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Home My WebLink AboutPR17-8026CD F- L W cc CC rn W 0 M cz LUG J 5 0 z a 0 cp w << CITY OF DIAMOND BAR DEPARTMENT OF COMMUN_T.TY S- 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@diamondbarca.gov JOB SITE ADDRESS 4 APN LOT TRACT OWNER 3.75 HUl - a ADDRESS 5)p IIw\ S nS �r. CITY 'U:` ,-A �� ZIP /+� TEL 07)145- APPLICANT 7)145-APPLICANT TEL. CONTRACTOR ADDRESS ILf 64.)o11� AFIJ G 7-1b 5' _ CITY TuS+v.\ ZIPW-_J-90 TEL. ARCH/ENG/ DESIGNER ADDRESS 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, atter, improve, demolish, or repair, any structure, prior 10 its issuance, also requires the applicant forthe 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 (censure 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 ($500). U I, 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 sale (Section 7944, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through employees' er 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 for the purpose of sale.). CJ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Secfiou 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of properly who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). (_) i am exempt from licensure under the Contractor's State License law for the following reasorl Date: Signe By my signature below I acknowledge that, exceptior my personal residence in which I must have resided for at least one year prior to completlon Df the improvements covered by this permit,I cannot legally sell a structure that I have bui€t as an owner -builder if It has not been constructed in Its entirely 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/www.leglnfo,ca,govlcalaw.hri 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 mylicenseis In full force and effect. LICENSE CLASS: C LIC. NO.: ❑ 1V'04 � 'J S cl V EXP. DATE: ZO / %' CONTRACTOR; 0 W il Gni n ) I- ill r—n c . WORKER'SCOMPEN ATION DECLARATION I HEREBY AFFIRM UNDER PENALTY DE PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Selt-Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the workfar 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 workfor which this permit Is Issued. My Worker's Compensation Insurance Carder and Policy Number are: y CARRIER 5�`h POLICY NUMBER RHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 5100 OR LESS). I certify that In the performance of the work for which this permit is issued, I shall not employ any person In any manner se as to become subject to the Worker's Compensation Laws of California, And agree that It I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code. I shall forthwlth comply with those provisions. DATE; APPLICANT; WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000}, in addition to the cast of the compensation, damages as provided for in section 3700 ofthe 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. 3007, CIV. C.). LENDER'S NAME: LENDER'S AOCRESS: 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 10 enter upon the above-mentloned property for inspection purposes. PE SIGNA RE DATE i APPLICATION DATE: Qi // P/C# ISSUE DATE: -7 / IN ��PERMIT# : � \—I t TYPE CONST. 1`'1'yadJf'%J°21 }ACC kiCC GROUP: Scope of Work Rr_,2/5 e_ir w, t, I- CP rj� L IL D r J5 � v # DWEL. UNITS ( # STORIES 7- # BEDROCMS 3 DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport LO W Patio/Deck W LL Pool/Spa zRe -Roof Commercial r0 Valuatfolrt 3 Adj. Area: QUANTITY DESCRIPTION FEE d c� x V J w z m a 4 S U g CONSTRUCTION: I �, \1 . �-cR PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: a� PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID RY: VALIDATION: RFCEIPT# PAID BY: �® VALIDATION: WHITF Department Copy, YELLOW— Finance Copy, PINK—Assessor Copy SETBACK/ LETTER TIiACI AND LEDGEH SWI7CI1 GEAR COMMERCIAL HOOD I"-IiAR INII:HGEI'1kR MOPISHOWFRPAN FOOTINGS FORMES SIAB UG. PLUMBING UG. ELECTRICAL . ........ - ...... .... ... ......... ...... - -- - ----- .......... . _ ..._ .__._.._.._... _ .... .... _.._ UFCR GROUNDHOT - SEWER LATERAL - SI"PTIC/GFSSPOOL MAIN WATER LINE SEWER CLEANOUT HERS REPORT RECEIVED DCMOI ITION ROOF SHEATHINGROOF" DRAINS _-._._ ...... FLOOR SHEATHING ROUGH CONDUIT SHEAR MALLS EXTERIOR POOL/SPA . SHEAR WALLS INTERIOR ROUGH PLUMB#NG FRAMINGIVENTINGROUGH ELECTRICAL ROUGH MECHANICAL. ROUGH ELECTRICAL W( ) C () ROUGH PLUMBING INSULATION WAIL INSULATION CEILING DRYWALLFENCE LATH (PRE) LATH EXTERIOR LATH INTFREOR - -- ROUGH MEGIHAN[CAL GAS TEST -- PRE GUNITE POOL PRE DECK BONDING P -TRAP / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL GAS TEST SCRAICII COAI ELEGI HIC MEET ER RELEASE GAS MVI E:R 11ELEASE SPECIAL INSPECTION WALL STEEL 1sT( ) 2ND( ) LfFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL YJ RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL BUILDING ....... - - FINAL MECHANICAL ------------------ FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING __..--------------- FINAL PLUMBING FINAL ENGINEERING/ PSV T,C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: