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Home My WebLink AboutPR17-13989D ND BAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUTNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7011 FIRMLY PERMIT APPLICATION www.cityofdiamondbar.com butilditil 0mondbarca.gov JOB SITE ADDRESS APN LOT TRACT OWNER f g� ADDRS APPLICANT TEL. CONTRACTOR _ ADDRESS U v. CITY ZIP TEL.k ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 of county that requires a permit to construct, atter, improve, demolish, or repair, any structure, prior to its Issuance, also requires the applicant for the permltto 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] Dr 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 subjectsthe appllcantto 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 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 bu€Iding 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 tar the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Processions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the pfojects with a licensed Contractor pursuant to the Contractors' State License Law,) {r j I am exempt from licensure under the Contractor's State License law for the fallowing reasons): 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 prior to completion of the improvements covered by thls permlt,l cannot legally sell a structure that I have buih 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: http/www.leginfo.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 Sectlon 7000) of Division 3 of the Business and Professions Code, and my Ilcwse Is in full farce ani effect. �t LICENSE CLASS: LIC. NO.. EXP. DATE: -,r �. .. "F -. CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and wIII maintain a Certificate of Consent to Self -Insure tar Worker's Compensation, Re provided by Sectlon 3700 of the Labor Code, for the performance of the work tot 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 WI this permit is issued. My Worker's Compensation Insurance Carrier and Policy Num are: 1 , r, CARRIER : s _ ffi%'`® POLICY NUMBER r' (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS 5190 OB LESS}. I ceditythat in the performance of the work for which this permit is Issued, I shall not employ any person In any mannerso as to become subject to the Worker's Compensation Laws of California. And agree t ecome subject to the Worker's Compensation envisions of Section 3790 of the Labor Cede, I shall fort ID' comj se gf�ovlslons. GATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, an subject an employer to criminal penalties and civil fines up to- one hundred thousand dollars ($100,000), In addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's lees. 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. 3997, Civ. C.), LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is cofrect. 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 enter upon the abovs-mentioned property for inspection purposes PERMITTEE NAME (PRIN j 4 gg SfGNATUR�OF...86G DATE APPLICATION DATE: %1a4-1%-1 ISSUE DATE: �+ a�'i 1-1 PERMIT# : TYPE CONST. PIC# Pfd 171 — V� OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w Patio/Deck LU Li Pool/Spa ZRe -Roos O Commercial CD Valuation: Adj. Area: QUANTITY DESCRIPTION FEE V J w Lo .'�LAO Z M J Q U 4 x V CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE:• ��- SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE:_ PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES�� COMMENTS: , P/C: PAID BY: VALIDATION: RECEIPT# 'ffcb PAID BY: VALIDATION: WHITE —Department Copy, YELLOW Plnarce Copy, PINK— Assessor Copy CITY OF D BAR INSPECTION SEFBACK/ LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL INTERCEPTER IIFFR GROUNDHOT ......_ SFWER LATERAL MAIN WATER LINE MOP/SHOWERPAN - SEPTIC/CESSPOOL HERS REPORT RFC EIVFD DEMOLITION ROOF DRAINS ROUCH CONDUIT POOL/SPA SEWER CLEANOUT- ROOF SHEATHING FLOOR SHEATHING; SHEAR MALLS EXTERIOR SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL_ - _ ROUGH MECHANICAL ROUGH ELECTRICAL. W( ) C () ROUGH PLUMBING GAS TEST PRE GUNITE INSULATION WAIL �y _.. ... POOL PRE DECK BONDING INSULATION (; FII INGP-TRAP . .., _..._. _ ..... DRYWALL FENCE 1 GATE/ ALARM . LATH (PRE) FINAL POOL LATH EXIF.RIOR WALLS: WALL FOOTING/STEEL WALL Sl ELL '1"( )2 ND( ) LIFT WALL BONO HIAM WALL DRAWL SLAL LATH INTI RIOR GAS TEST SCRATCH COAT ELE( IRI(; METER RELEASE GAS MFILR RELEASE SPECIAL INSPECTION WALL FINAL R0, FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL. MECHANICAL FINAL ELECTRICAL ' ' FINAL PLANNING FINAL ENGINEER€NGL PW FINAL PLUMBING,- ,. T.0 a1 OCCUPANCY FINAL. COMMUNITY SERVICES HNAL HEALTH DEPT. FINAL INDUSTRIAL WASTE CERT. of OCCUPANCY COMMENTS: