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Home My WebLink AboutPR17-0799w a N e e I_CITY OF DIAMOND BAR l ` DEPARTMENT OF COMMTMIN & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 REBS (909) 839-7020 Fax: (909) 811 Building Inspection Hotline (909) 839-7027 sma�, BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diannondbarea.gov IFIRMLY JOB SITE ADDRESS(ift b' APIA OT TRACT OWNER 414Z�,TEL, ADDRESSCITY :.> ZIP APPLICANT N TEL. CONTRACTOR A.ADDRESS-$ CITY iNpi ZIP TEL. 6 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 reasons} indicated below Ly the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and Professions Cade: Any city or county that requires a permit to construct, after, improve, demolish, or repair, any struciure, 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 with Section 7000 of Division 3 of the Business and Professions Cade] Drthal 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 ($500). (-) I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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 compietion,the Owner -Builder will have the burden of proving that It was not built or Improved for the purpose of saie.j, (-) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Protassions Code: The Contractors' State License Law does Rot apply to an ewmer of property who builds or improves thereon, and who coni for the projects with a Ilcensed Contractor pursuant to the Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the following reann(si 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 prior to completion of the Improvements covered by this permitJ cannot legally sell a structure that I have built Rs 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 Profeselons Code is available upon request when this application is submitted or atthe following Web site: httpAoiww.leglnfo.ca.gov/calaw.htmi. „ 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 Dill 3 of the Business and Professions Code, and my Ilcensa is in full force and effect. LICENSE GLASS, LIC. N0.'. It ° U 3 Zi6WEXP. DATE: CONTRACTOR, - A 4 i WORKER'S GOMPENSAT16N DECLARATION I HEREBY AFFIRM UNOER 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 i Section 3700 of the Labor Code, for the performance of the work for which this permit N issued, i I 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 Insurance Carrier and Policy Number are: i ! CARRIER i POLICY NUMBER r (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED COLLARS $100 OR LESS). I certify that in the performance of the work forwhich this permit Is 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 If I should become subject to the Worker's iCompensation provisions of Section 3700 of the L ' ar,�odrl shall fedhwith comply with those provisions. DATE: I `�- APPLICANTS �¢;1 �F i WARNING: Failure to secure Worker's Compensation coverage Is unlawful, and shall. subject an employer to criminal i penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, 5 damages as provided for In section 3708 of the labor code, Interest, and attorney's fees CONSTRUCTION LENDING AGENCY ] I lie redy 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' c LENDER'S ADDRESS: - I certify that €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 above-mentioned property for inspection purposes. PERMITT E NAME [PRI T} - -� • , �, IGNA RE OF P MITT DATE ' Lf I APPLICATION DATE:—WI f P/C# ISSUE DATE: S -!� 1�"n PERMIT# : — fV-1, X-1 — TYPE CONST.U'® N ayn -• OCC GROUP: Scope of Worky' t 71 # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANR SFR/ADDIREM Garage/Carport W Pallo/Deck LL PooVSpa Re -Roof of Commercial ,T 7 m valuation: Adj. Area: QUANTITY DESCRIPTION U U w w m � rL U p z CONSTRUCTION: PLAN REVIEW:¥'s`'� ELECTRIC: e PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: ®a SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PIAN: ZONING CLEARANCE: 7 TOTAL FEES COMMENTS: PAID BY: VALIDATION RECEIPTPAIDBY:'Idf �S\ VALIDATIOI WHITE — Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy t--UATION FEE EN CITY OF DIAMOND I N S P E C T I �NI SETBAM LET FER f OOTING5 FORMS SLAB UG. PLUMBING UG. ELECTRICAL .._. ... LIFER GROUND SEWER LATERAL MAIN WATER LINE SEWfR CLEANOUT ROOF SHEATHING FLOOR SHEATHING �.. SHEAR WALLS EXTERIOR SHEAR WALLS INTLHIOR —._..— FRAM NGIVENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( } C ( ) ROUGH PLUMBING � — INSIIIJATION WALL INSULATION CEILING DRYWALL LATH (PRF) LATH EXTERIOR LATH INTF.RIOR _ _. GAS TEST SCRATCH COAT ELECIHIC MEIER RELEASE _ GAS ML"TER RELEASE SPECIAL iNSPECTION FINAL. BUILDING — FINAL. MECHANICAL FINAL. ELECTRICAL f FINAL PLUMBING T . of OCCUPANCY CCUPANCY I RACT AND LET)UF= R "WITCH GEAR COMMERCIAL HO( T' -RAR INTERCEPTER HOT MOPISHOWEI 1 PAN SFPTI('ICESSPDOL_ HERS REPORT REIN EIVED i)EMOLITION ROOF DRAINS ROUGH CONDUIT POOLISPR ROUGH PLUMBING. ROUGH ELECTIC L_ ROUGH MECHANIOAL GAS TEST _ _....� PRE GUNITE POOL PRE DECK 30NMNG P -TRAP FENCE 1 GATE/ ALARM FINAL POOL WALLS: WALL. FOOTING/STEEL — WALL- STEEL. IST( ) 2i1°( ) LIFT WALL BOND BEArA WALL DRAINI SEOUL_ WALL FINAL RO, FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ Paid FINAL COMMU iTY SERVICES FINAL HEALTH DEFT.