The URL can be used to link to this page

Home My WebLink AboutPR17-10225CITY OF DIAMOND BAR DEPARTMENT OF COMM -UNITY & DEVELOPMENT SERVICES SII ... 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.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS APN LOT TRACT OWNER ADDRESS CITY ZIP TEL. APPLICANT TEL. CONTRACTOR ADDRESS t f CITY %i tr c d ZIIIF.,. $ -_ Ti ARCH/ENG/ DESIGNER-1.it4t` ADDRESS. t ag �d2f - CITY Li. 7l I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasons) indicated below by the checkmar9c(sj, I have placed next to the appllcabie Iterl (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 aIle a signed statement that he or she is licensed pursuantte 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 mare than five hundred dollars ($500). U I, as owner of the property, or my employees with wages as their sole compensation, will de O all of or L) po tions 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 thatthe improvements are not Intended or offered for sale. It however, the building or improvement is sold within one year of completion, the Owner-Sullder 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 for the projects with a licensed Contractor pursuant to the 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, except for my personal residence in which I must have resided for at least ons year prior to completlon of the Improvements covered by this peal l cannel 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 Professions Code is available upon request when this application is submitted or at the following Web site: hJplwww.leglnfoca.govlcalaw.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 Bilvisio-n 3 ofthe Busuress and Professions Code, and my license is in full force and effect. LICENSE CLASS:' LIC, NO.: 'A (_ IDATE: CONTRACTOR;+t-=y WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS, have and will maintain a Certificate of Consent to Salf-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, have and will maintain Worker's Compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the wurkforwhich this permit Is Issued. My Worker's Cornpensatlon Insurance Carrier and Policy Num are: ^l� CARRIER �j� POLICY NUMBER '% C• u �.:]- r (PHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT 15 FOR ONE HUNDRED DOLLARS $100 OR LESS). I ceithy that in the performance of the work forwhich this permit is issued, I shall not employ any person In any mariner so as to become subject to the Worker's Compensation Laws of California, And agree that if I should became subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pravlslans. 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 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 whlch 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 ME { INT) SIGNATURE OF PERMITTEE DATE 11, APPLICATION DATE: 2- 'C`" 111 11' 7g,,.� ISSUE DATE: �i �' , 7 PERMIT# : TYPE CONST. R E m— PIC# pilo _f T I X125 � ry 7 ; Z07 - OCC GROUP: t Scope of Work t i, y? Ii # DWEL UNITS # STORIES ` ' d La 4 C # BEDROOMS DESCRIPTION SQ. FT. FACTOR I ADJ. AREA/VALUATION SFFVADD/REM Garage/Carport Luji Patio/Deck Lu LL Pool ZRe -Roof Commercial m valuaill Adj. Area: QUANTITY DESCRIPTION FEE U_ U w CD M J rz J U_ L) U CONSTRUCTION:y PLAN REVIEW: ELECTRIC: _El r PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: a ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: `TA BASF: PLOT PLAN: ZONING CLEARANCE: 34 TOTAL FEES COMMENTS: P/C: PAID BY: -75 VALIDATION: 1103 7 RECEIPT# PAID BY: VALI(3A710N: y �" WHITE— Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy INSPECTION41ITY OF DIAMON-0 BAR f ORD ® ® w i SETBACK/ LETTER TRACT AND LLUGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T BAR UG ELECTRICAL INTERCEP] E:R UFER GROUND HOT MOP/SHOWERPAN SEWFI1 LATERAL SEPTIC/CF8SPOOL MAIN WATER LINE HERS REPORT RECEIVED SEW( R CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS Ft. OOR SHEATHING ROUG}I CONDUIT SHEAR WALLS EXTERIOR POOLISPA SHEAR WALLS INTERIORROUGH PLUMBING . FRAMING/VENTING _ ROUGH ELECTRICAL ROUGH MECHANICAL. ROUGH MECHANICAL ROUGH ELECTRICAL W( } C ( ) GAS TLST ROUGH PLUMBING PRE GUNITE INSULATION VVAI.I POOL PRE DECK BOND€NG INSULATION GEI[ ING P THAP DRYWALL . f _ FENCE i GATE/ ALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WAI I FOOTING/STEEL. GAS TEST WAI,I STEEL 15T( ) �rru� ) LIFT SCRATCH COAs WALL BOND BEAM ELECTRIC MEIE:R RELEASE WALL DRAIN/ SEA1_ GAS METER HELEASE WALL FINAL SPECIAL INSPECTION R0. FRAMING PLANNING APPROVAL FINAL BUILDING i ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL' - FINAL PLANNING -- FINAL PLUMBING FINAL ENGINEERING/ PW Wof OCCUPANCY t FINAL COMM€ LAITY SERVICESS of OCCUPANCY FINAL HEALTH DEPT, ^ FINAL INDUSTRIAL WASTE COMMENTS: