iAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUEO,I ECHA /1!� C�S SHALLNOTEMPLOYANYPERSONINANYMANNE OASTOBECOMESUBJECTTOTHE .r_��T � WOFKERS'CAMPENSATION UWS OF CALIFOR AND A�REE THAT IF I SNOULD BECAME INSPECTION FEE S SU&IECT T THE RKERS'COA/VENSATIO VISIONS OF SE ON 370o OF THE LABOF J� E,I ALL TM COMPLY WI E PRO ION UANC /�[J�.�� p DATE; O I I� APPLICAN� �2�(p� W � WARNING FAILURE TO SECURE WORKERS' MPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECT AN EMPLOVER TO CRIM WAL PE TIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND N RGY PE � . '3� OOIURS(f100.oa0),IN ADDITION TO TN OST OF CAA/PENSATqN,DAMAGES AS VFOVIDED FOR IN J SECTqN 370!OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. w ETENTION FE � - � O=D � . O CONSTRUCTION LENDING AGENCY P A FEE: � I HEREBYAFFIRM UNDEF PENALTV OF PERJURV THAT THERE IS ACANSTRUCTION LENDINO AGENCV `�� FOR THE PERFORMANCE OF THE WORN FOR WHICH iHIS PERMIT IS ISSUED(SEC.3087,CIV.C.�. t� l � Z W � LENDER'S NAME � LENDER'SADDRESS W I CERTIFY THAT I HAVE READ 7HIS APVLICATION AND STATE THAT THE ABOVE INFORMATIOfJ IS CARRECT. TOTAL F E ES �V 3 /S� � I AOREE TO COMPLV WITH ALL CRY AND CWNTV ORDINANCES ANO STATE LAWS HEUTINO TO BUILOINO ` (/ � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OFTHIS CWNTY TO ENTER UPON THE ' / Z ABOVE-MENTION D ROPERTV FOR INSPECTION PURPOSES. COMMENTS � JG� T ��-- m PERMITTE (P NT) . ¢ /� 6 �, � � � SI R I D � RECPT.NO. PAID BY VALIDATION WHI7E—DepaAment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,(iOLDENROD--File Copy,GREEN—Applicant's Copy CITV O� �!�►illiCDND ��,R INS�ECTIOi� 6��CORD 3 ��, ��p�c�4ao� . o �`i� � � � ��a�c�� ar��p�c�o� � ��:� ��p�t�i��s: SET BACK , 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 H'T. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAivI FRAMINGNENTILATION FINAL BOND BEAM • ROOF COVER PRE-GRADING ROUGH HEATING Z BENCHING ROUGH ELECTRIC /b ROUGH GRADING ROUGH PLUMBING !! FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF S�TE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPElIRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. � � FIRE DEPT. FINAL � FINAL HEATING ��b _ HEALTH DEPT. FINAL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUMBING ENERGY %vS pqL� 12 t�� — ��a � . COMMENTS s�� 1��—� �--�� SEPTIC TANK SIZE SEEP PITlU SIZE a � Q :=�. . Q.t- �� o .