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Home My WebLink AboutPR17-5861x 'T' CITY OF DIAMOND BAR DEPARTMENT OF CONLVIUNI<Y & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765PRESS s..F. (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com buildin6i),diamondbarea.eov JOB SITE ADDRESS — J u , APN €�QT A TRACT OWNER `t.,h ADDRESS :' Jy1l CITY,. ZIP"�EL. APPLICANT '`-'-1 TEL Ho CONTRACTOR m _ ADDRESS " L ' CITY IP EL. C "r ARCH/ENG/ a 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 Cade: 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 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from hcensure and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the appllcart to a clvll penalty of not more than live hundred dollars {$500). U 1, as owner of the property, or my employees with wages as their sole compensation, will do (-A all of or O 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 chat 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 hurden of proving that it was not built or improved for the purpose of sale.j. O 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Cade: 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.). U I am exempt from licensure under the Contractor's State 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 prior to completion of the improvements covered by this permit,i 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 avallatle upon request when this application Is submitted or at the fallowing Web site: httplwww leglnfe.ca,gov/calaw,himl. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. LICENSE CLASS: A J LIC. NO.: 1 t � _. _ IA EXP, DATE CONTRACTOR_w WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING UECLARATIONS: 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 ofthe work for which this permit is Issued, I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is Issued My Worker's Compensation Insurance Carrier and Policy Numter are'. CARRIERr'1(" POLICY NUMBER r"=e" V (THIS SECTION NEED NOT BE COMPL D IIFTHFFFRVIT IS FOR ONE FLNDP D DOLLARS $100 OR LESS). I certify that in the performance of the work forwhlch this permit Is Issued, i shall not employ any person in any manner so Est become subject to the Worker's Compensatlon Laws of California. And agree that If I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. DATE' APPLICANT: WARNING; Failure 10 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 cost of the comper lan. 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 Co-nstruction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, ON 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 relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned propertyfor inspection purposes. PERMITTEE NAME (PRINT),..' _ _ r DATE r APPLICATION DATE: & /;— i I_ P/C# P R j 7�rrR� g_ 4 ISSUE DATE: /23/1 PERMIT# : PRP ' -e i TYPE CONST. OCG GROUP: Scope of Work �}r� # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport LOU Patio/Deck Lu LL Pool/Spa ZRe -Roof _j Commerofal 5 m Valtuati Adj. Area: QUANTITY DESCRIPTION FEE U r U uJ w ca m J a c� z x U 27 CONSTRUCTION: PLAN REVIEW: P5 ELECTRIC: PLUMRING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: , BASF: PILOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: , PlG: PAID RY' VALIDATION; RECEIPT* PAID RY: VALIDATION: WHITE — Department Copy, YELLOW --- Finance Copy, PINK—Assessor Copy SETBACK/ LETTER FOOTINGS FORMS - SLAB .... .... .--- UG, PLUMWNG UG. ELECTRICAL RICAL LIFER GROUND . - SEWERIATERAL MAIN WATER LINE SEWTTi CLEANOUT ROOF SHEATHING 1`1:9.9 SHEATHING SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL —. .._._... — ROUGH ELECTRICAL W( } C ( } ROUGH PLUMBING INSUI ATION WALL INSULATION CEILING DRYWALL I ATH (PRE) I. ATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER IILLEASE .............. GAS METER RELFASE SPECIAL INSPECTION FINAL BUIL IS FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT, of OCCUPANCY CITY OF DIAMOND RECORDINSPECTION TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MCP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST - . ..... - _.. PRE GUNITE POOL PRE DECK BONDING P -TRAP -- FENCE / GATE/ ALARM FINAL POOL WALLS: WALL. FOOTING/STI`CI. WALL S IF F E I;( ] 2N°( 1 LIFT ............. WALL BOND BLAM WAF.L LI RAIN./ SEAL WAI L FINAL. RO FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGI EERING1 PW