The URL can be used to link to this page

Home My WebLink AboutPR17-4945D�11,10i'm Bu CITY OF DLXMOND BAR 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.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS y z (�t (� APN LOT TRACT OWNER i % t- L _ ADDRESS -` 4 &. .Ems - 71 i k\YE. CITY L�02EV€' b�j) ' €P TEL. ` cba S CXD APPLICANT TEL. CONTRACTORV 0 a ADDRESS CITY ZIP TEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL, OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractor's State License Law for the reasons) Indicated below by the chackmark(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, prior to Its Issuance, also requires the applicant for the permit be 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 7090 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). I, as owner of the property, or myemployees with wages as their sole compensation, will dor U portions of a work, and the structure is not Intended or offered for sale (Section 7044, business an AlPro salons 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 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 forthe purpose of sale,), (r ) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who huilds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State Llcense Law.). (} I am exempt from Ilcensure and r he Contractor's Ste Icensa law for t #ollewln eason( ) 2. Date -1,L _Z i Ira I Sign: -6 , e By my signature below I acknowledge that, exceptfor my p' l residence In which I rrd have resided for at least one year priortu 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 raw, Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at the following Web site: httplwww.leglnfo.ca.gov/calaw.htmi. 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 Professlors Code, and my license is in full force and effect, LICENSE CLASS: LIC. NO.: EXP, DATE: CONTRACTOR' WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and w€d malntain a Cent'rficate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the workfor which this permit Is Issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, 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 (THIS SECTION NEED NOT BE COMPLETED 1F THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I cerlify that in the performance of the workfor which this permit Is issued, I shall not employ any person in any manner so as to became subject to the Worker's Compensation Laws of California. And agree that if ! should become subject to the Worker's Compensation provisions of Section 3700 of tha Labor Cade, I shall forthwlih comply with these provisions, DATE: APPLICANT, WARNING: Failure 10 secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and clvi fines up to Due hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor cods, 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, 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. IJ PERMITTEE NMF (PRINT) SdGNA OF PRMITFEE DATE ,l APPLICATION DATE: (",z i r i PICO P t _i91_ . ISSUE DATE: Z I %A '9PERMIT# : S TYPE CONST.i OCC GROUP: g Scope of Work [ P612igDE loo /+ 31i p _'a # DWEL. UNITS # STORIES_ # BEDROOMS DESCRIPTION SO. FT, FACTOR PSF ADJ. AREANALUAT€ON SFR/ADD/REM Garage/Carport 10 Patio/Deck LJ LL Pool/Spa ZRe -Roof O Commercial 0] Valuation: Adj. Area: QUANTITY DESCRIPTION FEE c V U �u co z a 1 U Z z ca CONSTRUCTION: PLAN REVIEW: _ ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: Bell 1 SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: 2 - PHE-ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES e i COMMENTS: RlC: PAID BY: VALIDATION: RECEIPT# PAID BY:VALIDATION: WHITE Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy SETBACK/ LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATHW MAIN WATIll FINE SEWER CI_.EANOUT ROOF SHFATI IING FLOOR SHFATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( j C ( ) ROUGH PLL)MBING INSUIIITION WALL INSULATION CEILING DRYWAI L LAi"H (PREj IKiH FXIERIOR I ATI{ INTERIOR GAS II;ST SI;RATCH COAT ELLCTRIC METER RELELASE GAS METER RELEASE SPEGIAL INSPECTION FINAL BUILDING FINAL MECHANICAL. FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY Tl' OF DIAMOND BAR ASPECT!ASPECTION RECORD 7TRACTANDEDGI 13 R _..._ COMMERCIAL I{00D 7- BAR INTERCEPTER HOT MOP/SHOWI-IIPAN SEPTIC/CESSPO01_ HERS REPORT RE CEIVED DEMOLITION ROOF DRAINS ROUGH CONIIU{T POOLISPA ROUGH PLUME31NG m _. ROUGH ELECIRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE _ POOL PRE DECK BONDING P -TRAP FENCE 1 GATF/ ALARM FINAL 11001.. WALLS: WALL FOOTING/STEEL WALL, S FLL 1ST( ) 2%D( ) LIF/ WAIL BOND BEAM ......... . WALL URAINI SEAL WALL FINAL RO F=RAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FfiNAL FIRE DEPARTMENT FMAL PLANNING FMAL ENGINEERING/ PW FWAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL TASTE r "',"— CITY OF DIAMOND BAR �y DEPARTMENT OF COMMUNITY & B'EVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91763 _.._...- (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 erg s BUILDING PERMIT APPLICATION www.citvofdiamondbar.com building nriti6rr innIfIrl C L JOB SITE ADDRESS Z-0 y G ] APN LOT TRACT OWNER_ c� U :( V C s M d l� ' of 5' VIP— ADDRESS i"ADDRESS O It N�r a raL G 1i CITY APPLICANT APPLICANT TEL. CONTRACTOR p 'a ADDRESS d b O CITY vf't} ZIP EL. b ARCH/ENG/ DESIGNER ADDRESS C 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 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 j 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 licensure and the basis for the alleged exemption. Ary violation of Section 70315 by any appficantfor a pormltsubjects the applfcant to a civil penalty Of not more than five hundred dollars (5500). j U I, as owner of the property, or my employees with wages as their sole compensation, will do i1 aft of or{) portions of the work, and the structure is not In larded or offered for sale (Section 7044, Business and Professions Code: The i Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds E 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 if was not built ' or Improved for the purpose of sale.). U I, as owner of the property, am exclusfvely contracting with licensed Contractors to construct the project (Section 71744, Business and Professions Cade: The Contractors' Stale 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 exemptfrom licensure under the Contractor's State License law for the following reason(s): Date: Sign: Ry my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this pormlt,l cannot legally sell a structure that I have built as an owner -builder it 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 atthe following Web site: http/wvvw.laglnfo.ca.gov/calaw.htmi. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provislons of Chapter 9 (commencing with Section 7000) of Dlulslan 3 of the Business and Professions Code, and my license Is In full force and effect, LICENSE CLASS', LIC. NO.: EXP. DATE: D w CONTRACTOR: +ve J Aor7e_ D j1 WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certlticate of Consent to Self -Insure for Worker's Compensation, as provided by Sectlen 3700 ofthe Labor Code, for the performance of the work for which this permit Is issued I have and w€II maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for To performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are'. CARRIER POLICY NUMBER THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS) I certifythat In the parformance of the work forwhich this permit is issued, I shall not employ any person In any manner so as to become subject to the Worker's Ccmper len Laws of California. And agree that if I should become sud]ect to the Worker's Compensation provisions of Section 3700 of the Labor Code I shall forthwith comply with those provisions. fJA7E:APPtICANT: C c /n WARNING: Failure to secure Worker's Compensation coverage is unlawful and shall subject an employer to criminal perralfles and clvfl 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 attomey'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, 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 on and county ordinances and state laws relating to building construction, and hereby authorize represenfabves of this county to enter upon the abova-mentloned property for inspection purposes, 51 V -e_ PERMITTEE NA rRf SIGNA RE OF PERMITTEE DATE FIRMLY APPLICATION DATE: 1p Z S I P/C# ISSUE DATE: PERM{T# TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES Of BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport LOU LU Patlo/Deck LL Pocuspa ZRe -Roof i Commercial X Valua'tlort: O d O v Adj. Area: QUANTITY DESCRIPTION FEE 4 1,/ O r v a o U C u/ ua � co z m a U Z CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP:p ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: 3o r PLOT PLAN: ZONING CLEARANCE: TOTAL FEES L COMMENTS: PAID BY: VALIDATION: RECEIPT# �tO PAID BY: VALIDATION: VO WHITE —Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy SETBACK/LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL LIFER GROUND. SEW R LATERAL MAIN WATER LINE SEWER CLEANOUT_ —_ ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTR[CAL W( ) G ( ) ROUGH PLUMBING INSULATION WALT_ _ INSULATION CEILING DRYWAI-I. LATH (PRF.) LATH EXTERIOR LATH iNTERIOFi CAS TES f SCRATCH COM� ELECTRIC METER RELEASE GAS METER RLLEASE SPECIAL INSPECTION FINAL BUILDING FINAL_ MECHANICAL FINAL ELECTRICAL FINAL PLUMBING — T.C. of OCCUPANCY _ CERT. of OCCUPANCY I COMMENTS:-,,;", RECORD,MOND BAR N. ® d IIiACT ANI) LEDGER SWITCH GEC COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWFIIPAN SEPTICAl'SSPOOI HERS RE PORT RECEIVED DEMOLITION — -- RODE DRAINS — _.— ROUGH CONDUIT POOLIPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST _ PRE GUNITE POOL PRE DECK BONDING P -TRAP FENOF 1 GATE/ ALARM F[NAL POOL WALLS: _ WALL FOOTINGISTEFI.� WALL_ STEEI IT( ) 2"a ( ) LIFT WAIL BOND BEAM RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL. ENGINEERING/ PW FINAL COMMUNITY SERVICES FINIAL. HEALTH DEPT. _P_y�ll 1 lam_.......—