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Home My WebLink AboutPR17-12784MOND +- 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 BUH.DING PERMIT APPLICATION www.cityofdiamondbar.com building diamo arca.gov JOB SITE ADDRESS�— APN A LOT TRACT OWNER AD KESS L A7��--- Cl f 7�r ZIP EL. APPLICANT Ti CONTRACTOR ADORES CITY C, L, 1.I "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 far the reasons) indicated below by the checkmark(s), I have placed next to the applicable items) ]Seclfon 7031.5, Business and Frofessiens Cade: 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 pursuantto the previsions of the Contractor's State License Law {Chapter S} Commencing with Sectian 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($540). U I, as owner of the property, or my employees with wages as their sole compensation, will do V 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 If however, the building or Improvement is sold within one year of completion, the Owner Bullder will have the burden of proving that it was not built or improved forthe purpose of sale,), u I, as owner of the properly, am exclusively contracting with licensed Contractors to construct the project (Sectlon 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 contractsfor the projects with a licensed Contractor pursuanttothe Contractors' State License Law, 1. U I am exemptfrom licensure under the Contractor's State License law for the following reasons}: 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 prlorto completion of the improvements covered by this perni cannot legally seE1 a siructura 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 applicable law. Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at the fallowing Web site: h iplwww.Ieglnfo.ea.govlcalaw.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 o1 the Bu I alProiesslons Code�nd pens i in full c ffect. LICENSE {:LASS; LiU. NO.; KP. DATE: CONTRACTOR: WORKER'S A 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 permlt is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofthe Labor Code, for the performance of the won fowhich this permit is issued, My Worker's Compensation Insurance Carrier and Policy Num her are; �� / CARRIER A POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERNITIS FOR ONE HUNII u LLAR3 Six OR LE53), caddy that in the performance of the work for which this permit is issued, I shall not employ any person in any manner sa asto 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 Cade, 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 ($100,0001, in addition to the cost of the compensation, damages as provided for in sectlon 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, 31 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 agnea to comply with all city and county ordinances and state laws relating to buhding construction, and hereby authorize representatives of this county to enter upon the above- entered property for insp tion purposes. ERM EE JAME(PR IGNA OF P11`9111 DATE APPLICATION DATE: ISSUE DATE: d5/14 I 1 -"'PERMIT# : FX1"- " e 4 " &T- TYPE CONST. DCC GROUP: Scope of Work C — # UW EL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARE"ALUATION SFR/ADD/REM Garage/Carport Ow Patio/Deck U-1 LL Poof/S a Re -R f J ommercial [0 Vatuatio Adj. Area: QUANTITY DESCRIPTION FEE U r U w w co a M J d J U Q x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: 1 ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: 0 , PAID BY: RECEIPT# 6(.*\ Q a PAID BY: VALIDATION: VALIDATION: WHITE— Department Copy, YELLOW— Finance Copy, PINK—Assessor Copy CITE OF DIAMONDA INSPECTION C SETBACK/ LE ["FEB ................................. FOOTINGS FORMS SLAB .......... UG. PLUMBING UG. ELECTRICAL UFER GROUND SEWER I ATF RAL MAIN WA('LR LINE SEWER CLEANOUT ROOF SHEATHING j FLUOR SHEATHING SHEAR WALLS EXTERIOR __.._.. - SHfAR WALLS INTERIOR FRAMING/UENTING f('H MECHANICAL ROi a ROUGH ELECTRICAL W( } C.( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL IATH (PRE) - LATH EXTERIOR LATH INTERIOR .......... ._ GAS TEST SCRATCH COAT EL FCTRIC METER RLLEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING d� - FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. Gf OCCUPANCY COMMENTS: IRACI AND I I0GIA SWI ICH GE:AII COMME_RGIAL HOOD 'F -IiAfI I F HW111IHER HOT MOP/SHOWERPAN SFPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP _., FENCE I GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1S7( ) 2NJ( } LIFT WALL BOND BEAM WALL DRAIN/ SEAT_ WALL FINAL- _ RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW - - FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. - - - FINAL INDUSTRIAL WASTE