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Home My WebLink AboutPR17-13661BMW R 107110R } i1 CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES e� J 21810 Copley Drive, Diamond Bar, CA 91765" PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839- 0- ► .� BUILDING PERMIT APPLICATION w►v.cityofdiamondbar.com buildinori dta ndbarea.gov FIRMLY w JOB SITE ADDRESS U r Q J e r W Or APN WT TRACT OWNER CA Tud Cox ADDRESS CITY ZIP TEL. APPLICANT TEL. CONTRACTORV M O ADDRESS D w:, �S CIT`! ZIP 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 next to the applicable Rem(s) (Section 7031,6, Business and Professions Code: Any city or county that requires a permit to construct, after, 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 provisions of the Contractor's State License Lew (Chapters) Cammencing 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 Sectlan7031.5 by any applicant far a permit subjects the applicant to a civil penatty of not more than five hundred dollars ($500). O f, as ownerof the property, ar my employees w€thwages as tbefrsole compensatton, will do Q all of or Q portions of the work, and the structure Is not intended or offered for sale (Secton 7044, Business and Professions Code: The Contractors' State license Law does not apply to an owner of properly who, through employees' or personal short, builds or improves the property, provided that the improvements are Rot Intended or offered for sale. if however, the building or improvement Is sold within one year of completion, the Owner-Bullderwlll have the burden at proving that R was not built or Improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the proJeot (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of properly who buildsor improves thereon, and who contracts forthe projects with a licensed Contractor pursuantto the Contractors' State License Law.). U I am exempt from 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,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 lacy, Section 7044 of the Business and Professions Code Is available upon request when this application Is submitted or a1 the fallowing Web site: hUphwnv.teginfo.ca.gov/calaw.himl. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 7000) of Division 3 of the Business and PrroGofessions Code, and my license Is In full force and effect. LICENSE CLAuSS�rLiC.NO: &C 3 l EXP. DATE: CONTRACTOR: �_5... WORKER'S CDMPENSATION DECLARATION t HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section $700 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 We ' Compensat€on Insurance Carder and Policy Number are: — CARRIER IoM r POLICY NUMBER (fHISSECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $1 Do OR LESS). I cerfilythat In the performance of the work far which this pamilt Is Issued, i sball 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 Section 37OG of Me Labor Cade, I shall forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage Is unlawful, 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 at the labor code, Interest, and aftarney'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 whish this permit Is Issued (Sac. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certfy that I have read tjhis application and state that the above Information Is correct. I agree to comply with ail city and counlyordirtances and state lays relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for Inspection purposes. PERMITTEE NAME (PRINT) SIGNATURE OF PERMITT DATE APPLICATION DATE:, Z ) - 12 P/C# \ `— ISSUE DATE: PERMIT# : TYPE CONST. DCC GROUP: ((�� Scope of Work Q e # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SO. FT, FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/REM Garage/Carport j Pablo/Deck LL Pool/Spa ZRe -Roof _3 Commercial 5 a0 Willi Valuation: to T. Adj. Area: QUANTITY DESCRIPTION FEE s ti v w w eu z m J a z a x U CONSTRUCTION: PIAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: �1r� ISSUANCE: SMIP: ENERGY P/C: LNLRGY PERMIT: RETENTION FEE: s� PRE -ALT FEE: BASF: ®e PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: ? PAID BY: / VALIDATION: RECEIPT# 14 PAID BY: v` + VALIDATION: WRITE — Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy -.01TY OF 1' : r BAR INSPECTION SETBACK/LETTER FOOTINGS FORMS SLAB UG, PLUMBING UG. ELECTRICAL UFER GROUND SFWFR LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING — SHEAR WALLS EXTERIOR SHEAR WALLS INTERMOR FRAM/ NGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ROUGH PLUMBING INSULATION WALL .. _.... INSULATION CEILING DRYWALL _.._..__..._...._....... ...... .._ _--- - LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE —..... SPECIAL INSPECTION _...... FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL ................... __....._........ -- ..._.... ------..... - — .... FINAL PLUMBING T.C. of OCCUPANCY GIRT. of OGCUPANGY COMMENTS: 1 ' TRACT AND LEDGER SWITCH GEAR �! COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE — POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM - FINAL POOL — �- WALL& WAI L FpOTING/STL'E:L. WALL STEEL 1sT( ) 2"'( )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