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HomeMy WebLinkAboutPR17-15847................ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES =' 2.1810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861.-3117 Building Inspection Hotline (909) 839-7027 FIRMLY 'egg' BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea,gov `au JOB SITE ADDRESS j �.�'.ty APPLICATION DATE: P { PIC# —P R `� - i N 8 z ISSUE DATE: I 1 "� PERMIT# : APN LOT TRACT LU OWNERrC.s }'ss TYPE CONST. DCC GROUP: ADDRESS f CITY P7 A d"op='D 17> A 4 ZIP J{lE, i TEL. $l { o APPLICANT jl --,- ^ I Cr . 3y . TEL. 62, J _, { �L Qe" o CONTRACTOR -� � , Sl. L" ".: eco ADDRESS o CITYZIP-��,.- TEL. �{ -:c:.: © ARCH/ENG/ a DESIGNER z ADDRESS m CITY ZIP TEL. x OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasm(s) Lu indicated below by the checkmark(s), I have placed next to the applicable Items} [Section Section 7031,5, Business and K 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 pursuantto the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section his 7000 of Division 3 of the Business and Pfofessions Code} or that he or she Is exempt from licensure and the basis for c0 the alleged exemption, Any vIclation of SBttlD5 7031.5 by soy apipfcartfor a permit subjoDls the applicant to a civil Penalty °C of not more than No hundred dollars ($500). 0 ®U I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or O portions of the work, and the structure is not intended or offered for sale (Section 1044, Business and Professions Code: The w Contractors' State License Law does not apply to an owner of property who, through emplevees' or personal effort, builds or Improves the property, provided that the Improvements are not Intended or offered for sale. It however, the bullding or o improvement is sold within one year of completion, the Owner -Builder wOl have the burden of proving that it was nat built co unimproved forthe purpose Df sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7644, 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.}, CD U I am exempt from licensure under the Contractor's State License law for the following reason(s). LL Date: Sign'. z 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,l cannot legally sell a structure that I have built as an a 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: httpM"w.leginfo,ca.govlcaiaw.html. v LICENSED CONTRACTOR'S DECLARATION ILL I hereby affirm under peraity of perjury that I am licensed under provisions at Chapter 9 (commencing with Seidler 7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect. LICENSE CLASS, �y ) LIC. NO.: EXP. DATE A71f� Ii CONTRACTOR' p WORKER'S COP -MA -fl -ON DECLARATION H 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ¢o I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by SE)i 37GO of the Labor Code, for the performance of the workfer which this permit Is Issued. 7 I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for 0 the performance ofthe work for which this permit Is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER 2 �? POLICY NUMBERCID ✓ . (THISSECTION NEED NOT BE COMPLETED IF THE PERMIT IS iDR ONE HUNDRED DOLLARS $100 OR LE$5j C:, I certify that in the performance of the workfor which this permit Is Issued, I shall notemploy any person harry manner so ss tc a became subject to the Worker's Compensation Laws of California And agree that.d I should become subject to the Worker's Lu Compensation pravislons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. IDATE: APPLICANT: WARNING: Failure to secure Worker's Compensaikon coverage Is unlawful, and shall subject an employer to criminal Lu penalties and civil fines up to one hundred thousand dollars ($100,660}, In addition to the cost of the compensation, COL damages as provided for In section 3708 of the labor code, interest, and attorney's fees. cam., CONSTRUCTION LENDING AGENCY Lu I hereby affirm under penally 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.). H LENDER'S NAME: LENDER'S ADDRESS: LW certify that I have read this application and state that the above Information Is correct. E agree to comply with all city and z county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to p enter upon the above-mentioned property for inspection purposes. J G PERMITTEE NAME„(1?RIN�j" SIGNSE.. DATE H Ytc, Scope of Work I # DWEL. UNITS # STORIES # BEDROOMS W Lu u - C7 Z O cc DESCRIPTION SQ. FT. FACTOR PSF ADJ, AREA/VALUATION SFRlADD/REM Garage/Carport PatiolDeck Pool/Spa Re -Roof Commercial Va1LJ0f1Di1:'. `"`".. Adj. Area: CONSTRUCTION: QUANTITY DESCRIPTION FEE J U v w MECHANICAL: M a ISSUANCE: ca z ENERGY PIC: v ENERGY PERMIT: CONSTRUCTION: PLAN REVIEW: LLFGTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BAST: i PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: p/Cz� �- PAID BY: "`9.� / d VALIDATION'. RECEIPT# PAID I3Y: � 1 VALIDATION', WHITE — Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy CERT. ®f OCCUPANCY COMMENTS: SWITCH GEAR COMMERCIAL IIOOD T -RAR INTERCEPTER HOT MOP/SHOWERPAN SEP TICICESSPOOL HERS REPORT R[GEIVED DEMOUTION ROOF DRAINS ROUCII CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHAMCAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE /GATE/ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEFL 1sT( ) 2"D( )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 SETBACK/LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL IIFER GROUND SEWER LATFRAL MAIN WATER LINE SI'.WER CLEANOUT ROOF SHEA I LING FLOOR SHEAlIfiNG SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( } ROUGH PLUMBING INSULATION WALL INSUI.AT€ON CFILING DRYWALL LA7 (PRE) LATH FXTERIOH LATI I INTERIOR GAS TFST SCRAICH COAT ELECTRIC METER RELEASEE GAS METER RELEASE SPECIAL. INSPECPON FINAL BUILDING ..... FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. ®f OCCUPANCY COMMENTS: SWITCH GEAR COMMERCIAL IIOOD T -RAR INTERCEPTER HOT MOP/SHOWERPAN SEP TICICESSPOOL HERS REPORT R[GEIVED DEMOUTION ROOF DRAINS ROUCII CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHAMCAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE /GATE/ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEFL 1sT( ) 2"D( )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