The URL can be used to link to this page

Home My WebLink AboutPR17-8857" .._.� CITY OF DIAMOND BAR I I I i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES Y 21810 Copley Drive, Diamond Bar, CA 91765 V PRESS n. (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY ga d BUILDING PERMIT APPLICATION www.cityofdiamondbar.com buildingtalltiondbarca.gov JOB SITE ADDRESSL. �� C14 APN LOT—TRACT— OWNER OTTRACTOWNER ADDRESS CITY C,> b ZIP 11�l APPLICANT _ X4'1 dam- stn A^—f w TEL. 77:!1, S ! l CONTRACTOR Ltv ADDRESS 0q q Ga 1 6 + �S; � - CITY lj� ZIP TEL. ARCH/ENO/ DESIGNER ADDRESS C[TY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that € am exempt from the Contractor's State Llcense Law for the reasons) (reheated below by the checkmark(s), I have placed next to the appllcahle items) [Section 7031.5, Buslnass 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 permittn file a signed statementthat he or she Is licensed pursuant to the provisions of the Contractor's State License Law (Chapter B) Commencing with Section 7000 of Division 3 of the Business and Professions Cede] or that he or she is exempt from licensure and the basis for the alleged Zra llon Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to acivil penally of not more than five hundred dollars ($500). (-) I, as owner of the property, or my employees with wages as their sale compensation, will do LJ all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Cii 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. It however, the building or improvement is sold within one year of completion, the Owner-Bullder will 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 thereon, and who contracts forthe projects with a licensed Contractor pursuantto the ContractorsState License Law) O I am exempt from licensure under the Contractor's State License law for the following rsason(s): Date: Sign: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one I year prior to completion of the improvements covered by this permlt,l cannot legally sell a structure that 1 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 I applicable law, Section 7044 of the Business and Professions Code is available upon request when this applicator Is submitted or at the fallowing Web site: http/wwwJeginfe.cagovlcalaw.html. j LICENSED CONTRACTOR'S DECLARATION iI hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 7000) of DNIsIen 3 of the Business and Professions Coda, and my license cejis in full force and effect. LICENSE CLASS: 13 6(O LIC. NO EXP. OATS: i ?e CONTRACTOR: ea :Y -7 S WORKER'S COMPENSATION DECLARATION u I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: i- I have and will maintain a Certificate of Consent to Salf-Insure for Worker's Compensation, as provided by G Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, s t�4 I have and will maintain Worker's Compensation lnsurance, as required by Section 3700 of the Labor Code, for 2 the performance of the work for which this permit Is €sued. My Worker's Compensation Insurance Carrier and Policy Number are: . a CARRIER -� �"�eT��' POLICY NUMBER �� " f (THIS SECTION NEED NOT RE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 ORI j 1 certify that in the performance of the workfor which this permit Is Issued, I shall not employ any person In any manner se a; to become subject to the Worker's Compensation Laws of California And agree that If I should become subject to the Worker's i Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. J DATE: APPLICANT: cWARNING: Failure to secure Worker's Compensation coverage Is unlawful, and shall subject ar employer to criminal u penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cast of the compensation, damages Rs 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 far which this permit is Issued (Sec. 3097, Civ. C.). LENDER'S NAME: C LENDER'SADDRI Li i. 1 certify that I have read this application and state that the above Information is correct. I agree to comply with all city and 25 county ordinances and state laws relating to building constmetlon, and hereby authorize representatives of this county to :1 enter upon the above-mentRonad property for inspection purposes. J D M &,i ,",11 n T] PERMITTEE NAME {PRINf n SIGNATURE OF PERMITTEE DATE APPLICATION DATE: PIC# ISSUE DATE: PERMIT# : 1S TYPE CONST. OCC GROUP: nn p ® Scope of Work r`-�d i-� _ tr.�2.� b # DWEL. UNITS # STORIES 5 -& i,,* -i 0 3G ial # BEDROOMS DESCRIPTION SQ. FT, FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Patlo/Dock LL Pool/Spa ZRe -Root O Commercial 07 lfaluafklon: Adj. Area: QUANTITY DESCRIPTION FEE c� w w z m J z v CONSTRUCTION: PLAN REVIEW: a ELECTRIC: 2 55 PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SM€P: I ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: 1.00 PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C'. ID BY: � ""T <'%o 2 4. It. VALIDATION: RFCEIPT0 PA€DBY:)` .,3(0"Y VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy CITY OF DIAMONDR INSPECTION C SETBACK/ LETTER FOOTINGS FORMS SLAB IJG. PLUMBING UG, ELECTRICAL LIFER GROUND SF'Wt R LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR MALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( } C (, ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWA€ I LATH (PRI:) LATH EXTFRIOR LATH INTFMOR GAS TES I SCRATCH COAI El FCTRIC METLPi RELEASE GAS METER RELEASE SPECIAL INSPEC I ION FINAL BUILDING FINAL MECHANICAL. _.. FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: - TRACT AND LLDGER SWFC11 GEAR COMMERCIAL. I f00D T-BA1 i - INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL KERS 13EPORT RECEIVED DEMOI ITION ROOF DRAINS ROUGH CONDUIT' POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE I GATE/ ALARM - FINAL POOL WALLS. . WALL FOOTING/STf:EL WALL ST'I:FL IST( ) 2K( ) LIFT WALL BOND REAM WALL DRAIN/ SEAL WALL FINAL RO FRAMING PLANNING APPROVAL — ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PVI/ FINAL COMMUNITY SERVICES ... _ ._ .... FINIAL HEALTH DEPT. FINAL INDUSTRIAL WASTE