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Home My WebLink About17750 (669) CITY OF DIAMOND BAR ` � ---��`— DEPARTIviENT OF COIvIIvIUNTI'Y&DEVELOPIv�NT SERVICES I'� 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS "'�� BUILDING PERMTT APPLICATION FIRMLY QJOBSITE ,,n 33� ' /�I �`C� QL DATECATION '1 � ( I-�a NUMB R �� #/C O � S ¢ ADDRESS 4 L �i �_ r Ch � issuE TYPE occ Q,�,/ ,. APN LOT TR T DATE CONST. � GROUP '% Lt� p OWNER CI o ADDRESS 'Z Z L ZONING SETBACKS Z CITY ZIP TEL. � '� FRONT qyy ❑ � APPLICANT ^-i7 1 �, REAR � �� SIDE/SIDE STREET RW O CONTRACTOR SIDE ❑ ADDRESS � CITY ZIP TEL. PROPOSED USE � , oARCH/ENG/ � z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES �_ BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDEF DECLARATION SFR/ADD/REM O p 1 HEREBV AFFlRM UNDER PENALTY OF PERIURV THAT I AM E%EMPT FFOM THE CONTRACTORS L6 G0f896/C9fPOR ' W CENSEUWFORTHEFOLLOWINOREASON(SEC.70.91.5BUSINESSANDPROFESSIONSCODE:ANVGTVOR (n U COUNTYWHICHREWIRESAPERMITTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIRANVSTRUC- w 7URE,PRIOR TO ITS ISSUANCE,AL50 REOUIqES THE APPLICANT FOR SUCH PERMIT TO FILE A 51(3NED w Pgtio/Deck � STATEMENT h1AT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF iHE CONTMCTORS LI� � � CENSE UW(CHAPTER B(COMMENCINO WITM SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� POOUSPB � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFflOMANDTHEBASISFORTHEALLEOEDE%EMP� C7 TION.ANVVIOLATIONOFSECTION7031.68YANYAPPLICANTFORAPERMITSU6IECTSTHEAPPLICANTTO Z Re-Root A CIVIL PENALTV OF NOT MORE THAN FNE HUNDRED DOLURS(f500).): � OI.ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, O CORIrt10fC181 � Z NALL DO THE WORK,AND THE STRUC7URE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W�,BUSI- J N NESS AND PFOFESSIONS COOE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PFOPERTV WFIO BUILDS OR IMPROVES THEFEON.AND Vh10 DOES SUCH WORK HIMSELF OR HERSELF Oq � THROU(3H HIS OR HER OWN EMPLOVEES,PROVIDED 7}UT SUCH IMPROVEMENTS ARE NOT INTENDE�OR m 0 OFFEREDf-0RS�LEIF,HOWEVER7}1EBUILDINGORIMPROVEMEMISSOLDWfTHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASON7JEROF7HEPROPERTV,AMEXCLUSIVELYCONTRACTINOWITHLICENSEDCONTRACTORS � TO CONSTRUCT THE PR0.IECT(SEC.70/1,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI� VBI118f1Of1 ADJ.AFIEA W CENSE UW DOES NOTAPPLV TO AN ONRJER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � NMOCONTRACTSFOFSUp1PRQlECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTAAG QUANTITY DESCRIPTION FEE � TORS�L/ICENSE LAW.�. !O I MI E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON J � Q ?� U ' � DATE OWNER � Z U �Q LICENSED CONTRACTORS DECLARATION W CL I HEREBY AFFIqM UNDER PENALTV OF PEiLIURV THAT I AA/LICENSED UNDER PROVISIONS OF CHAPTER � � D(COMMENCINO WRH SECTION 7000)OF DNISION�OF THE BUSINE55 AND PROFESSIONS CODE,AND Z I �� MY LICENSE IS IN FULL FORCE AND EFFECT. m � UCENSE CLASS LIC.NO. � � U DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q , � I HEREBV AFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWINO DECLARA710N5: U � Z �Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WOHI(ERS' a • Q COM7ENSATION,AS PROVIDED Bv SECiION 370o OF THE LABOR CODE.fOR THE PERFORMANCE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W � � Qw _I HAVE AND WILL MAINTAIN WORI(ERS'CAMPENSATION INSURANCE,AS FE�UIRED BV SECTION 3l0o OF THE LABOR CODE,FOR THE PERFORMMlCE OF THE WORN FOR N?11CH THIS PERAl1T IS — ISSUED.MV WOR)(ERS'COMPENSATION INSURANCE CARRIEF AND POLICV Nl1MBEflAAE: CONSTRUCTION J l � CARRIER PLAN REVIEW � � ZPOLICV NUMBER ELECTRIC Q 0 (1}YSSECI%7NNE�NOTBECONPLET�EDOF7HEPERA9TISFbRONEViU�DREDOq.LAliS(E100)OqLESSl PLUMBING -W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH h115 PERMIT IS ISSUED,I MECHANICAL L7 SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE (/) WORKERS'CAMPENSATIONLAWSOFCALIFORNIA�NDAGREETHATIFISHOULDBECOME INSPECTIONFEE = SU&IECTTO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 3�OOOF THE LABOR CODE,I SHNl FORTHWIhi COMPIY WITH THOSE PROVISIONS. ISSUANCE � p DATE: APPLICANT. SMIP � ;SC� W � WARNINa:FAILURE TO SECURE WOHI(ERS'CAMPENSATION CAVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C � SUBJECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDPED THOUSAND ENERGY PERMIT DOLURS(f1oo,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN � SECTION37080FTHELABORCADE,INTEREST,ANDAITORNEV'SFEES. RETENTIONFEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: u� � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CQYSTRUCTION LENDINC AGENCV - FOR THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.�007,CIV.C.). Z W � LENDER'S NAAIE H LENDERSADORESS w I CERTIFY TMAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IN RMAT�oN�s�qRE�T. TOTAL FE ES � I AGREE TO COMPLV WITN ALL GTV AND COUNTV ORD CES AND STAT REIATING TO BUIL�INO ��U � CONSTRUCTION,/WD HEREBV AUT R2E REPRE ATIVES OF THI TV TO ENTER UPON THE I � � Z ABOVE�ME ED P PERTY I PECT RPOSES. COMMENTS � J � ¢ FE E E_IP IN7) ' � � / Uj 'SIGN REOFPERMITTEE DATE � RECPT.NO.• PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy � �qlp _ _ ��.lf'� � �9LWUbC4J�di1� �4WU-ll � IiC��'L'�' �i„r�tl�YYCI Y'l1�Wo�i('il� ?• � oa�c�ooa �ca� ` oa�c�a oa�c�ooa oa� aa� o � 5El" BACK ^� 4 FLOOR JOIST FTGS/FORMS/STEEL ' FHA RECaMTS ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMBING i UNDER�FLOOR CU�IDUIT SLAB GRADE � ` FIREP,LACE FOUNDATION TEMP POWER _ FIREPl..p�C�BOND BEAM WATER SERVICE M!D HT. BOND BEAM � i ROOF SHEATHING & FT. BOND BEAM FRAMINGNENTILIATION -��h2� � FINA�BOf�D BEAM ROOF COVER PRE-GRADING ROUGH NEA7ING BENCHING ROUGH ELECTRIC �'�-�--�� ROUGN,GRAdING ROUGH PLUfVIBING FINISH`uRADiNG SHOWER/1"UB TEST • ' POO�ELECTRIC EXT. LATH/SlDING POOL FENCING WALL IPISULATION POO�FINA� CEILING IfVSU�ATION OFF SITE IMPS. � DRYWALLNAILING ��t'L-p� DEpICATIONS SEWER FINAL ENG. SEPTIC TANK . LANDSCAPE/IRRIG. SEEP PiT/L.L. ON SITE IMPS. GAS AIR TEST $-�-0 y FINAL ZONING FINAL CONST. (� �� F!RE DEPT. FINA� �� FINAL HEATING HEALTH D�PT. FINAL FINA�ELECTRIC /� rjZ � DEV. FEES PAID FIiVAL PLUMBING ENERGY �t�,� o_ .Q�o,� COi�iNiENTS 1_3_��02 c�:�—�—��R� Pcd�s_��p.?-�-A��r��. � co+��.GyA_-5_I.u�c: u�►.o�5_.�G�S-�_g�T P_t�°S��E�R_�c� SEPTIC TANK SIZE SEEP PIT/U SIZE — � � � � ,