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Home My WebLink AboutPR17-9646log z LU x k— LU a- cr. c� z 0 J_ 5 co Q CA CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 851-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityoldiamondbar.com building@diamondbarea.gov JOBSITEADDRESS +�a -n'e APN LOT TRACT OWNER .Jel-N A?_%, cA e_v-) ADDRESS CITY ZIP TEL. -6110_sS APPLICANT TEL. CONTRACTOR Pv A rip h� ADDRESS 0.r CITY�lv+�ZIPZ.- 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) Indfoated below by the checkmark(s), I have placed next to the applicable iiem(s) [SeotloR 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, Improve, demolish, or €epafr, any structure, prior to Its Issuance, also requires the applicant for the permit to fife a signed statement that he orshe is licensed pursuant to the provisions of the Contracter's State License Law (Chapter9) Commencing with Section 711011 of Division 3 of the Business and Professions Cade] or that he or she le examptfrom licensure and the basis for the alleged exemption. Anyvlolation of Sectlon 7031.5 by any applicantfora permitsubjectsthe applicant tea civil penalty of not more than five hundred dollars ($500). (-) 1, es owner of the property, or my empioyeesw€h5 wages as their sots compensation, will do U all of or Q portlons 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 eOort, 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 year of completion, the Owner -Builder will have the burden of proving that It was not built or improved for the purpose of sats.). (-) 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 forthe projects vilth a licensed Contractor pursuant to the Contractors' State License Law.), U 1 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 priorto completion of the improvements covered by this permit,l 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 submited or at the fallowing Weh site: btlpAvvm.leginio.ca.gov/calaw.himl. 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: 4 b 6 LIC. NO.: IOf) 6 FxP. DATE: CONTRACTOR: P C_ A •ry v 1 n �!T� WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ( 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 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 Carrier and Policy Number are: CARRIER POLICY NUMSFR (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). 1 certify that In the performance of the work torwhich this permit Is Issued, I shal l not employ any person in any manner so as to become subject to the Worker's Compensation wsQf Callfomfa. And agree that B I should become subject to the Worker's Compen tl n rovisior s tion 3700 of the b Cede, i sha forf e ' r comply with those provisions. DATE- E, �( A PL!CANT: WARNING: Failure 1e secure Worker's Comp- ei on coverage nlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (5100, 00), in addition to the cost of the compensation, damages as provided for In section 3700 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 Is Issued (Sec. 3097, Civ. G.J. LENDER'S NAME: LENDER'S ADDRESS: I cartity 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 tthhu a bove-mentioned property for Inspection purposes. PERMI E (PRINT) Iro SIGNA�RMITTE DATE APPLICATION DATE: —4/241—+ P/C# PRi-n-9(a ISSUE DATE: -T/; 9 t PERMIT#: PR IJ-- -I&q4_ TYPE CONST. OCC GROUP: Scope of'Work I � t �, P 'e:L If DWEL. UNITS If STORIES � # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w PatiolDack UJ IL Pool/Spa ZRe -Roof _3 Commercial 5 [i7 Valuation: Adj. Area: QUANTITY DESCRIPTION FEE J v w w co z m J rL U z 4 x v CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 159.00 MECHANICAL: INSPECTION FEE: ISSUANCE: 3(0- i2 SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: 2.00 BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: ��• IL P/C: PAID BY: VALIDATION: RECEIPT #-,54 94 PAID BY: cr S('% VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy CITY OF DIAMOND RAR INSPECTION RECORD SETBACK/ LETTER _ FTRACT ANO LEDGER FOOTINGS FORMS ._ _. _ SWITCH GEAR _ SLAB _. -- ......._. COMME11CIAL. HOOD _ UG. PLUMBING T -BAR _ UG, ELECTRICAL - INTERCEPTER HOT MOP/SHOWERPAN UFER GROUND SEWER LATERAL. SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED DEMOLITION SEWER CLEANOUT ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR _ POOL/SPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL __.._.... _m. _. _. _._.. ROUGH MECHANICAL - ROUGH ELECTRICAL W( ) C O ROUGH PLUMBING - GAS TEST PRE GUNITE _ INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING _....__... _ P -TRAP DRYWALL FENCE / GATE/ ALARM I ATH(PRE) _ . _...._ FINAL POOL l_ATII EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sT ( ).2NP._.( ) LIFT SCRAICH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE SPECIAL INSPECTION WALL FINAL R0, FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL .FINAL PLANNING ___... FINAL PLUMBING T.C. of OCCUPANCY — FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES CEIRT. of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: - ___ -V