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Home My WebLink AboutPR17-3708U1010ND'RAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION w iriv.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS \-{— APN LOT TRACT ill R' OWNER 'tip ADDRESS C Ir CITY ZIP ( TEL.!70 -Lo 8y APPLICANT r fP° TEL. CONTRACTOR i ADDRESS , CITY ZIP TEL. e' 63 ARCH/ENG/ DESIGNER Patio/Deck ADDRESS Lu LL CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor'a State Llcense Law for the reasw(s) Indicated below by the checkmark(s), I have placed next to the applicable [tam(s) [Section 7631,5, 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 far the permit to file a signed statementthat he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7666 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for the alleged exemption. Any violafion of Sectlon 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) (-) 1, as owner of the property, or my employeeswith wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for safe (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of properly who, through employees' ar 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 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,). U I, as owner of the property, am exclusively contracting with licensed Contractors 10 construct the project (Section 7044, Business and Professions Code The Contractors' 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 Contractor pursuantto the Contractors' State License Law,), U I am exemptfrom licensure under the Contractor's State License law for the following reason(s): Date: Sign. By my signature below I acknowledge that, uceptfor my personal residence in which I must have resided for at least one year prior to 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 at the following Web site http/www.leginfaca.govlcalaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7090) of Dlvlslon 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: LIC. NO.: EXP.DATE: CONTRACTOR: WORKER'S COfr1PENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY DNE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certli cate of Consent to Self -Insure for Worker's Compensation, as provided by Section 37CO of the Labor Code, for the performance of the work for which this permit Is Issued. I have and wlli maintain Worker's Compensation Insurance, as required by Sectlon 3700 ofthe Labor Code, for the performance of the work for which this permit is issued, M Worker's Compensation Insurance Carrier and Policy Number are:, , CARRIER POLICY NUMBER .% C - FS (6,11 2-- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS) I certify that In the performance of the work for which this permit is issued,[ shall not employ any person in any manner so sale 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 tines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for In sectlon 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, CN. C,). LENDER'S NAME: LENVER'S ADDRESS: U_ 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 "an to building construction, y authorize representatives of this county to enter upon the above -men' rte property or inspection purposes, PERMITTEE NAME (P 7) @ 51014ATURE OF PERMITT DATE PRESS FIRMLY APPLICATION DATE -7 rl-1 P/C# III 166UEDATE: /.11411 x- PERMIT#: PJ+— TYPE CONST. OCC GROUP: \-{— Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/AD D/REM - Garage/Carport 07 LW Patio/Deck Lu LL Pool/Spa ZRe -Roof aCommercial m Vahrati®n: Ad]. Area: QUANTITY DESCRIPTION FEE WU J J z m ii J Q U_ x U CONSTRUCTION: PLAN REVIEW:<16 . O „L ELECTRIC: a . &:3, PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: ----{ SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: SIC., BASF: r PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: ` �3 �g�^ PAID BY: yif X*Qr VALIDATION: RECEIPT# rte. PAID BY Z( } t^ ``j VALIDATION:"°`°" WHITE— Department Copy, YELLOW— Finance Copy, PINK— Assessor Copy SETBACK/ LETTER -- .._... FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL - UFER GROUND SEWLR I Al FRAL MAIN WATER LINE SEWCER CLEANOUT ROOF & [EATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( } C ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT, of OCCUPANCY CITY OF DIAMOND BAR INSPECTION C IRAC! AN l) I..E:DGER SWI IGH- GEAR .......... COMW.:RCIAL HOOD I -RAR . ........... IN FE1RCEPTER HOR MOP/SHOWFRPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOLISPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST - PRE GUMTE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM FINAL POOL WALL& WALL FOOTING/STEEL WALL STEEL isr( )2 NE( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL -- ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT ------ ----- FINAL --- FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE