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Home My WebLink AboutPR16-1073M CD w rr d 0 rrc 0- 2f LUx 2 w CL. co 2 0 J_ M Q U) H DI: ►IOND BE1R SSf ry'.� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & 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 rwv.cityofdiamondbafr.com building@diamondbarca.gov JOBS€TEADDRESs21 r APN LOT TRACT OWNER ADDRESS CITY 1�_€ t € .r, <' e_ t r Zi ". d �,,t.. TEL. Y t:' , n APPLICANT TEL. CONTRACTOR ; °,h%4't; ✓ `7 z ADDRESS �` � �' �.: it •�. `�� F CITY ZIP t 'lam TEL ARCH/ENGI DESIGNER ADDRESS CITY ZIP TEL. OWER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasun(s] Indicated below by the checkmark(s), I have placed next to the applicable item(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, priorto its issuance, also requires the applicant for the permit to I a signed statement that he or she is licensed pursuantto the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Codel orthat 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 applicantto a civil penalty of not more than five hundred dollars ($500). 01, as owner of1he property, or my employees with wages as their sole compensation, will do (J aft of or (_) 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 ane year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). (r) 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professlons Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contractoforthe projects with alicensed Contractor pursuant to the Contractors' State License Law.). O I am exempt from licensure under the Contractor's State License law for the following reason(s): By my signature beiow I acknowledge that, except for my personal residence in which I must have resided for at least one year priorte completion of the improvements covered by this permit 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 7044 of the Business and Professions Code is available upon request when this application is submitted or atthe following Web site: httplvdww.leglnfo.ca.gov/calaw.htmi. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7G00) of Division 3 of the Business and Professions Code, and my license is in full force and effect. �'-.��< LICENSE CLASS G'i LIC. NO DATE: n r a.: 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 Code, for the performance of the workfor which this permit Is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for To performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER {PHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1G0) OR LESS). I certify that in the performance of the work for which this permitis issued, I shall not employ any person in any manner'so astir become subject to the Worker's Compensation Laws of California. And agree chat if I should become subject to the Worl Compensation provigions of Section 3700 of the Labor.Ca)1p, I shall fn�thwi h comply with those provisions. DATE APPNCAM: WARNING: Failure to secure Worker's Compe4sation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($10QGG0), in addition to the cast 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. 3097, Clv. C.). LENDER'S NAME - LENDER'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 relaling to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. 33 PERMITTEE NAME (Pl ' SIGNATUREDFP,ERNEiFl DATE f APPLICATION DATE: +E i i ii ISSUE DATE:,r,1 PERMIT# : TYPE CONST. I A b - Etzn�`"l S OCC GROUP: Scope of Work # Di UNITS # STORIES . # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w Pat10/Deck LU LL PooVSpa ZRe -Roof i Commercial I]] Valuation: Adj. Area: QUANTITY DESCRIPTION FEE V it U w w c� z m J a. J �d z U CONSTRUCTION: PLAN REVIEW: ELECTRIC:a PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCL: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PIC: ^� PAID BY: VALIDATION: RECEIPT it PAID BY: VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy !SFTBACK/ LETTER CITY OF DIAMOND INSPECTION BAR RECORD TRACT AND LEDGER FOOTINGS FORMS -- SWITCH GEAR ---- -- SLAB COMMERCIAL HOOD I-RAR Ur. PLUMBING —V-V— LIG. ELECTRICAL INILItCEPTER 1101 MOP/SHOWERPAN UFER GROUND SLWER LATERAL SFL'TIC/CESSPOOL MAIN WATER LINE SEWER GLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR HERS REPORT RECEIVED I)EMOLITION HOOF DRAINS ROUGH CONDUIT P001LiSPA ROUGH PLUMBING _ FRAMINGNENTINGl— ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C (}m mm GAS TEST ROUGH PLUMBING tNSIJLATION WALL PRE GUNITE I OOL PRE DECK BONDING INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TCST SCRATCH COAT P-TRAP FENCE 1 GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1-( ) 2N°( } I IFT WALL BOND BEAM EL.EGIRIC METER RELEASE L WALL DRAIN/ SEAL GAS MFTER RELEASE WALL FINAL SPLI:IAI- INSPECTIONRO. FRAMING PLANNING Al'PROVAL _..— ._..... ... _... _ FINAL. BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINIAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: