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Home My WebLink AboutPR16-1203H CD d LU T_ LU o= 0- 0 w x H d cZ ZZ 0 J_ m c) 60 2 H CITY OFDIA iND BAR DEPARTMEN . OF COMMUNITY & DEVELOPMENT SERVIill 21810 Copley Drive, Diamond Bar, CA 91765PR ESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOBSITEADDRESS Z4-4?— r- APN LOT TRACT OWNER _%2tc �n.d ADDRESS CITY .-Zip TEL. APP (CANT `—JAC - /,Z rs�TEL. 1 ?�� 751j� m 1 r CONTRACTOR i'F ADDRESS CITY ZIP TEL. ARCH/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 reasons} indicated below by the checkmark(s), 1 have placed next to the applicable items) [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 pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exemptfrom licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicantfora permit subjects the applicardto a civil penalty of not more than five hundred dollars ($500). U I, as owner of the property, or my employees with wages as their sole compensation, will do (-) all of or (-) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License taw does not apply W an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are Rat intended or offered for sale. If however, the building or improvement is sold within one year of complellon, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). - U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: 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 tothe Contractors' State License Law.). L) I am exempt from licensure ander the Contractor's State License law for the following reason{s}: 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 permllij cannot legally sell a structure that I have bulli as an owner -builder 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 Code is available upon request when this application is submitted or at the following Web site: http/wvrw.ieginfo.cagov/calaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. ICENSE CLASS: 6 __C__A7LIC. NO.:il ATE: jCONTRACTOR: _.,�,[! eAf five WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -insure 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 pertormance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIERNLt'Ad Ix^41!iINSWAAC POLICY NUMBER W V ggfy (IRIS SECTION NEED NOT BE COMPLETED IF THE PERMT IS FOR ONE HUNDRED DOLLARS ($100) OR LESSj. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of California. And agree that if I should become subject 10 the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DATE: APPLICANT: WARNING, Failure to secure Worker's Compensation coverage is unlawful, and shall subject an .employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3709 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS' I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. ,► PERMITTEE NAME (PRINT) SIGNATURE OF PER - DATL 1 16 APPLICATION DATE: �% P/C# M& ... ISSUE DATE: ! 1k.PERl TYPE CONST. r OCC GROUP: Scope of Work C, r # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport LU Patio/Deck w LL Pool/spa ZRe -Roof o Commercial 5 [0 Valuation: Adj. Area: QUANTITY DESCRIPTION FEE ¢ r /r r1 hes w c� m cl. a v z a x U CONSTRUCTION: PLAN REVIEW:` ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: �. . PLOT PLAN: ZONING CLEARANCE: TOTAL FEES /rI COMMENTS: P/C: - PAID BY: • VALIDATION: It RECEIPT# PAID BY: ' VALIDATION: WHITE — Department. Copy, YELLOW — Finance Copy. PINK— Assessor Copy CITY OF DIAMOND INSPECTION RECO SI•TBACK/ LETTER FOOTINGS FORMS _ SLAB e UG. PLUMBING INTEl1('1 PI ER _ UG. ELECTRICAL �.H.1)'.lMllI)lll'IlWlllAN GLSSPOOL LIFER GROUND SEWER LATERAI WAMI INE:NOI.IT ROOF SHEATHING�- R01161-1 CONDUIT POOLIS A FLOOR SHEATHING ROUGH PLUMBING SHEAR WALES EXTERIOR ROUGH ELECTRICAL SHEAR WALES INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELFf TI$ICAL W( ) C {) ROUGH PLUMBING _ INSULATION WALL �NSULALION UFILING__ DRl'1ilAL.L_ LATH (PRE) LATH FXTFRIOR LATH INTERIOR GAS TES SCRA I C TI COAT LELEG I RIG METER RELFASF GAS METER RELEASE -_ _ FLNCE 1 GATE/ ALARM FINAL POOL _ ... ...... .... WALLS: "_I'1-f;lAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING TZ. of OCCUPANCY" CERT. of OCCUPANCY _ COMMS TRAGI AND LLDGER SWH(31 GFAR COMM1.11MAL HOOD 'F BAR -._-�- - INTEl1('1 PI ER .......... . �.H.1)'.lMllI)lll'IlWlllAN GLSSPOOL HERS REPORT RECEIVED I)FMOLITI0N HOOF DRAINS R01161-1 CONDUIT POOLIS A ROUGH PLUMBING _ ROUGH ELECTRICAL ROUGH MECHANICAL PRE GUNITE - _ POOL PRE DECK BONDING P IIIAP FLNCE 1 GATE/ ALARM FINAL POOL _ ... ...... .... WALLS: WAIL FOOTING/STEEL WALL STEEL 1-( ) 2ND( ) LIFT _- WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIFE DEPARTMENT FINAL PLANNING FINAL ENGINEERING1 PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. --- -� A FINAL INDUSTRIAL MASTS -.... _