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Home My WebLink AboutPR17-16972CITY OF DIAMOND BAR ' I I i DEPARTMENT OR COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 �S� (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FI R M LY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS - ,71 IL APN LOT TRACT OWNER Ck 141 4 J ADDRESS r CITY C(�! rt E I C�L._ APPLICANT +] F- Lk ✓ TEL. CONTRACTOR yp�� ADDRESS d—�ix i �e 11 1J CITY_ tZIP _2/TEL, Y&:16, — 5 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 reasan(s} Indlcaied below by the checkmark(sb I have placed next to the applicable items) lSectian 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 9) Commencing wit) Section 7000 of Division 3 of the Business and Professions Code] orthat he or she is exempt from€censure and the basis for the alleged exemption. Any violation of SEction 7031.5 by any app€Icantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($900). L) I, as owner of the properly, 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 Professlans 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 Owner -Builder 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 licensed Contractors to construct the project {Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of pmpedy who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuanttothe Contractors' State License taw.), U I am exempt from 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 most have resided for at least one year prior to completion of the Improvements covered by this permlt,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 contractors. I understand that a copy of the apph"cable law, Section 7044 of the Business and Professlans Code Is available upon request when this application is submitted or at the following Web site: http/www,lagiflfo.Da.gov/calaw 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 affect. LICENSE CLASS: 113 P LIC. NO,: & �W k �i1 "( EXP. DATE .ate .'J CONTRACTOR: _ /!'+� 4'+ m`✓ '�� Or e WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 1 have an dl maintain a Cerlfflcate of Consent to Self-€msure for Worker's Compensation, as provided by S n 3700 of the Labor Code, for the performance of the work ter which this permit is issued. have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the workfor which this permit is issued. My Worker's Compensation Ins tante Carrier and Policy Number are CARRIER - r POLICY NUMBER rA (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HDNDRED DOLLARS $1W OR LESS}. I cerl€fy that in the performance of the workfor which this permit Is Issued, I shall not employ any person in any mannerso solo become subject to the Worker's Compensation Laws of California. 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: APPLICANL WARNING: Failure to secure Worker's Compensation coverage Is unlaWtUIr and shall subject an employer to criminal penalties and civil (Ines up to one hundred thousand dollars (S100,000), In addition to the cost of the compensation, damages as provided for In section 3709 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.). LENDER'S NAME: LENDFR'S ADDRESS: I certify that I have read this appllcation and slate 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 ofthis county to enter upon a above-mentloned property for inspection purposes. PERMITTEE NAME (PRIN .. SIGNA F FERMI DATE APPLICATION D�AyTE:I r /T Pr/C# ISSUE DATE: 7 �� I + PERMIT#: PRI—F— 1&9+Z TYPE CONST. OCC GROUP: Scope of Work t Cdr m n o -- same 106x60*% # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Lu Patio/Deck LL Pool/Spa ZRe -Roof Camrnorcial m valuation: Adj. Area: QUANTITY DESCRIPTION FEE U a= ryU� J u� c� z m a U Q x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 573 . MECHANICAL: INSPECTION FEE: ISSUANCE: 'A j _ SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: . (O PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES 9 COMMENTS: P/C: PAID BY: 11 VALIDATION: RECEIPT # PAID BY: '^T VALIDATION: IAC— WHITE —Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD SETBACK/LFTTER IRACI AND LEDGER SWI ICII GEAR LOMMLRCIAL HOOD I -13A3 IN I ERGEPTER HOT MOP/SHOWFRPAN SFF'T1C/CESSPOOL HERS REPORT RECEIVED FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFEA GROUND SEWER LATERAL MAIN WATT R UNE SEWER Cl EANOUT ROOFSHEATHING FLOOR SI IFATHING SHEAR WALLS EXTERIOR I.T. MOLITION ROOF DRAINS ROUGH CONDUIT PQIaLlSP� .. ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE SHEAR WALLS INTERIORR FRAMINGAIENTING ROUGH MECHANICAL _ .. ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LAI-I(PRE) /.ATI I EXTERIOR _. POOL PRE DECK BONDING P -TRAP. FENCE/ GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STFFL WALL STEEL is7( )2 ND( ) I. .IFT I Ai II INTERIOR GAS TEST SCRATCH COAT %' WALL BOND BEAM WALL DRAIN/ SEAL ELECTRIC METER RELEASE GAS METER RELFAa.. WALL FINAL SPECIAL INSPECTION RD. FRAMING PLANNING APPElOVAL ROUGH FIRE APPROVAL FINAL BUILDING FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICALFINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE