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Home My WebLink AboutPR17-6241-1 CITY OF DIAMOND BAR r i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES \10lI . VI S"V.' 21810 Copley Drive, Diamond Bar, CA 91763PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PER -MIT APPLICATION www.ei(yotdiamondbar.com buildin ty gCadiamondbarca.j;ov JOB SITE ADDRESS I C:2� A2P APN LOT TRACT OWNER / ADDRESS f4'Cz CITY /` ,t!3 ZIP09/ TEL.72 gP& APPLICANT TEL. CONTRACTOR ADDRESS ti L CITY ZIP TEL. ARCHIENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION 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 or county that requires a permit to construct, alter, Improve, demolish, or repair, any structure, prlorto its Issuance, also requires the applicant farthe permitto 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 Gode] 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 far a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}, L -I L as owner of the property, or my employees with wages as their sore compensation, will do U all of or(—) portions of the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professions Cade: 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. 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 bunds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contmetors' 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, exceptfor my personal residence in which 1 must have resided for at least one year phorto completion attire Improvements covered by this permlt,l cannot legally sell a structure that I have built as an owner-bullder 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 Cade Is available upon request when this application Is submitted or attire following Web site: httplwww.leginfo,ca.gov/calaw.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 Division 3 of the Businessand Professions Code, and my liceeess 16 in full t. force and effec LICENSE CLASS: L- -! s LIC. NO.:�+rCi EXP, DATE J� 3%�I, CONTRACTOR:37� WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS' I have and wll[ maintain a Certificate of Consent to 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 ofthe Labor Code, far the performance oflhc work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: / CARRIER ✓? e POLICY NUMBER JHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 5100 OR LESS), I certify that In the performance of the work for which this permit is Issued,[ shall not employ any person in any manner so as 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 forlhwffh comp€ywlth 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 10 one hundred thousand dollars ($100,000), in addition to the cost of the compensatlon, 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 Informatian 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. PERMI NAME PRlN SIGNATURE F ERMITTF DATE APPLICATION DATE:-- Z 7— ISSUE DATE: PERMIT# :17k n — Ila TYPE CONST. OCC GROUP: Scope of Work z5Ve l # DWEL. UNITS # STORIES ®� ti / a # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport LOU Patio/Deck W LL Pool/Spa ZRe -Root ES f Commercial CID Valuation: Adj. Area: QUANTITY DESCRfPTiON FEE U U J W cv Z J C. J a z U CONSTRUCTION: PLAN REVIEW: x� ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: -Z— ` SAS F: 2� PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PIC: PAID BY: VALIDATION: RECEIPT # PAID BY: NOS — VALIDATION-10„_� WHITE — Department Copy, YELLOW — Finance Copy, PINK -- Assessor Copy SETF;AE;K/LETTER ..... MAW ANU Lruucrs FOOJINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG, PLUMBING I -RAR UG. ELECTRICAL INTERCEPTER UFFR GROUND HOT MOP/SHOWFRPAN SF'WER LATERAL SFIF'TIC/CESSPOOL MAIN WATER LINL KERS REPCRT RFCEIVED SEWER CLEANOUT w- I)EMOLITION _ HOOF SHEATHING ROOF DRAINS I LOOK SHEAl'I ZING HOUGH CONDUIT SHEAR WALLS EXTERIOR POGUSRA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL .._ ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL, W{ } C { ) CAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION GFILING P -TRAP DRYWALL FENCE / GATE/ ALAR€Vi LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH IN iFRIOA WALL FCOTINC/STEL GAS TEST WALL STEEL I"( ) 2"0( ) LIFT SORATCI I COAT WALL BOND RE AM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS MLI FR RELEASE WALL FINAL SPECIAL INSPECTIONRO. FRAMING PLANNING APPROVAL. _ ..-_ FINAL. BUILDING 7Z.o �' :' ROUGH FIRE APPROVAL FINAL MECHANICAL. FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERIGI PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT'. of OCCUPANCY [FINALEALTH DEPT. DUSTRIAL WASTE COMMENTS: