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Home My WebLink About17633� � `---_�� _ CIT'Y OF DIAMOND BAR �v 1 �Q�� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21825 E.Copley Drive "� (909)860-3195 Fa�c(909)861-3117 — � PRESS ��'�:�� BUILDING PERMIT APPLICATION � FIRMLY o DDRIESS��GJ� W�F'� LOtIKC'c^r �� DATECATION �`� 6�,NUMB R 1 l3 • #/C .J � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER p ADDRESS Z H W � CC9(JQ �E� �— (� ZONING SEfBACKS Z CITY � ZIP TE�4D7�� FRONT Ryy p �p APPUCANTiQc9V MCFIAMMI'"�— TE .li�[�7-d�/9e SDE/SIDESTREET RW ❑ ' � CONTRACTOR COIJS! 1/G D NC SIDE p o ADDRESS F'� PROPOSED USE o CITY /�'Q'T�.�/La ZIP o of TE �'� o ARCH/ENG/ z DESIGNER � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS cn N DESCRIPTION Sd.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERri1RV THAT I NA E%EMPT FROM THE CONTRACTORS LI- G8f8JB/CBfPOA W CENSELAWFORTHEFOLLOWINGREASON(SEC.70.71.6BUSINESSANDPROFESSIONSCODE:ANVCITVOR (n C� COUNTVWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORqEPAIRlWYSTRUC� w w TURE,PRqR TO ITS ISSUANCE,ALSO RE�UIRES hiE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patlo/Deck � STATEMENT THAT HE OH SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CAMRACTORS LI- � CENSE LAW(CHAPTER e(COMMENCINO WITH SECTION 7000)OF DMSION 3 OF THE BUSINE55 AND PRO� u' POOVSPB � FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALlEOED EXEMP- (� V TION.M1V VIOLATION OF SECTION 7031.5 BV ANV APPUCANT F-0R A PERMIT SU&IECTS THE APPUCANT TO Z Re-Roof A CIVIL PEN/�LTY OF NOT MORE THAN FNE HUNDRED DOLLqRS(5600).): � ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTMEIRSOLECOMPENSATION, � COrt1rt18fCIdI Z WILI DO THE WORK,AND THE STRUCNRE IS NOT INTENDED OR OFFEFED FOR SALE(SEC.70u,BUSI� J � � NESS AND PROFESSIONS COOE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF j VROPERTV Wlq BU0.D5 OR IMPROVES THEREON,M1D NM1IO OOES SUCH WORK HIMSELF OR HERSELF OR w TFIROUGH HIS OR HER OVM EMPIOVEES,PROVIDED THAT SUCH IMPROVEMENTS AAE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERNEBUILDM�ORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� ' Z TqN,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE OID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I.ASONRJEROFTHE PROPERTV,AM E%CIUSIVELV CqMMCTING WITH LICENSED CONTRACTORS � TO CONSTRUCT THE PRQIECT(SEC.70N,BUSINESS AND PROFESSIONS CODE:THE CANiRACTORS LI- V8IU8�lOf1 ADJ.AREA W CENSE UW DOES NOTAPPLY TOMI OWNER OFA PFOPERTV WHO BUILDS OF IMPqOVES THEREON.AND = N11000NTRACTSFORSUCHPRQIECTSWITHACONTRACTOP(S)UCENSEDPURSUMfiTOTHECONTRAG FEE ►— roAs ucENSE uw.�. caunr�nrv DESCRIPTION � ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q S �v� I T�R E U � DATE OWNER � G E ICC.E Z U �Q LICENSED CONTRACTORS DECLARATION w 2 I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AA1 LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCWO WI7H SECTION 7000)OF DIVISION 3 OF THE BUSINESS AN�PROFESSIONS CADE,AND Z LLI MV LlCENSE IS IN FULL FORCE AND EFFECT. m � LICENSE C S C�� 1 �,�.No. 1` 3 � V DATE O CONTRACTOR 0 ��N17 I ' a w � � WORKERS'COMPENSATION DECLARATION ¢ � U � I HER�$Y'AFFIHM UNDER PENALTV OF PERIURY ONE OF THE FOLLOWINO DECLARATIONS: Z / � � 1 MAVE M1D WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WOqKERS' _ Q COMPENSATION,AS PqOVIDED BY SECTION 3�00 OF THE LABOR CODE,FOR THE PEHFORMANCE U /OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � W V I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LA80R CODE,FOR THE PERFORMANCE OF THE WORN FOR WHIC11 THIS PERMIT IS ISSUED.MV WORKERS'C�.•IrPEdNSATION INSU�NCE CARRnIER AN�POLICY NUMBER ARE: CONSTRUCTION ' `I J j C�qqIER v/rl ✓ PLANREVIEW Z POLICV NUMBER �L I� �� ELECTRIC Q � � (1FCSSECf101JNE�NOTBEOJMPLEfmOF7}EPEPo.1frI5FOqONEHlNDi1mDOLLPASK��I�LESS} PLUMBING I�� W Z I CERTIFV THAT IN THE PEPFORA/ANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C.�} SHAIL NOT EMP�OY/J!Y PERSON IN ANV MANNER 50 AS TO BECOME SUBJECT TO THE (/� WORKERS'CAMPENSATION LAWS OF CALIFORNIA�ND A(3REE THAT IF I SHOULD BECAME INSPECTION FEE = SUBJECTTOhIEWORKERS'COMPENSATIONPROVISIONSOFSECTION37aoOF�nnt��eee��7�000R ��, ` COD ,ISHAL-FORTHWITHCOMPLYWITHT aovisio � ISSUANCE ) � �r p DATE: � / � 0l�+ APPLICANT: f7j�%��f"� SMIP W J WARNIN6:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C J �y SU&IECTANEMPLOVERTOCRIMINALPENPLTIESANDCNILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(Slao.000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES A$PfiOVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND�TTO{iNEV'S FEES. w RETENTION FEE: . O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CANSTRl1CTION LENDINO AOENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUE�(SEC.30B7,CIV.C.). Z W � LENDERS NAME � F— LENDER'SADDRESS � w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL F E ES � I AGREE TO COMPLV WITH ALL CfTV AND COUNTY ORDINANCES AND STATE UWS REUTING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CAUNTV TO EN7ER UPON THE � Z ABOVE-MENTIONED PROPERTY FOR INSPECTqN FURPOSES. COMMENTS � = c�y DH-AM n�t A D m PERMITT E(PRI � Q � Uj SIONATUR OF FMITfEE DATE � RECPT.NO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicent's Copy �8�1'�7 �L� (CD�/�l�li�frV�7 [��lff� � . 9�,'�L�Ic��l'�� 6�[��2�f�i[CD ) � n a��a Dc�a� � o�� ° ��ru�a. Da`� oa�� SET BACK FLOOR J�IST - ' FTGS/�ORMS/STEEL FHA REQMTS ELECTR(C GROUND UNDER FLOOR DUCT GROUND PLUMBI(VG UNDEr� FLOC�R GU��[?UIT � SLAB GRADE FIREPLACE FOIiNDATION TEMP POWER FIREPLACE BOND BEAM � WATER SERVICE MID HT. BOND SEAM ' ROOF SHEATHIPVG 8 FG B(JNQ BEAM � FRAMINGNENTIUATION ' FINAL BOND BEAM - ROOF COVER PRE-GRADING ROUGH HE,4TtNG BENGHIR�G ROUGH ELEC7RIC ��Z � � RQUGH GRADING ROUGH PLUMBING FINISN GRADING SHOWER/TUB TEST � , POOL ELECTRIC EXT. LATH/SIDING T�POOL FENCING �� __ '�' _ WALL iNSULAI"IOId POOL FINAL � CEILING iNSULATION �OFF S�ITE IMPS. � DRYWALL.NAILIIVG D' EDICATIONS SEWER FtNAL ENG. SEPTIC TAfVK LANDSCAPE/lRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST , FIIVAL ZONING . FlPVAL COP�lST. ' ' �IRE DEPT. FINAL FINAL HEATING ' HEALTH DEPT. FINAL FlNAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY � � ��o � , J � COii�MEfVTS � • �, . SEPTIC TA�lK SIZE SEEP PfT/U SIZE — � � — �IA . . �[� � � � � � �