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Home My WebLink AboutPR16-22180 CL0 a LW C!7 J Q m a r a 0 0 m x 0 n LL O d on O n 0 M aw. r) 0 13 CJ LL O U H 0 2 G] Y rr O w z 0 m i a f - v U-1 m' N cn 0 Zd U-1 H 6 0 0 d CT M co I= LU 0 n u - J LU 0. s a. 2 x w CD Z q cc Q v_; V. 2 H APPLICANT I � ��Gif_..KfLI sem` -TEL. ZIP ( M!r TEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. oWNER-BUILDER DECLARATION 4 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 next to the applicable hems) [Section 7631.5, 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 91 Commencing with Section 7009 of Dill 3 of the Business and Professions Code] orthat he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any appllcantfora permit subjectsthe apphcanito a civil penalty of not more than five hundred dollars ($599). LJ I, as owner of the property, or my employees with wages as their sole compensation, will do O all of or L) portions of the work, and the structure is not intended or offered tot sale (Section 7044, Business and Professions Code: The Contractors' State License Law does net 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 a 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.). O 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 builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuanttothe Contractors' State License Law.). U f am exemptfrom licensure under the Contractor's State License law for the following reasorl By 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 permlt,l 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 7944 of the Business and Professions Code is available upon request when this application is submitted or at the following Web site: http/www.legiafo,ca,gov/calaw.11i 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 Division3 ofthe Bu Ines, and Professions Code, and my license is in full force and effect. LICENSE CLAS : L".". EXP. DATE: CONTRACTOR. WORKER'S CO PENSATION OECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the tabor Code, for the performance otthe 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, far the performance of the wedcfor which this permit Is issued. My Worker's Compensation insurance Carrier and Policy No r re: h CARRIER POLICY NUMBEP. � ..__�______._,� -., �-•` A cordfythat in the performance of the work for which this permit Is Issued; l 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 Cade, I shall forthwith complywith those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil flnes up to one hundred thousand dollars ($100,000), In addifion 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. 3997, Civ. C.} LENDER'S NAME. LEN DER'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 t ave -mentioned opertyfor inspection purposes. PERMITTEE NAME (PRINT) SIGNATURE OF PERMITTEE, CATE Scope Of Work # DWEL. UNITS At STORIES m LU LL LL Z d m # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARE:ANAL.UATION SFR/ADWAFIV Garage/Carport Patlo/Deck Pool/Spa Re -Roof Commercial Valuatfoirs: Adj. Area: CITY OF DIAMOND BAR J I i H DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES w w 21810 Copley Drive, Diamond Bar, CA 91765 PRESS CM m (949) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.govv a JOB SITE ADDRESS APPLICATION DATE: i q , < A P/C# PRIG-2-21 a ISSUE DATE: E PERMIT# : APN LOT TPAP l TYPE CONST. OCC GROUP: OWNER h/Y.� _ _ _.. _ .. .e x r APPLICANT I � ��Gif_..KfLI sem` -TEL. ZIP ( M!r TEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. oWNER-BUILDER DECLARATION 4 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 next to the applicable hems) [Section 7631.5, 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 91 Commencing with Section 7009 of Dill 3 of the Business and Professions Code] orthat he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any appllcantfora permit subjectsthe apphcanito a civil penalty of not more than five hundred dollars ($599). LJ I, as owner of the property, or my employees with wages as their sole compensation, will do O all of or L) portions of the work, and the structure is not intended or offered tot sale (Section 7044, Business and Professions Code: The Contractors' State License Law does net 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 a 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.). O 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 builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuanttothe Contractors' State License Law.). U f am exemptfrom licensure under the Contractor's State License law for the following reasorl By 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 permlt,l 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 7944 of the Business and Professions Code is available upon request when this application is submitted or at the following Web site: http/www.legiafo,ca,gov/calaw.11i 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 Division3 ofthe Bu Ines, and Professions Code, and my license is in full force and effect. LICENSE CLAS : L".". EXP. DATE: CONTRACTOR. WORKER'S CO PENSATION OECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the tabor Code, for the performance otthe 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, far the performance of the wedcfor which this permit Is issued. My Worker's Compensation insurance Carrier and Policy No r re: h CARRIER POLICY NUMBEP. � ..__�______._,� -., �-•` A cordfythat in the performance of the work for which this permit Is Issued; l 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 Cade, I shall forthwith complywith those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil flnes up to one hundred thousand dollars ($100,000), In addifion 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. 3997, Civ. C.} LENDER'S NAME. LEN DER'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 t ave -mentioned opertyfor inspection purposes. PERMITTEE NAME (PRINT) SIGNATURE OF PERMITTEE, CATE Scope Of Work # DWEL. UNITS At STORIES m LU LL LL Z d m # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARE:ANAL.UATION SFR/ADWAFIV Garage/Carport Patlo/Deck Pool/Spa Re -Roof Commercial Valuatfoirs: Adj. Area: CONSTRUCTION: PLAN REVIEW: 54•00 ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: q3-314 6x+ oV Ex 9i red Milli Q 8• TOTAL FEES COMMENTS: PIC: a 9A.3 2_ PAID BY:V TJ � 9 � VALIDATION: LC RECEIPT# _ PAID BY: VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy QUANTITY I DESCRIPTION FEE J a V w w CM m a a a U CONSTRUCTION: PLAN REVIEW: 54•00 ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: q3-314 6x+ oV Ex 9i red Milli Q 8• TOTAL FEES COMMENTS: PIC: a 9A.3 2_ PAID BY:V TJ � 9 � VALIDATION: LC RECEIPT# _ PAID BY: VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITE OF DIP INSPECTION REC COMMENT& TRACT AND LL.UGER SWI f CH GEAR COMMERCIAL, I IOOD T -RAR _ INTHRCEPTER _ HOT MOP/SHOWERPAN SEPTIC/CESSPOOL KERS REPORT RECEIVED DEMOLITION RCOF DRAINS F GI i CONDUIT L/SPA GH PLUMBING GH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PHE DECK BONDING P -TRA [' _. FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTINGISI FEL, WALL ST£:EL 1s'( ) 7"0( } LIFT WALL BONi7 BEAM WALL DRAIN/ SEAL _ WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL - FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE SETBACK/ LEITER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL _... UFER GROUND SEWER LATERAI MAIN WATER U SEWER CLEANOUT EIOOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING _ ROUGH MECHANICAL .... _._. ........ ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INYJIATION WALL. INSULATION CEILING DRYWALL LAI FI (PRE) LATH FXIERIOR LATH INTERIOR GAS I LST SCRAICI I COAT ELECTRIC METER RELEASE GAS ME IFR RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C, of OCCUPANCY CERT, of OCCUPANCY COMMENT& TRACT AND LL.UGER SWI f CH GEAR COMMERCIAL, I IOOD T -RAR _ INTHRCEPTER _ HOT MOP/SHOWERPAN SEPTIC/CESSPOOL KERS REPORT RECEIVED DEMOLITION RCOF DRAINS F GI i CONDUIT L/SPA GH PLUMBING GH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PHE DECK BONDING P -TRA [' _. FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTINGISI FEL, WALL ST£:EL 1s'( ) 7"0( } LIFT WALL BONi7 BEAM WALL DRAIN/ SEAL _ WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL - FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE