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Home My WebLink About11-1469 ^, _�`_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �, 21825 Copley Drive,Diamond Bar,CA 91765 (9U9)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702 PRESS � '^�", BUILDING PERMIT APPLICATION FIRMLY I o DDRESS^�� I ' ` '��L��(� DATE ��5� NUMBER /rI 1�f� #�\\— 1�}� >- APPLICATI PERMIT p/C � OCC APN OT TR CT D TEE �� I _ONST. GROUP p OWNER o ADDRESS - � ZONING SETBACKS z CITY � �_ TEL _ �! FRONT qyy p � APPLICANT L. REAR � �� SIDE/SIDE STREET RW ❑ CONTRACTO �C- �� SIDE p ADDRESS � CITY ZIP TEL. -� "PROPOSED USE � w ARCH/ENG/ �n � /��, �z DESIGNER X (J'C•J 1?�a��z(/�� NO.DWEL. NO. a ADDRESS NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SF AD EM O I HEfiEBV AFFlRM UNDER PENALTV OF PERNRV THAT I AM EXEMPT FROM THE CONTRACTOqS LI- �W CENSEUWFORTHEFOLLOWWOREASON(SEC.7031.SBUSWESSANDPROFESSIONSCADE:PNVCITVOR � Garage/Carport U COUNryWH�p{REOUIRESAPERMITTOCANSTRUCT,AITER.IMPROVE.DEMOLISH,ORREFAIRANVSTFUG w w NRE,PRqR 70 RS ISSUANCE.�LSO REaUIRES 7HE APPLICANT FOR SUCH PERMI7 TO FILE A SIONED w Pa�io/DeCk � STATEMENT THAT HE OR SHE IS IJCENSED PURSUANT TO THE PROVISIONS OF THE CANTRACTORS ll� � CENSE UW(CHAPTEH�(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AN�PR0. PooUSpe � FESSIONSCODE)OR7HA7HEORSHEISEXEMPTTHEREFROAIANDTNEBASISFORTHEALlEOEDEXEMP� (� - TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PEFUIIT SU&lECTS THE APPLICANT TO Z Re-Roof A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(5500).): Q ❑4��WNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrt1RIBfC18I Z WILL DO THE WORK,AND 7HE STRUCTURE IS NOT INTENOED OR OFFERED FOR SALE(SEC.7011,BUSI- J � NESS AND PROFESSIONS CODE:THE CANTRACTOf75 LICENSE LAW DOES NOT APPLV TO AN OWNER OF � �\ � . PROPERTY NM1iO BUIlDS OR IMPROVES TMEREON,AND WHO DOES SUCH WORN HIMSELFOR HERSELF OR • � wTNROUGH HIS OR HER OWN EMVLOVEES,PROVIDED THAT SUCN IMPROVEMENTS ARE NOT INTENDED OR m , . 0 OFFEREDFORSALEIF,HOWEVERTNEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER�BUIIDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUIID OR � IMPROVE FOR TME PURPoSE OF SALE). w ❑I,ASONRJEROFTHEPROPERTY,AME%q.U51VELVCqNTRACTINOWITHLICENSEDCW/TRACTORS � TO CONSTRUCT THE PRQIECT(SEC.7011,BUSINESS AND PROFESSIONS CODE:THE CONTRACTOqS LI- V81U9�1Of1 ADJ.AREA W CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTMEREON,AND � NM1fOCONTRACT5FOR5UCHPR0.1ECT5WITHACONTRACTOR(5)LICENSEDVURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION TORS LICENSE I.AW.). FEE � ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � ?� U LL DATE OWNER ¢ � O � � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENALTV OF PERIUFY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � I � 9(COMMENCIMO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSKKJS CODE,AND Z / �� MV LICENSE IS W FULL FORCE AND EFFECT. m � LICENSE GLASS LIC.NO. � ) ^ / V DATE � � CONTRAGTOR �� ' d � �J , W � WORKERS'COMPENSATION DECLARATIO� � � U � I H EBY AFFIRM UNDER PENAL7V OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z �i Q � � �HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _ � COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE U Q OF THE WORK FOR WHICH THIS PEFMIT IS ISSUED. � ,� � _I HAVE AND WILL MAINTAIN WORKERS'CqMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3�00 OF THE LABOR CODE,FOR THE PEHFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ��y� `tl ISSUED.MV WOflKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBERAAE: CONSTRUCTION �[.JCaC"�� jc�aaiEFl ' PLAN FEVIEW . �� POLICV NUMBER ZQ ELECTRIC �� 0 (1HISSECiKXJNE�NO7BECOA/PLEfFDOFTNEPEpMfilSFpqpNEHlR�L7iiEDDqlAfiSR100)ORLESS} PLUMBING � w n` � Z I CERTIFV TiAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL L� C} SHALL NOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECOME SU&IECT TO THE (/� WORNERS'COMPENSATION UWS OF CALIFORNIA AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE ? SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSE 7000FTHELABOR � CODE.I SFIALL FORTHWI7H COMPIV WITH THOSE PROV ISSUANCE � � p DATE: � " APPLICANP. SMIP _ . W ERGY P/C �� •4 C{ J WARNIN(i:FAILURETO SECURE WOFiKERS'COMP � NC�VERAdE IS UNUWFUL,AND SHALL BE � SUBJECTANEMPLOVERTOCRIMWALPENALTIESAND�'lYlt.'�INESUPTOONEHUNDREDTMWSPND ENERGYPERMIT �p�j. � \ DOLLARS(f10o,000J,IN�ODITION TO THE COST Of COMPENSATqN,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,MTEREST,AND ATTORNEV'S FEES. CL RETENTION FEE: aw. CONSTRUCTION LENDING AGENCY PRE- T F E: �Z� � � I HEREBV AFFIRM UNDER PENPLTV OF PERJURV THAT THERE IS ACONSTRUCTION LENDIN(i AGENCV I��'� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.C.�. -�� Z W � LENDER'S NAME � LENDER'SADORESS w I CERTIFV THAT I HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES T ,�--�' �� r� �� I AOREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES ANO STATE LAWS REUTING TO BUILDINQ � CONSTRUCTION,ANDHEREBYAUTHORIZEREPRESENTATNESOFTHISCOUNTVTOENTERUPONiHE Z ABOVE�MENTIONED PROPEf7TV FOR INSPECTION PURPOSES. COMMENTS ' 0 � ,�(��(,��1,/�t� m PERMItiEE N Nn - � Q cn (p. �L �PI G �O 1 a��\ . �`rY1 � PERMI EE DATE � � RECPT.NO. PAID BY' VALIDATION WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy, E RO ile Copy,GREE Appllcanfs Copy l CO�Y O� Di,�MOND ��►R ; ' � � � . , I�S��CT`60i� ��CORD . . :�,. � ,,,�;. .. e � �;. ��]�pGC�400�1� , . o ,'`� ° = D�l�p��G�` � Oa�pCC��Oa � � o�.`� � , ��. . �r a SET BACK FLOQR JOIST FTGS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT GROUND PLUMBING � UNDER 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 COVER PRE-GRAOING ROUGH HEATING BENCHING ROUGH ELECTRIC � � RQUGH GRADING ROUGH PLUMBIPIG FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATHlSIDING ( � POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION J /! OFF SITE IMPS. DRYWALL NAILING � �L DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL FINAL ELECTRIC }r�2j�Z DEV. FEES PAID FINAL PLUMBING EN�RGY ��o ' ` n COMMEIVTS r5-�ci�5��t�a-L��l � , � � c � , .�,�� „ � � d�. C,�N r Z _G_r— __ _ - �, _ � ,.� � � t `, SEPTIC TANK SIZE SEEP PIT/U SIZE a ,� � �;;�.. '�� , � WALNUT VALLEY UNIFIED SCHOOL DISTRICT - 880 SOUTH LEMON AVENUE WALNUT CA 91789 CERTIFICATE OF COMPLIANCE �/�l�N/��s With Fee Provisions of �� ,� �-A. Government Code Section 6599 (' � � `� �Jy DEVELOP � 1.- C(�J �G( '�Q��`� ADDRESS `. � Signature of Appli CITY/ZIP � The person signing represents that he/she is authorized TELEPHONE �- C� to sign on behalf of the owner/developer and that the information provided is true and accurate to the best of his/her knowledge. NEW LOT ADDRESS- USE OF BUILDING TOTAL SQ.FT. , • ResidentiaUCommerciaUlndustrial City HOME IMPROVEMENT OR REMODELING PROJECT ADDRESS . DESCRLPTION TOTAL SQ.FT. 3 �' l.vbd5 �nr,: lv,�m Add��-. 54O , Diamond Bar Walnut (Bedroom,Family Rm.,Kitchen,etc.) Signature of Superintendent of Buildings _ Date �� 14-� �\ -�- . TO BE COMPLETED BY SCHOOL DISTRICT FEE SCHEDiJLE: The development fees levied by the Walnut Valley Unified TOTAL FEES DLJE School District under provision of Government Code §65995 $ �, GQ�, $'� ' are: (EFF. 12/1/08) Residential Development $2.97/sq. ft. Rec ipt # CommerciaUlndustrial $0.47/sq. ft. Date��l,s=/� Fees are assessed on TOTAL square footage "living space" of ALL new or remodeling construction projects OVER 500 sq. feet (eliminating garage or uncovered patio). I /'` This is to certify that all fees due to the Walnut Valley Unified School District under provision of Government Code Section 7 65995 have been received and a building permit may be issued. T'his is to certify that the above described development has been determined to be EXEMPT from the development fees of Government Code Section 65995 and a building permit may be issued. Exemption Justification: PROJECT IS 500 OR LESS SQUARE FEET OTHER ack eB Assistant Superintende�t ; Business Services 1/87 Rev.2/88;6/88;8/89; 1/90; 8/90; ]0/90; 8/92;6/93; ]l/93; 8/94; 6/96; 1/97; 8/98; 7/04;6/06;2/08' 12/08 ,. , NOTICE OF 90-DAY PERIOD FOR PROTEST OF FEES Section 66020 of the Government Code enacted as Assembly Bill 309"1, set forth as Chapter 549, Statutes of the State of California, 1996 effectiye 7anuary 1, 1997, requires that this school district provide a written notice to the project applicanf at the time of payment of school fees, mitigation payments or other exactions. This notice is to advise you that any protest in�regard to such amounts or the validity thereof in accordance with Section 6602Q of the Government Code and other applicable law, commences with such payment or performance of any other requirement as described in Section 66020 of the Govemrnent Code.. Additionally, this notice advises that the protest thereof must occur within 90 calendar days thereafter. � • � � . . . . , , _. , . '. . .. . . � . � _ ,'.�., . . -. . ,. . . � , ' , � � � � � , � . Date: /�j o�� CONCURRENT LETTER I understnnd that submitting my plans to Building & Safety for plan check prior to pinnning department approvnl, monies paid to Building-& �� Snfety is not refundable and additional monies mny be required if � � � pinnning depnrtment does not npprove or changes�-nre mandated: . Name: �I�� i'l��ZJ(�� c`��,y�'� n/��,1/l�C� ��f��` 1:��.L�-YI� e Address: �e�.�_/��Tr�,o`r�T��I� �i�.r� �'� ��7 Phone Number: �,�� ' 3�2� �??r-� Site Address: - � 12�(� � v � Signature ' �` - — G:word/forms/concurrentletter