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Home My WebLink AboutPR17-11971CL a c C: F U. a c i a c DI MOND BAR 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) BUILDING PERMIT APPLICATION w-w-mcityofdiamondbar.com JOB SITE ADDRESS �s (D clear APN I LOT TRACT OWNER S / ADDRS < L CITY f L. `0 APPLICANT r Wit• TEL, S _' CONTRACTORAl ` ADDRESS ` IQ q 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 reason(s) Indicated below by the chackmark(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, prlorto Its Issuance, also requires the applicant for the permit to fife a signed statement that he orshe Is licensed pursuantto the provisions of the Contractor's State License Law (Chapter9) Commencing with Section 7000 of Division 3 of the Business and Professions Cade] or that he or she Is exempt from licensure and the basis for the alleged exemption. Anyviolatlen of Section 7031.5 by any applicant fora permitsubjeuts the applicant to acivll penalty of not more than five hundred dollars ($50D). (-j I, as owner of the properly, or my employees with wages as thelrsole 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 She improvements are not Intended or offered for sale. if however, the building or improvement Is sold wRhln one year of completion, the Owner -Builder will have the burden at proving that it was not built or Improved for the purpose of sate.). 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' Stats License Law does not apply to an owner of property who builds or Improves thereon, and who contractsforthe projects with a licensed Contractor pursuant toihe Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the following reason(s): Gate: 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 permlt,l cannot legally sell a structure that I have bul t 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 submRted or at the following Web site: hftp/www.leglnfo.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 7006) of Division 3 of the Business and Professions Cade, and my license is In full force and effect. LICENSE CLASS: ate'/ Lf C. NO.: q El(P.OATE:� CONTRACTOR _ 6 IL1 WORKER'S COMPENSATION DECLARATION i I HFRFRYAFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I ha a and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by ction 3700 of the Labor Code, for the performance of the work forwhlch this permit Is Issued. I have and will maintaln Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the perforAllowork for which this perm€t is sued. My Worker's Compensation Insurance Carrir and PolicyNuCARRIER'tPOLICYN (THIS SECTION NFFO NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $1 DO DA LESS). I certify that In the performance of the work for which this permit Is issued, I shall not employ any person In any manner so as to become subject to the Wodcer's Compensation Law of Caffom€a. And agree that If I should became subject t the Worker's Compensatio is n Sac€ion 3700 of the L r e, shall fodhvrhh comp{y se provisions. DATE: APPLICANT: 7 -P.I %_ +� Mia - J WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shat! subject an employer to criminal penaltlas and civil fines up to one hundred thousand dollars ($101),OD6), In addition to the cost of the compensation, damages as provided for in sectlon 3708 of the 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 perfotmance of the work for which this permit Is Issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that 1 have read this application and state that the above Information Is correct. I agree to comply with all city and county ordlna s and state lays relating to building construction, and here y authorize representatives of this county 1a enter upon ova -mentioned props for Inspection purposes. PERMITTEE NAME (PRINT) SIGNATURE OF PERMITT DATE PRESSt 839-702-7 FIRMLY building@diampndba rca.gov APPLICATION DATE: M10 ISSUE DATE; F T TYPE CONST, —' P/C# M77-10 .: r "" 97,1 PERMIT# : F R OCC GROUP: Scope of Work 0 'P # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT, FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/AEM Garage/Carport 23 Patio/Dock LL1 Li PooVSpa ZRe -Roof Commercial ED tY1 vialuatlors; Adj. Area; QUANTITY DESCRIPTION FEE us w co s 'm J a �d x v CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE:. SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: , C BASF: PLOT PLAN: ZONING CLEARANCE: TOTALFEES. COMMENTS: ��- (o,PAID BY: PIC: &'Z- RECEIPT 43 .1 ear PAID BY: ¢¢�� VALIDATION: 015,14 VALIDATION: Lx WHITE - - Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy 7SFTBACI(U/ LETTER 7TTRAGER COMMERCIAL HOOD T-BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL_ FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT HERS REPORT RECEIVED DEMOLITION ROOF GRAINS ROOF SHEATHING FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOL/SPA SHEAR WALLS INTERIOR - ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C (} ROUGH PLUMBING GAS TEST PRE GUNITE MSULATION WALL POOL PRE DECK BONDING €NSULATION LFII ING DRYWALL- -_ _ _ P-TRAP FENCE / GATF/ ALARM _ . - LATH (PRE) LATH FXTFRI0R I ATH INTERIOR GAS I"LS1 FINAL.. POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1-( ) 2N°( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL _...... .._.... ......... ......... _...... WALL F[NAL -- SCRA-ICH COAT ELECTRIC METER RELEASE GAS METER RELEASE _... - SPECIAL INSPECTION _... ..... - - - - - RD. FRAMING PLANNING APPROVAL ........__ FINAL BUILDING _........_. - ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING _.. FINAL PLUMBING _... T.C. of OCCUPANCY CERT. of OCCUPANCY ....., ... FINAL ENGINEERING/ PW: .. . -- --.... FINAL COMMUNITY SERVICES .................__,___ FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: