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Home My WebLink AboutPR17-127824 DUVIOND Si1R JOB SITE ADDRESS AP N ----_T_ OWNERa ADDRESS Z u Z CITY Mor, APPLICANTS ora' LOT CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES PRL.%J%i 21810 Copley Drive, Diamond Bar, 11 91765 t (969) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbaneojn building@diamoudbarea.gov G Q� APPLICATION DATE: U ^ I L', ' PIC# PIS ISSUE DATE: PERMIT# : TEL. 114 — S - -3 1 t- TEL. Z'S^3 51 - C) ` CONTRACTOR l r'► r r �- r �tv ADDRE�(S 1 3 T �� 4v to Yl�'Gs`flos CITYll 1nY i Y1�P ZIP TEL.11 ARCH/ENG/ DESIGNERpti U CIN!{u h o iJ Gi CL - OWNER -BUILDER DECLARATION I hereby affirm under penalty of psrjury that 1 am exempt from the Contractor's State License 7 3tSo theBusNOSness and Indicated below by the checlonark(s), I have placed next to the applicable itam(s) [Sel 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 pursuant to the provisions of the Contractor's State License Law (Chapter g) Commencing with Section 7000 of Division 3 of the Business and Professions Cndej orthat 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 five hundred dollars ($500). U 1, as owner of the property, or my employees with wages as their sole compensation, will de U all of or (_) portions of the work, and the structure Is not Intended 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 ihat 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,), K110--4, as owner of the property, am exclusively contracting with licensed Contractors to con an o the project (Section 4, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of properly wile bullds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.}. (,T I am exempt from licensure under the Contractor's State License law for the following reason(sp. Data: —.Sign:,�`�,% By my signature below I acknowledge that, exceptfor my personal residence In which I most have resided for at least one year prlorto completion of the improvements covered by this permlt,l 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 Professlons Cade is available upon request when this application Is submitted or at the fnllowing Web site'. httplwww,leginto.ca.gavlcalaw,html. I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) at Divlslon 3 of the Business and Professions Code, and my, license Is in full force and effect. LICENSE CLASl I 0 EXP DATE. 1 U ` U ^ If CONTRACTOR: -5 - _'�1- L LS WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Cer flcate of Consent to Self -Insure for Worker's Compensation, as provlded by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ 1 have and will maintain Worker's Compensation 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 nsurance Carrier and Policy Nurrdperare. — _ t is POLICY NUMBER =L (7HIS SECTION NEED NOT BE COMPLETED IIFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I col- that In the performance of the work for which this permitis issued, l shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of Califamla. And agree tat If i should become subject to the Worker's Compensatlon provisions of Section 3700 of the Later Cade, I shall forthwith comply with those provisions. DATL. APPLICANT: WARNING: Failure to secure Worker's Compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil floes up to one hundred thousand dollars (5l 10,000}, in addition to the cost of the compensation, damages as provided for in section 37CB 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 far which this permit is issued (5ec. 3097, Civ. C.}, LENDER'S NAME LENDER'S ADDRESS: carilfy 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 the above-mentioned property for Inspection purposes. PERMITTEE DATE TYPE CONST OCC GROUP: Scope of Work 1-14- Moll /ry # DWEL. UNITS # STORIES J6f # BEDROOMS DESCRIPTION DESCRIPTION SQ. FT. FACTOR PSF Al AREANALUAI IQN SFR,/ADD/REM Garage/Carport Patio/Deck Pool/Spa Re -Roof Commercial Valuation: Adj. Area: DESCRIPTION 9 Z a FEE CONSTRUCTION: PLAN REVIEW: $ ELECTRIC: 1 . PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PHF-ALT FEE' _ Z'i BASF: 00 PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PAID BY: RECEIPT #, - _tlf PAID BY:' _ VALIDATION:!ll i VALIDATION:--- .— WHITE— Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy SETBACK/LETTER — — FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFER GROUND — SEWER LATERAL_ — MAIN WA7FR LINE — — — 5EWIlR CLEANOUT — — — — 11001` SHEATHING_— — — f=LOOK SHEATHING — —.. SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMI TRACTAND I.LDGER SWITCH GEAR COMMERCIAL HOOD— — — T-HAR _ INTf:RCE}'TER HOT MOP/SHOWERPAN SEPTIC/CI:?SSPOOL HERS REPORT RECEIVED — — — — _.RT — DEMOLITION Ii00F DRAINS — — — — — -- ROU{;H CONDUIT — — — — — -- POOL SPA ..— —... ROUGH PLUMBING HOUGH ELECTRICAL ROUGH MECHANICAL _. NGNENTING .�.._.._ HOUGH MECHANICAL PIiE GUNITE ROUGH ELECTRICAL W( } C ( _...- ) POOL PRE DECK BONDING ROUGH PLUMBING — -- INSULA1ION WALL _.. INSULATION CEILING FENCE / GATE/ ALARM DRYWALL FINAL POOL LATiH (PETE) LATH E(TERIOR� i — LATI f INTERIOR WALL FOOTING/STEEL GAS TEST — — — — — WALL STEEL ISr —_ ) zao () LICIT AT ELECTRIC ME TET{ RELLASE� {"AS METER RELEASE WALL DRAIN/ Sf:AL SPECIAL. INSPECTION _ FINAL BUILDING WALL FINAL. FINAL MECHANICAL FINAL ELECTRICAL. ROUGH FIRE APPROVAL FINAL PLUMBING T.G. o. OCCUT'ANGY FINAL. FIRE DEPARTMENT CERT. Of -OCCUPANCY— COMMENTS: TRACTAND I.LDGER SWITCH GEAR COMMERCIAL HOOD— — — T-HAR _ INTf:RCE}'TER HOT MOP/SHOWERPAN SEPTIC/CI:?SSPOOL HERS REPORT RECEIVED — — — — _.RT — DEMOLITION Ii00F DRAINS — — — — — -- ROU{;H CONDUIT — — — — — -- POOL SPA ..— —... ROUGH PLUMBING HOUGH ELECTRICAL ROUGH MECHANICAL _. GAS TEST .�.._.._ PIiE GUNITE _ POOL PRE DECK BONDING — -- P-TRAP _.. FENCE / GATE/ ALARM FINAL POOL WALLS.. — — — WALL FOOTING/STEEL WALL STEEL ISr —_ ) zao () LICIT WALL BOND BEAM WALL DRAIN/ Sf:AL WALL FINAL. — — — ---_� TIO. FRAWNG PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL. FIRE DEPARTMENT FINAL PLANNING —. FINAL ENGINEERING/ PW FINAL Com INUNITYSERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE