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Home My WebLink About12676 �,�,�_ CITY OF DIAMOND BAR ��C� �� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21825 Copley Drive,Diamond Bar,CA 91765 � - �"� I (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS '��'+ BUILDING PERMIT APPLICATION FIRMLY QJOBSITE , j)� Q ��•7 �/ APPLICATION�-/ � NUMBER�6/��#/C ¢ ADDRESS (/ �/(/ � DATE �� O � � � ISSUE �7 � TYPE OCC APN LOT TRACT DATE v CONST. l� GROUP p OWNER /S Gt �1 o ADDR . fJ GG I fi . / ZONING SETBACKS Z CITY �la�i �/�ZIP�TEL.��= c_,__G FRONT qyy p _�_ REAR o APPLICANT TEL. � � SIDE/SIDE STREET RW ❑ � CONTRACTQR �� TC( X��Cv/GY/� l G� SIDE ❑ ADDRESS Pi �FJ _ � � G'C P_(ilyL� � CITY �CP.�PC�- ZIP R_`S.�GT�E. �SO '"d'� PROPOSED USE �� liC��. e//' o ARCWENG/ O�U� z DESIGNER � � ' a ADDRESS NO.DWEL. NO. ^ NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS N cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AFIEANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDEfi PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� Gflfe9B/CBfpOA W CENSE LAW FOR 7HE FOLLOWINO REASON(SEC.7031.5 BUSINESSAND PROFESSIONS CADE:ANV CI7V OR (n U COUNTVWHICHREOUIRESAPERMITTOCONS7RUC7,AL7ER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W P8fi0/DBCk w TURE,PRIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w � STATEMENT 7HAT HE OR SHE IS�ICENSED PURSUAN7 TO THE PFOVISIONS OF 7HE CONTRACTORS LI� � CENSE UW(CHAPTER 8(CAMMENCING WI7H SEC710N 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB , 0 FESSIONSCODE�OR7HATHEOfiSHE15EXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP� (� V TION.ANVVIOLATIONOFSECTION7031.SBYANYAPPLICAN7FORAPERMITSU&lECTSTHEAPPLICANTTO Z Re-Roo( A CIVIL PENALTV OF NO7 MORE THAN FIVE HUNDRED DOLLARS(f50o).): ZOI,ASOVMEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COfi1ff10fClel WIIL DO THE WORN,AND THE STRUCTURE IS NO71N7ENDED OR OFFERED FOR SALE(SEC.70�t,BUSI- J N NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW�OES NO7 APPLY TO AN OWNEH OF � PROPERTY WHO BUILOS OR IMPROVES TNEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER ON?J EMPLOVEES,PROVIDED 7HA7 SUCH IMPROVEMENTS ARE NO71N7ENDED OR m Q OFFEHEDFORSALEIF,HOWEVER7NEBUILDINGORIMPROVEMEMISSOLDWITHINONEYEAROFCOMPIE- � Z TION,7HE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OP . � IMPROVE FOR THE PUR705E OF SALE). W ❑I,AS OWNER OF THE PHOPER7V,AM E%CLUSIVELY CONTMCTING WITH LICENSED CANTRACTORS Q TO CANSTRUCT THE PRQIECT(SEC.70�1,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- \IaIU8NOf1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPER7YWHOBUILDSORIMPROVES7HEREON,AND � VlHOCANTRACTSFORSUCHPqOJECTSWITHACONTMCTOR(S)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE Y 70R5 LICENSE LAW.). , �� ❑I AM EXEMPT UNDER SEC. 6.8 P.C.FOR THIS REASON Q U � � DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION W � � I HEREBY AFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CODE,AND Z X MV IICENSE IS IN FULL FORCE AND EFFECT. � � LICENSE CIASS v �� LIC.NO. �/� �/ / j , I ~ DATE ��v � CONTHACTOR d U � w � WORKERS'COMPENSATION DECL ATION Q � I HEREBV AFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DECLARATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSEN7 70 SELF-INSURE FOR WORKERS' _ Q COMPENSATION,AS PROVIDED BY SECTION 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE U THE WORN FOR WHICH THIS PERMIT IS ISSUED. W � � � � � FHAVE AND WILL MAINTAIN WOHKERS'COMPENSATION INSURANCE,AS REOUIRED BV SEC710N Q 3700 OF THE UBOR CODE,FOR THE PERFOR NCE OF THE WORK FOR WHICH THIS PERMI715 ISSUED.MV WORNER COMP SATION INSU ANCE CARRIEH Ayp POLICV NUMBER ARE: CONSTRUCTION / j CARRIER � PLAN REVIEW ZPOLICV NUMBER �� ELECTRIC Q � (iHISSECTqNNEmNOTBENMPLEfEDOFTHEPERMffISFORONEHUPDREDDOUApS(5100)ORLESS} PLUMBING � W Z I CERTIFY THAT IN THE PERFOqMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL U' SHALL NOT EMPLOY ANV PERSON IN ANY MANNEF 50 AS TO BECAME SU9JECT TO THE . � WORKERS'COMPENSA710N LAWS OF CALIFORNIA,ANDAGREE 7HA71F I SHOULD BECOME INSPECTION FEE = SUBJECT TO THE WORKERS'COMFENSATION PROVISIONS OF SECTION 37oa OF 7HE LABOF � CODEI HALLFOR7IWITNCOMPLVWITHT�QSEP IONS. ISSUANCE 0 r' /.�= /�]/ p DATE:��v PPLICANT: V / ��L(Jv� SMIP �� J WARNING:FAILURE TO SECURE WORKERS'CAMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SUBJEC7AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 700NE HUNDRED THOUSAND ENERGY PERMIT �` DOLLARS(5100,000),IN ADDITION TO THE COST OF CAMPENSATION;DAMAGES AS PHOVIDED FOR IN � SECTION 3708 OF THE LABOR CODE,IN7ERE5T.AND ATTORNEv'S FEES. RETENTION FEE: � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFlFiM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W � LENDER'S NAME � LENDER'SADDRESS � � TOTAL FEES � � I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. � w 1 AGREE TO CAMPLY WITH ALL qTY AND COUNTY ORDINANCES AND STATE LAWS REUTING TO BUILDING � d I � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. COMMENTS � � �� T� ��li''v�''� - m PERMI7TEE NAME(PRIN7 `, /n � ¢ ��(/ /Ov , � N SIGNA7URE P IT7EE DA7 r = RECPT.NO. 'PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREE —Applicant' Copy - .: . ._ . , . , . , . - . . , . �@�'V O� D6RfV��6�1� ��ff� � . I�lSf��C�� (�I��IR� Oa�pC�C�400a DQ4C� Oa�3pCC�40a Oa�3pf�C�400a DGJ4C Oa�pGC�40a 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 BEAM FRAMINGNENTILATION 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 i FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING ! HEALTH DEPT. FINAL ----------- --------....____ - __-- ----__._ --------------_------_.--------------- FINAL ELECTRIC � ___ l DEV. FEES PAID _ _ ___ _ FINAL PLUMBING � ENERGY �� COMMEfVTS - SEPTIC TANK SIZE SEEP PIT/U SIZE a � � - �