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Home My WebLink About18282 � CITY OF DIAMOND BAR � �� -----��'— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �1 21825 E.Copley Drive ' � �� (909)860-3195 Fax(909)861-3117 � PRESS "��W BUILDING PERMIT APPLICATION � l FIRMLY y JOBSITE � M Q ;! U APPLICATION PERMIT � a�-�P/C ¢ ADDRESS �lJ V o DATE NUMBER 0�!' � APN LOT ! - TRACT �� ISSUE TYPE OCC �� `� DATE CONST. GROUP p OWNE�UIi1.trM o ADDRESS � T3l.tI ZONING SETBACKS , z CITY 10 - ZIP TEL3f��(�'3%/�'O FRONT RW ❑ o APPLICANT TEL. REAR p z¢ SIDE/SIDE STREET RW ❑ � CONTRACTOR L L(� SIDE ❑ o CDDRESS Z�P ,TEL. a�O�'�C)�� PROPOSED USE w ARCH/ENG/ D 1 1 l p z DESIGNER i�r �7C�c�1 CY Y 1�S 5�G • � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS cr� � DESCRIPTION SQ.FT. FACTOR BSF ADJ.AREANALUATION O OWNER-BUILDER DECLARATION SFR/ADD/REM 7j � p I HEREBV AFFIRM UNDER PEN/�LTV OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� G0f0 0/Ca ft /� W CENSELAWFORTHEFOLLOWINOREASON(SEC.7031.5BUSINESSAtJOPROFE5S10N5CODE:ANYCITVOR (n 9 � 1�� C-� COUNTVYrtiICHREOUIRESAPEqMITTOCONSTFiUCT,ALTER,IMPROVE,DEMOL15H2ORREPAIRMIVSTRUC� w w 7URE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FIIE A SIGNED w Patio/Deck ' � STATEMENT THAT HE OR SHE IS LICENSED PURSUM7T TO THE PROVISIONS OF hIE CONTMCTORS U- � CENSE UW(CHA7TER G(COMMENCINO WITH SECTpN 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooVSpa 0 FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROIAANDTHEBASISFORTHEALLEOEDE%EMP� (7 V TqN.ANY VIOLATqN OF SECTION 7031.5 BV ANV�PPLICANT FOR A PERMIT SU&lECTS iHE APPLICANT TO Z Re-Roof � A CNIL GENALTV OF NOT MOqE 7NPN FIVE HUNDRED DOLLARS(5500).): � ❑I.ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAOESASTHEIRSOLECOMPENSATION, � COff1RIBfC18I Z WILL DO THE WORK,M!D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SAIE(SEC.7044,BU51- J � � NESS AND PROFESSIONS CODE:7HE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � / PROPERTV WHO BURDS OR IMPROVES THERE-0N,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR w THROUGHHISORHEROWNEMPLOYEES,PROVIDED7HATSUCYIIMPROVEMENTSARENOTINTENDEDOR m � OFFEREDFORSALEIF,HOWEVERTNEBURDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUIID OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPERTV,AMEXq.USNELVCAMRACTINOWITHLICENSEDCONTRACTOqS � TO CANSTRUCT THE PRQIECT(SEC.7011,BUSINESS/WD PROFESSIONS CODE:THE CONTRACTORS LI� V8IU8tlOf1 ADJ.AREA W CENSE LAW DOES NOTAPPLY TO AN ONMER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,/V�D WFIO CONTRACTS FOR SUCH PRQIECTS WITH A CONTRACTOR�S)LICENSED VURSUANT TO THE CANTMC- FEE � ioas ucEr+sE uw.). �UANTITY DESCRIPTION � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q OD � {/�J�y � � DATE � � � OWNER F- � LICENSED CONTRACTORS DECLARATION w � ' �CA� � I HEREBV AFFIRM UNDER PENALTY OF PERIURY THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � / �C�^ - •— ,� d e(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE.AND Z �}�T � � X MY LICENSE IS W FULL FORCE AND EFFECT. p'/! m � � LICENSE CLA�SS �_'✓ LIC.NO. ( l ` Z Z � V DATE 7I� BZ ' CONTRACTOR r^� C� a W � WORKERS'COMPENSATION DECLARATION � � U N I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWING