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Home My WebLink AboutPR17-16704..... ........ CITY OF DIAMOND BAR ° i ' DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 'r 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.cityofdiamondbancam building(&diamondbarca.Lrov JOB SITE ADDRESS _ C ZC- p APN t €' LOT TRACT 49 �, 7 OWNER V f"p" .p L,- ADDRESS 1-14 w -v CITY ZIP rEL. C — APPLICANT TEL. CONTRACTOR a ?/4uo, . #).4-S ADDRESS 2 �!2 CITY a IP 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 reasons) 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, 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 % Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exemptfrom Ilcensitre 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 (S500). U I, as owner of the property, or my employees with wages as theft We oampensaliom will do U all of or U portions of the work, and the structure Is not Intended or offered for sale (Section 7044, Bualness 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 side. If however, the building or improvement is sold within one year of completion, the Dwner-Builder will have the burden of proving that it was not built or Improved fur the purpose of sale,). 11, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Prafesslons Code: The Centractars' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Coniractor pursuant to- the Contractors' State License Law.). (-) I am exempt from licensure under the Contractor's State License law for the following reason(s): Date: Sign: By my signature below 1 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 permlt,i cannot legally sell a structure that I have built as an owner -builder it 11 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 Wet s te: http/vvww.logiRfg,ca,gov/colaw,mtmi. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions at Chapter 9 (commencing with Section 7000) of Division 3 of the Buslaess and Professions Code, and my license Is in full force and effect. LICENSE CLASS: LIG. NO.: �' 1 EXP. DATE: CONTRACTOR:`G;,,.C'-`,_'� WORKER'S GOMPENSATION DECLARATION 1 HEHEBYAFFIRM FINDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 1 have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 ofthe Labor Cade, for the performance of the 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.M Worker's Compensation Insurance Carrier and Policy Number are: (_ CARRIER -✓ �'t` POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED 001-1.ARS $100 OR LESS). 1 certify that into performance of the workforwhl& this permit Is Issued, I shall not employ any person in any mannerso alto become subject to the Worker's Compensation Laws of California, And agree that If I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forihwlth 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 ($300,000), in addition to the cost 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, Civ. Op. LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above Informatlon is correct. I agree to comply with all city and county ardinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentloned property for inspection purposes PERM�(PRI � -•, SIGNATURE DATE APPLICATION DATE: l f PIC# ISSUE DATE_ 'Pj/I � PERMIT#: R 0 TYPE CONST. OCC GROUP: Soope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport w Patio/Deck Lu LL Pool/Spa 0 Re-Rocf Q Commerciai Z) m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE .t U w c7 m r1 d x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION F EE: PRE -ALT FEE: ' BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: /"..1Qej,.11 rm ORt pi P/C: PAID BY: VALIDATION: RECEIPT # C-:" PAID BY: CZE ;6'j VALIDATION: WHITE — Department Copy, YELLOW -- Finance Copy, PINK— Assessor Copy D IAMOND BAR INSPECTION R SETBACKILETTER TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T-13II FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL LIFER GROUND SEWI R LATERAL. MAIN WATER LINF SEWL.R CLEANOUT ROOF SHEATHING Fl 0014 SHEATHING SHEAR WALLS EXTERfOR INl LRCEPTER HOT MOP/SHOWERPAN SF.Pi]C/CESSPOOI HERS REPORT RECIIVED OFMOLTION ROOF DRAINS ROUGH CONDUIT POOL/SPA ....... _.... __..._ _ _.... SHEAR WALLS INTERIOR _..._.._ ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTR[CAL ROUGH MECHAN{CAL ROUGH ELECTRICAL W{ } G ( ) ROUGH PLUMBING INSULATION WALL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK HONDING INSULATION CFII ING DRYWALL I Al H (PRE) I ATH EXTERIOR LATH INTERIOR GAS TEST P. -.TRAP FENCE / GATE/ ALARM _ FINAL POOL WALLS; WALL FOOTING/STEEL WALL STEFI 1 '( ) 2N0( ) LIFT WALL BOND BEAM WALL DRAY SEAL SCRATCH COAT ELECTRIC MLiER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING WALL FINAL RO. FRAMING PiANNINGAPPRdVAL ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL ELECTRICAL 1 FINAL PLUMBING T.C, of OCCUPANCY CERT. of OCCUPANCY COMMENTS: FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE