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Home My WebLink AboutPR17-5304LLI 0 CL0 0 W J ac C7 a 10 C3 0 J O Z a 0 LU c� U10101VID BAR �r CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91'765 1, PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 '_ 11 �" � � � � �� BUILDING PERMIT APPLICATION www.cityoidiamondbar.com iniIr�ing@di0 tape dbarea.gov JOB SITE ADDRESS APN LOT TRACT OWNER ADDRESS CITY ZIP TEL. APPLICANT TEL. CONTRACTOR/0✓ ADDRESS �5 - CITYU'< 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(s) indicated below by the checkmark(s}, I have placed next to the applicable item(s) )Section 7031.5, Business 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 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 axempt 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 Phan five hundred dollars ($500), O I, as owner of the property, or my employees with wages as their sole compensation, will do (-) 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, bonds or improves the property, provided that the Improvements are not Intended or altered for sale. If however, the building or improvement is sold within one year of completlan, the Owner-Buhder will have the burden of proving that it was not built or improved for the purpose of sale.). U 1, 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 pursuant to the Contraclors' State License Law.). U I am exemptfrom licensure under the Contractor's State License law for the following reasons}: Date: Sign: By my signature below I acknowledge that, except for my personal residence In which I must have reslded 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 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 Pmfesslons Code is available upon request when this application is submitted or at the following Web site: http/wwvv.legirlfo,ca,gov/calavv.html. 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 Uivision 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS, Am LIC. NO,, _ p' _ Y[ EXP. DATE: ' CONTRACTOR: [T_ N WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE HOLLOWING DECLARATI0KR I have and will maintain a CertlTlcaie of Consent 10 Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I 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 POLICY NUMBER FHIS SECTION NEED NOT BE COMPLETED IF THE PERMITIS FOR ONE RUNORED DOLLARS $100 OR LESS), I certifythat in the performance clans workforwhich this permit Is issued, I shall not employany person In any manner so as to become subje to t o Worker's CO.pensaLton Laws of California. And agree that if I should became subject to the Worker's Comp sat n R ,Ions of Section 3700 of the Labor Code, l shal€ forthwith cYomnply�witthh thgp• se provls[ons. DATE: APPLICANT: i../l16- L T!V WARNIN : Fall re to secure Worker's Compensation roverag is unlawfulk and shall subject an employer to criminal penalties and civil tines up to one hundred thousand dollars ($100,000), in addition to 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 penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Clv. C.), LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above "fmmag" is ca4�,rect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby autgorize representatives of this county to enter upon the above-mentloned property for In i purposes. /�� +t.d I � PERMITTEE NAME (PRINT] 6 �i SIGNATURE OF PFRM17EF DATE APPLICATION DATE: � l "1 PIC# ISSUE DATE: [ P PERMIT# : 5ao li TYPE CONST. OCC GROUP: p p Scope of Work C "�i �f L e& 'Pi? # DWEL. UNITS # STORIES # BED OOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARFANALUATION SFR/ADWREM Garage/Carport w Patio/Deck LU LL PooVSpa ZRe -Roof 0 Commercial m Valerafian: t(D Adj.Area: QUANTITY DESCRIPTION FEE U_ U w ul ca a Ft n. U z U CONSTRUCTION: 12-1, PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: v ENERGY P/C: ENERGY PERM[T: RETENTION FEE: v� PRE -ALT FEE: BASF: oa PLOT PLAN: ZONING CLEARANCE: 2 TOTAL FEES k —75. COMMENTS: PIC: PAID BY: VALIDATION: , V. (1) RECEIPT # 65 V W PAID B I� VALIDATION: 1r� WHITE— Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy CITY OF DIAMOND Sk� INSPECTION RECONI-1 SETBACK/ LETTER TRACT AND LLOGLH FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD T -BAR UG. PLUMBING UG. ELECTRICAL €NTERCEP'IF.Ii UFFR GROUND HOT MOP/SHOWF RPAN SEWER LATFRAI SEPTIC/CESSPOOL HERS REPORT RECEIVED DL:MOI (TION 11001'DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL MAIN WATER LINE SEWER GLI:'ANOUT ROOF SHFA1111NG FLOOR SHFKI TNG SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C O ROUGH PLUMBING INSUI.A'TiON WALL INSUI ATION CEILING DRYWALL LATH (PRE) I ATLI EXTERIOR ROUGH MECHANICAL GAS TEST PRE (AUNITE ....... ..... _.. -- POOL PRE DECK BONDING — P -TRAP FENCE 1 GATF/ ALARM FINAI. POOL WALLS: I..AT'H INTERIOR WALL FOOTING/STEEL CAS TEST WALL STEEL l"( ) 21`0( } LIFT SCRATCH COAT WALL BOND BEAM -± _ ELECTRIC MLILR RELEASE WALL DRAIN/ SIAL GAS METER RELEASE WALL FINAL SPECIAL INSPE :CTICN RO. FRAMING PLANNING APPROVAL FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINALPLUMBING _ .. ....... _. T.Go of OCCUPANCY CERT. of OCCUPANCY ROUGH FIRE APPROVAL FINAL FIRE DEPABTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEIN. FINAL INDUSTRIAL WASTE