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Home My WebLink AboutPR17-8187J L--- 21_ 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 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building(a),diamondbarca.gov -)f`€'# 6� JOBSITEADDRESS ' �8 qq [ specir-,rs APN LOT TRACT OWNER ADDRESS CITY "ZIP TEL. APPLICANT TEL. CONTRACTOR ADDRESS CITY, ,V,1,,7 a - ZIP ��Tl 7 «<6 ARCH/ENG/ DESIGNER ADDRESS CITY 71P —TEL, OWNER�EIUILDER DECLARATION I hereby affirm under penalty of perjury that I arif exempt from the Contractor's State Lbamsa Law for the reasons) indicated below by the Dbeckmark(s), I have placed next to the applicable Iterni [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 statemeritthat he or she is licensed purrsual 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 licensure and the basis for the alleged exemption. Anyviolallor of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). L-) 1, as owner of the property, or my employees 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 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 building or improvement Is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not I or improved for the purpose of sale.). (-) 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sisclil 7044, Business and Professions Codc: The Contractors' Stale Liberec, Law does not apply to an owner of property who builds or improves thereon, and who contracts fortire projects with a licensed Coal bursuaritto the Contractors' State License Law.). (-) I am exempt from 11censure 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 pDrri 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 roil when this ripplIcatlor is submitted of at the following Web site: hftplwww,leginfo.ca.gcv/Dalaw.html, LICENSED GONTRACTORIS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing Alth Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect LICENSE CLASS: /_7 LIC. NO.: EXP, I CONTRACTOR! I—C-V y WORKER'S COMPENSATION DECLARATION i HEREBY AFFIRM UNDER PENALTY OF PERJURY ME OF THE FOLLOWING DECLARATIONS: I have and will maIntain a Certificate of Consent to S911 -Insure for 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 mall Worker's Compensator Insurance, as required by Section 3700 ofthe Labor Code, for the performance of the work for which this permit Is issued My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (TRIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS 5100 OR LESS). I cortify-that In the performance of the work forwhl this permit is issued. I shall not employ any person In any manner so a to become subject to the Worker's Compensation Laws of California And agree that it 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 socurn Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines no to one hundred thousand dollars ($100,000), In addition to the cost of the compensation, damages as provided for in section 3706 of the labor code, url 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. C.). LENDERS 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 properly for inspection purposes. 5 PERNI ME, P91I .. I _�Z_ 4 - .. 4=1 —, SIG NAT EOFPERMITTEE DATE APPLICATION DATE: 12/1 -` P/c# P R fT - 8 1' S� ISSUE DATE: PERMIl P I 1 -1 — 8 i TYPE CONST. OCC GROUP: Scope of Work iz� et", # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. Fr. FACTOR PSF ADJ. AREA/VALUATION SFFVADD/REM Garage/Carport LW Patio/Deck U Pool/Spa Re -Roof J Commercial 5 Valuation: Adj. Area: QUANTITY III a EE rMI-MMI I CZA T— I F% 9 , co r% A 'U PlEft Continuous work d nt meem thiS pe;j val d--- to-naermllan the S fliftid 53 CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL INSPECTION FEE: ISSUANCE: SMIl ENERGY P/C: ENERGY PERMIT: RETENTION FEE: Pi FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES Wor-K H o np_t�w COMMENTS: Be ji� P �8 llj� rrv�L-ll wos cv(��,, v,lbrK' 5-toiii-Jed P/C: PAID BY: VALIDATION: T ILL P ECEIPT 0 PAID 13Y: 1/ 3 VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assesnor Copy SETBACK/ LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFFR GROUND ........................... SFWFR I ATPRAL MAIN WATER LINE SL.WI.R CLEANOUT 11001 SHEATHING FLOUR SHEATHING SHEAH WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING HOUGH MECHANICAL ROUGH ELECTRICAL W( ) C YlOUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH LATH INTERIO GAS TEST SCRATCH COAT ELECTRIC A WVA§p' GAS METER KELP 'v i SPECIAL INSRII i FINAL BUILDING CITY OF DIALiOND BAR INSPECTION E IRACI AND LEDGER SWITCH GEAR COMMERCIAL HOOD I' -RAH ........... . IN] F'HCEPTER NUT MOP/SHOWFRPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST . PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATU ALARM RNAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1'-( ) 2`0( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL