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Home My WebLink AboutPR17-14094w Cr 0 z O Z C'3 4MIXOND BAR 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 BUIL DING PER VIII APPLICATION www.cityot'diamondbar.com bnilding@dlamondbarea.gov JOB SITE ADDRESS — _ t' 'tdIif APN LOT T CT OWNER ADQRESS 2 - CITY% ZIP . IMI 1 APPLICANT a m TEL r� CONTRACTOR - ADDRESS CITY &"" 4— ZIP TEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty at 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 Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any structure, priortD 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 70DO of Division 3 of the Business and Professions Codej or 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 subjects the applicant to aclvll penalty of not more than five hundred dollars ($500). { j I, as owner of the property, or my empleyees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Pmiassions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' cr personal effort, builds or improves the property, provided that the improvements are net intended or offered for sale. If however, the building 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 for the purpose of sale.). () 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 Llcensa Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). () I am exemptfrom licensure under the Contractor's State License law forthe following reason(s): By my slgnature 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 permii,l 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 milerstand 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 Weh site: http/www.leginfo-ca.gov/calaw.himl. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Seaton 7090) of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: LIC. NO.: --_� DATE; F CONT€tACTOR: WORKER'SC MP -E B'A TO i ION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THF FOLLOWINGLARATIONS: I have and will maintain a Certificate of Consent to SelfInsurefor Worker's Compensation, as provided by Section 3700 of the Labor Code, 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 Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and j Policy Number arab CARRIER °4:�.--�= •'-' POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS EOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to 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 forthwith 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 ($100,000), in addition to the cast of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm cinder penalty of perjury that there is a Construction landing Agency for the performance of the work for which this permit Is Issued (Sec 3097, Civ. C.). LENDER'S NAME; LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct, I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter I the above-mentioned property r inspection p uses. PE#1' EE Nr �. DATE APPLICATION DATE: PIC# l�L N ISSUE DATE; 2-RPERMIT# : W 41 4 0'0I TYPE CONST. GROUP: /OCC Scope of Work �a''1 tae ®�l�" %d.r'G�e , # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SO. I FACTOR PSF ADJ. AREA/VALUATION SFFVADD/REN Garage/Carport LOU Patio/Deck LU rc Pool/Spa ZRe -Roof Commercial m vafua$f®n: Adj. Area: QUANTITY DESCRIPTION FEE U it U w m a ca z v CONSTRUCTION: PLAN REVIEW: -7'0 Z ELECTRIC: PLUMBING: MECHANICAL; INSPECTION FEE: ISSUANCE:3 �L SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: . no BASF: �p PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID BY: RECEIPT # 1, 1""g. PAID BY: V : 8, 53 a VALIDATION: VALIDATION: WHITE—Department Copy, YELLOW Finance Copy, PINK—Assessor Copy B,: INSPECTION SF.TBAMLETTER ' ;i, : ,'��;' 1 ; ' TRACTAND LEDGER ` FOOTINGS FORMS f SWITCH GEAR ✓ _ SLABCOMMERCIAL HOOD UG. PLUMBING -.� T -BAR m UG. ELECTRICAL LIFER GROUND SEWER LATERAL MAIN WATER LINES SEWER CLEAN OU E ROOF SHEATHING FLOOR SHEATHING SHEARWALLS EXTERIOR SHEAR WALLS INTERIOR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/GESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH GONDUIT POOUSPA ROUGH PLUMBING _ FRAMINGNENTIW ROUGH ELECTRICAL _ ROUGH MECHANICAL ROUGH MECHANIGAL ROUGH ELECTRICAL W( } G(ALAy�, GAS TEST--� ROUGH PLUMBING INSULATION WAIL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR - _ - GAS TEST SCRATGII COAT PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STF-EL - WALL STEEL 15T( ) 2N°( E IE f - WALL ROND RFAM WALL DRAIN/ SEAL WALL FINAL. ELECTRIC METER RELEASEE GAS ME TFR RELEASE SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ' `/ =" c ' �� ROUGH FME APPROVAL FINAL MECHANICAL FINAL ELECTRICAL„1a FINAL PLUMBING T.C, of OCCUPANCY CERt of OCCUPANCY FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ TNG/ PW FM AL COMMUNETY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE