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Home My WebLink AboutPR17-4550CITY OF DIAMOND BAR A i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES s" 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS.3 E:, ' APN LOT TRACT OWNER ADDRESS 3 1 CY:� r CITY `' tCk Qyi, y 1P� TEL I i f � a a � r L- i APPLICANT Pf Cts' -2�j CONTRACTOR ` _z`34C�a. CDDHES Z P ��TEI + g+ ARCH/ENG/ DESIGNER , ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION € 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 checkmark(s), I have placed next to the appilcable liem(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, 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 provlslons of the Contractor's State License Law (Chapter 9) Commencing wIM Section 7000 of Division 3 of the Business and P€olesslons Code] or that he or she Is exempt from licensura and the basis for the alleged exemption. Anyviolatlon of Section 7031.5 by any applicant fora permitsubjects the applicant to a civil penalty of not more than five hundred dollars ($500). U 1, as owner of the property, or my employees with wages as their sole compensation, will do ()all of or(.] portions of the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professions Cada: The Contractors' State License Law does not applyio an ownerof property who, through employees' or personal effort, builds or Improves the property, provided [hat the Improvements are not Intended or offered for sale. If however, the building or Improvement Is sold within one year of compfo0on, the Owner -Builder will have the burden of proving that ft was not built 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 Professions Code: The Contractors' State License Law does net apply to an owner of properly who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant io the Contractors' State License Law.). (-) I am exemptfrem licensure under the Contractor's State License law for the following reasonis): 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 permit,l cannot legally sell a structure that I have bunt 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 avaitabie upon request when this application Is submitted or at the following Web site: hUptmw,ieginfo.ca.gov/caiaw.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 ProfVons Code, and my license Is In full force and effect. LICENSECLAS . '~ LIC.NO.:. >XP.DATE: 2C-, V1 CONTRACTOR:y WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and AN maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Coda, for the performance of the work for which this permit Is Issued. I have andwill 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 Policy Number are: y CARRIER j POLICY NUMBER (CHIS SECRON NEED NOT BE CUMPtETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LFSSI, I certify that Inthe performance of the work forwhich this pormitis Issued, € shall not empfoyany person in any manner soaato become subject to the Worker's Compensation Laws of California. And agree that If I should become subject to the Worker's On PTY pro 'stns of Suchen 374DWA eh�LaborODde IFforth�vdh comply with those provisions. DATE: r F APPLICANT: WARNING: Failure to secure Worker's Componsatioa coxa ge Is unlawful, and shall subject an eemp oyario (ninaf 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 seotfon 3708 at the labor coda, Interest, and allurmy's fees. CONSTRICTION LENDING AGENCY I hereby affirm under penalty of per(ury that there is a Construction Lending Agency for the performance of the work for which this permit Is issued (Sec. 3097, Clv. C.). LENDER'S NAME: LENDER'S AODHESS: I cergiy that I have read this application and slate 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 for Inspection purposes. e EE NAME gRINT) € SIGNATURE OFnP ITr' — DATE APPLICATION DATE: �I �� 1\1 ISSUE DATE: 1 R I\Pi PERMIT# : TYPE CONST. P/C# tP R \—I— 4 S S'O OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFRIADD/REM Garage/Carport w Patio/Deck 0- PooVSpa Re -Roof _3 Commercial ED ED valuation: Adj. Area: QUANTITY DESCRIPTION FEE I` w co z m RPM i IQ F -M J rz ,..,. CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: rl b INSPECTION FEE: ISSUANCE: Bio • {� SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: �}•. BASF: PLOT PLAN: ZONING CLEARANCE; TOTAL FEES COMMENTS: �6 • S P/C: PAID 13Y: VALIDATION: RECEIPT It35aa� PAID BY: VALIDATION:_ WHITE— Department Copy, YELLOW — Finance Copy, PINK --Assessor Copy DIAMOND BR INSPECTION RECORD lb7 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 HERS REPORT RECEIVED SEWER CLEANOUTDEMOLITION _.___............ _.__._..___._ ...__._._.. ROOF SHEATHING ROOF DRAINS FLOOR SHEATHINGROUGH CONDUIT SHEAR WALLS EXTERIOR POOL/SPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGIVENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( } C (} GAS TEST ROUGH PLUMBING _ _ ......... _-...._. . - _ PRE GUNITE INSULATION WAI I- POOL PRE DECK BONDING INSUI ATION CEILING P -TRAP DRYWALL FENCE / GATE/ ALARM LATH (PR[) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST - WALL STEEL IST( )2 ND( ) LIFT SCRATCH COAT ._.... WALL BOND BEAM- - ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASEWALL FINAL _._... _..... ...... ....... ...- SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING _... FINAL ENGINEERING/ PW -- ......_...... .... ....... _.__— T.C. of OCCUPANCY FINAL COMMUNITY SERVICES__-__... — - ..__.___ CERT, of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: