The URL can be used to link to this page

Home My WebLink AboutPR16-0457z C !cc cca X w 0 H H L W U. Cr C z a U1010ND BAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fag: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JO SITE ADDRESS 2-1,zWl A44410 W- "® AP LOT`"'-�' TRACT OWNER ) '""l t C. 4 -a -sl fv vlSA ADDRE S 6 C€TY r I L5 TEL. APPLICANT a i}f-°d'i" "TEL. GONTRACTOR ADDRESS °, 3 I -' _'-� ' i �� 7 5 CITY£" rff ZIP TEL. RCH/ENG/ ,;DESIGNER ADDRESS CITY ZIP TEL, OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that 1 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 items) [Section 71 Business and Professions Cade: 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 permitto 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 exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). (-) 1, as ownerofthe property, or my employees with wages as thefrsole compensation, will do (-) all of or i 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 rot apply to an owner of property who, through employees' or personal effort, bunds or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or improvement is sold within ane year of completion, the OwnerBuilderwil€ have the burden of proving chat it was not built or improved for the purpose of sale.). (04 as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who I or improves thereon, and who contracts forlhe projects with a licensed Contractor pursuardth the Contractors' Stata License Law.). U I am exempt from licensure under 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 impmvemenls covered by this perri cannot legally sell a structure that I have built as an owner builder if it has not been constructed it Its entirely 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: hffp/wwwA lnfo,ca.govlDalaw.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 Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: LIC. NO.: DATE: CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Cert'dicate of Consort to Solt -insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this penult is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the perfonnarce of the workfor which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER PIS SECTION NEED NOTBE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS), I certifythat In the performance of the workfor whlchthls permd Is issued, i shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of Callforne. And agree that if I should became subject to the Worker's Compensation provisions of Section 3700 cf the Labor Code, I shalt 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 3708 of the labor code, interest, and aiierney'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 t have read this application and state that the above information is correct. I agree to comply with all city and county ordlnances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. PERMNTEE NAME (PRINT) SIGNATURE OF PERMITTEE DATE APPLICATION DATE:_ AP/11/60 PIC# 26, ISSUE DATE: PERMIT# : TYPE CONST.�'Z, ` 154'Lt OCC GROUP: Scope of Work # DWEL. UNITS # STN ES 40e-elz._ # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARFA/VALUATION SFR/ADD/REM Garage/Carport E) Patio/Deck W tL4 Pool/Spa Re -Roof Commercial rn [p 1Vaf —tion: Adj. Area: QUANTITY DESCRIPTION FEE V U w w co z m rz c U_ x U CONSTRUCTION: PLAN REVIEW: ggl //,,�� __ V , C J ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: V121 S BASF: PLOT PLAN: . -3 2 ZONING CLEARANCE: TOTAL FEES` COMMENTS: ' P/C:PAID RECEIPT# g F. BY: i% iJ PAID EIY� VALIDATION: VALIDATION: WHITE-- Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy SETBACK1LETTER _ FOOTINGS FORMS SLAB UG. PLUMBING UG, ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT HOOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FR_AMINGNENTING W ROUGH MECHANICAL /ROUGH ELECTRIGAL W( } C ROUGH PLUMBING INSULATION WALL INSULATION CEILING OHYWALL LATH (PRE) — LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT_ _ ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING_ FINAL MECHANICAL. FINAL ELECTRICAL. FINAL PLUMBING T.C. of OCCUPANCY CERT. Of OCCUPANCY CO ED rs: TRACT ANL) LDGL R SWITCH {'CAR COMMERCIAHOOD T BAR._�_. INiLFICEI'7EI{ ......................................................... HOT MOP181IOWFIiWAN 4E:6'1"I(:;ICESSC'(1{ll_ HERS R1:110 RT RECEIVED ...................... DEMOLITION ROOF DRAINS ROUGH CONDUIT' PC OUSPA ROUGH PLUMBING ROUGH ELECTRfCAL ROUGH MECHANICAL GAS TEST PRE (RINIT E POOL PRE DECK BONDING I'-TLiAI' FENCE 1 GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1-( ) 2N°( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PY6f FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE