The URL can be used to link to this page

Home My WebLink AboutPR17-0984 (15)CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com buildingrdiamondbarca.gov JOB SITE ADDRESSS;-JQ APN LOT TRACT OWNER m ADDRESS CITY ZIP TEL. �c - 3 APPLICANT TEL. CONTRACTOR 6fL ' OVI Cn ADDRESS2 L)Y Q CITY ZIP 4TEL. ARCH/ENG/ ,r DESIGNER , C 'r CA .j C. ADDRESStA4 e CITY ZfP TEL. OWNER-BIJILDIEkIDECLARATIl 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 chackmark(s), I have placed next to the applicable tom(s) [Section 7031.5, Business and Professions Code: Any city nr 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 with Section 7000 of Division 3 of the Business and Professions Cade] er that he or she is exempt from licensure and the basis for the alleged exemption. Any, violation of Section 7031,5 by any applicantior a permit subjects the applicantto a civil penalty of not more than five hundred dollars ($500). 11, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (T portions of the work, and the structure Is not Intended or offered for sale (Section 7644, 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 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 property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuantto the Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the following reason(s): Pate: Sgm 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 permit,] cannot legally sell a structure that I have built as so 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 oratthefollowing Web site: http/www.loginfo.ca.gov/caiaw.htmi LICENSED CONTRACTOR'S DECLARATION € herehy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7001 of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE GiAS5 LIG, NO.: EXP. DATE: CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS', I Cori and will maintain a Corof Consent to Self -Insure for Worker's Compensation, as provided by Section 3766 of the Labor Code, fortho performance of the work for which this permit Is Issued, I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofihe 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 (TMS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS), I cartify 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 Compensafien provisions of Section 3700 of the Labor Code, I shall iDdinwith comply with those provisions. DATE: APPLICANT: WARNING: Failure to secura Worker's Compensation coverage is unlawful, and shalt subject an employer to cnminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 ofthe 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 fur which this permit is issued (Sec, 3097, Civ. C.). LENDER'S NAME LENDER'S ADDRESS: I earthly that I have read this application and state that the above information is correct, I agree to comply with ail city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter oa the above-mentioned properly for inspection purposes. PERMITTEE NAME fPBfJ.T) SIGNATURF OF PERMITTEE DATE PRESS FIRMLY APPLICATION DATE: ISSUE DATE: TYPE CONST. P/—Cp# �B �a�I _ PERMIT# OCC GROUP: ,p Scope of Work iNQ-1 Si -,%N — i # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARLANALUATION SFR/ADD/REM Garage/Carport w Patio/Deck ui LL Pooll ZRe -Roof Es Commercial W Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a U U �u w co z m J d J U Z U g CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID BY: v� VALIDATION: �� RECEIPTtk PAID BY: ��/ VALIDATION: 1,�/j' WHITE- Department Copy, YELLOW —Finance Copy, PINK— Assessor Copy SETBACK/ LETTER 100 DINGS FORMS SLAB UG. PLUMBING UG, ELECTRICAL IJFF.R GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING 1LOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGIVENTING ROUGH MECHANfCAL BOUGH ELECTRICAL W( ) C ROUGH PLUMBING INSULATION WALL. INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR — LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METEH H LEASE GAS METER RELEAM' SPECIAL INSPFCIION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL . ............... _ FINAL PLUMBING T.C, of OCCUPANCY CEIRTa ®f OCCUPANC COM ENTS: CITY f INSPECTION 1 RACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD I ...BAR INTERCEPTER HOT MOP/SHOWERPAN SFPTIC/CFSSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT PDOL/SPA ... ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FFNCF I GATE/ ALARM FINAL POOL WALLS: WALL FOOTINGISTEEL WALL STEEL 1-( ) 2N°( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL 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