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Home My WebLink AboutPR14-1721CITY OF DIAV 'D BAR DEPARTMENT „r' COMMIll SsDEVELOPMENT SERVICE - 218 10 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 .Fax. (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION 444 ZONING SETBACKS FRONT REAR SIDF/SIDE STREET 11 SIDE JOB SITE ADDRESS APN LOT TRACT OWNER ADDRESS CITY ZIP TEL. APPLICANT -,'144rT $ EJ °A/ pTE,L, CONTRACTOR )< Q ® ADDRESS a i g CITY 6, _�C@ FiX/\ ZIP L. (0 % ARCH/CNG/DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exampt from the Contractor's State License Law for the reasons) indtcated below by the checkmarkis), I have placed next to the applicable item(s) (Section 7031.5, Business and Processions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair, any structure, priorto its Issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7060 of Division 3 of the Business and Professions Code] orthathe or she is exempt from licensure and the basis for the alleged exemption.Any violation of Section 7031,5 by any appiicantfor a permit -subjects the applicantte a civil penalty of not more than fivo hundred dollars ($500). (-)1, as ownerof the properly, or my employees with wages as theirsole compensailor ll do (, all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Rosiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, bujlds or improves the properly, provided that the improvements are not intended or offered for sale. If however, the building or improvement I5 sold within one year of completion, the OwnerBuilderwill have the burden of proving that it was not Witt or improved for the purpose of sale). U t, as owner of the property, am exclusively contracting with licensed Contractors to construct Die project tSection 7D44, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant io the Contractors' Slate License law.). (.) I am exernptham licensure under the Contractor's Stale License law for the following reason(s): By my signature below I acknowledge that, except far my personal residence to 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-bullderit 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 Code is available upon request when this application is submitted or at the following Web site: blip/www,leginfe.ca.govlcalaw.html. DATE: SIGN: 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 Division 3 of the Buq44s and Professions Code, and my license is in full force andVz t oc SEgCLASS: __..._..a LIC.NO.: CONTRACTCR: 7 0 11-1 rl °- _ - _ WORKER'S COMPENSATION DECLARATION I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS; I have and will maintain a Certificate of Consent to Self-lnsure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is lssued. My Worker's Compensation Insurance Carrier and Policy Number are: 41 CARRIER . J $ ' . X POLICY NUMBER,,,°�.� (� (DIISSECNON NEED NOT BE COMPLETED IFTHE PERM€T IS FOR CNEHUNDRFD DOLLARS *100) OR LESS}, I certify that in the perfomiartce oftliewoA forwhich this permit a issued, I shall not employ any person in any manner so asto become subject to the Worker's Compensation Laws of Califomia.And agree that if I should became subject to tie Worker's Compensation provisoes of Section 3700 of the Labor Code, I shall lorthwlti comply Vdhlhose provisions. DATE APPLICANT: C f ' C) 5-I & - t y WARNING: Failure to secure Worker's ComperssaFion coverage is uniawlul, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the Bost of the compensation, damages as provided for in section 3708 of the laborcode, interest, and atiomey's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this perm€t is issued (Sec. 3097, Civ. C.). LENDER'S NAME LENDER'S ADDRESS: I certify that I have read this application and state that the above irrforrnaflun is correct. € agree to comply with all city and county ordinances and state laws relating to bullding constmcflon, and hereby authorize representatives of this county to enter upon the�a{bove-mentioneefd property for lntiurposes. specon p P RPRINT) 7. :% _ �'6 S}G ATU ...,..__..,....:..... a'✓' DATE PRESS FIRMLY APPLICATION DATE: � P/Cf{�„� — t �T ISSUE DATE: �� PERMIT# ® Y — / 7 TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT REAR SIDF/SIDE STREET 11 SIDE RW E [] RW [] C7 PROPOSED USE Ccs .V VC C-' # DWEL. UNITS Ct °� 4 �TORIESr-1 61 <t.;4— it BFDROCMS DESCRIPTION SO. FT FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM � Garage/Carport co W Patio/Deck LL Pool/Spa _pZ Re -Roof J Commercial Valuation: to y Adj. Area: QUANTITY DESCRIPTION FEE a td `, S oc U tltl 6 cvr m A rl caa zVX a Sidiyja x CONSTRUCTION: �I PLAN REVIEW_ 7 ELECTRIC: ksE] +l PLUMBING: ZwC] tea`. MECHANICAL: INSPECTION FEE: ISSUANCE: E �$ SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: Qc i • eli�b ®laid Do BSAF: d0 TOTAL FEES 2,?2,-7¢ COMMENTS: d FECFIPT1k2/VT'Z PAID BY: VALIDATION: x_ - WHITE — Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy, GOLDENROD —File Copy, GREEN —Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD S> TIiAClU LETTEf- TRACT AND LEDGER FCBOTINOS FORMS ;B t SWITCH GEAR S a COMMERCIAL HOOD SIC. LUiI81 - T -BAR L; ,LECTI I F L iNTERCEPTER DFI P Ci 3 P C� OT MCIF/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAi,o WATER LINE HER$ REPORT RECEDED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHE WALLS EXTE91011 7777777--. O Li F? A SHEI WALL tiTERI(iI )UGH IyLUIBINI VIiNG 1dENTING :RQUGH ELECTRICAL 4TDG1I MECHANICAL ROU H. IECIANiCAL . fs 70GH I L-( WAL GAS TEST = ow - PRE PRE GUNII E INSULATION WALL POOL"PRE DEQK.9 1DING '. INSULATION CEILING F -TRAP DRYWALL FERCE! GPTEI AL RM . LACH (PRE) FINAL PGCL LATH EXTERIOR WALLS. LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 ST( )2nn( ] LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASI_ WALL DRAINI SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO FRAMING RIsL. NINIGAF VAL iA TiNAL. 813IiC11 CaII04lGti I jR FRO AL Ftil 1VlE(; IAhIICAL FIIV7�L t3EIA IEPdT , Fl I I EI GTI 1t AL FII4AL P! ANNIA6. F AL>�L }MSlf G F NAI I EERINW PW' - :..a [}GE[JFANCY 3J i3lNillI1TY SERVICES UAL, HEALTH OPT, FDI &%YSTRiAL WASTE'`