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Home My WebLink AboutPR17-16854CITY OF DIAMOND BAR I I l i DEPARTMENT OF COMMUNITY k DEVE=LOPMENT 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@diamondbarea.gov JOB SITE ADDRESS -6 7 t r ji p os PL APN LOT TRACT OWNER �"t d ADDRESS r 9' c:! - CITY jGOEIP E �I , APPLICANT Efi. i S CONTRACTOgtRp� s^ ADDRESS. CITY �` �� ZIP �d %OTEL. t0&—'4--& 3W -y ARCH/FNG/ DESIGNER ADDRESS CITY 71P 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 itam(s) [Section 7031.5, Business and Professions Code: Any city at county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prior to its issuance, also requires the applicant for the permftto file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Stale License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Cadej or that he or she is exemptfram licensure and the basis for the alleged exemption, Any violation of Section 7031.5 by any applicamifor a permitsub)ects the applicant to a civil penalty of not more than five hundred dollars 0500). {) I, as ownerof the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure Is not intended or offered for sale (Sectlon 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. If however, the building or Improvement is sold within one year of completion, the Cwner-Bul i 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 Ilcensed 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 for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). L) I am exemptfram licensure under the Contractor's State License law for the following reason(s): Date; Sign: By my signature below I acknowledge that, exceptfor my personal residence in which I must have resided for at least one year prior to completion of the Improvements covered by this permiLl cannot legally sell a structure that I have built as an ownar-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 atthe following Web site; httplwww.leginfe.ca,govlcalaw.himl. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provislons of Chapter 9 (commencing with Section 7000) o1 Division 3 of the Business and Professions Cede, and my license Is in full force and effect. LICENSE CLASS: : LIC. NO.: C7 o �r EXP.DATE CONTRACTOR:l —0 0iip- N D WORKER'S COMPENSATIOECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certlflcate of Consent to Self -Insure for Worker's Compensation, as provided by /Suction 3700 of the Labor Code, forte performance of the work for which this permit Is issued. r' I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Palley Number are: CARRIER "� r< _ POLICY NUMBER ' c 2---e (f HIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS), I certltyihat In the performance of the work for which this permits 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 It I should became subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prcyisiens, DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil flnes 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 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, Clv. C.j. LENDER'S NAME. LENDER'S ADDRESS; 1 cart fy that I have read this application and state chat 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 enterupo th above-mentioned property for inspection purposes. 6T PERMITTEE NAME (PRINT) SIGNATUTE>k0qff1TTEE Z DATE APPLICATION DATE: jj !' ISSUE DATE: I t PERMIT# : TYPE CONST. -y f" y I T" o S PIR OCC GROUP: 1 ScRe of Work ' 1 _ f "t # DWEL. UNITS # STORIES R i' I �1 fe 6--r— # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Lo Patio/Deck LU LLL Pool/Spa ZRe -Roof Commercial 1✓alua#ion: Adj. Area: QUANTITY DESCRIPTION FEF 4 U 2 ca +u w t� z m d U Z Q U g CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 228, 4 MECHANICAL: INSPECTION FEE: ISSUANCE: 4 -3 , SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEF: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: �_ o PIC: f PAID BY; RECEIPT# dG-CC PAID BY: � VALIDATION: (° VALIDATION: �w WHITE— Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy SETBAW LETTER FOOTINGS FORMS SLABC - UG. PLUMBING UG. ELECTRICAL LIFER GROUND SFWFII I ATFHAI MAIN WATER i INF SI-WI H Cl LANOUT ROff SHI ATHING FLOOH SI II-ATIIING SHEAR WALLS EXTERIOR SHEAH WALLS INTERIOR FRAMIING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C { - ..... I MCI AND LEDGER _.......... SWITCH GEAR OMMERCfAL HOOD - -- BAR IN f [-.RCEPTER HOT MOP/SHOWERPAN OL AFP ICICF:SSPOOL HERS REPORT RECEIVED DFMOI (TION ROOF DRAINS ROLJGI I CONDUIT' POOL/SPA ROUGH PLUMBING /TOUGH ELECTRICAL % ....... ROUGH MECHANICAL GAS TEST 'f�E Gl1NfIE POOL PRE DECK BONDING P TTRAP ......... -- FFNCF I GAIT/ ALARM FINAL POOL. _ ...... MALLS: WALL FOOTING/STFFI WALL. STf:f'l. Is'( ) 2M°( } LIFT WALL BOND IILAM WALL DRAIN/ SEAT. WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT .. -..._ FINAL PLANNING _ ROUGH PLUMBING INSULATION WALL INSULATION CFiLNG _ DRYWALL LATH (PRE) -__ LATH EXTERIOR _ LATH INTERIOR GAS TEST SCRATCH CCAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING FINAL ENGINEERING/ PW T,C, of OCCUPANCY FINAL COMMUNCTY SERVICES GERT. of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE _._...—._ COMMENTS: