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Home My WebLink About11-464� _ ��`_ CITY OF DIAMOND BAR . DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 I (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS y'"�"� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE >- ' Q� APPLICATION PERMIT / _ /C o ADDRESS � � + DATE NUMBER � # � ISSUE NPE OCC APN LOT TRACT DATE �I I� CONST. � GROUP p OWNER N tJ o ADDRESS ZONING SETBACKS � CITY ZIP EL. � FRONT Ryy � APPLICANT EL. REAR � �� SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE Q ADDRESS � I O C��. � E � PROPOSED USE I w ARCWENG/�`�`A L ..(��O n� � ADSD ESS ` 9`�' ' � ` �?�/ NO.DWEL. —� NO. NO. N UNITS STORIES BEDROOMS N CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION, SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT I AM EXEMPT FROM 7HE CONTMCTORS LI- G8f8 0/Ce W CENSE lAW FOR THE FOLLOWINO REASON(SEC.7031.6 BUSINESS AND PROFESSIONS CODE:ANV CITYOR (n 9 �R ZCOUNTVNTIICHREOUIRESAPERMITTOCONSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- W patlo/Deck W NRE,PRqF TO ITS ISSUANCE,ALSO RE�UIRES 7HE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w � STATEMENT 7HAT HE OR SHE IS IICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS ll� � CENSE LAW(CHAPTER D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � Pool/Spa FESSIONSCODE)ORiHATHEORSHEISE%EAIPTTHEREFROMAND7HEBASISFORTHEALIEGEDE%EMP- (� TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPUCANT FOR A PERMIT SU&lECTS THE APPLICMIT TO Z Re-Roof A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOlLARS(f5ao).): � ❑I.ASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COR1rtI0IC18I � Z WILL DO THE WORI(,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70�1,BUSI� J N NESS AND PROFESSIONS CODE:TME CONTRACTORS UCENSE LAW DOES NOT APP�V TO AN OWNER OF � PROPEHlY NTiO BUILDS OR IMPROVES THEREON,AND NMO OOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMEMS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,HOWEVERTNEWtLDINGOqIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE- Z TION,THE OWNEp-BUILDER WILL HAVE THE BUflDEN OF PROVING THAT HE OR SHE DID NOT BUIID Oq � IMPROVE f-0R THE PURPQSE OF SALE�. � W ❑I.AS ONMER OF THE PROPEHTV,AM EX0.USIVELY CONTMCTINO WffH LICENSED COMMCTORS [[ TO CANSTRUCT TME PRQIECT(SEC.7011,BUSINESS AND PqOFESSIONS CODE:THE CONTRACTORS LI� VBIUOflOf1 ADJ.AREA � CENSEUWDOESNOTAPPIVTOANONTJEROFAPROPERTVWHOBUILD50RIMPROVESTHEREON,AND WHOCONTRACTSFORSUCHPR0.IECTSWITHACONTMCTOR(5)LICENSEDPURSUAtJTTOTMECONTiUG QUANTITY DESCRIPTION Y TORS LICENSE LAWJ. FEE � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR TIiIS REASON � � U � DATE OWNER � Z U • � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER 7ROVISIONS OF CNAPTER � � 0(COMMENCINO WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PROFESSKKJS CADE,ANO Z �l� MV LICENSE IS W fULL FORCE AND EFFECT. �� m � LICENSE CLASS_��_ LIC.NO.