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Home My WebLink AboutPR17-14759CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 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.cityofdiamondbancom building@diamondbarca.gov JOB SITE ADDRESS 2-5 m APN LOT TRACT OWNER fG - p I-& - ADDRESS L 57 t�fC l Ct CITY ZIP TEL. APPLICANT -ter %srPOV TEL. CONTRACTOR 60A 5.7` ADDRESS lql// 0—caf25 CITY H, ( . ZIP EL. % f 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 Ear the reason(s) Indicated below by the checkmark(s). I have placed next to the appl#cable Item(s) [Section 7031,5, Business and Professions Cade: 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 permitto file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with section 7000 of Division 3 of the Business and Professions Code] or that he or she Is exempt from Ilcensure and the basis for the alleged exemption. Any violation of Section 7031.5 by anyapplicant for a permit subjectsthe applicant to a civil penalty of not more than Eve hundred dollars ($500). (31, as owner of the property, or my employees with wages as their sale compensation, will do (J all of or (} porfioas 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 ownerof property 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 year of completion, the Owner -Builder will have the burden of proving that 11 was not built or Improved for the purpose of sale.). ( ] f, 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 licensed Contractor pursuant to the Contractors' State License Law.). () I am exempt from licensure undarthe Contractor's State License law for the fallowing reasoa(s): Date: Sign: By my signature below I acknowledge that, exceptfor my personal residence In which I must have resided for at leastone year prior to completion of the Improvements covered by this permll,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 Cade is available upon request when this application is submitted or at the following Web site: hhpAvm•r.ieginfo.ea.gov/calaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provlalons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is In full force and effect. LICENSECLASS, I �I0 LEC. NO.: to f 7 3G3 EXP.GATE:i i CONTRACTOR•64.e c.4k," WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _ I have and wltl malnlatn a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Cods, 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 far vdnich this permit Is Issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (THISSECTION NEED NOTDE COMPLETED IFTHE PERMIT IS FOR GNE HUNDRED DOLLARS $100 ORLFSS). I certify that In the performance at the work far Witich this permit is Iss ed, i shall not employ any person in any manner so ffi to become subject to the Worker's Compensation of in ' . d agice that 4 € should become subject to the Worker's Compensation provisions of Section 3700 of th a e, I I rth r camplyVAtb those provisions. DATE' `"z'1'l APPLICANT• WARNING: Failure 10 secure Worker's mpensa ion coverage Is unlawful, and shall subject an employer to criminal penalties and civil tines up to one Wadred thousand doflars ($106,000), In addition to the cost of the compensation, damages as provided far 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 Is Issued (Sec. 3097, Civ, C.). LENDER'S NAME; LENDER'S ADDRESS: I certify that I have read this application and state thatlhe above Information Is correct. I agree to comply whh all city and county ordinances and state laws relating to building construction, and hereby authadze. representatives of this county to enter upon the above-mentioned property for Inspection proposes. Rohe, -(- cntt PRMITTE E(PR€N 2-t-17 ATTIRE ER E DATE APPLICATION DATE: '�"l'1'9 ) ) !I PIC# e_- ISSUE DATE: r I PERMIT# : i 'R N ®1 — I TYPE CONST. OCC GROUP: Scope of Work 1AJ t c +A,L� /-J s 0-A C l&/-,- j ,a Tzjl., tt e—t E> �-�,a�x�d-y-j �c+r• # DWEL. UNITS # STO"RIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport W Patio/Deck ul LL Poovspa Z_ Re -Roof 9 Commercial a0 Valuatlan: Adj. Area: QUANTITY DESCRIPTION FEE t4 6f-I-S CD m +JSrA 08-1112f?- 71`F-CONSTRUCTION: CONSTRUCTION: PLAN REVIEW: ELECTRIC: to PLUMBING: 7;3 +_ MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES 9. -6f� COMMENTS: P/C: PAID BY: p VALIDATION: RECEIPTfF�� PAID BY: VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy COMMENTS; TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTFIi HOT MOP/SHOWFHPAN SEPTIC/CFSSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNIT _....__. POOL PRE DECK BONDING _ P -TRAP FENCE / GATE/ ALARM FINAL POOL _._..... WALLS: WALL. FOOTING/STEEL WALL STEEL IW( )2 ND( } LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE