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Home My WebLink AboutPR17-13055DIA��IOA� BAR CITY OF DIAMOND BAR DEPARTMENT OF COMML�NIT i DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7.0,2T. - FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com buildingCdiamondbarca.gov JOB SITE ADDRESS APN LOT TRACT OWNER - ADDRESS o CITY -7 HP TEL. 7 . & f _, • ; { zjf F APPLICANT TEL CONTRACTORd§ ADDRESS CITY j °/' ZIP TEL. ARCH/FNG/ DESIGNERS ADDRESS CITY Ls, OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasons) Indicated below by the checkmark(s), I have placed net to the applicable item(s) [Section 7031:5, Business and Professions Cade: 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 licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any appllcant for a permit subjects the applIcart to a civil penalty of not more than five hundred dollars (^$500). L) I, as owner of the property, or my employees with wages as their sale compensation, will do CJ all of orU 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 properly whe, through employees` or personal effort, hullds 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 at proving that 11 was not built or Improved for the purpose of sale.). (-) €, 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.), L 1 I am exempt from licensure under the Contractor's State License law for the following reason(s): pate: Sign: By my signature below I acknowledge that, except for my personal residence in which i must have resided for at least one year priorto completion of the Improvements covered by this permii,i 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 Professlons Coda is available upon request when this application is submitted or at the following Web site. bttp/vdww.l6glnfO.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} Df Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: ^(f.�(.' LIC. NO.: : J s c" EXP. DATE CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY A UNDER PENALTY OF PERJURY ONE OF THE FOLLOWINO DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance ofthe work for which this permit Is Issued. I have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance ofthe work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number re: CARRIER t�R'A�I1�itL� L_— POLICY NU BERi k-0 (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT 15 FOR ONE HUNDRED DOLLARS S100 OR LESS). I certify that in the performance of the worktor which this permit Is issued, I 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 afire Labor Code, I shall firdhwith comply with those provislons. DATE: APPLICANT: i WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal i 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 I he by 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. SO97, Civ. C.). LENDER'S NAME: L£ ER's ADDRESS: i 'ty that I have read this application and slate 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 i enter upon the above-mentioned property for inspection purposes i a PERMITTEE NAME (P SIGNATUREOFIPERMITTEE DATE t~ APPLICATION DATF: �'� P/C# ISSUE DATE:(0 1� PERMIT#: 1D — TYPE CONST. OCG GROUP: Scope of Workrfg # DW EL. UNITS # STORIES it BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport T Patio/Deck LL LL Pool/Spa ZRe -Roof Commercial Valua til Adj. Area: QUANTITY DESCRIPTION FEE V_ w w cg z m rz U_ x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PTC: PAID BY:j _ VALIDATION: RECEIPT�� PAID BY: 1 VALIDATION: WHITE — Department Copy, YELLOW -- Finance Copy, PINK— Assessor Copy CITY OF DIAMOND INSPECTION 1p d 00 SETBACK/ LETTER 7TRACTANDGERFOOTINGS 0 A FORMS SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL INTERCEPTER LIFER GROUND SEWER LATFRAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL POOL/SPA _ ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST ............ _. -. - ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSULATION WALL PRE GUNITE POOL PRE DECK BONDING INSULATION CEILING P -TRAP DRYWALL FENCE / GATE/ ALARM LATH (PRE) FINAL POOL _ .. ....... ._...-_...._ LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL JsT( ) 21JD( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASEWALL ___._ _-... ._. GAS METER RELEASE DRAIN/ SEAL -.. WALL FINAL SPECIAL INSPEC'fIONRO. FRAMING PLANNING APPROVAL FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL Fl-N.A.L.-PLUM BING T.C. of OCCUPANCY CERT, of OCCUPANCY ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE CC)MMENT&