DEGAFATIONS: Z �Z _I HAVE AND WILL MAINTAIN A CEFTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' a Q COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE.FOR THE PEFFORMANCE U Of THE WORK FOR WHICH THIS PERMIT IS ISSUEO. W � � / � � ��I HAVE AND WILL MAIMAIN WORKERS'COMPENSATION INSURANCE,AS REWIRED BY SECTION Q 3700 OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WOR)(FOq WHICH TNIS PERMIT IS � ISSUED.MV WORN5p5O��PENSATION IN�./;l�CAQRIER AND POLICY NUMBER ARE: CONSTRUCTION �.,y_, .�.•f �j CAAFIER � � /� `•t � d PLAN REVIEW POLICY NUMBER [�J 1 ��O ' ¢ � - ELECTRIC D � (IFUSSECTIONNE�NOTBEOJA�ALEfEDOF7HEPEFUMISFORONEHIX�DF7EDDOLLFRS(f1o0)ORLESS} PLUMBING -, W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I MECHANICAL G�J SHALL NOT EMPLOY ANV GERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE N WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECT�ON FEE SUBJECTTO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 3�OOOF THE L/�BOR � cooE,i srwl Foarriwini canv�v wini niose caovisioNs. ISSUANCE O p DATE: APPLICANT: SMIP W � WARNING:FAILURE TO SECURE WORNEfiS'COMPENSATION COVERAGE IS UNLAWFUL,M1D SHALLBE ENERGY P/C J ' LL SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLAAS({100,000),IN PDDITION TO hIE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTqN 37oB OF THE IABOR CODE,INTEREST,AND ATTORNEV'S FEES. � � w RETENTION FEE: O CONSTRUCTION IENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURV THATTHERE IS ACONSTRUCTION LENDINO AGENCV � f-0R THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oB�,CIV.C.). Z W � LENDER'S NAME F- IENDER'SADDRESS w ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES � 1� � I AOREE TO CAMPIV WITN ALL GTV AND CWNTV ORDINANCES AND STATE LAWS RELATINO TO BUILDIN6 � CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER U70N THE Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPoSES. COMMENTS � � 0.w�e S � � gv��F�S m PERMITTEE N E(PRINT) ¢ V� C/� � SIONAT PERMITTEE DATE � RECPT.NO. PAID BY -� VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—AppllcanYs Copy �� ' ��1�� I�l�f� ' , � ��S�t�CG�'9�G� (��C�� 0��- o0a �IaS� ;° ° o � �� '4L� ; O[�� .. o 0 5ET BACK FLOOR JflIST • � • . FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND � UNDER FLOOR QUCT � GROUND PLUMBING � UNDER FLOOR CUNDUIT SLAB GRADE � FIREPLACE FOUNQATION � TEMP POWER ' FIREPLACE BOND BEAM WATER SERVICE MiD HT. BOND E3EAM ROOF SHEATHING ' 8 FT. 60N� BEAM FRAMfNGNENTILIATION FiNAL BOND BEAM ROOF COVER � PRE-GRADING ` � RC�UGH�I ATING � � �L"'~�� BENCHING � ROUGH ELEC�C ',� �~;h ' i�_+. ROUGH GRADING \ ROU '�i�''i L'ti�� iVG �''= FiNISH GRADit�1G SH(�WER/TUB TEST � P�OL E�ECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATiON POOL FINAL ! �� CEIUPlG IhJ�ULATIOtV OFF SITE IMPS. ��— � y DRYWALL fVAILiNG DEDICATIONS SEWER � FINAL ENG. SEPTIC TANK LANUSCAPE/IRRIG. SEEP P�T/LL. QN SITE IMPS. GAS AIR TEST FINAL ZONING FlNAL CONSL F!RE DEPT. FINAL F1NAL HEATING '' .% HEALTH bEPT. FINAL -� . 'R. - -iT�' __ •'"' FyNA�E�EC�TRI � j��.i_ � 1 �`'�`� DEV. FEES PAID `FNAL ISLUP/IBING ` � ENERGY -T i— -- e� C �If�.O C'o� � CQ��5 SEPTIC TA�lK SIZE SEEP PIT/U SIZE - � � ' -[ — �