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Home My WebLink About10825r 0 CITY OF DIAMOND BAR Cz COMMUNITY DEVELOPMENT DEPARTMENT '721660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 861-3117 ' PRESS BUILDING PERMIT APPLICATION ( I FIRMLY AD RIE S J ?,() IrUPAPN J A P LAtil& APN LOT -7-9 TRAP OWNER Tty(�1GHC-hS �}l�1EI �r "Pi W61r_t L{ YANG ADDRESS CITY442 ZIP 9nQ}'TEL.a 3 -6,- APPLICANT t TEL. CONTRACTORAcLF10, SERA j'CE$ i 1�'U � �tYt ttdC ADDRESS 186Zf'15-- L- - AVC , 5l((T_ 3 CITY (kL,7iiS�tzT_ ZIP TEL.S 1,0'L ARCWENG/ DESIGNER 106-0-'1AC51 sic�, u tZA: ADDRESS S55 iN LAMFG-KT Sc((iC CITY I;5 Rz—A ZIP 19_ 1 TEL. F L Z T OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS U. CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRESA PERMITTO CONSTRUCT, ALTER, IMPROVE. DEMOLISH, OR REPAIR ANY STRUC- TURE. PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 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 7031.5 BY ANYAPPLICANT FOR A PE IT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (S I: LJ 1. AS OWNEROF THE PROPERTY, OR MY EMPLOYEES AGES AS THEIRSOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTE D OR OFFERED FOR SALE (SEC. 7044, BUSI. NESS AND PROFESSIONS CODE: THE CONTRACTC CENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS ORIMPROVESTHEREO ND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES IDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF HOWEVER, THE B INGORIMPROVEMENT ISSOLD WITHINONEYEAR OFCOMPLE- TION, THE OWNER BUILOER WILL H THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF E). ❑ I, AS OWNER OF THE P ERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PRO, (SEC, 7044, BUSINESS AND PROFESSIONS CODE' THE CONTRACTORS LI- CENSE LAW DOES NOTA Y To AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTSFO UCH PROJECTSWITHACONTRACTOR(S)LICENSED PURSUANTTOTHE CONTRAC- TORSLICENSED . 1 MPT UNDER SEC. B. A P.C. FOR THIS REASON E OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 O THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. �} Ci LICENSE CLASS C� LIC NO. l S DATE 1 CONTRACTOR , _ V WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE gF THE WORK FOR WHICH THIS PERMIT IS ISSUED, V 1 HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REOUIRED eY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERSCOMPENSATION IINNSURRAANCE CARRIER AND POLICY NUMBER ARE: CARRIER CAL KI _ POLICY NUMBER l_- 9C, C_ 1 4W43 (MISSECTIONNEEDNOTBE COMPLE.-EDOFTFE PERW LSFORCNE HUNDRED COLLARS(5100)ORLESS) I CERTIFY THAT IN THE PERFORMANCE OF 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 37000F THE LABOR CODE, I SHALL FORTHWITH COMPLY THO DATE: J a,Z APPLICA \� WARNING: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALLBE SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTHOUSAND DOLLARS ($ 100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE pOFFTTHE WORK FOR W�HI %CH THIS �PERRMMIITTIIS ISSUED SEC. 3097. CIV. C.). LENDER'S NAME_ /�_� e 1�(NX''L+`� LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH 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. PERMITTEE NAME (PRI s z� 40 SIGNATURE OF PERMITTEr 1 APPLICATION PERMIT P/C C'i�/_ DATE NUMBER G # _��_sl� ISSUE TYPE OCC DATE _ CONST. GROUP ZONING SETBACKS FRONT RW L REAR ❑ SIDE/SIDE STREET RW D SIDE L-1 p ,r PROPOSED USE t`,/ A -5b H KT APDr-'j i 4LL4 IltC_4-uD&9 `rF IWi sut If RR NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. I FACTOR PSF ADJ. AREANALUA_TION SFR/ADDIREM fA Garage/Carport WPatio/Deck LL Pool/Spa 0 Z Re -Roof Commercial t m i• 1 Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J U ccQ U W UJ U Z �L] I 6 _U Z Q 2 WI CONSTRUCTION 7 f7 - 4ti PLAN REVIEW _ > e ELECTRIC 1, PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMTP ENERGY P/C ENERGY PERMIT RETENTION FEE: _ PRE -ALT FEE: _ TOTAL FEES ` COMMENTS r RECPT. NO. PAID BY i VALIDATION WHITE—Department Copy, YELLOW—Finanoe Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD SET BACK i FLOOR JOIST,,. FIGS/FORMS/STEEL FHA ELECTRIC GROUND UNDLA FLO*of4,r.buCT GROUND PLUMBING LINDEO 'FIJ0bR:-ltjbNibulT SLAB GRADE_-' FIREPLACE FOUNDATION TEMP POWER VAATER.$E,RVICE" ROOF SHEAfk IN G" MID HT. BOND BEAM: BOND BEAM FRAMINGNENTILIATION FINAL BQND.PEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING i FINISH GRADING POOL ELECTRIC POOL FENCING POOL FINAL SHOWER/TUB TEST EXT- LATH/SIDING WALL INSULATION CEILING lNSUL ION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS -4 -SEWER FINAL ENG. SEPTIC TANK ---LANDSCAPE/IR RIG. SEEP PIT/L.L. ON SITE IMPS.' GAS AIR TEST FINAL CONST. r FINAL ZONING 1 FIRE DEPT FINAL —FINAL HEA-T—IN—G FINAL ELECTRIC 1 FINAL PLUMBING 1+ HEALTH DEPT FINAL V. FEES PAID ENERGY "s rA a ral COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE