The URL can be used to link to this page

Home My WebLink About11-1579 ��_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS '�'°�"� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE n � f �J ADDRESS 2y 039 W a�(OI.J �e k \C� DATE CATIO � NUMBER'/�/�� ! #/C � APN LOT TRACT ISSUE TypE /� � DATE CONST. KC�� GROUP S F 2 p OWNER AwsTh{oNc, /S2rRe� Iti1 °LE��S p ADDRESS O IIo� �eGlt r2.d ZONING SETBACKS z CITY ews� ZIP QI'7[o5 TEL.�Q 717�lS87 FRONT qyy � o APPLICANT (,�� frG��uSow� TEL.'1��1'11'1�lo�lo REAR � zd SIDE/SIDE STREET q�y ❑❑� �� CONTRACTOR �CoR �w�� SIDE ADDRESS . o ,�t.eclf � � CITY �:wb 21�t�rM ZIP 1 07 TEL.7��l 71)yoyD PROPOSED USE O � �� (r f ta f t t ti4T�� µrw'b o ARCH/ENG/ ra L t� lt DESIGNER �I� �'wa ST1 11 p�t s�,�,�ee.�0 21 4� I lr' L�i7 NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS b N F STORIES � ; Z" BEDROOMS � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTORS U� G8f89B/COfPOfI W CENSEUWFORTHEFOILOWINOREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITVOR (n ZCOUNTI'WHIp1RE-0UIRESAVEfiMIT70CANSTRUC7,ALTER,IMPROVE.DEMOLISH,ORREPAIRA/JYSTRUC- W patl0/DBCk w TURE,PRIOR TO ITS ISSUANCE,AL50 RE�UIFES hIE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W � STATEMENT THAT HE OR SHE IS LICENSED WiiSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE UW(CHMTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � � POOUSpB ^ FES910NS COOE)OR THAT HE OR SHE IS E%EMPT THEREFROAI AND THE BASIS FOR 7HE ALLEOED E%EMP- (� � TION.ANV VqLAT10N OF SECTION 7031.5 BV ANV A7PLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO RB-flOOf � A CIVIL PENALTV OF NOT MORE THAN FIVE HUNORED DOLURS(fSOD).): Z �� Q ❑4��WNEROFTMEPROPERTV,ORAIVEMPLOVEESWITHWAOESASTHEIRSOLECAMPENSATION, 0 COrtIRI8fCI01 Z WILL DO THE WOHI(,AND THE STRUCTURE IS NOT INTENDEO OR OFFERED FOF SALE(SEC.70/�,BUSI� J � NESS AND PROFESSIONS CODE THE CONTRACTORS UCENSE LAW OOES NOT APPLV TO AN OWNER OF j 7ROPERTY NMO BUILDS OR IMPROVES THEREON,AND NM1iO DOES SUCH WORN HIMSELF OR HERSELF OR CC THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFEREDFORSALEIF,FIOWEVEF�7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE- Z TION,THE OWNER-BUIL�ER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � fMPROVE F-0N THE PURPOSE OF SALE), w ❑I,AS OWNER OF THE PROPERiV,AA1 EXCLUSNELV COMRACTINO WRH LICENSED COMqACTORS �/aa � TO CONSTRUCT THE PROJECT(SEC.]ON,BUSINESS AND PROFESSIONS CODE:THE CONTMCTOR$LI- V8IU8t1011 ADJ.AREA W CENSEUWDOESNOTAPPLYTOANONMEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � MM1IOCONTRACTSFORSUCHPR0.IECTSWITHACONTMCTOR(S)IICENSEDPURSUANTTOTMECONTRAC- QUANTITY DESCRIPTION Y TORS IJCENSE LAW.). FEE � ❑1 AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � � U � DATE OWNER F— Z U � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRM UNDEH PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(COMMENCIMO WfTH 5ECT10N 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSIONS CODE,AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT. m � UCENSE CIASS C39 � UC.NO. V"'1��v v � � V DATE �� 1 4i� !1 cowrancroa Y[�Cntr+i�+k � ` a � w � WORKERS'COMPENSATION DECLARATION - Q N 1 HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOL�OWING DECIAAAT10N5: U N Z �Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSEM TO SELF-INSURE FOR WORKERS' a Q COMVENSATION,AS PROVIDED BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U OF hIE WORK FOR WHICH THIS PERMIT IS ISSUED. � � Q �I HAVEAND WILL A1AINTAIN WORKERS'CAMPENSATION INSURANCE,AS PEWIRED BV SECTION 3700 OF THE LABOR CODE,FOp THE PERF-0{iMANCE OF THE WORK FOR WHICH THIS PERMIT IS / �•yy `(� ISSUED.MV R)(ERS'CAMPENSATION INSU CE CAARIER AND POIICV NUMBERAAE: CONSTRUCTION �i '� � jCARflIER ��GYL1C2� �RI I. PLANREVIEW ¢ POLICV NUMBER��O"�O— $S� —0 0 ELECTRIC p f�SSECf10NNE�NOTBEWAW.ETEDOFTI�PERAYTISFOqpNEFiIR�DiiEDDOU}RS(t10p)OqLE55} PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHlp/hIIS PERMIT IS ISSUED,I MECHANICAL �} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE (/� WORKERS'CAMPENSATION IAWS OF CAIIFORNl0.M1D AOREE TNAT�IF 1 SHOULD BECAME INSPECTION FEE SUBJECTTOTHEWOR7(ERS'COMPENSATIONPROVISIONSOFSECTION37o00FTHELABOq ', � � O CODE,I SHALL FORTHWITM COMPLY WITH THOSE PROVIrSIONS. + ISSUANCE ' p DATE: � � APPLICANT: � r�/ZG Vf Or SMIP e. � W • J WAFiNINO:FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � J � SUBJECTANEMPIOVERTOCRIMINAI.PENALTIESAN�CIVILFWESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOlLARS(5100,000),IN�DDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN w SECTION 3708 OF THE LABOR COOE.INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: • �O O CONSTRUCTION IENDING AGENCY PRE-ALT FEE: � I HEREBY AFFIRM UNDER 7ENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDINO AGENCV FOR THE PERFORMANCE OF 7HE WORK FOR WHICH THIS FERMIT IS ISSUED(SEC.308�,CIV.C.). W � � LENDER'S NAME F- LENDER'SADDRE55 w I CENTIFV THAT I HAVE READ THIS APPIICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES �� I � � I A�REE TO COMPLY WITH ALL CfTY AND CAUNTV ORDINANCES AND STATE UWS REUTINO TO BUILDIN6 1 � CONSTRUCTION,ANDHEREBYAUTViORIZEREPRESENTATIVESOFTHISCWNTYTOENTERUPONTHE Z ABOVE-MENTIONED PROPERTV FOR INSPECTqN PURP0.5E5. COMMENTS ' � ��s � �r�la�.i.�lo.—� ' m PERMITTE AME(PRINT) ' � ¢ � /� /$ /1 - O 7 RE OF PERMI7TEE DATE � • RECPT.NO. P/UD B VALIDATION WHITE—Depertment Copy,YELLOW---Flnance Capy,PINK—Assessw Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy c��-v o� ��a�o�� ►� i�s��c�io� ��co�� oa�pc�c�400a �a� . oa�a��a oa�p�c��ooa - t�a4� - oa�cx��c� �- SET BACK FLOQR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNt�: R FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER . FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING 8 FT.BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF C�R � _�� l �, , PRE-GRADING ROUGH HEATING T BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. �o�, FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY C��o c . COMMENTS _�a_�(2��-1_�._� SEPTIC TANK SIZE SEEP PIT/U SIZE a � a �:� ,��r �.