The URL can be used to link to this page

Home My WebLink AboutPR17-6348DiAVIOND B CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY cot DEVELOPMENT SERVICESHERS RM -1-1- 21810 r; Copley Drive, Diamond Bar, CA 91755 �Atss (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839 7 'S �i BUILDING PERMIT APPLICATION www.cityofdiamondbar.com buildi " �`Ja cianntbrazgow JOB SITE ADDRESS APN LOT TRACT OWNER ADDRESS r CITY Ct ZIP TO APPLICANT TEL - CONTRACTOR AM- &DIcte -AaANd! Ar 14 ADDRESS ._ CIN ARCH/FNG/ DESIGNER ADDRESS CITY ZIP TEL. 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 eheckmark(s), I have placed next to the applicable Itom(s) [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 4) Commencing with Section 7040 of Division 3 of the Business and Professions Code) or that he or she Is exempt from Ilcensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant far a permit subjects the applicant to a civil penalty of not more than five hundred dollars O I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale {Section 7044, Business and Protesslans Code: The Contractors' State License Law does not apply to an owner of property who, through amplayees' cr 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 ore year of completion, the Owner -Builder will have the burden of proving that It was not built or Improved for the purpose of (-) 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 ?hereon, and who contracts toy the projects with a licensed Contractor pursuant to the Contractors' State License Law}, U I am exemptfrom Ilcensure under the Contractor's Stella 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 prier to completion of the improvements covered by this permiLl cannot legally sell a structure that I have hunt as an owner-bulldcr If It has not been constructed in its oral 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 r submitted or at the following Web site: httpfwww.leginfo.ca,govfcalaw.html. LICENSED GONTRACTOR'S DECLARATION iI 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: LIC. NO.: 1 FXP. DATE: _.g_ CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREB FIRM UNDER PENALTY OF PERJURY ONE OF THF 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 required by Section 3700 ofthe Labor Code, for the performance of the work for which this permit is issued. My Worker's Compensatlon Insurance Carrier and S Policy Number are: � CARRIER 7 POLICY NUMBER - (CHiS SECTION NEED NOT BE COMPLETED IF THE PERMIT l5 FOR ONE HUNDRED DOLLARS $100 OR LE55). j I certify chat In the performance of the work for which this permlt is issued, i shall not employ any person in any manner so ris to become subject to the Worker's Compensatlon Laws of California. And agree that if I should became subject to the Worker's Compensation provisions of Sadden 3700 of the Labor Cade, I shall forthwith comply with those provisions. DATE: APPLICANT E WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fires up to one hundred thousand dollars ($100,000). In addition to the cost of the compensation, j damages as provided for in section 3708 of the labor code, Interest, and attorney's fees. E CONSTRUCTION LENDING AGENCY Ei I hereby afflrm under penalty of perjury that there Is a Construction Lsnding Agency for the performance of the work for y which this permit is issued (Sec 3097, Civ, C.). LENDER'S NAME: '-�- LENDER'S ADDRESS: u L I certify that I have read this application and slate that the above information !s correct. I ogres to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to Jenter upon the above enfloned pr rtyfor inspectlp purposes. n PE TT ENA (PRINT] Ic E S NA OF ERM17EE DATE APPLICATION DATE: 419 P/C# ISSUE DATE: iY �PERMITTO: 1F, k TYPE CONST. OCC GROUP: - 3 Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADL. AREA/VALUATION SFFVADD/REM Garage/Carport Patio/Deck u � Pool/Spa zRe -Roof � Commercial m Valuation: Adj- Area: QUANTITY DESCRIPTION FEE J U r w w z U z U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES /00,0 r COMMENTS: PIC: PAID BY: VALIDATION: RECEIPT PAID BY: VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy SETBACK/LETTEH FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL CITY OF DIAMOND BAR UFFR GROUND HOT MOP/SHOWFRPAN WALLS: WALL FOOTINGISTEEL WALL STFFL'IET( ) 7'�r'( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL SEWER IATERAL SEPTICICESSP001... 5 METER RELEASE GA.._ SPECIAL INSPEf €ION MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY ROOF SHFAFHING . _ .. ROOF DRAINS FLOOR SI IFA FHING ROUGH CONDUIT SHEAR WALLS EXTERIOR PODL/SPA SHEAR WALLSINTERIOR _ _ ROUGH PLUMBING FRAMING/VENTING _. _ ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( } GAS TEST ROUGH PLUM13ING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P -TRAP (IRYWALL FENCE 1 GATE/ ALARM LATH (PRE) FINAL P001 /ATH EXTERIOR .__ _.. LATH INTERIOR GAS TEST SCRATCH COAI ELECTRIC METER RELEASE WALLS: WALL FOOTINGISTEEL WALL STFFL'IET( ) 7'�r'( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL _. 5 METER RELEASE GA.._ SPECIAL INSPEf €ION WALL FiNAI.. R0. FRAMING PLANNING APPROVAL FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY �� a ROUGH FIRE APPROVAL, FINAL FIRE DEPARTMENT FINAL PLANNING _.. FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL TASTE