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Home My WebLink AboutPR16-1966u F - CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 539-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION www.cityofdiamoiidbar.com building@diamondbarea.gov JOB SITE ADDRESS Lill 1-) 4 -1 -- APIA LOT TRACT OWNER & t (GYm-C;`�, ii ADDRESS q&1 €Jill CITY T3 T3 . ��'a�` Zli TEL. APPLICANT e% ,rTI&11d TEL. 1", 2-& -t 1q, S�C CONTRACTOR ADDRESS CITY ZIP E 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(s) indicated below by the checkmark(s), I have placed next to the applicable items) [Section 7031.5, Business and Professions Code: Any city orcounty 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 (Chapter9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from ]!censure 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). 11, as owneroi the property, or my employees with wages as their sale compensation, will do (-) 411 of or )portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contactors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or lmpmves the properly, provided that the improvements are not intended or offered far 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,). 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 for the projects with a licensed Contractor pursuantto the Contractors' State License Law.). (-J 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 pef50nal residence In which I must have resided for at ]east one year prior to 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 entlrety 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 suhmitled or at the following Web site: ht[plwww.leginfo,ca.govlcalaw.htrnl, LICENSED CDNTRACTDR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 ofthe Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: - C^ L'1tIC.NG.: EXP. DATE: 2 777 t I [;. CONTRACTOR: Vials ._ WORKER'S COMPENSATION DECLARATION I HEREBY 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 ofthe Labor Code, forthe performance ofthe workforwhich this permit is issued. ! 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 Insurance Carrier and Policy Number are: CARRIER Zr r— r POLICY NUMBER -W' C.—e2�'l 9 2- G (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT 15 FOR ONE HUNDRED DOLLARS $ICO OR LESS). I certify that in the performance of the work for which this permit (s Issued, I shall not employ any person IF any manner sow to become subject 10 the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Cade, I shall forthwith 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 fines up to one hundred thousand dollars ($100,000), In addition In the cost of the Compensation, damages as provided for in section 3708 of the labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY 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). LENDER'S NAME: LENDER'S ADDRESS: I certify 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 NA! nn p ` SIGNATURE OF PERMITTEE DATE ® f PRESS FIRMLY APPLICATION DATE: 8 lora PIC# r ISSUE DATE: PERMIT# : TYPE CONST. OCC GROUP: 1 Scope of Work Ve 7C�,vgY # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR I ADJ. AREA/VALUATION SFR/ADDlREM Garage/Carport LUPatio/Deck iiA Li- Pool/Spa ZRe -Roof _J Commercial 5 CO Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U U w c� z a� 4 z a x U CONSTRUCTIO PLAN REVIEW: s ELECTRIC: s PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: _ g 5-+2.2q SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: e . BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL PEES " COMMENTS: 1 P/C: PAID BY: ,may, VALIDATION: RECEIPT# �- PAIDBY: ! t.J - �" VALIDATION: WHITE —Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy COMMENTS: on LU H Q 0 a 6 G z c� CITY OF DIAMOND BAIT LII I i 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 BUILDING PERMIT APPLICATION www.eityofdiamoudbar.com building@diamondbarca.gov JOB SITE ADDRESS e)P APNLOT TRACT OWNER dtfl1f ADDRESS 4'63 /! per _. H did (M . CITY --ZIP !!7J;J& TEL. APPLICANT /U&J�7 t) 6. TEL, CONTRACTOR ADDRESS f ` e �, S •� CITY ZIP TEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP Ti OWNER -BUILDER DECLARATION I hereby affirm under penally at perjury that I am exempt from the Contractor's State License Law for the reasons) indicated below by the checkmark(s), I have placed next to the applicable items) [Section 7031.5, Business and Professions Gods: 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 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from Ilcensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicantfor a permit sublectsthe apphcantio a civil penalty of not more than five hundred dol ars ($500), U €, as owner of the property, or my employees with wages as their sole compensation, will de U all otor U 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' nr 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 will have the burden of proving that it was not built ar Improved for the purpose of sale.), U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project {Sectlon 7044, Buslness and Professions Code: The Confractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contractsforthe projects with a licensed Contractor pursuanttathe Contractors' State License Law.), U 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, excepi for my personal residence In w1flclf 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 bullt as an owner-but€dor If it has not been constructed In its entirety by licensed contractors. i understand that a copy of the appllcable law, Section 7044 of the Business and Professions Code Is available upon request when this application Is submitted or at the following Web site: http/www.leginfo.ca.gov/calaw.htmf. LICENSED CONTRACTOR'S DECLARATION I 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 Coca,,, and my license is In full force and effect. ��1 LICENSE CLASS: -LIC. NO.: !Si ZS ( e V EXP. DATE: d ?s( i rid CONTRACTOR: amu. WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintaln a Certificate of Consent 10 Self -Insure for Worker's Compensation, as provided by Sector 3700 of the Lador Cade, far the performance of the work far which this permit is issued. �e9........... I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofthe labor Code, for the performance of the workfor which this permit Is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER��Otftl POLICY NUMBER {THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED COU ARS $100 OR LESS], I certify that in the performance of the work for which this permit is Issued, I shall not employ any person In any manner so Ess to become subject to the Worker's Compensation Laws of California. And agree that If I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions DATE: APPLICANT'S WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition 10 the cast of the compensation, damages as provided for in section 3708 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 for which this permit is issued (Sea. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify 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. 44 c_-�t D PERMITTEE NAME {PRINTI _ - } �y SIGNATURE OF PERMITTEE DATE APPLICATION DATE: f ISSUE DATE: f��I� PERMIT#: TYPE CONST. Rev' i P/Cy#�y___ 11�,`I"I (0ll D OCC GROUP: Scope of Work 1 # DWEL. UNITS # STORIES A Al S 4 L, r — # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carpert CO Patio/Deck L-1 LL Pool/Spa ZRe -Roof Commercial CD Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U w w c� z In 2 rz U Z Q x U 2 CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PIC: PAID BY, RECEIPT # PAID BY: VALIDATION: VALIDATION: LL ..,. WHITE Department Copy, YELLOW — Finance Copy, PINK Assessor Copy CITY OF DIAMOND INSPECTION SE MACK/ LETT I R FORMS - ._ SLAB LJG. PLUMBINGT-BAR UG. ELFCTRICAL UFER GROUND ..FOOTINGS - — .... _.... ......... ......... _..-.__._ _ ...... ........ ..... 7TRACTANDLEDGER GEAR -_ _.. - . _........ COMMERCIAL HOOD - INTERCEPTER HOT MOP/SHOWERPAN — HERS REPORT RECEIVED DPNMLITION DRAINS - - - ROUGE( CONDUIT POOL/SPA SEWER LATERALSEPTIC/CESSPOOL ....... MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHINGROOF FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST IRE GUNITE ERAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P -TRAP FENCE 1 GATE/ ALARM - ..._...._ ..... - FINAL POOL. ...... WALLS: WALL FOOTING/STEEL WAI-I Sl FFI 1"'( ) 2"( ) LIFT WALL BOND SLAM WALT_ DRAIN/ SLAL. WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW ..... FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, DRYWALL LATH (PRE) _.. LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CE Ta of OCCUPANCY FI NAL I N 0 USTRIAL WASTE DocuSlgn Envelope ID: 8D714AFO-A437-4F78-9BCB-3F64F7FD9480 CITY OF DLIMOND BAA? BVILD17VG & ,SA.TETYDIT>ISIDN 2,1810 Cop[ eyDrive Diamond Bar, CA 91765 (909) 839-7420 SMOKE ALARM AND CARBON MONOXIDE CERTIFICATION In order to help assure the life and safety within existing dwellings, the 2013 California Residential Code (CRC) Section 8314 and 8315, along with the California Building Code Section 420.5 and 420.5 requires existing dwel#ings to have smoke alarms and carbon monoxide alarms installed within the upper 12' of the ceiling when a building permit is issued for, worked on, or in a building that is valued at $1,000 or more. Alarms may be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Starting July 1, 2014 aU smoke alarms including combir►atton smoke alarms, that are solely battery powered shall contain a non -replaceable, non -removable battery that is capable of powering the smoke alarm for at least 10 years. CARBONMONOMDEALAAMS REQUIRED IN EXISTING DWELLINGS: Where a permit is required for alterations, repairs or additions exceeding $1,000- : Existing dwellings or sleeping units that have attached garages or fuel burning appliances. Carbon monoxide alarms shall be installed: Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedroom(s). • On every level of a dwelling unit including basements - REQUIRED - RED IN NEW pWELLINGS , Carbon monoxide alarms Shall be installed: ■ Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedrooms(s). On every level of a dwelling unit including basements - Alarms shall receive their primary power from the permanent building wiring without a disconnecting switch other than as required for overcurrent protection. Battery backup Is required. NOTE: Mulfiple-purpose alarms. • f_rsted and labeled combination carbon monoxide/ smoke alarms are acceptable in new and existing dwellings. Carbon Monoxide Alarms is a requirement that is in addition to required Smoke Alarms. EWE] D DocuSign Envelope ID: 8D714AF4-A437-4F78-9BCB-3F64F7FD9480 The alarms are required to be installed in the following locations; ❖ Smoke alarms in all sleeping roorns_ :• CO alarms in all sleeping rooms where fuel burning appriances are installed. ❖ Smoke alarm and CD alarm in hallways preceding sleeping rooms. + Smoke alarm and CO alarms on each dwelling level including basements and habitable attic roams. The smoke and Co alarms are required to comply with the above when requesting a final inspection. Please make sure an adult is present to allow the Inspector access to the home to verify compliance with the above requirements. If no one Mill be available, you may apt to complete the Instaliation Certification below and leave it with the job card. (Please fill out and gear off this portion to leave with the job card If no one will be available to allow the inspector inside the house.) iNSTALLATION CERTIFICATION For the property located at 401 Deep Hill Rd- I hereby certify that the required s al mwand cartoon monoxide alarms have been instailed as listed above. M4)Ah roi5{V Ou Orlando Castrejon 8/17/2016 0 U 14M, tv Print Name nate Relationship to project (please check one)- eOwner o Agent for Owner a Licensed Contractor o Agent for Licensed Contractor If "Licensed Contractor" or "Agent for Ucensed Contractor' is checked, please complete the following: Contractor Contractor=s State License Number