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Home My WebLink About13647 (865) (I - . . . . . .. .. . . �_ - � ,�f�' �dG�b� • -� 1� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ��I��D 21660 E.Copley Drive Suite 190 � (909)860.3195 Faz(909)861-3117 S C P 1 � 20�� PRE$$ `'��'� BUILDING PERMTT APPLICATION FIRMLY o� JOBSITE �� /• � A , , G / (L�^ APPLICATION PERMIT a� P/C I ADDRESS �`� �Yu-�'i' �1'-�"' DATE NUMBER Gf0 # � APN Z � �� TRACT ISSUE TYPE OCC � DATE CONST. � GROUP p OWNER �� G " ADDRE S Dl A' G1� ZONING SEfBACKS � CI � ZIP TEL. � ' a^ DZ FRONT RW ❑ APPLICANT TEL. ? REAR ❑ SIDE/SIDE STREET RW ❑ � CONTRACTOR L��I S SIDE ❑ q� ADDRE S ' PROPOSED USE��`�"��'G �"� ��9/"'SLL � CITY ZIP,�i'1 CG4hTEL. / L o ARCH/ENG/ -3 e� � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES / BEDROOMS � � CITY ZIP TEL. cn y DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p I MEREBV AFFlqM UNDER PENALTV OF PERIURV 7HA7 I AM E%EMPT FROM THE CONTRACTORS U- GeI890/CefpOR W CENSELAWFORTHEFOILOWINGPEASON(SEC.7a'f1.58USINESSANDPROFE5510NSCODE:ANYCITVOR (n C� COUHfYWHICHREOUIRESAPERMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH.ORREPAIRANVSTRl1C- W P8110/DBCk w NRE,PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPIICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMEHT THAT HE OR SHE IS LICENSEO PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE UW(CHAPTER Y(COMMEHCINO WITH SECTION 7000)OF DIVISION a OF THE BUSINESS AND PRO- � POOUSpe I FESSpNSCODE)ORT/iATHEOR5HEI5EXEMPTTIEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� TION.ANYVIOLATIONOFSECTION70�7.5BYANVAPPLICANTFORAPERMITSU&IECTSTHEAPPUCANTTO Z Re-Roof � A CIVIL PENALTY OF NOT MORE THAN FNE HUNDRED DOLLARS(i5oo).j: ^ OI,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWI7HWAGESAS7NEIqSOLECOMPEN5A710N, 0 COfI1ff18fCi81 . � � WILL DO THE WORK,AND THE STRUCTURE IS NOT IN7ENDED OR OFFERED FOR SALE(SEC.70s1,BUSI- J N NESS AND PROFESSIONS CODE:THE CONTMC70R5 LICENSE UW DOES NOT APPLV TO AN OWNER OF � PROPEHTYNRfOBUIIDSORiMPROVESTHEREON,ANONMODOE55UCHWORKHIMSELFORHERSELFOR m Q 7HHOU(Y1 HIS OR HER OWN EMPLOVEES,PROVIDED hiAT SUCH IMPROVEMENTS ARE NOT INTENDED OR � OFFEREDFORSALEIF,FiOWEVERTMEBUILDINGORIMPfiOVEMENTI550LDWITHINONEYEAROFCOMPLE- Z �'TqN,THE OWNER�UILDER WILL HAVE THE BURDEN OF PROVINO hIAT HE OR SHE DID NOT BUILD OR � IMPiqVE FOfl THE PURPOSE OF SALE). w ❑I,ASOMMEROFTHEPROPERTY,AME%CLUSNELVCANTRACTINOWfTHLICENSEDCON7RACTORS � TO CONSTRUCT THE PR0.IECT(SEC.7os1,BUSINESS AND PROfE5510N5 CODE:THE CONTMCTORS LI- V81U8110f1 ADJ.AREA W CENSE LAW DOES NOTMPLY TO AN OWNER OF A PROPERTV WFIO BUILDS OR IMPROVES 7HEREON,AND � Nh1000NTRACTSFORSUqiPR0.1ECTSWITHACON7MCTOR(5)LICENSEDPURSUANTTOTHECONTMG pUANTITY DESCRIPTION FEE � � TORS LICENSE UW.). ��r�( ��/� / 0 O I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q Z �^'�•' `"�^�`• �^�' `O�� 3 � 6� �S � Zl � � DATE OWNER V Q �O 1() Q� Z w O �" O � LICENSED CONTRACTORS DECLARATION W (C y '1' �... �/ 1 HEREBY AFFIRM UNDEH PENAL7Y OF PEFLIURV THA71 AM LICENSED UNDEH PROVISIONS OF CHAPTER � �(>�G �DB� '�� Y(COMMENCINO WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PROFESSIONS COOE,AND ' �� MY UCENSE IS IN FULL iORCE AND EFFECT. O � � �^ �� f Of�O O� W � LICENSE C S LIC.NO. �� J I�r"�" �"•�^ �D L3 V DATE CONTRACTOR L�� a ,-)dCx..f O � � j W � W^rY! � WORKERS'COMPENSATION DECLAAATION � Q prJR, �90 � � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE Of THE FOLLOWING DECLAFATIONS: Q � � � � �' � I HAVE AND MALL MNNTAIN A CEfiTIFICA7E OF CONSENT TO SELF-INSUPE FOR WORKERS' S I� /� � � �ry�� FNSATION,AS FHOVIDED BY SEC7ION 370o OF THE UBOR COOE,FOR 7HE PERFORMANCE U �� Q OF 7HE WORK FOR WNICH THIS PERMIT IS ISSUED. � �� L �D � $0 d W _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 37a0 OF THE UBOR CODE,FOR THE 7ERFORMANCE OF THE WORK FOR WHICH 7HI5 PEHMIT IS ISSUED.MY WORKERS'CAMPENSATION INSURANCE CARRIER M1D POUCY NUMBER ARE: CONSTRUCTION jCARRIER a PLAN REVIEW ZPOLICV NUMBER � � ELECTRIC � '� � Q l.l- . � (TF165ECiXXINEFDNO7BE001.�LEfIDOFhEPERMTISFOfi�NE/0.��DREDD(X1IRS(f100)ORLESS} PLUMBING •� --:-- W � �1"� Z 1 CERTIFY THAT IN 7HE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL �r'L"- �} SHAl1 NOT EMPLOY ANY PERSON IN ANV MANNER SO AS 70 BECAME SUBJE O 7HE N WORKERS'COMGENSATKKi LAWS OF CALIFORNIA,AND AGREE 7 AT IF I SHO D BECOME INSPECTION FEE � SUBJECi T THE WORKERS'COMPENSATION PROVI510 S OF C ON 37 OF THE LABOR Q`,,,�� r� CAD,I S FOiiTHWITH COMPLV WITH E PRO SI ISSUANCE _�•�•+ � SMIP ,�l;1 J ,• t��`�'•� p DATE: � APPLICAN2 , � � . W ,��j ' q�'�.'.},.�' :.t�-'+��a J WARNING:F ILUR TO SECURE WORKERS'CAMPENSATI COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C +�'�./ /1T� �_}r h.I�%' J ' _ '� . � SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND L FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT i�F T�'V 7"�."��1!� � �1=� _ -� DOLURS(i100,000),IN ADDITON TO THE COST OF CO ENSA710N,DAMAGES AS PROVIDED FOR IN — __._-.. J SECTqN 3708 OF THE LABOR CODE,IN7ERE5T,AND A oaNErs Fees. RETENTION FEE: � d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O Q I HEREBV AFFIR/A UNDEH PENPLN OF PERIURV THAT 7HERE IS A CANSTRUC710N LENDING AGENCV � FOR 7HE PERFORMANCE OF 7HE WORK FOR ICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.), � Z �I iJ w /�l ��(• � LENDER'S NAAIE F- LENDER'S ADDRE55 � //} �j � I CERTIFV THAT I HAVE REM THIS APPLICATION AND STATE THAT 7HE ABOVE INFORMA7pN IS CORRECT. TOTAL FE ES .f / V S� "/ � w I AaREE TO CAMPLV WI7H ALL CITV AND COUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � CANSTRUC710N,AND MEREBY AUTHORRE REPRESEN7ATIVES OF 7HI5 COUNTV TO ENTER UPON 7HE ,'�}I�/_ �. ZABOVE�MENTIONED PHOPERTY FOR INS ECTION PURPOSES. COMMENTS � `�V' " � O �n J (/ Q PERM (P � L /_� D !J cn / � TURE OF PERMITT DAT � RECPT.NO. � PAID BY VALIDATION WHITE�epartment Copy,YELLOW�inance Copy,PINK—Assessor Capy,GOLDENROD--File Copy,GREE —Applicant's Copy . .` -••t; t . , ,, . C�.r��` � 1+.�.`� �•.�..`n;:�, . ' , �I�'�( �� CDBA�I��I� �Aff� . , o�1S�f��C�'D�G�II�f��C�� , ,. ... .. , � u. __ � _ � . . .. . t �, � � � � - �- `�1�G� � o �� ` ��' '�I �° o �� ° ,[�.�� - a . � , = o�� - � , . _ _. � - . SET BACK , ` • FLOOR JQIST ' � - s, ; ,-, : � � . , ��- '� 1 ..__•.,.. , , ; _ .. ------ .�`. . ,• . _ ._., .. �- � --- FTGS/FORMS/STEEL , - ,. .::. ,��., �� ` i� FHA RE�MTS--- --,��.- _ __ _._._._. - -- -.. _- - —= ELECTRIC GROUND j UNDER FLO�R GUCT •` �`-'`�' �'' � : _ .:�. . . ..,. _. GRC)UND PLUMBING UNDER FLOOR CCi:k; L�iT�� ,=,�� ` ' _.<�..a� 1� .`a,l; � ,.•, . .. SLAB GRADE FIREPL`�''��Qqi'�fS�QTION ` ��i , �:��:��k�' h 1 TEMP POWER � � FIREPL'.A�E�B`O't�l'D`E3�I�M '�' . ,--'�•� x-';; . ';�=�1';•�. � —�__MID HT. BOND B�7 . �a` 'ti.;�::�;`..`., �:>�_.`t —.--._. WATER SERVICE ,' ROOF SH�'A��13t�iG ':�=w. �;'-• ''> �,,;�„:�,�.a`.� 8�'T'. BON��.- ','MA :'' -,:-�-+-�;—.��, ; -t— �.-s-=':',-- _ _ � ! :.•..'`�`'. `` 1=RAMItvGNENTILIATiON FiNAL BQrt,1��AM ` ' - -.... ----- -�..�_.---._._ _—_______ ROUF COVF_R 1 PRE-GRADING � �f�OUGH HEATING BENCNING �ROU aH ��E�TRIC I ROUGH GRADING � ROl)�a!� PLUMBING � FINISH GRADINC J __�._._� T ;i1-!Gv�[��-��'UB TEST � POOL ELECTRIC __ �_�_.___ -- � �XT. L�TNiSIDING POOL FENCING I ! iNALL INSULATION POOL FiNAL �-- � C�iE_�iJG I�1�ULATION OFF SITE IMPS. ' + ..�.�..__._.� _ �- ----- � Df3�1NAL.�f�A�LtNG DEDICATIONS � —��_� � ? ��i��{ � � FINAL ENC'a. � � --- � :�k:P:E�TANK LANDSCAPE/IRRIG. j�St=��' '-�T/LL. ON SI"fE IM�S. r-�-:_-_'--.,.». € ".,-�;��'�: f�ST FINAL Z�NING ?�� '' ..'.`'ii��T. .�.:. :-�t . .. �::�..: �a:��..:,�,�a •�;.�FiRE DER7. FINAL M ------_— _� _— t_...', . � i., - "�;:i��ATIf�3G . . .`,,s''. `:i:�`.:a ��' HEA�.Tf-1 bEPT. FINAL .,'�r. ��'C�R� :e. . . .. . ..�,;.�_z� , '�DEV�.' 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