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Home My WebLink AboutPR17-67920 F- U) rn L1 C.5 LU Ca J 7 C3 2 Q a w DIA,11I0N BAIL � CITY OF DIAMOND BARr7 --+ DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES ►"� 21810 Copley Drive, Diamond Bar, CA 91765 P R ESQ (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamoadbar.com building@diamottdbarea.gov JOS SITE ADDRESS q q 1 13T APN LOT TRACT OWNER PAC (6 i V'(!r ADDRESS over -e& r : mC ' CITY ZIP7T7 aTELL '31V ie�t APPLICANT AWkUWJ(✓. TEL. Uq ( �✓i� CONTRACTOR %)- ADDRESS 9111 4 fNK i'_ CITY a ZIP 0 • l' -7 '7 2, 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 checkmark(s), I have placed nerd to the applicable items) [Section 7031,5, Business and Professions Code: Any city or county that requires a permit to construct, altar, 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 pursaantto the provislons at the Contractor's State License taw (Chapter 9) 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. AnyviolatIon of Section 7031.5 by any applicantfora permit subjects the appllcantto a civil penalty of not more than five hundred dollars ($500). U I, as owner of the property, at my employees with wages as their sole compensation, will do (_) all of or (-) portions of the work, and the structure fs 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 the Improvements are not fntended or offered for sale, if however, the building or Improvement is sold within one yearoi completion, the Owner-Bulider will have the burden of proving that it was not built 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 Cade: The Contractors' State License Law does not apply to an owner of properly who bunds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant 1a the Contractors' State License Law.). U I am exemptfrom licensure under the Contractor's State License law for the following reason(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 permit,) cannot legally sell a structure that I have built as an owner -bulkier it it has not been constructed In its entirely 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 of the following Web site: httphwrw.laginfo.ca.govlcalaw.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 Divlslon 3 of the Business and Professions Code, annd my license Is In full force and effect. LICENSE CLASS: 110,C. NO.: --!y-(v,557� EXP. DATE: t ' 1 UJDNTMCTOR: r a �t v ►'t EGL(r 41L4� 4�1�� WORKER'S COMPENSATION D tARATION I HEREBY AFFIRM 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, for the performance of the work far which this permit is issued. I have and will malolain 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 Pollcy Number are: �1„+ GAMIER C+ S- Ufa'` POLICY NUMBER (MISSECT10N NEED NOT BE COMPLETED IF THE PERMITS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certlythat In the performance of the work for which this permit Is issued, I shalt not employ any person In any manner so roto become subject 1a the Worker's Compensation Laws of Califomla. And agree that If I should become subject to the Worker's Compensa provisions of Section 3700 of the L r Cod�srep'fl'a ft co t�aublpoml �aqplqcr DATE: T APPLICANT: !INO: Fat re to secure Worker's Compensafie wiui, and stcriminal penalties and civil lines 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 rude, 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 far which this permit Is issued (See. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that 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 propertyfor Inspection Aerrw er PERMl1T E W_(PUITT 0 7 2 SIGMA HE F PER EE DATE O APPLICATION DATE: 3 t r�(P�/C# ISSUE DATE: PERMIT# TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSI= ADJ, AREA/VALUATION SFR/ADD/REM Garage/Carport W Patio/peck uw.. PooVSpa z Re -Roof '3 3 a Z Z � Q Commercial Valuation: Adj. Area: QUANTITY DESCRIPTION FEE r— U w z m a_ Q _U x V CONSTRUCTION: PIAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: _!e ENERGY P/C: ENERGY PEHMIT: RETENTION FEE: PRE -ALT FEE: �. BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID BY: RECEIPTff PAID BY: VALIDATION: �y VALIDATION: (_ WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy liliA11111111111 0 N FOOTINGS FORMS SLAB UG, PLUMBING UG. ELECTRICAL LIFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING 7 l FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING. ROUGH MECHANICAL ROUGH ELEGTRICAL W( ) G ( } ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST - SCRATCH COAT ELECTRIC . GAS METERRELEASE ._- - SPECIAL INSPECTION _FINAL BUILDING , FINAL MECHANI AL ........- FINAL ELECTRICAL, FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY COMMEWS:._ TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEWED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL - HOUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM - FINAL POOL WALLS: WALE. FOOTING/STEEL WALL STEEL 1ST( )2 U( ) LIFT WALL BOND BEAM WALL DRAIN/SEAL -.._.. - ........ .._ WALL FINAL RO FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE