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Home My WebLink AboutPR17-16859ter'' CITY OF DIAMOND BARp�� DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES N`9� 21810 Copley Drive, Diamond Bar, CA 91765PRESS r„ (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 �I��L� BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS APN LOT TRACT OWNER; ADDRE ^ " CITY1,r . ;. APPLICANT - ',,I/ ° EL. CONTRACTOR A D D R 017YfiT & ZIP I .e" ARC /ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable Item(s) [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractor's State License Law (Chapter B) Commencing with Section 7000 of Division 3 of the Business and Professions Co li or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicantfar a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500), 11, as owner of the property, or my employees with wages as their sole compensation, will de (j all of or U portions of the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professions Code, The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort. builds or Improves the property, provided that the Improvements are not intended or offered for sale, If however, the building or improvement is sold within one year of completion, the Owner -Builder wil€ have the burden of proving that it was not built or improved for the purpose of sale,) (-) 1, as Owner of the property, am exclusively contracting with licensed Contractors t9 construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with R licensed Contractor pursuaottothe Contractors' State License Law.). I I am exempt from licensure under the Contractor's State License law for the following reason(s)! Date: Sign: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that i have built as an owner-bulldar If it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Ccde is available upon request when this application is submitted or at the following Web site: htlplwww.leginfo,ca.govlcalaw,html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Vvlslon 3 of the,B�siness and Professions Code, and my license is in full force and effect. # e::7; x LICENSE CLASS of ' LIC. NQ: .e :- EXP: DATE; N. ONTR4CFOR ..- �/: WORKER'S 00MPENSATI " CL It} HEREBY AFFIRM UNDER PENALTY Of PERJURY ONE OF THE R(� ING DECLARATION6 I have and will maintain a Certificate of Consent to Sell Insure for Workeris ompensatiorras provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain Worker's Compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for whlch this permit is issued. My Worker's Compensation Insolence Carrier and Policy Number are; CARRIER — POLICY NUviBER (THIS SECTION NEED NOT ItE COMPLETED €F THE PER IS t ONE HUNDRED DOLLARS $100 OR LESS. I certify that In the performance of the workfor which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation La of California. And agree lhatlfl should hec a2ubject to t d'Workaf's Componsatlon provisions Fe tion 3700 of th q6r Code s I forth III c II th A ions k DATE. :.r - LICANT:,,,.-'. WARNIN : Falfure to sWorker's Compensation cover - unlawful, and shall subject an employer fO cri al penalties and civil fines up to are hundred thousand dollar (5100,000), in addition to the cost of the compeneatio damages as provided for In section 3708 of the labor code, interest, and attorney's lees CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there Is a Construction Lending Agency for the performance of the wBrK°for which this permit Is Issued (Sec. 3097, Clu: C.). LENDER'S RAVE: LENDER'S ADDRESS I certify that I have read this application and state that the above information is correct, i agree to comply with all city and county, ordinances and state laws relating to building construction, and hereby authorize representatives of this county to alter,I'!'},1'µ` n11 a above -men toned p psfor Inspectl purpas 6 1 / 3 $. p P€ E€ NAS (P INT) — .! U 0 MITE d DATE APPLICATION DATE: ISSUE DATE; PERMIT# : g TYPE CONST. OCC GROUP: Scope of Work.6` # DWEL. UNITS C, 4 # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF Ai AREANALUATION SFWADDlREM Garage/Carport W PatWDeck L L Pool/Spa ZRe -Roof Commercial 7 valuation: Adj. Area: QUANTITY DESCRIPTION FEE U H U W Ed 0 z m J rL J z x v CONSTRUCTION: PLAN REVIEW: ' ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 5 : l SNAP: 7. . ENERGY PIC: ENERGY PERMIT: RPF,NliON FEE: W -ALT FEE: { BASF:i_ PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: r C,'0 PIC: PAID BY: VALIDATION: riECEIPT# PAID BY: 1' VALIDATION:_ WHITE — Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy CITY5 P li BAR INSPECTION L ROUGH PLUMBING INSULATION WALL INSULATION CEfl ING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SETBACK/ LETTER FOOTINGS FORMS SLABCOMMERCIAL UG. PLUMBING UG ELECTRICAL TRACT AND LEDGER ELECTRIC ML:TER RELEASE SWITCH GEAR .......... HOOD T -BAR - - INTERCEPTER FINAL BUILDING a UFER GROUND HOT MOP/SHOWERPAN FINAL MECHANICAL SFWFR LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SFWLR CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FI OOR SHEATHING ROUGH CONDUT SHEAR WALLS EXTERIOR CERT. al -OCCUPANCY PODUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL. W( ) C ( ) GAS TEST ROUGH PLUMBING INSULATION WALL INSULATION CEfl ING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAI ELECTRIC ML:TER RELEASE GAS MEITII RELEASE SPECIAL INSPECT[ON FINAL BUILDING a FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T,C. of OCCUPANCY CERT. al -OCCUPANCY COMMENTS: