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Home My WebLink AboutPR17-11745F71ION BARI1R' CITY OF DIAMOND BAR ` W 4.$4 PA 74 DEPARTMENT OF COMMUNI"Y & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fag: (909) 861-3117 Building Inspection Hotline (909) 839-7027 PRESS FIRMLYBUILDING PERMIT APPLICATION www.cityofdiamondbar.com btjtildingCaDdianfondbar6a.gov r ,- Scope of Work ke " _� d IL_ if # DWEL. UNITS # STORIES [v # BEDROOMS— JOB SITE ADDRESS a Am _ Al �r m�p L! ° APN LOT TRACT OWNER ADDRESS CITY ZIP TEL. APPLICANT � l? d �V,4461 TEL. !q1 ,-7& '°__2.>Z CONTRACTOR ADDRESS !' ` CITY UtW4WKZIP `, STEL. l 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 Licerse Law for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable hem(s) [Section 7031.5, Business and Professions Code: Any city or county 'hat requires a permit to construct, alter, improve, demolish, or repair, any structure, prier 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 exempt from licensure and the basis for the alleged exempri Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of rat more than flue hundred dollars ($500). U I, as owner of the property, or my employees with wages as their sole compensation, will do C 1 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' Slate 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 howsver, the building or improvement is sold within one year of completion. the Owner-Bullder wlll 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 pursuaril the Contractors' State License Law), U I am exemptfrom 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 completlon of the Improvements covered by this permit,l carnal legally sell a structure that I have built as an ewner-Bullder 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 ava€labls upon request when this application is submitted or at the following Web site; htlp/www.leglnfo.ca.gov/calaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby afflrm under penalty of perjury that € am licensed under pmvlsians of Chapter 9 (commencing with Sectien 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. L` 1LEC. LICENSE CLASS: NO.: EXP,CATE! cONTRACrOR: - —1- 4 ) 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 Compensalien, as provided by Section 3700 of the Labor Code, for the performance of the work far which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofthe Labor Code, for the performance ofthe work for which this permit Is € pod. My orker's Compensation Insurance Carrier and Number are: RR CARRER C CAI POLICY NUMBER [THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LES5}, I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in any mannerso unto become subject to the Worker's Compensation Laws of California And agree that I I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pmvlsians. 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 (5100,000), In addition to the cost of the compensation, damages as provided for In section 3708 of the labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby all 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 corstructlon, and hereby authorize representatives of this county to enter upon the above-mentioned property for Inspection purposes. 'sem I "A 16f PERMITTEE NAMt (PRINT)y] II j SIGNATURE OF PERMITTEE DATE IF APPLICATION DATE: O� 1-4— � "P/C# PR IT — m ISSUE DATE: PERMIT# : PR 17 — 11:7q-5 TYPE CONST. DCC GROUP: r ,- Scope of Work ke " _� d IL_ if # DWEL. UNITS # STORIES [v # BEDROOMS— DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport E3 Patlo/Deck Lu LL PoDuspa ZRe -Roof Ccmmerclal valuatloiri Adj. Area: QUANTITY DESCRIPTION FEE c� U w iu z z m a U_ U CONSTRUCTION: PLAN REVIEW: MR 29 ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SJIIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE ALT FEE: O® BASF: 1.00 PLOT PLAN: ZONING CLEARANCE: 13,314 TOTAU FEES COMMENTS: 386,51 P/C: PAID BY: VALIDATION: P RECEIPT # S 9 WA PAID BY: _C� S h VALIDATION: L C° W H ITE —Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy CITY OF DIAMOND ` O SETBACK/ LEITER TRACT AND LEDGER M7 SWITCH GEAR COMMERCIAL HOOD T -BAR FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL INTERCEPTER HOT MOP/SHOWFRI'AN SEPTIC/CESSPOOI HERS RLPORT Rf:G1 IVSD DEMOI ITION ROOF[TRAINS ROUGH CONDUIT POOL/SPA PLUM81NG ....... . .. -- ROUGH. ELL C.TRICAL UFER GROUND SEWER 1 A,FFRAL MAIN WATER LINE SEWFR CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHIAR WALLS EXTERIOR ge lie I I - SHEAR WALLS INTERIORROUGH FRAWNGNENTING ROUGH MECHANICAL ..... ROUGH MECHANICAL GAS TEST PRE GUNITE - --- - ROUGH ELECTRIGAL W( ) C ( ) ROUGH PLUMBING INSUI ATION WALL POOL PRE DECK BONDING . INSULATION CEILING P TRAP 1)13YWALL FENCE / GATE/ ALAR{ AiH (PRE) -- W , FINAL POOL LATH EXTERIOR WALLS: WALL FOOTING/STEEL WAI.I STEEL IST( )2 ND( ) LIFT WALL_ BOND BEAM WALL DRAIN/ SEAL WALT.. FINAL 130. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING LATH INTERIOR (IAS TEST SCRATCH COAT ELECTRIC METER RLLLASE GAS METER RELEASE SPECIAL INSPECI ION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. T.G. of OCCUPANCY CERT. @f OCCUPANCY