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Home My WebLink AboutPR17-12103DUNOND BAR CI'T'Y OF DIAMOND BAIL=, DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91,765 I Y PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 / FIRMLY w BUILDING PERMIT APPLICATION w%v.cityofdiamondbar com building cr diamondbarca.gov JOB SITE ADDRESS - I �LP S C h ) m 7-1-'q i l APN LOT—TRACT— OW OT TRACT OWNER ra_Y i ex, <5 q y'LT K- (,,U ct d ADDRESS I � G/ t.[ cJ'.f�.:.. r, r -r Lt i- ciTy0),drnun,5t Oar Z[P 61 174 EL.17Q7 APPLICANT S h f TFL. o f CONTRACTOR r r ADDRESS 14?S rY D i-rl C- G[ C7 d' CITY ZIP r' 77 -,STEL. F 41)-0 7 ARCH/ENG/ DESIGNER ADDRESS CITY ZIP -L. OWNER-BIAN DER ATION I hereby affirm under penalty of perjury that I am exempt fror.. a Contractor's State License Law for the reason(s) Indicated below by the checkmark(s), I have placed next to th, applicable items) [section 7O31.5, Business and Professions 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 pernaRto 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 74)00 of Divislan 3 of the Business and Professions Code[ or that he or she Is exempt from licensure and the basis for the alleged exemption. Anyvlolalion of Section 7031.5 byany applicantfor a permit subjects the applicant too civil penalty of not more than We hundred dollars ($500). U I, as owner of the properly, or my employees with wages as their sale compensation, will do U a0 of or (-) portions of the work, and the structure Is Fiat Intended or offered for sale (Section 7944, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or persunal effort, builds or Improves the property, provided that the Improvements are not Intended or offered for sale. fi however, the building or Improvement Is sold wllhiri one year of completion, the Owner-Bullder will have the burden of proving that Itwas not bullt or Improved for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professlons Code: The Contractors' State License Law does not apply to an owner of property who bullas or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). U I am exemptfrom Ncensure under the Contractor's State License law for the fallowing reason(s): Date: Sign: By my signature below I acknowiedpthat, except for my personal residence In which I must have resided for at least one year pilar (o completion of the Improvements covered by this permit,( 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. t understand that a copy of the applicable In, Stollen 7044 of the Business and Prolesslons Code Is available upon request when this application is submitted ora( the folfawing Web site: httpAwAy.legInfo.ca.gov/calaw.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 of the Business and Professions Code, and my license Is in full force and effect. LICENSE CLASS: C D NG NO, CO z LP EXP. DATEt CONTRACTOR: ir WORKER'S COMPENSA N DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintaln a Certificate of Consent to Seff-Insure for Worker's Compensation, as provided by Secden 3700 of the Labor Code, forlhe performance of the walk 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 Carder and Policy Number are: CARRIER It) rF t -t POLICY NUMBER Z (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). 1 cera fythatin the performance of the work tor which this paunit ls issued, I shall not amploy any person in any manner so as to become subject to the Worker's Compensation Laws of Califamia. And agree that R I should become subject to the Worker's Compensation provlslons of Sectiun 3700 of the Labor Code, I shall forthwith complywith those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensailon coverage Is unlawful, 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 compensation, damages as provided for in section 3708 of the labor code, Interest, and attorney's fees. CONSTRUCTIOR 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. 3097, Civ. C.). LENDEH'S NAME: LFNOFH'SADDRESS: I certify that I have read this application and state thatihe above Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, aad hereby authorize representatives of this county to enter upon the above-mentioned property for Inspection purposes. ({ 0 PERMITTEE NAME (PRINT) SIGNATURE OF PERMITTEE DATE APPLICATION DATE: ot 1 I 4P/C# /� ISSUE DATE: *1PERMIT# : V 1r�7�j r 1, — I !�! 63 TYPE CONST. OCC GROUP: Scope of Work e If DWEL. UNITS If STORIES - # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFWADD/REM Garage/Carport LOU Patio/Deck Lu u Pool/Spa Z Fie -Roof 0 Commercial 5 co Valuation: L Adj. Area: QUANTITY DESCRIPTION FEF J c� w co Z mWAA J 0. c� d z U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: & • 2 MECHANICAL: INSPECTION FEE: ISSUANCE: �r�o •l SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: _ PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTALFEES COMMENTS: P/C: PAID BY: VALIDATION: J� RECEIPT If PAID BY: ✓ VALIDATION: � O WHITE — Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy EmEmmimmoom, SETBACK/ LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE SEWER CLEANOUT HERS REPORT RECEIVED DEMOLITION ROOF SHEATHING ROOF DRAINS FLOORSHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA . ......... . SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( C O GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WAIJ, INSULATION CEILINGP-TRAP DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR POOL PRE DECK BONDING FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL GAS TEST SCRATCH COAT WALL STEEL I ST ( ) 2ril)( )LIFT WALL BOND BEAM ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL BUILDING FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING /T f7. p F[NAL ENGINEERING/ PW T,C, of OCCUPANCY FINAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE COMMENTS: . . ... .. .....