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Home My WebLink About17684 (1112) � CITY OF DIAMOND BAR �" `----��`--- DEPARTMENT OF COMMUNTI'Y&DEVELOPIvIENT SERVICES 21825 E.Copley Drive - (909)860-3195 Fax(909)861-3117 PRESS '`�� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE /� APPLICATION �� PERMIT � �� P/C o ADDRES � � � L/ S � �' DATE NUMBER # � ISSUE t� TYPE ' CC APN ��OT TRACT DATE � v� CONST. GROUP °C OWNER � O - �` ADDR So�. .3 3 � l S' 't� ' /�' ZONING SETBACKS Z CITY �/ ZIP TEL. "' FRONT R1p/. ❑ � APPLICANT % TE 3iv12C"�-M-�c REAR ❑ � � SIDE/SIDE STREET RW O z ¢ CONTRACTOR SIDE ❑ ADDRESS�� - - Y ' � CITY�L L.' ZIP�j�L�L TEEjiU�L1�';�'Z2_� PROPOSED USE o ARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV 7HA7 I AM EXEMPT FROM THE CONTRAC70R5 LI� G2f890/C8fp0A W CENSEIAWFORTHEFOLLOWINGREA50N(SEC.7031.5BUSINESSANDFROFESSIONSCADE:ANYCITVOR (J� U COUN7YWHICHREOUIRESAPERMITTOCANSTRUC7,ALTER,IMPROVE,DEMOLISH,ORFIEPAIRANVSTRUC� W Patio/Deck Z 7URE.PRIOR TO ITS ISSUANCE,AL50 REQUIFES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w S7A7EMENT 7HA7 HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON7RACTORS LI� w � CENSE LAW(CHAPTER B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO- LL' POOUSPB FESSIONSCADE�ORTHATHEOHSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� � TION.ANYVIOLATIONOFSECTION7031.SBYANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE NUNDRED DOLLARS(f50o).): Z ❑I,ASONTIEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrt1rtI0fCiel - WILL DO THE WORN,AND 7HE S7RUCTUiiE IS NO7 INTENDED OR OFFERED FOR SALE(SEC.7041,BU51� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � 7ROGERTY VJHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � 7HROUGH HIS OR HER OwN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMEN7S ARE NOT INTENDED OR m � OFFEREDFORSALE.IF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE� Z TtON,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,ASONTJEROFTHEPROPER7V,AME%CLUSIVELVCONTRACTINGWITHLICENSEDCON7RAC70RS ¢ TO CANSTRUCT THE PRQIECT(SEC.7014,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS ll- V81U8�i0f1 ADJ.AREA W CENSEUWDOESNO7APPLYTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVES7HEREON,AND � NMOCONTRACTSFORSUCHPR0.IECTSWITHACAN7FAC70R�5)LICENSEDPUFi5UAN7TOTHECANTRAC- QUANTITY DESCRIPTION FEE Y 70RS LICENSE IAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U � � DATE OWNER � Z W � LICENSED CONTRACTORS DECLARATION � � I HEREBY AFFIRM UNDER PENALTV OF PERJURV THA7 I AM LICENSED UNDER PROVISIONS OF CHAPTER d 9(COMMENCING WITH SECTION 7000)OF DIVISION 9 OF THE BUSINESS AND PROFESSIONS CODE,AND Z . � X MV LICENSE IS IN FULL FORCE AND EFFECT. �!` • p � � LICENSE CLA S Lf .�7_[r7 LIC.NO. �� 'G� � j / (/ F— c�L —' / U DATE Z CONTRACTOR � L a W � WORKERS'COMPENSATION DECLARATION a � I HEFiEBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ COMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE W OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION Q 370o OF 7HE LABOFi CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS FERMI715 ISSUED.MY WORKERS'CpMPENyA710N INSURANCE CARRI�R AND POLICV NUMBER ARE: CONSTRUCTION J ��.�r J� j CARRIER �S7"f'f�'f' . �n-�l PLAN REVIEW Z POLICY NUMBER y ELECTRIC 0 (iHI55ECIlONNE�NOTBE00AARtTEDOFTHEPEWMISFORONEHUI�DREDDOLV3�S(itOD)ORLESS} PLUMBINCi y W Z I CEFTIFY THAT M THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (} � SHAIL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE N WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE 7HA71F 1 SHOUL ECOME INSPECTION FEE SUBJ CT TO THE WORKERS'COM� PROVISIONS OF SECTION 370o O� E LABOR � �,I SHA ORTHWITH COMPLV WITH TH PROVI510 � �SSUANCE p DATE:r ��APPUCANT: � � SMIP J WARNIN :FAILURE TO SECURE WOFiKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5700,000),IN ADDITION TO 7HE COST OF COMPENSA710N,DAMAGES AS PROVIDED FOR IN � SECTION37080FTHELABORCODE.INTEREST,ANDATTORNEY'SFEES. RETENTIONFEE: • ow.. CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED(SEC.3oe7,CIV.C.�. Z W � LENDER'S NAME H LENDER'SADDRESS � TOTAL FEES �/j�, �� I CERTIFY THAT I HAVE F7EAD THIS APPLICATION AND STATE THAT THE ABOVE W FORMATION IS CAFRECT. w I AGREE TO COMPLY WITH ALl CITV AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHOFIZE REPRESENTATNES OF THIS COUNTY TO ENTER UPON THE � ABOVE-MENTIONE PROPERTV FOR INSPEC N PURPOSES. Z COMMENTS 0 � � m ITTEENAME PRINT) � � �%'� ¢ I/ � Uj SI NATURE OF ERMIT7E ATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy � _. _ _ .. _ }� . . . . . - , ., _... ,i:.,.:.�.. ..}:4.a.. ....�v,?r.. ..... -,wre.. _. , , .. . . .. . . . .. . lyli�� L�IUHII�J�LUI L�G�1� �f�a��V��u�' �t�'v�� oa�� ora� o�� o� � �c� y a� a .� �aP �� a o �.�4 . SET BACK ^ � FLCOR JQISI' _ i ' - -- — _.. �__--�-;---- FTGS/FORMS/STEEL ' ' FHA REQMTS _ � —�.------ --- -------------_.. . -- ELECTRIC GROUND ; UNDER FLOOR DUCT ! --- --...-•-- --._._.._ _:__ ....__.---- -__...__. GROUND PLUMBING � __ ,______ i UNDER FLOOR CUf�IDU1T J' — --- ;-------__ _— .- I ' -------- SLAB GRADE � � FIRERLACE FOUNDATION � � TEMP POWER ' FIREPLACE BOND BEAM __ _ WATER SERVICE I � MID HT. BQND BEAM — -- - _._.._._.------. __... � ROOF SHEATHING � 8 FI�. BOND BEAM � ---- ^� _�__...__ _.—._________.._ —_.___.____—� ----.....___..-- FRAMI(VG/VENTILIATION i FINAL BOND BEAM � _� __--- ----�-- --- ---{.....--- ' ------ ROOF COVER PRE-GRADING i ' ROUGH HEATWG BENCHING ! ROUGH ELECTRIC R�UGH GRADING _..— _,..___._— --------�_ __..____ _ RQUGH PLUMBING �- � FWISH GRADING --- ---... _...__ ___�. ----------- -_._.._..__._.__ SHOWER/TUB TEST � POOL ELECTRIC _ EXT. LATHISIDING � � PUUL FENCING ( WALL INSULATION i POOL FINAL _. _..._ CEILING INSULATION ' OFF SITE IMPS. I - ----_ _ _.__._. __..___._._.._----.�._____ ____ __ DRYWALL NAILIiVG DEDICATIONS SEWEFI -- ---- FI(�AL ENG.-- --•----- SEPTIC TAIVK LANDSCAPE/IRRi�. ; SEEP PITlL.L. Of� SITE IMPS. GAS AIR TEST --- FINAL ZOi�ING '-- ,� _..__� FINAL CONST. ��RE DEPT. FINA! FINAL HEATING HEALTN DEPT. FINAL FINAL ELECTRIC � ! DEV. FEES PAID FINAL PLUMBING ENERGY , /�_�� __— _ -------__— ___._._.... u./��y�. �<•'A(� �/j b Z �/��^ � I ��o _ .. �� i ------- - ... ._ -- . _ �_;_ _ _ � - - __— _ CUMiViENTS SEPTIC TANK SIZE SEEP PIT/U SIZE - - _-._____._�_.��- ---_-_..-- y� -- --- _..._._......_._ � � ____._- � , .