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Home My WebLink AboutPR17-12781N CD 0 M J J LL LUJ rr 0 CL rl z LUS F_ Lu 4. 2z z c3 on Q co en T H CITY OF DIAMOND BAR j I I i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES - 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hottine (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS 1 APN LOT TRACT OWNER ADDRESS e1�3 "r�g f'� Y'lli A CITY l/4rA401f*lP TEL. APPLICANT TEL. CONTRACTOR . P,p 71 ADDRESS. CITY i ZIP aTEL. ' ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty at 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 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 ler the permit to file a signed statementthat he or she is licensed pursuant to the provisions of the Contractor's Stale 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 Sectlon 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500). U 1, as owner of the property, or my employees with wages as their sole compensation, will do all of or L-) 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 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 -Buhler will have the burden of proving that It was not built or Improved for the purpose of sale.). (_) 1, 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' Stale License Law.). U I am exempt from licensure under the Contractor's State License law for the fol€owing reasnn(s); Date: Sign: By my slgnature below I acknowledge that, exceptfor my personal residence In which I most have resided for at least one year prlorto completion of the improvements covered by this permit,l cannot legally sail 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 Code is available upon request when this application Is submitted or at the following Web site: hftp/wwwdeginfo.ca.govlcalaw,html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sudan 7000) of Mvlslon 3 of the Business and Professions Code, and my license is in lull force and effect. LICENSE CLASS:- � LIC. NO.: �! r EXP. DATE: CONTRACTOR: WORKER'S COMPENSATION DECLARATION 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 Labor Cade, for the performance of the work for which this permit is Issued I have and will maintain Worker's Compensatlon Insurance, as raqulred by Section 3700 of the Lahor Code, 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 {CHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS), i cerhfythat in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to becurre subject to the Worker's Compensation Laws of California. And agree that If I should become subject to the Worker's Compensation prov€sions Section 3700 of the Labor Cade, sh forthwith com I ith those provisions. GATE APPLICANT, ��p WARNING, Failure to secure Worker's Compensation coverage is Unlawful, and sha subiset an employer to criminal penalties and civil fines up to one hundred thousand dollars (55100,000), in addllicn 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 Construct€on 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 ilial 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 CCHISI ucfon, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. R Izo. i PER' Ti ENA E PRI SIGNATURE DATE APPLICATION DATE: / 5/ I P/C# gp g ISSUE DATE: PERMIT# -Q,, i_ - t TYPE CONST. 112 1 OCC GROUP: Scope of Work A DWEL. UNITS # STORIES A BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Lu Patio/Deck Lu L4 Pooi/spa ZRe -Roof Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE J a U v w w cM g a U z a x v CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: r MECHANICAL: INSPECTION FEE: ISSUANCE:_ SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BAS F: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES �- I(7 COMMENTS: P/C: PAID ii VALIDATION: RECEIPT# d Z PAID BY:sR VALIDATION: WHITE —Department Copy, YELLOW— Finance Copy, PINK—Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD GA5 METER RELEASE SETBACK/ LEITER WALL FINAL, SPECIAL INSPECTION TRACT AND LEDG f: R RO. FRAMING PLANNING APPROVAL FINAL BUILDING FOOTINGS FORMS ROUGH FIRE APPROVAL SWITCH GEAR SLAB FINAL FIRE DEPARTMENT FINAL ELECTRICAL COMMERCIAL HOOD FINAL PLANNING UG. PLUMBING T -BAR UG. ELECTRICAL FINAL COMMUNITY SERVICES INTERCEPTER ... UFEq GROUND HOT MOP/SHOWFIIPAN SEWER 1. Al FRAL MAIN WATER LINE SEWER CLEANOUT ROOF: SHEATHING FLOOR SHEATHING SEPT[C/0ESSPOOl..-,---- HERS REPORFRIECEIVED DEMOLITION ROOF DRAINS ROUGH CON.I.)ULT SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMMiVENTING POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL . . . . .........- .... ...ROUGH ROUGHMECHANICAL ROUGH MECHANICAL --- - --- ..... ROUGH ELECTRICAL W( )C() ROUGH PLUMBING GAS TEST PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING . . . . . . . P -TRAP FENCE i GATE/ ALARM FINAL. P.091. DRYWALL LATH (PRE) LATH EXTERIOR WALLS: WALL. FOOTtNG/STEEL WALL STEEL 1sT( ) 2NL( LIFT WALL BOND HEAM LATH INTERIOR GAS TEST SCRATCH COAL ELFCTHIG METER RELEASE If "q, WALL DRAIN/SLAL GA5 METER RELEASE WALL FINAL, SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING r FINAL ENGINEERINGI PW TZ, of OCCUPANCY FINAL COMMUNITY SERVICES CERT. of OCCUPANCY . . . ..... ... FINAL HEALTH DEPT. LtLNAl IND. USTRIAL WASTE COMMENTS:--..-.-.