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Home My WebLink AboutPR17-11374UVION'D BAiR. CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building*iamondbarca.gov 4514 JOB SITE ADDRESS 4 A_cko T APN LOT TRACT OWNERC+ �C:r'`D 3 di�I 2T ADDRESS 52 AiAgAAA+ tkAyAl CITY J ZIPTEL. APPLICANT =(> MA" Ta -- CONTRACTOR rt ADDRESS_ I%ir CITY ZIP � OeS _ TEL. 3-- MT - & i� ARCH/ENO/ DESIGNER ADDRESS CITY —ZIP—TEL. OWNER-BUILDE IPTEL- 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 statementthat he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 91 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 anyappiicantfor a permitsubjects the applicant to a civil penalty of not more than five hundred dollars ($500). { j I, as owner of the property, or my employees with wages as their sole compensation, will do Q 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. It however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.), 4I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project {Section 7044, Business and Professlons Code; The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts far the projects with a licensed Contractor pursuant to the Contractors' State License Law.), L1 I am exempt from licensure under the Contractors State License law for the following reason(s): Dare: Sign: By my signature below I acknowledge that, exceptfor my personal resldence In which I must have resided for at least one year prinrto completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed In its entirety by licensed contractees. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code Is available upon request when this appllcatlon Is submitted or at the following Web she: hvplwww.leginfo.ca.govlcalaw.htrnI LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am €ICensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profess€ons Code, and my Ilconse is In full force and effect. LICENSE CLASS: (-3% LIC. NO.: EXP. DATE, t` C—'I[ —8 ? CONTRACTOR'dt� F ire 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 performance ofthe workfor which this permit Is Issued My Worker's Compensation insurance Carrier and Policy Nu bee are: g , CARRIER i.:d ` d'koin `�' - �� POLICY NUMBER —LAX—'?��?.�]�_`r-ems (f HIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $1 CO OR LESS). I cortify that in the performance of the workfor wblch this permit is Issued, i shall not employ any person In any manner se as to become subject to the Worker's Compensation Laws of Cailfornla. And agree that if I should become subject to 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 37DB 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,}, LFNDFR'S NAME, LEN DERS 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 ofthls county to enter upon the above-mentioned property for inspection purposes. T .E�r l %y�ImLtl�.r F 1yj PFRMITTEE NAME (PRINT) SIGNATURE DATE APPLICATION DATE: £ P/C# ISSUE DATE: 0 I PERMIT# : —I — % 3i TYPE CONST. OCC GROUP: t�',, Scope of Work �� rpt # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport CO Patlo/Deck w LL Pool/Spa ZRe -Roof o Commercial 5 m Vafesatfon; Adj. Area: QUANTITY DESCRIPTION FEE U W ca m 8 J a U Z Q x V CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEESS�j COMMENTS: v 32 PIC: PPAID BY; / VALIDATION: RECEIPT # t`5 dq +�O PAID BddY; 2-06 2 q VALIDATION: VU WHITE— Department Copy, YELLOW -- Finance Copy, PINK—Assessor Copy SETBAM LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE: SEWER GI_EANOUT ROOF SHEATHING FLOOR SHFAI HIND SHEAR MALLS EXTERIOR SHEAR WALLS INTF:RIOH FRAMINGIVENfINC ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( } ROUGH PLUMBING ®i __14� -..._ - - - INSULATION WAI I INSIII.ATION (,FII ING DRYWALL LATH (PRf) I ATI I f XTFMOR I A7I1 INTERIOR GAS II:51 SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINALPLUMBING y m- _.W ! T.C, of OCCUPANCY CERt of OCCUPANCY COMMENTS:..... L RACI ANI} I.LDGER SSI I CII CLAR COMMLLR{ IAL MOOD 1, RAI _ . .......... . ........ - IN I EIiCLPI"Fil HOT MOWSHOWFRPAN SEPTICIfiF'SSPOOI. HERS RFPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POWSPA ROUGH PLUMBING ..... ...... ..._,__,._ ROUGH ELE{ f RICAL ROUGH MECHANICAL GAS TEST PRE GUNITE _.. POOL PRE DECK BONDING P -TRAP FENCE 1 GATE/ ALARM FINAL POOL - - WALLS: WALL FOOTINGISTEEL. WALL STEEL JST( ) 2ffr, ) I IFT WAI L BOND BEAM ......... - WALL. DRAIN/ SEAL WAL L FINAL. RO FRAMING PLANNING APPROVAL ......... --- ROUGH FIRE APPROVAL FINAL EIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE