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Home My WebLink AboutPR17-437CITY OF DIAMOND BAR I I I i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES = 21810 Copley Drive, Diamond Bar, CA 91765 PRESS)86 _ (909) 839-7020 Fax: (901-3117 Building Inspection Hotline (909) 839-7027 FIRMLY `.�gi. BUILDING PERMIT APPLICATION www.cityofdiamondbar.com buildine(d-diamondbarca.eov JOB SITE ADDRESS APN -- 0 4 T TRACT OWNER ADD Rt SS `. < r-F,i CITY ZIP TEL. APPLICANT g =� TEL. ":,7`a a CONTRACTOR ADDRESS CITY ZIP TEL. ARCH/ NGT DESIGN R ADDRESS CITY if o✓gyi, & ZIP -_ TEL - r" OWNER- UILDER 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 items) [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 of 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 licensure and the basis for the alleged exemption; Any viciation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500), U I, as owner ofthe property, or my employees with wages as their sale compensation, will do { j all of or (-) portions of the work, and the structure Is not Intonded 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 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 sale.), O I, 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 property who builds or Improves thereon, and who contracts forthe pmjsctswith a licensed Contractor pursuantto the Contractors' State License Law.). (-) I am exempt from licensure under the Contractor's State License law for the following reason(s): Data: Sign: By my signature belD,.v I acknowledge that, oKceptfor my persona[ residence In which I most have resided for at least one year prior to completion ofthe Improvements covered by this permit,) cannot legally sell a structure that I have built as an owner -builder if it has not bean 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 submitted or atthe following Web site: httpAmw,leglnfo.ca.gov/calaw.html, LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SectloR 7000) of Division 3 of the Business and Professions Code, and my liceppnse Is In full force and effect. LICENSE CLASS: g LIC, NO.: i T` A s EXP. DATE: �@n-"'"(' ONTRACTOR: _e WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM TINDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and wild maintain a CerllfIcate of Consent to Self -Insure tar 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 Cade, for the performance ofthe work for which this permit is Issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (THIS SECTION NEED NOT RE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ST00 OR LESS). I certifythat in the performance ofthe worktor which this permit is Issued, I shall not employ any person in any Marmerso as to become subject to the Worker's Compensation Laws of California. And agree that If I should become subject to the Worker's Compensation provisions of Becton 3700 ofthe Labor Code, 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 (5100,000}, 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 work for which this permit is issued (Sec. 3097, Clv. 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 fhs above-mentioned property for Inspection purposes. PERMt E NAME (PRINT) SIGNATU 0F`PERMI. Y - DATE APPLICATION DATE: �Je_l1� P/C# ISSUE DATE; 6r21,5a9 PERMIT#�"" TYPE CONST, OCC GROUP: Scope of Work # DWEL. UNITS STOR x # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport au Li Pool/Spa ZRe -Roof 0 Commercial 0] Valuation: -s �Zl Adj. Area: QUANTITY DESCRIPTION FEE u.r c �s z J J z x c -y g CONSTRUCTION: PLAN REVILW; s, SS ELECTRIC: , PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE:7_, z li Si ENERGY P/C: ENERGY PERMIT: RETENTION FEE: 00 PRE -ALT FEE: BASF: J . ; PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID BY: VALIDATION: RECEIPT# PAID Pill VALIDATION: WHITE Department Copy, YELLOW —Finance Copy, PINK — Assessor Copy SETBACK/ LETTER FOOTINGS FORMS t17b-7 SLABCOMMERCIAL UG. PLUMBING UFS. ELECTRICAL.INTERCEPTER ........__... UFFR GROUND SEWER LATERAL MAIN WATER I INI_ SEWER CLEANOUT ROOF SHEATI IING /� ;' FLOOR SHI A[ I IING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR i rsHLi ANU LLUULH SWITCH GEAR HOOD _._ I -BAR — _._._..... - HOT MOP/SHOWERPAN SEPTICICESSPOOI. HERS REPORT IiFM KD DEMOLITION ROOF DRAINS ROUGH CONDUIT PODLISPA ROUGH PLUMBING ROUGH ELECTRICAL ... _ _ ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRF DEE;K BONDING FRAMING111kNTING ` ROUGH MECHANICAL ROUGH E-1,10 LRICAL W( ) C ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWX I �' J LATII (PIIS) _ . _ LAIII F:XTERIOR �� LATA INTERIOR C.;A`; FESTWALL _..._ - uCItALr_.H CQ�.T ELECTRIC MI I LR RELEASE= P -TRAP FENCE / GATT/ALARM FINAL. FOOL. WALLS; WAL.I F00TINIG/STEEL Tai F FL 1 O 2N0( ) LIF -1 WALL L3F1ND BEAM - WALL DRAIN/ SIAL GAS METEH RELEASE WALL FINAL SPECIAL. INSPECTION ' RO. FRAMING PLANNING APPROVAL �` ROUGH FIRE APPR10YAL FINAL RLlILi7iNG °' � �' � .. FINAL.. MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL . - $ r Iti FINAL PLANNING __ FINAL PLUMBING FINAL ENGINEERING/ PVV L OCCUPANCY FINAL COMMUNITY SERVICES T.G. o CERT of OCCUPANCY FfNlAL HEALTH FINIAL INDUSTRIAL WASTE