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Home My WebLink About18246` CITY OF DIAMOND BAR DEPARTMENT OF COMMUNTIY & 1DEVELOPMENT SERVICES 21825 E. Copley Drive (909) 860-3195 Fax (909) 861-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS OTS l 61 (, ) M20I f APN LOT TRACT OWNER ADDRESS CITY p • ZIP"1lL-jLaa TEL. U e% t,Cr 1 APPLICANT I745e TEL�S'";�2T CONTRACTOR ADDR S ^_%A� CITY CoAlufc ZIP 902S:s-TEL.-2$'3_-S=a ARCWENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI. CENSE LAW FOR THE FOLLOWING REASON (SEC. 7071.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REOUIRES A PERMIT TO CONSTRUCT, ALTER IMPROVE. DEMOLISH, CR REPAIR ANY STRUC. TURE. PRIOR TO RS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT 70 THE PROVISIONS OF THE CONTRACTORS Lt - CENSE LAW (CHAPTER 5 (COMMENCING WITH SECTION 7000) OF DIVISION 7 OF THE BUSINESS AND PRO. FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7071.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SSW) ): CI 4 AS OWNEROF THE PROPERTY.OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE R NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NO. -APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTSARE NOT INTENDED OR OFFERED FOR SAE IF,HOWEVER THE BUILDING OR IMPROVEMENT 15 SOLD WITHIN ONE YEAR OF COMPLE- TION• THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O 4 AS OWNER OF THE PROPERTY AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70". BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI. CENSE LAW DOES NOT APPLY TO AN OWNER OFA PROPERTY WHO aU9.DS OR IMPROVES THEREON. AND WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW). O I AM EXEMPT UNDER SEC. B. l P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER P (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PP.OFESSIONS CODE. AND MY LICENSE IS IN FULL FORCE AND EFFECT. LICENSE CUSS_ LIC. NO. ✓� �, D DATE CA2 Z�1 �-O' CONTRACTOR WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELFaNSURE FOR WORKERS' COMPENSATION. AS PROVIDED BY SECTION 37000F THE LABOR CODE, FOR THE PERFORMANCE OF TME WORK FOR WHICH THIS PERMIT IS ISSUED. _I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION 3700 OF THE LABOR CODE• FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION SURANCE CARRIER AND POLICY NUMBER ARE: CARRIER �iF7ff i= POLICY NUMBER lL 01 %d 75-2--1 L7 ITHM SECTION NEEDNOT BE UX.SiETED OFTHE PERMT ISRJR CNE H "AM DOUARS (FIOC) OP LESSI I CERTIFY THAT IN THE PERFORMANCEOF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE, I SHALL FORTHWITH COMPLY WITH T170 PROVISIONS. DATE: /IAPPLICANT �� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (1100.000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM 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, CN. C.). LENDERS NAME LENDER'SAODRESS 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY %7TH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE.MENTIONED PROPERTY FOR INSPECTION PURPOSES. i PE ITTE AJOE(PFUNP 31GNATVNE OF PERMITTEE DA - FIRMLY APPLICATION PERMIT -� P 6 DATE (1 �� X� NUMBER � ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport W Patio/Deck LL POOVSpa ZRe -Roof 0 Commercial 5 In Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J a U Cr H U W J W L7 Z m Mi _3 a Ise t. _U Z Q S U W CONSTRUCTION PLAN REVIEW ELECTRIC _ PLUMBING __7 MECHANICAL INS?ECTION FEE , ISSUANCE SMTP ENERGY PIC A-_• - - --- ENERGY PERMIT ---_.._-- RETENTION FEE: PRE -ALT FEE:' TOTAL FEES G g.Sa COMMENTS - RECPT. NO. PAID BY VALIDATION WHITE—Department Copy, YELLOW—FKlance Copy, PINK—Assessor UOpy, UULUGNHULI 118 L,OPy, U"L=N—APPIIGanl 3 a Py CIT`,` DF DIAf,!,, °,,D BAR HNIS .'ECTIOW RECDi3D �ArF`I�d��r�� J� ►�� ti �� I�� r� e ��R77 i;+ jj` 11 SET BACK FLOOR JO!ST — -a--- —��- �-----• - -- =- __ -- 1- .. FTGS/FORMS/STEEL I FHA RE0I`,1TS l I WINDER FLOOR DUCT- ELECTRIC GROUND �_ GROUND PLUMB.ING SLAB GRADE TEMP POWER WATER SERVICE ROOF SHEATHING — _ - -- I ! I _ I UNDER FLOOR CONDUIT I FIREPLACE'FO_UNDATION FIREPLACE BOND BEAM PAID HT. BOND BEAM 1 8 FT. DOr,IQ BEA%l FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING ROUGH ELECTRIC BENCHING ROUGH GRADING ROUGH PLUMBING SHOWERITUB TEST EXT LATH/SIDING WALL INSULATION CEILING INSULATION DRYWALL NAILING SEVIER SEPTIC TANK SEEP PIT/LL. GAS AIR TEST FINALCONST. FINAL HEATINGJ FINAL ELECTRIC ---� _I —I f OL • I �_ _ _ _ _ _ — _ - -- -- - _ I v _ _; _FINISH GRADING POOL ELECTRIC__ I POOL FENCING I POOL FINAL - --_ ( OFF SITE IMPS. _DEDICATIONS _jFINAL ENG. I LAND_SCAPEJRRIG. T ON SITE IMPS. FINALZONING - RE -DEPT. FINAL_ 1 HEALTH DEPT. FINAL I DEV. FEES PAID FINAL PLUMBING ENERGY — }II COMMENTS - SEPTIC TANK SIZE SEEP PIT/U SIZE - -