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Home My WebLink AboutPR15-743DLL}I01 TD -BAR JOB SITE ADDRESS CITY OF DIAMOND BARExpireJ DEPARTMENT O€' COMMUNITY & DEVELOPMENT SERVICES PRESS 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7€127 FIRMLY BUILDING PERMIT APPLICATION APN LOT TRACT OWNER Q ADDRESS — CITY n _ IP TEL. APPLICANT TEL. CONTRACTOR ADDRESS 4 CITY ZIP �(si .- —TEL• ARCH/ENG/DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that t am exempt from the Contractor's State License Lav for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable RENTIM [Section 70315, 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 far the permit to file a signed statement that he or she Is liceased pursuant to the provisions of the Contractor's State License Law (Ghapter9) Commencing with Section 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 appRcardt for a permit sub(ectsthe applicardto a civil penalty of not more than two hundred dollars ($500). U I, as owner of the property, or my omptoyeeswith wages as theirsole compensation, will do U all of ort) port€ons 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 ownerof 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 praying that It was not built or improved for the purpose of sate.). (-) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The GanUactors' State L eense Law does net apply to an owner of property who builds or improvesthercon, and whocontraclsfortho projects with alicensed Contractor pursuant to the Contractors' State License Law.). (� I am exempt from licensure under the Contractor's State License law for the fallowing reason(s): By my signature below I acknovdedge that, except for my personal residence In which 1 must have restded for at least one year prior to comptction of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand thata 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 following Web site: httphwN,.legiafo.co.gov/Waw.htmi. DATE: SIGN: € 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 Profeselons Code, and my license is in full form and effect. LICENSE CLASS: llC. NO.: Eve ZA ()ATE: CONTRACTOR,--�"' WORKER'S COMPENSATION DECLARATION I HEREBYAFfIRM UNDER PENALTY OF PERJURY ONE OFTHE 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, Tor the performance of the work for which this permit is issued. _ I have and will maintain Worker's Compensation Insurance, as required by Secl€on 3700 of the Labor Code, for the performance of thework for which this parmit is Issued. My Worker's Compensafun Insurance Carrier and Policy Number are- CARRIER re: R �} CARRIER--J—X y l�y� r POLICY NUMBER X_ W_Z�-6 [dam✓` (MIS SECTION NEED NOT BECOMPI_ETFO IFTREPFAMfrt FOR ONEHUNDRFD DOLLARS f$100) OR LESS). I certify that io the performance of the workfor which this permit Is Issued, I shall not employ any person in any manner sa as to become subject to the Worker's Compensation Laws of California. And agree that ti I should become subjectto the Worker's rCompan f en pmpvsionsQLSecErm 3700 of the Labor Cade, I shall forthrdth comply with those provisions. DATE: f APPLiCANT:.� �— WARNING: Failure to secure Worker's Compensation coverage is unlavdnl, and shall subject an employer to criminal Penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the cumpensation, damages as provided for In section 3708,ef the labor code, interest, and attumeys fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work far which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME:_ .—— LENDER'S ADDRESS: �. I certitythat 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 above-mentioned property f r inspection purposes. PERMITTIENAME (PFIINT� —VL OF PERMITTEE DATE APPLICATION DATE: l 'I -s P/C# ISSUE DATE: PERMIT# TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE # DWEL. UNITS # STORIES #BEDROOMS CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: `` MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE:. PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: RECEIPT 01 — PAID f3Y:Ate, _ VADDATION:_ WHITE— Department Copy, YELLOW -- Finance Copy, PINK —Assessor Copy, GOLDENROD — F€fe Copy, GREEN —Applicant's Copy DESCRIPTION SO, FT. FACTOR PSF ADJ. AREA/VALUATION I SFR/ADD/REM Garage/Carport Patio/Deck LL PODUSpa ZRe -Roof 0 Commercial ED ED Valuation: QUANTITY Ad(. Area: DESCRIPTION FEE 4 r— U J W Jas U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: `` MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE:. PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: RECEIPT 01 — PAID f3Y:Ate, _ VADDATION:_ WHITE— Department Copy, YELLOW -- Finance Copy, PINK —Assessor Copy, GOLDENROD — F€fe Copy, GREEN —Applicant's Copy CITY OF DIAMONDBAR INSPECTIONRECORD �m S TRAGIC,: TTER ` TRACTAN€J LEDGER I"4l0TINI;S F'€IGMS . ; _...,_____...___....._....._.�..—..._.�-.._._..� SWITCH GEAR vl1�B COMMERCIAL HOOD 11G PLLiNiBIG T -BAR ELECTRJCA� — — INTERCEPTER R GRtiI1NIl HOT CIDP/SHOWERPAN SEWER LATERAL_ SEPTIC/CESSPOOL FAIN WATER LINE —-- — -._ —..... ...__—..._ rHERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ---....--...__.._-._. ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING — SH fIi ALLS EXTERIOR — ROUGH CONDUIT SHEARI�A{.I=S INTERIOR ` [ OLISPA t�iJGH PLIJMI31�iG FI 'm 14 -GAVE TING MUM ELECTRICAL, ROUGH MECHANICAL., TH ROUGH ELECTRICAL'.M ) >i ) Rt3U GHlECI-IANICALnw GAS TEST }Oi�Cf� PLt�fVPI�II�;C PRI GUNlTE INSULATION WALL POOL PRE BECK BONING It;ISOLATION CEILING — — -- CiRYWALL FENCE i GATE1.ALAR /ATH PRE LATH EXTERIOR WALLS, LATH INTERIOR WALL FOOTING/STEEL uAS IBT _ n S—e sr 2ro 7 ET _ — WALL TEI 1 _—.....�i SCRATCH COAT — — � .—__—..._. _, �-.. � i ( LI MALL B0ND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL _-.-___. PECIAL INSPECTfON — FINAL RUILGIi.G - aul��A��I�� u PUMINING�+AL FINAL MECHANICAL FINAL" ELECTRICAL FINAL, F... ART N ---- FINAL PLANING FINAL: PLUMBING G FI AL' EN'GIUEERIt GI PW RT OCI;i €ANCY INAL-NEALT SEP SE EG S rAI. ��I'��I�T� P ;�iNAL INiiSTIAL!�TiIASTE �: