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Home My WebLink AboutPR17-830CITY 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 vww.cityodiamondbar.com building@diamondbarca.govBUILDINGPCRMITAPPLICATION � e a JOB SITE ADDRESS ,) z CD APN r LOT_ LU OWNER g ADDRESS; CITY G o APPLICANT TRACT 2 I-79i,� TEL. ldq+` CONTRACTOR Ill�— ADDRESS 6'� k� � �- A CITY dal `Q ZIP 6 TEL. ARCH/ENG/ ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractar's State License Law for the reasons) indicated below by the checkmarKs), 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 far the permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 70DO of Division 3 of the Business and Professions Code] or that he or she is exemptfrom licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by arty applicant fur a permit subjects the appiicantio acivil penalty Of not more than five hundred dollars ($500). U I, as owner of the property, or my employees with wages as theirsole compensation, will do H all of or (r) portions of the work, and the structure is not intended or offered for sale (Section 71 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' er personal effort, builds or improves the property, provided thrid improvements are not intended or offered for sale. If however, the building or improvement Is sold within one year of completlon, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale,), L} 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 for the projects with a licensed Contractor pursuantto the Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License taw for the following reasen(s]: 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 permiLl 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 submitted or atthe following Web site: httplwww.ieginfo.ca.gevlcalaw.htmi. aml I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700C) of Division 3 of the Business and Professions Cade, and my license is in full force and effect. n r—' LICENSE C SS: UC. NO.: l 0 2 DATE: `f CONTRACTOR: a o WORKER'S LARATIO - I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF TRE FOLL WING -0 RATIONS: Q € have and will al a Csrbflcate of Consent to Self -Insure for Worker's Compensation, as provided by J Section 3709 of the Labor Code, for the performance of the work for which this permit is Issued. o � I have and will maintain Worker's Compensatton 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 '37�c` _ POLICY NUMBER 07 F- ([HIS SECTION NEEP NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). 0 � I certify Shat In the performance of the work forwhichthis permit is issued, I shall not employany person in any manner so as to o become subject to the Worker's Compensation Laws of California. And agree that if I should become subjectto the Worker's Com III n provisions of Section 3708'6ff�e a n shall to r Ittres - with these provisions. DATE: APPLICANT:- WARNIN . Failure to secure Worker's Co on c vor awful, 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, CL O damages as provided for In section 37CO ofthe labor code, interest, and attomey's fees. d CONSTRUCTION LENDING AGENCY Lu T hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work tar which this permit is issued (Sec. 3097, Civ. C.). H LENDER'S NAME: LFNDER'S ADDRESS: LU CL 1 certify that I have read this application and state that the above information is correct 1 agree to comply with all city and county ordinances and state Taws relating to building construction, and hereby authorize representatives of His county to enter upon the above- entioned property for purposes. 1v"a G 1 J 21 / � rn F=-• APPLICATION DATE: '11 W / / /— P/C# ISSUE DATE: PERM IT# TYPE CONST... OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS co LU U-1 z z O J m DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Patio/Deck Pool/Spa Re -Roof Commercial VaLcration: Adj. Area: CONSTRUCTION:'"'` QUANTITY D{fE�SCRIPTI FEE J /ON ep 4 v EE U w w z m PIC: RECEIPT# -'' ��f'1- f c - VALIDATION: VALIDATION: J4 SMTP: z U CONSTRUCTION:'"'` s " PLAN REVIEW:' ELECTRIC: TOTAL FEES COMMENTS: PLUMBING: MECHANICAL: PIC: RECEIPT# -'' ��f'1- f INSPECTION FEE: VALIDATION: VALIDATION: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: DI nT Pl. Al ZONING CLEARANCE: TOTAL FEES COMMENTS: - PIC: RECEIPT# -'' ��f'1- f PAID BY: PAID BY: - -w-" VALIDATION: VALIDATION: WHITE— Department Copy, YELLOW -- Finance Copy, PINK —Assessor Copy TRACT AND LEDGER SWITCH GI AR COMMERCIAL HOOD I -BAR INTERCEPTER I IDT MOP/SROWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED_ DEMOLITION ROOF DRAINS HOUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE/ GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1sT{ ) 2N"( )LEFT WALL BOND REAM WALL DRAIN/ SEAL WALL FINAL. _R0. FRAMING PLANNING APPROVAL ._. ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL CUM SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE fi= SETBACK/LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECI RICAL UFER GROUND . SEWER LATFIIAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHiATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VFNTMG ROUGH MECHANICAL _ ROUGH ELECTRICAL W( } C () _ ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL RYWALL LATH (PRE) LAFH EXTERIOR I ATH INTERIOR GAS TEST :SCRATCH COAT I L.ECTRIC MINTER RELEASE (AAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL . 6 _. ... ._.._ ',..... FINAL ELECTRICAL FINAL PLUMBING T.Ce of OCCUPANCY CERT. ®f OCCUPANCY TRACT AND LEDGER SWITCH GI AR COMMERCIAL HOOD I -BAR INTERCEPTER I IDT MOP/SROWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED_ DEMOLITION ROOF DRAINS HOUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE/ GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1sT{ ) 2N"( )LEFT WALL BOND REAM WALL DRAIN/ SEAL WALL FINAL. _R0. FRAMING PLANNING APPROVAL ._. ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL CUM SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE fi=