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Home My WebLink AboutPR17-3546DIA,lIO�D SSRXr CITY OF DIAMOND BAR r DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 rPRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRRULY BUILDING PERMIT APPLICATION wtivw.cityofdiamondbarcom buildingrcdiamondbarca.gov JOB SITE ADDRESS2SOz t APN LOT TRACT OWNER _lurma�l V 1 tr -- ADDRESS CITY ZIP ' ' ri^b STEL. O - 251 343 ,. APPLICANT TEL. CONTRACTOR 47% 0 -rte, u ick-� I 1 ifldhkvA, ADDRESS 110- LJ CITY G—�,, Jw A ZIP ��['� L: O`�- qV 2-[,i Y'V ARCHIENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER-BDILO€R 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 Items) [Section 7031.5, Business and ProfeaalORS Cade: Any city or county that requires a permit to construct, atter, Improve, demolish, or repair,any structure, prior to its Issuance, also requires the applicant for tate permit to file a signed statementthat he ar she Is licensed pursuant to the proylslons of the Contractor's State License Law (Chapter 9) Commancing 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). U I, as owneraf the property, or my employees with wages as thairsole compensation, will do U all of arU portions of the work, and the structure Is not intended of offered for sale (Section 7044, Business and Professions Cade: The Contractors' State License Law does not apply to an ownerof properly 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 your of completion, the Owner -Builder will have the burden of proving that it visa not bunt or improved for the purpose of sale.). U 1, 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 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 mason(s): 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 permlt,I cannot legally sell a structure that I have built 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 submitted or at the following Web site: http/vnvw.leginfo.ca.govlcalaw.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 Division 3 of the Business and Professions Code, and my license is In full force and effect. p LICENSE CLASS: i LIC.NO.:�►— El(P. DATE: CONTRACTOR: WDRKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLAWITiONS: 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, forihe performance of the work for which tire permit is issued. I have andwiil 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 Carrier and Polley Number are: r� CARRIER Mod - POLICY NUMBER od-POLICYNUMBER S -V-05 CO t 1, (MG SECTION NEED NOT BE COMPLETED IF THE PERMIT 3 FOR ONE HUNDRED OOLLAfiS $100 CRUZ), 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 Worker's Compensation Laws of California. And agree that if I should became subject to the Worker's Compensation provisions of Seaton 3700 of the Labor Cade, I shall forthwith comply w(th those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage Is unfawlul, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), In addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there Is a Construction Lending Agency for the performance of the work for which this permit N issued (Sec. 3097, Ov. Q. LENDER'S NAME: LENDER'S ADDRESS: I codify that I have read this application and stale that the above Information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned propertytor In ection purposes. 4� � 4-1 PERMITTEE NAME INT) SIGNA URE OF PERMITTEE DATE APPLICATION DATE: (0/6 AI I _ PIC# _ � 35 1I ISSUE DATE; _�V Z � PERMIT# : _5 TYPE CONST. OCC GROUP: [ Scope of WorkYv�u� • T b NI AiZUJ cvNbiti y # DWEL. UNITS # STORIES # BEDROOMS ha LVJ W DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFRIADD/REM Oarage/Carport W Patio/Deck LLL Pool/Spa ZRe -Roof 9 Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE w aY1,•' m r CL veii TUE._ w CONSTRUCTION: PLAN REVIEW: • 13 t, _ ELECTRIC: . �) PLUMBING: 1 '- MECHANICAL; INSPECTION FEE:f ISSUANCE: L$ SMIP: SO ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: � f P/C: PAID BY: VALIDATION: RECEIPT # r PAID RY: v` VALIDATION: L WHITE — Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy 0 It v I t a t [ft I LORI SETBACK/ LETTER FOOTINGS FORMS TRACT AND LEDGER SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL INTERCEPTER UFFR GROUND HOT MOP/SHOWFRPAN SEWER LATERAL . .. .......... . MAIN WATER. LINE SEWER CLEANOUT SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF SHEATHING FLOOR SHEATHING ROOF DRAINS ROUGH CONDUIT SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR -POOL/SPA ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C (179 ROUGH MECHANICAL GAS TEST ROUGH PLUMBING PRE GUNITE POOL PRE DECK BONDING INSULATION WALL INSULATION CEILING P -TRAP DRYWALL LATH (PRE) LATH EXTERIORWALLS: FENCE/ GATE/ ALARM FINAL POOL I -ATH INTERIOR ..GAS TEST -SCRATCH COAT . .... ...... WALL FOOTING/STEEL WALL STEEL 1ST( ) 2tjD( LWT WALL BOND BEAM WALL DRAIN/ SEAL ELECTRIC METER RELEASE GAS METER RELEASE WALL FINAL SPECIAL INSPECTION . ...... .. .. RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING_._.__ T.C.ofOCCUPANCY LCERT. of OCCUPANCY COMMENTS: A I 1 FINAL FIRE DEPARTMENT FINAL PLANNING _..... FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. -FINAL INDUSTRIAL WASTE