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Home My WebLink AboutPR17-14762CITY OF DIAMOND BAR, DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drives Diamond Bar, CA 9.1765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 ` FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@di �°', Ilarca.gov JOB SITE ADDRESS C -S ` w APN LOT TRACT OWNER t125 ;�—� ADDRESS 2_ltl r`teOF" t � t ! r CIT)UW,yycv'{ps.l it ZIP TEL. g�s APPLICANT ` g,°�� TEL t G CONTRACTOR pli ADDRESS CITY e �t y ZIP..- ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that 1 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 applicahle item{e) [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 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). (r) T, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure Is not Intended or offered for safe (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 that the Improvements are not intended or offered for sale. It however, the building or Improvement Is sold within one year of compEetion, the Owner -Builder will have the burden of proving that It was not built or Improved for the purpose of sale,), (_J 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 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: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year grlorto completion of the improvements covered by this permlt,l cannot legally sell a structure their 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: httplwm leglnfo.ca.gov/calaw.himl. 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 Professions Code, and my license is in full force and effect. LICENSE CLASS:! 1 :* LIC. NO.:- EXP.DATE: CONTRACTOR: .G.P',a"a�a:f WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Cerdilcate at Consent to Self -Insure for Worker's Componsatlon, 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 of the Labor Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: t CARRIER S_toa''..vIL!f 111 jI fMt' POLICY NUMBER _7 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I cefffythat In the performance of the workfor which this permit is issued, I shall not employ any person in any manner sore to become subject to the Worker's Campensatlon Laws of California. And agree that If I should become subject to the Worker's comp °i p sio , f Section 3700 of the Labor Cn half forthwith comply with those provisions. DATE: R < `C Z 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 ($1 OVOO), in addition to the cast of the comper lan, damages as provided for in section 3700 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY i I hereby affirm under penalty of perjury that there Is a Construction Lending Agency for the performance of the work for which this permit Is issued (Sec. 3097, Dv C.), LENDER'S NAME: LENDER'S ADDRESS: 7 I certify that I have read this application and state that the above information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to i enter upon the above m tinned property for Inspection purposes. i PERMITTEE NAME P Tf SIGNATURE OF PERMITTEE DATE APPLICATION DATE: 8/zqA T � P/C#�p ISSUE DATE: �� —PERMIT# : t'" J T " j7ECc,2_ iYPE CONST. OCC GROUP: Scope of Work 'Pe a " E" re A,h f' # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFRIADWREM Garage/Carport LO Patio/Deck LLL Pool/Spa ZRe -Roof Commercial 03 Valuation: Adj. Areal QUANTITY DESCRIPTION FEE V U Hca w co z m J U Z z U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 22&,20 MECHANICAL' INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: , g RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES N ., COMMENTS: P/C: PAID BY://,, VALIDATION: RECEIPT# 3� PAID$Y: ""-1°'�il VALIDATION: WP[TE— Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy DIAMONDCITY OF ` ` G n INSPECTION RECORD ®w1 7FOOT�NGS TRACT AND LEDGER SWITCH CI AH COMMEI1CIAL HOOD T -BAR INTERCEPI Llt HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA -_ .._ ._. ............ - - _ UG. PLUMBING _ — UG. ELECTRI{ AL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHfNG FLOOR SHEATHING SHEAR WALLS EXTEHIOR SHEAR WALLS INTERIOH - ROUGH PLUMBING FRAMING/VENTING .... ROUGH ELECTRICAL .......... ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH MECHANICAL GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P -TRAP _. DRYWALL FENCE / GATE/ ALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: WALL FOOTING/STEEL LATH INTERIOR GAS TEST WALL STEEL V'( ) 2N°( } LIFT SCRATCH COAT WALL BOND BFAM ELECTRIC METER RELEASE WALL DRAIN/ SLAT_ GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL ELECTRIGAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: let FINAL FIRE DEPARTMENT FINAL PLANNING" FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL. WASTE