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Home My WebLink About17884 (1997) . , CITY OF DIAMOND BAR �� ----�F� — DEPARTMENT OF COMMUNITY&DEVELOPIv1ENT SERVICES 21825 E.Copley Drive � ° � (909)860-3195 Fax(909)861-3117 � � PRESS `�'%�� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE �� /�� APPLICATION L.� )�(!�NUMBER I D��#/C ADDRESS �� DATE I 1 � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER p ADDRESS ZONING SETBACKS z CITY ZIP TEL. FRONT RW ❑ g APPLICANT TEL. REAR ❑ SIDE/SIDE STREET RW O � CONTRACTOR !� SIDE ❑ ADDRESS �' o C�T• Z�P TE� PROPOSED USE oARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFlRM UNDER PENALTV OF PERIURV THAT I M/E%EMPT FROM THE CONTRACTOFS LI� G0f896/CBfpOR W CENSE UW FOR THE FOLLOW WO flEA50N(SEC.7a91.5 BUSINESSAND PROFESSIONS CODE:ANV CITV OR (n C.� COUNTVWHICHPE�UIRESAPERMRTOCANS7AUCT,ALTER.IMPFOVE,DEMOLISH,ORREPAIRANYSTRUC- w W TURE,PRIOR TO ITS ISSUANCE,ALSO RE-0UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck � STATEMENT h1AT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF hIE CONTRACTORS LI- � � CENSE LAW(CHMTER Y(COMMENCINQ WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� POOUSP9 ^ FESSIONS CODE)OH THAT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR TFIE ALLEGED E%EMP- (� V TION.ANVVqlAT10NOF5ECTVON7031.5BVANVAPPLICANTFORAPERMITSU&lECTSTHEAPPUCANTTO Z Re-Roof A CIVIL PENALT/OF NOT MORE THAN FIVE HUNDRED DOlURS(t500).): � ❑I,ASONRJEHOFTHEPROPERiY,ORMVEMPLOVEESWITHWAOESASTHEIR50lECAMPENSATION, O COrt1rtlBfCiBI � Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7o�a,BU51- J � NESS AND PqOFESSIONS CODE TNE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF ? PROPERTV NM110 BUILDS OR IMPqOVES THEREON.AND NTiO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUC/i IMPROVEMENTS AAE NOT INTENDED OR m � OFFEHEDFORSALEIF,HOWEVER,iHEBUILDINGORIMPROVEMENTIS50lDWRHINONEVEAROFCOMPLE- Z TION,THE OWNER�BUILDEH WILL HAVE 7ME BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR TME PUHPOSE OF SALE). �y,� ❑I,ASONTJEHOFTHEPROPERTV.AME%CLUSIVELYCONTRACTINGWITHLICENSEDCONTRACTORS [t TO CONSTRUCT 7HE PRQIECT(SEC.70u,BUSINESS AND PROFESSIONS CODE iHE CON7RACTORS LI- V81U8�1Of1 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANOWNEROFAPROPERTVWFIOBUIL�SORIMPROVESTHEREON,AND � WHOCANTRACTSFORSUCHVROJECTSWITHACONTMCTOR(5)LICENSEDPURSUANTTOTHECANTRAG QUANTITY DESCAIPTION FEE � TORS LICENSE LAWJ. � ❑1 AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON a L LJ v�� ,.�/ � U � DA7E OWNER ¢ � Z U � LICENSED CONTRACTORS DECLARATION W _. � � I HEREBV AFFIRM UNDER PENALTV OF PEqJURV THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER V. � D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND Z � � LLI MY LICENSE IS IN FUI.L FORCE AND EFFECT. m � LICENSE CLASS LIC.NO. � V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q � U � I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWIN(3 DECLAAATIONS: Z. � IHAVEANDWILLMAINTAINACERTIFICATEOFCONSEN7TOSELF�INSUREFORWORKERS' _ � COMPENSATpN,AS PqOVIDED BY SECTION 3�00 0F THE LABOR CODE,FOR THE VERFORMANCE U ' Q OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED. � � Qw _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REW IREO BV SECTbN 37000F THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION jCARRIER PLAN REVIEW � POLICY NUMBER Z ELECTRIC Q � (iH65ECilONNE�NO7BE00MPLEfEDOFTHEPEpAMISFpqONEMND{7EDOOL1AFiSK100)ORLESSI PLUMBING � W � Z I CERTIFY THAT IN TME PERFORMAtJCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE N WORKERS'COMPENSATION UWS OF CALIF-0RNIA,AND AOREE THAT IF I SHOULD BECOME INSPECTION FEE SU&IECTTO THE WORKERS'COMPENSATKKJ PROVISIONS OF SECTION 37000F THE LABOR : �j CODE.I SHALL FORTHWITH COMPLV WITH T}qSE PROVISIONS. ISSUANCE � 0 p DATE: APPLICANT: SMIP W J WARNINO:FAtLUHE TO SECURE WORKERS'COMPENSATqN COVERAGE I5 UNLAWFUL,AND SHALLBE ENERGY P/C J �y SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDGVILFINESUPTOONEHUNDREDT}10USAND ENERGYPERMIT DOLLARS(f10o,000),IN ADDI710N TO THE COST OF COMPENSATpN,DAA/AGES AS PROVIDED FOR IN J SECTqN 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. OC RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV THATTHERE IS ACONSTRUCTION LENDING AGENCV � FOR THE PERFORMANCE OF THE WOH7(FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.CJ. Z w � IENDEF5 NAME H LENDER'SADDRESS wI CERTIFY 7HAT I HAVE FEAD THIS APPLICATION AND STATE TMAT THE ABOVE INFORMATKKJ IS CARRECT. TOTAL FE ES t� � � � I AGREE TO COMPIV WITH ALL CfTY AND CWNTV ORDINANCES AND STATE UWS REIATINd TO BUILDING v � CANSTRUCTION,AND HEREBV AUTHORRE REPRESENTATIVES OF THIS CAUNTV TO EMER UPON THE s� �� Z PBOVE-MENTqNED PROPERTY FOR INSPECTqN PURPOSES. COMMENTS � J � m PERMIT7EE NAME(PRINT) Q � � SIONATURE OF PERMITTEE DA7E = RECPT.NO. PAID BY VALIDATION - ~ WHITE—Depertment Copy,YELLOW--Finance Copy,PINK—Assassor Co GOLDENR D--File Co GREEN— pY, py, ApplicanYs opy tC��'� (�(� ':�1��fil�D�QD (�1�� , - BG19��1�`�'8�f�� f�� Ul1i.I�Jl.r'L�v U lll..�iV�l 1�JQ�, ��l>u��Lro� � lA�' �� . p •� � � � • SET BACK FLOOR JO1ST FTGS/FORMS/STEEL FHA REQNiTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CU�IDUIT S�AB GRADE FIREPLACE FOUNDATION ^ TEMP POWER FIREPLACE BOND BEAM � � WATER SERVICE MID HT. BQND�EAM ' ROOF SHEATHING 8 FT. BQND BEAM FRAMINGNENTILIATION F�NAL BOND BEAM � ROOF COVER PRE-GRADWG ROUGH HEATING BENCHING ROUGH ELECTRiC ROUGH GRADING ROUGH PLUIVIBING FINISH C�RADING SHOWER�TUB TEST POOL ELECTRIC EXT. LATHlSIDING POOL FENCING � WALL IPJSULATION POOL FINAL � CEIUNG INSULATION OFF SITE IMPS. DRYWALL NAIUNG DEDICATIOIVS SEWER �INAL ENG. SEPTIC TANK LANDSCAPE/IRRfG. SEEP PIT/L.L. ON SITE iMPS. GAS AIR TEST FINAL ZaN1NG FINAL COiVST. ' FIRE DEPT. FIlVAL FINAL HEATING HEALTH DEPT. FWAL FiNAL ELECTRjC • DEV. FEES PAID FIiVAL PLUMBING g IQ--� ��r _ ��ENERGY � C�Of� a c o .. � COMIV(ENTS . , �,:s . . - - - - , t_ . . . SEPTIC TAfVK SIZE SEEP PIT/U SIZE � � — � . � c