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Home My WebLink AboutPR17-12109DIAH011'D BAR �s 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.cityofdiiamondbar.com buildinggoiamondbarca.gov JOB SITE ADDRESS r h - du APN LOT TRACT OWNER4, ADDRESS CITY ZIP TEL. APPLICANT TEL. CONTRACTOR 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 reason(s) indicated below by the checkmark(s), i 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 91 Commencing with Section 711Oo of Division 3 of the Business and Professlons Cade] or that he or she is exemptfrcm 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 Df not more then five hundred dollars {$506}, I, as owner of the property, or my employees with wages as their sole compensation, will do U 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' nr persomal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or Improvement is sold within one year of completion, the Dwner-Builder 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 Cade: The Contractors' State Llcanse Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuanttothe Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the fallowing reason(s): Date: Sign: By my signature below I acknowledge that, exceptfor my personal residence In which € must have resided for at least one year prior to completion of the Improvements covered by this permit,I cannot legally sell a structure that I have call 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 Cade Is available upon request when this application is submitted or at the following Web site: httplwww.leginfo.ca.govlcalawhtml, LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed undar provisions of Chapter 9 (commencing with Section 7000} of Division 3 of the Business and Professions Code, and my license Is In fall force and effect. LICENSE CLASS LIC, NO.: EXP. DATE4ONTRACTOR: WORKER'S COMPENSATION DECLARATION €i HE FFIRM UNDER PENALTYOF PERJURY ONE OF THE FOLLOWING DFCLARATIONS: 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 Cade, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policyare: CARRIER TATI p� CARRIERR ..... POLICY NUMBER (THIS SECTION NEED NOT BE COML IFTIFTEPERIVIII ONE HU $100 OR LESS). I cerdlythat In the performance of the vworkforwhch this permit is issued. I shall not employ any person in any mannered asto become subject to the Worker's Compensation Laws of Califomia. 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 tines up to one hundred thousand dollars ($100,000), In addition to the cast of the compensation, damages as provided for in secllon 3708 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�), LEN DEB'S NAME: LEN DEB'S ADDRESS: I certify that I have read this application and state that the above information Is correct. I agree to comply with all clly 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. r� Z. PERMITTEE NAME (PRINT) " JQ t4, SIGNATURE DATE APPLICATION DATE: € �I ISSUE DATE: � f q li i' -I TYPE CONST. \" E P/C# PERMIT# : 'F ' Q OCC GROUP: Scope of Work Ir # DWEL. UNITS # STORIES r # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFA/ADD/REM Garage/Carport w LU LJ- Patiel6eck Pcol/5pa rd 1 Re -Root _ i Commercial 10 m Valuaiton:Coo 9 Adj. Area: QUANTITY DESCRIPTION FEE a U it U J W to m U_ U CONSTRUCTION: PLAN REVIEW: `ter ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: - r SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE:_..... PRE -ALT FEE: - BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PIC: PAID BY: VALIDATION: RECEIPT# 2C&0 '� PAIDBY: I'ZA—r) VALIDATION: WHITE— Department Copy, YELCAW — Finance Copy, PINK— Assessor Copy CITY OF DIAMOND BAR INSPECTION COMMENTS: z_//zr �- SETBACK/ LETTER FOOTINGS FORMS TRACT AND LEDGIR _... _ SWITCH GEAR SLAB UG, PLUMBING UG. LLECTRICAL COMMERCIAL II000 L -BAR INTERCEPTER UFE13 GROUNDHOT .._ ... SEWER LATERAL. MAIN WATER LINT SLWER CLEANOUT R[}OF SHEATHING'S FLUOR SHEAPHNG SHEAR WALLS EXTERIOR _.. _ _... MOP/SHOWFRPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAIN ROUGH CONDUIT POOL/SPA SHEAR WALLS INTERIOR ROUGH PLUMBING . FRAMINGIVFNTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ). ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EX'I I'HIOR LATH INTI RIOR GAS TESL SCRATCII COATI ELEC I IK METER RFLFASE GAS ML:TER RELEA5L. SPECIAL INSPECTION FINAL BUILDING ROUGH MECHANICAL GAS TEST _ PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE/ GATE/ ALARM FINAL PO01 WALLS: WALL FOOTING/STEEL WALL STFL.I.,1-( ) 2`( ) LILT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL � R[) FRAMING PLANNING APPROVAL HOUGH FIRE APPROVAL FI AL FIRE DEPARTMENT FINAL MECHANICAL FINAL ELECTRICAL FINAL PLANNING FINAL ENGINEERIGI P4 FINAL PLUMBING T.C, of OCCUPANCY CERT. of OCCUPANCY FINAL COMMUNITY SERVICES FINAL HEALTH DEPT FINAL INDUSTRIAL WASTE COMMENTS: z_//zr �-