The URL can be used to link to this page

Home My WebLink AboutPR17-5471LEE CL CD O on U3 U3 CD 0 r 0 0 H 0 0 J J a CD x CL z H w ca• c� z 0 J C3 cn cn H QW10ND AR 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@diamondbarea.gov JOB SITE ADDRESS APN LOT TRACT OWNER �a] ADDRESSj,7 3 CITY ff �$ tl gi �ZIp APPLICANT TEL C± ' 0, CONTRACTOR V 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 reasurl 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, priarto its issuance, also requires the applicant for the perm€tto file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Cade] or Thal he or she is exempt from licensure and the basis for the alleged exisa lon,AnyviolationofSection7031.5byanyapplicantforapermitsubjeclstheapplicanttoacivl[penalty Xo not more than five hundred dollars ($500). as owner of the property, or my employees with wages as their sale compensation, will( o U all of or ortions 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 net 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 for the purpose of sale.). 11, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State Lieeuse 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), U I am axe m from I' ensure under t Contractor's S 'cense law for the following reason{5). Morse c By my signature below I acknowledge that, except to, m e ereona silence in will6 ust 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 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: httpAvww.Ieglnfaca govlcalaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commsncing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. LICENSE CLASS: LIC. NO.: EKP,DATE, CONTRACTOR: WORKER'S COMPENSATION DECLARATION I_HEREBYAFFIRM UNDER PENALTY OF PERJJRY 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, forthe 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 of the work for which this permit is issued My Worker's Compensation Insurance Carrier and Policy Number are, CARRIER POLICY NUMBER {CHIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS) I certify that in the performance of the workfor which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation taws of Callfcrnia. And agree that If I should became subject to the Worker's Compo Ion pr isions of Section 3100 of the or Code, I shall forthwithycomplywlth those provisions. DATE: APPLICANT:.. .,Y WARN[ : Fa ore to secure Worker's Co pensatlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars {$100,000), in aldltion 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 penally of perjury that thorn is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, 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 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the acove- mantifoned prop arty for 1help aDtlon purposes. PERM17 E {PRIN Sl , T . �� R _, T) .." DATE APPLICATION DATE:_fol a® ! 1'1 Ill _;I_ ISSUE DATE: �'/IaQ- I 1'•1 PERMIT# : koe \-I— ,PTYPE CONST. TYPEOCC GROUP: g� ; Scope of Work r k i t O # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. , FACTOR PSF ADJ. AREA/VALUATION SFR/ADD EM Garage/Carport Lo Patlo/Deck W LL Pooll ZRe -Roof i Commercial m Valuation: ° Adj. Area: QUANTITY DESCRIPTION FEE a OUT U � 4 J w c� z r J F.i z U CONSTRUCTION: 1 S(e . SS PLAN REVIEW: 9Sa • E,41A— ELECTRIC: PLUMBING: MECHANICAL: ii `. INSPECTION FEE: ISSUANCE: i.• 4-x`6 SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: C� PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES ` 9 COMMENTS: P/C: PAID BY: VALIDATION: RECEIPT # 3S PAID BY: VALIDATION: WHITE Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOCK SHEAT HING ROUGH CONDUIT SHEAR WALLS EX-ILRIOR POOLiSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL C ROUGH MECHANICAL .,.._...._.- ROUGH ELECTRICAL W( ) C ( j GAS TEST ROUGH PLUMBING PRE CIJNITE INSULATION WAI J POOL PRE DECK BONDING P -TRAP iNSULATION CFII INC; DRYWALL �^ FENCE / GATFI ALARM LATH (PRE) 1JFINAL P.4.4—v POOL _. .... LATH EXILRIOR MALLS: LATH INTI RIOR WAI J I-OOTINGISTEEL GAS TES I WAI I, STFFI. IST( )2 ND( j LIFT SCRATC`,II COAD WALL BOND BEAM DRAIN/ SEAL ELECTRIC METER RELEASEWALL GAS ME 11:13 RELEASE WALL FINAL RO. FRAMING PLANNING APPROVAL SPEGIAL INSPECTION FINAL BUILDING FIRE APPROVAL FINAL. FIRE DEPARTMENT FINAL MECHANICAL FINAL ELECTRICAL ?/` FINAL L'LANNING FINAL ENGINEERING/ PW FINAL PLUMBING4 FINAL COMMUNITY SERVICES 0 T.C. of OCCUPANCY FINAL HEALTH DEPT. CERT of OCCUPANCY FINAI.;YIDUSTRIAL WASTE