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Home My WebLink About12411i CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY > 21660 E. Copley Drive Suite 190 ADDRESS 6 j J��41 ADDRESS J (909) 960-3195 Fax (909) 661-3117 $UUMING PERMIT APPLICA JOBSITE-I— f ADDRESS 6 j J��41 ADDRESS J � # 1t APN LOT ACTZ?_Z�� j OWNER 3 ADDR S�� CONST. CITY ZIP TEL��•w j APPLICANT _ - TEL CONTRACTOR ADDRESS _ C ZIP TEL. ❑ . ARCH/ENG/ DESIGNER 3 ADDRESS RW ❑ CITY ZIP TEL. ❑ OWNER -BUILDER DECLARATION UNDER PENALTY PERA3TY THAT I EXEMPT FROM THE CONTRACTORS LI- 1 HEREBYTHE CENSE LAW FOR THE CJ.gNINO REASON (SEC. 1031.6 BUSINESS S AND PROFESSIONS CODE: ANY C111'OR F ( NO. COUNTY WHKkI REQLARESA PERARTTO CONSTRUCT.ALTER IMPROVE DEMOUSH,OR REPAIR ANY STRUG TUBE PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICAAIT FOR SUCH PERMIT TO FILE A SIGNED STIREIAENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE C@JTRACTORS L4 S 635 CENSE LAW (CHAPTER S (COMMENCING WITH SECTION TOM) OF DIVISION S OF THE BUSINESS AND PRO• FESSIONS CODE)ORTHATHEORSHE I3EXEMPT THEREFROM MOTHE BASIS FOR THEALLEGEDEXEMP- TON. ANY VIOLATION OF SECTION 7071.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (66001.1: O L ASOWNEROFTHE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, Garage/Carport WLI. DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 70M, SUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF 3 PROPERTYWHO HO BOLDS OR MPACIVESTHEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR C THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR �1 OFFERED FORSALE KHOWEVER THE BUILDING ORIMPROVEMENT IS SOLD WITHIN ONE YEAROF COMPLE. .� TON, THE OWNERALALDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOBE OF li". D OLAS OWNER CFTHE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70M, BUSINESS AND PROFESSIONS CODE: THE CONTRAOTORS U. L CENSE LAW DOESNOT APPLY TO IW OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND C WIND OONTRACIS FOR SUCH PROJECTS WITH ACONTRACTOR(S)LICENSED PURSUANT TOTHE OONTRAC- TORS LICENSE LAW.). 9 O I AM EXEMPT UNDER BEC. B. d P.C. FOR THIS REASON i DATE OWNER 5 LICENSED CONTRACTORS DECLARATION c_ = I HEREBYAFFIRM LARDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER B (COLMENCWa WITH SECTION 7000) OF DIVISION S OF THE BUSINESS AND PROFESSIONS CODE. AND K MY LICENSE IB IN FULL FORCE AND EFFECT. 3 CLASS ` LIC. NO. j 'SATE CONTRACTOR WE ADJ.AREA WORKERS'COMPENSATION DECLARATION A :A I HEREBYAFFIRM LNDER PENALTY OF PERJURY ONE OF THE FOLLOWINO DECLARATIONS: _ I HAVE AND WILLMAINTANACERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' U COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IB ISSUED. W 2 I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION Q 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANC AND POLICY NUMBER ARE: J'RWER CARRIER Y /1 Pmicymmsm 0 (IHS BECTON PEED NOT BE COMPLETED OFTHE PERMIT HB FOR ONE MARRED DOUARS(SKD)OR LESS), Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.I LS2 SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO B COME BUSJECT TO THE O ON LAWS OF CALIFORNIA. WORKERS'COMPENSATA AND TIF ISHOULD BECOME SUBJECT TO THE WDRKERS'COMP 011 PROVO �F�I }PA�F�TNE R� CODE. I SHALL F'ORTMWTH �!(� 9j� PPLICANT . DATE: WARNING: FAILURE TO SECURE WORKE 5RAGEIS UNLAWFUL, AND SHALL BE P�. ti BUBJECTIW EMPLOYER TO CRIMINAL IN WE3UPTOONE HUNDREDTHg5AN0DOLLARS(SIO).000). W ADDITION TO THE COST OF NSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE S ACONSTRUCTION LENDING AGENCY IL FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. SOT, CIV. C.). Z W LENDER'S NAME LENDER'S ADDRESS THAT THE ABOVE INFORMATION 13 CORRECT. u I CERTIFY THAT I HAVE READ THIS AfPLICATIDN AND STATE 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING AND D HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. L1 C P EE NAME N I Co aIORAN E &. DEVELOPMENT SERVICES 6�1 [TON PRESS FIRMLY APPLICATION ,�j VPERMIT ~_Jr, DATE 1.O _- 1^1 NUMBER # 1t ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFRIADD/REM CAI Garage/Carport WPatio/Dock LL Poovspa zRe -Root 9 Commercial 5 t� Valuation ADJ.AREA QUANTITY DESCRIPTION FEE U WU,J W Z IL IL u e, -, —y cG ! W 77 CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL J INSPECTION FEE ISSUANCE 6 SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES COMMENTS RECPT. NO. PAID BY I VALIDATION WHI11 Department Copy. YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—file Copy, GREEN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD SET BACK FLOOR JOIST "'* FTGS/FORMS/STEEL FHA REQMTS... ELECTRIC GROUND UNDER FLOOR DU7-111.1- GROUNDPLUMBING UNDER FLOOR CONDUI•. SLAB GRADE FIREPLAI✓E'FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H.T. BOND BEAM ROOF SHEATHING 8 FT BOND 8EAM FRAMING/VENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERITUB TEST _ POOL ELECTRIC EXT LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION i OFF SITE IMPS. DRYWALL NAILING ; DEDICATIONS SEWER FINAL ENG. SEPTIC TANK I I LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. I FIRE DEPT. FINAL FINAL HEATING i2 ! HEALTH DEPT. FINAL FINAL: ELECTRIC ; j DEV. FEES PAID FINAL PLUMBING j ; ENERGY COMMENTS .ti SEPTIC TANK SIZE SEEP PIT/Ll SIZE , ---