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Home My WebLink AboutPR15-2256M CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (9€19) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION JOB SITE ADDRESS et i- , 7 APN LOT TRAGI OWNER (. ADD1JfSS CITY '' ZI TEL. F APPLICANT TEL. CONTRACTOR l" ADDRE CITYr ; ZIP' TEL. 1 ARCH/ENG/DES ER ADDRESS CITY ZIP TEL, OWNER -BUILDER DECLARATION t hereby affirm under penalty of perjury that I am exempt from the Contractor's Stale License Law for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable Item(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 provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of 101tion 3 of the Business and Professions Code] or that he or she Is exempt from licensure and the basis for the alleged ex eruption. Any violation of Section 7031.6 by any applicant fora permit subjects the applicant to achdl penalty of not more than five hundred dollars ($500). O I, as ownerof the property, or myemployees with wages as theirsole 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 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 intended or offered for sate. If however, the building or Improvement is sold within one yearof completion, the Owner -Builder will have the burden of proving that itwas 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 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. andwho contractsforthe projects with a licensed Contraclarpursuantto the Contractors' State License Law.). (-J I am exempt from licensure under the Contractor's State License law for the following reason(s): By my signature below I acknowledge that, except far my personal residence In which I must have resided for at least one year pdorto completion of the impruvemenis covered by this permit,( cannot legally sell a structure that I have bullas an owner-bullder if it has not been constructed In its entirety by licensed contractors. I understand that a copy of tha appllcable law, Section 7944 ofthe Business and Professions Code is available upon request when this application is submitted or at the fellow ae: h vw.leglnfo.ca.gov/calaw.html. DATE: _,_..__ SIGN: LICENSED CONTRACTOR'S DECLARATION I hereby affirm order 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 fuli force and effect, LlGENS %SS: HC.HO.:��.-` DATE: I CONTRAC€DR: - 3- " WORKER'S COMPENSATION DECLARATION I HERFRYAFRR� UNDER PENALTY OF PERJURY ONE UFTHE 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 LahorCode, 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=. ,=- CARRIER POHCY NUMBER 0-1 - (MIS MON NEED NOTOE COMPLETED IFTHE PERMIT IS FORONERUNDREO DOLLARS ($100) OR LESS). I certify that in the performance of the work far which this permit Is issued, i shall riot employ any person in any manner so as to become subject to the Workers Compensation Las O Cal' mia.lJrsd agree that If I should Become subject to the Worker's Compo satin vislor�s of Section 3700 of the I Cod , I s fodhwiSh comply with those provisions. DATE 1 ' APPLICANT: t WARNIN : Fai re to secure Workers Compensate coverage is unlawful, and shalt subject an employer to criminal penalties and civil fines up to one hundred tho nd dollars ($100,0001, in addition to the cost of the compensation, damages as provided for 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 viork for which this permit Is Issued (Sec. 3097, Civ, G.T. 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 ordinarrces and state laws relating 10 building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. �h EE NAM (PRINT) SI61A R P MITTEE 0AXIE APPLICATION DATE: j ISSUE DATE: ZvZ d 7 6— TYPE CONST P il)° T P/C# PEAMITIt 4 / t OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW 171 171 RW ❑ i PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADd. AREA/VALUATION SF WADDMEM Garage/Carport w Patio/Deck LLL Pool/Spat ZRe -Roof 6 Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE J U or J [i r CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING:)' MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: +' BSAF: f 1 TOTAL FEES COMMENTS: RECEIPT # PAID BY, , P" VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy, GOLDENROD — File Copy, GFIEEN —Applicant's Copy SETBACK/ LETTER ` TRACT AND LEDGER FOOTINGS FOWS, SWITCH GEAR $LAB.COMMERCIAL H000 UG 'LfMS€C . ` T-BAR UG ELECTRICAL � � :': �; � <� � � �> �� INTERC INTERCEPTER ER UrI59 GRUUND_:-- .' HOTMOPiSOWERPAN SENDER LATERAL — SEPTICICESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING _ ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SH 114 AL.LS EXT REOI _ �CtOIlSE'A SHEAR WALL R(IUGH PLUMMNG FR t �8 ; �YENTl i(a A l:ROUGH.... ;LECTR}L `� R�}E}CHEC(EANICAL :" � i#tOGH iECf Kl1CAL Room E Ef C�fGAL;'W—(:' 7 C C R004l-["PWMBING` -. PRE CUNT E. ` INSULATION WALL _ Pi3Ol PSE i}fyG}4 BOT4ITINC INSLlLA1-ION CEILING }'."fRAP-, DRYWALL Eilf E/CATEIALARM LATH {PRE} SINAL I�IOI LATH EXTERIOR WALLS: LATH INTERIOR MALL FOOTINGISTEEL GAS TEST !MALL STEEL 19 ) 2`( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE MALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL -- SPECIAL INSPECTION _ >fl"FFIINC PiAh(I%tOAPI?OV'�L FINAL BUILDING'.: �i4�iJGH �,IEdEA�?PRi��fAi. ICAL NNAL. MECHANICAL FINAL FIRS UEPA&tT IENi FICIAL EmmLECTA10AL , FINAL PLANNING", F{Ng PLUME INd"NAL ENG T"fiiCCUPANC ";." , F6NAI. COMMUNITY SERVICES. = . MAT. of o . EiP. . . ; FI#14LAT}# SEPT 'i✓i�IALE�gUSTRBALAS� , ."' COMMENTS: