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Home My WebLink AboutPR17-0121�9' :.__ CITY OF DIAMOND BAR + DEPARTMENT OF COMMtiNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS 4, (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY `as9 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS2_ `-J. C C APN LOT TRACT OWNER, L ` ADDRESS 2 Qt C-.. CITY a "r� ° ZIP TEL' 1'•: 4 ? APPLICANT g TEI 61) "7'7 Ca CONTRACTOR t,. C ADDRE S C`�.�- �✓'�`� CITY'_., ) ZIP,. .TEL., �. 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 for the reason(a) indicated below by the checkmafk(s), I have placed next to the applicable item(s) [Section 7031.5, Business and Professions Coda: Any city air 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 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 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). U I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or Ll portions of the work, and the structure is not Intanded 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 whl have the burden of proving that It was 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 hereon, and who contracts forthe projects with a licensed Contractor pursuantto the Contractors' State License Law,). la I am exempt from licensure under the Contractor's State License law for the following reason(s): Date: Sign: By my signature below I acknowledge that, except for my personal residence In w*h I must have resided for at least one year prior to completion of the improvements covered by this permit,€ cannot legally sell a structure that I have built as an owner -builder it It has not been constructed in its entirety by licensed contractors. I understand that a copy of the 1 applicable law, Section 7044 of the Business and Professions Code Is available upon request when this application is submitted or at the following Web site: httpAwww,legintoca.gov/calaw.html. LICENSED CONTRACTOR'S DECLARATION i1 hereby affirm under 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 IlcensE is in full force and effect. LICENSE CLASS: �- �'� LIC. NO.: E EXP. DATE: CONTRACTOR: �* j WORKER'S CGMPENSATION DECLARAbi I MERSBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE 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 Labor Code, for the performance of the wofkfor which this permit Is Issued. I have and will mal in Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, tot the perlormancE of the work for which this permit is NsuedMy Worker's Compensation Insurance carrier and Polley Number CARRIER i r POLICY NUMBER C (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT 13 FOR ONE HUNDRED DOLLARS $100 OR LESS). D I certify that In the performance of the work forwhich this permit is issued, I shall not employ any person in any manner so as to became subject to the Worker's Compensation Laws of California, And agree that if I should became subject to the Workers � Compensation provisions of Sectlon 3700 of the Labor Code, I shall torthwlih 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 lines up to one hundred thousand dollars ($100,000), In addition to the cost of the compensation, j damages as provided for in section 3708 of the labor code, interest, and attorney's fees. L CONSTRUCTION LENDING AGENCY u 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.). y LENDER'S NAME: = LENDER'S ADDRESS: C u L I certify that I have read this application and state that the above information is correct. I agree to comply with all city and a county ordinances and state laws ralating to building construction, and hereby authorize rapresentatives of this county to J enter upon the above-mentioned property for inspection purposes. dr n PERMITTEE NAME (PRINT] = SIGNATURE 0 DATE APPLICATION DATE: I zt 'i z ! -+ P/C# Y R� i 4 ()17'1 ISSUE DATE: 3 PERMIT# : PI It TYPE CONST. OCC GROUP: � 1t Scope of Work a � # DWEL, UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADO/REM Garage/Carport Patio/Deck w LL Pool/Spa ZRe -Roof Q Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE J U U w w z a V U CONSTRUCTION: 209-89 PLAN REVIEW: ... ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: 10 •00 PRE -ALT FEE: �C9 47 BASF:' PLOT PLAN: ZONING CLEARANCE: TOTAL FEES ' COMMENTS: PIC: PAID BY: F _ VALIDATION: RECEIPT # 23 PAID BY: I/ q VALIDATION: LC— WHITE —Department Copy, YELLOW— Finance Copy, PINK —Assessor Copy SETBACK/ LETTER I OOTINGS FORMS SLAB UG, PLUMBING UG. ELECTRICAL UFFR GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHF-ATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WAILS INTERIOR FRAMING/VENTING ROUGH MKILANICAL ROUGH ELECTRICAL W( ) C ( j ROUGH PLUMBING INSULATION WALL INSULATON CEILING DRYWALL _ LATH (PRE) I I ATH EXTERIOR E 1_ATH INTERIOR GAS TEST cRArCH COAT ELLCIRIC METER JILLE:-ASE METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY I CERT OCCUPANCY .._�_... COMMENTS: CITY OF DlAPflC % DAR INSPECTION RECORD YI. I TRACT AND LL[)GER SWIICII GEAR COMMERCIAL. I FOOD T-BAI I INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS J.1 E PORT RECEIVED DEMOHTF ON ROOF DRAINS ROUGH CONDUIT POOL/SPA 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 y 7 ALL. STL I I i T % �:;N'( ) LIFT WAIL BOND EIEAM ak .. ? WALL BRAIN/ SEAL WALL FENAL R0, FRAMING PIANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING — FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE YI.