� � ~ /7� l� V �AT� CONTRACTOR d W � WORKEAS'COMPENSATION DEC ION a � I HEREBV AFFIRM UNDER PENALTY OF PERIURY ONE OF THE FOLLOWING DECURATqNS: � N Z � _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORNERS' _ Q CAMVENSATION,AS PROVIDED BV SECTION J700 OF 7HE LABOR CqDE,FOR THE PERFORMMICE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w I�HAVE AND WILL MAINTAIN WORKERS'COMPENSATqN INSURANCE,AS REOUIRED BV SECTION Q 70a OF 7HE LABOR CADE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS � ISSUED.MYWOH)(E �MPE�TION��CARRIERANOPOLICVNUMBERARE: CONSTRUCTION ] CARRIER �T_� � � PLAN REVIEW 0 POUCY NUMBER � ` ELECTRIC 0 (�11SSECiK7NNE�NOTBE001.AEfEDOFTiEpEpMilSFpqpryEFiIA�URFD00U��S100)ORLESS� PLUMBING _ �� W . -7— Z ICEqTIFVTHATINTHEPERFORMANCEOFTHEWORKFORWHIGITHISPERMITISISSUED.I MECHANICAL C.�} SMALL NOT EMPLOV ANV PERSON IN ANV MANNEF SO AS TO BECOME SU&IECT TO THE (/) WORKERS'CAMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF 1 SHWLD BECOME INSPECTION FEE = SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIO SOFSECTION370oOFTHEUBOR �� E,I SHALL FORTMWITH COMPLV WITH THOSE P ONS. ISSUANCE � p DATE: • APPLICANT. SMIP W J WAANING:FAILURE TO SECURE WORNERS'CAMP TION COVERAOE IS UNUWFUL,AND SHALLBE ENEFIGY P/C � J �y SU&IECTAN EMPLOVER TO CRIMINAI PENALTIE D CIVIL FINES UP TOONE MUNDRED TFqUSAND ENERGY PERMIT DOIURS(f10o.o00),IN ADDITION TO THE COST COMPENSATION,DAMAGES AS PqOVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTERES,AND ATTORNEI"S FEES. W RETENTION FEE: �,� O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNOER PENALTY OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH iHIS PERMIT IS ISSUED�SEC.30G7,CIV.CJ. Z W � LENDER'S NAME F— LENDERSADDRESS w I CERTIFY THAT I HAVE READ 7HI5 APPLICATION AND STATE THAT THE ABOVE WFORMATqN IS CARAECT. TOTAL FE ES /�3 f V y � I AGREE TO COMPLV WfTH ALL qTV AND COUNTY ORDINANCES AND STATE LAWS REUTING TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE FEPRESENTATIVES OF THIS COUNTY TO ENTER UVON THE ' � Z ABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � —�P,e�l h T�U�� J � m PERM TTEE NMIE(PRINT) ' � � • 22• 1 Uj SI�NATUFE OF PERMITT DATE ' 2 � RECPT.NO. PAID BY VALIDATION I— WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,(iOLDENROD—File Copy,GREEN—Applicant's Copy ��.` , �Ilf'V O� DiAi�i Oi�CD �A�i I�1SV�EC�'ICDI� R�GOIR�1 �:�o��p��4aoa �c�4� � oa�Q�c�� aa�r��oo� : -��a� �� o . .,o, Q a �f r� i�� ;.�. �� #, SET BACK FLOOR JOlST FTGS/FORMS/STEEL _.� FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMB(NG UNDER FLOOR CONDUIT SLAB GRADE FiREPLACE FOUNDATION TEMP POWER FIREPLACE BQND BEAM WATER SERVICE MID H'T. B�ND BEAM ROOF SHEA-i'HINCa 8 FT. BOND BEAM FRAM3NGNENTILATIQN FINAL SOND SEAM R0C7F COVER PRE-GRADING ROUGH H�ATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING Z(cs FIN15H GRADING SHOWER/TUB TEST POOL.ELECTRIC EXT. LATHISIDING PQOL.FENCING WALL INSULATION PQOL FiNAL CEII.iNG iNSUTATION OFF SiTE IMPS. DRYWALL RIAIUNG DEdiCATIONS SEWER FEM1lAL ENG. SEPTIC TANK LANDSGAPE/iRRIG. SEEP P!T/L.L � ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL GONST. FlRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FWAL FINAL ELECTRIC DEV. FEES PAID --- --...—...__....—.� FINAL PLUMBING � �,� �� ENERGY . � ��l' I'a '�.. GOMMENTS � � � SEPTIC 7ANK SIZE SEEP P1T/U SIZE [i� � �� [� �., � ��