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Home My WebLink AboutPR17-8185CITY 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 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building*,diamondbarea.gov FIRMLY JOB SITE ADDRESS 33 8 S, P"c s tc, r K6 68 APN LOTTRACT — OWNER e,% sr ADDRESS CITY APPLICANT TEL. CONTRACTOR 7, i 1_1 '�' 4 ADDRESS / &6.� e - 0 IFFY % -77 e -,, '2�� 11? ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL, OWNER -BUILDER DECLARATION I hereby affirm under penalty at perjury that I am exempt from the CmIll 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, prior to Its, issuance, also requires the applicant for the permit to file a signed statement that he at she is licensed pursuant to the provisions of the Contractor's Stale License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exampi llransu(D and the basis for the alleged axErriptlun. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of met more than five hundred dollars ($500), U 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 net 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-Bullder will have the burden of proving that ft was not built or Improved for the purpose of sole.). I f, as owner of the property, am exclusively contracting with licensed Contractors to 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 pursuant to 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, except for my personal residence IT which I must have resided for at least one year prior to completion of the improvements covered by this parmft,l cannot IE9811Y 8011 a Structure that I have built as an owner-bu;Ider 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 of at the fcllowlrg Web site: httpAmw.logirft.ca.gpv/calaw.htrnI LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under previsions at Chapter 9 (commencing with. Section 7000) of Division 3 of the Business and Professions Coda, and my license is in full force and effect. LICENSE CLASS: LIC. NO,: �72 EXP. DATE: CONTRACTOR: 5' 7- -e., WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS; I have and will maintain a Certificate of Consent to Sell for Worker's Compensation, as provided by Section 3700 ofthe Labor Code, for the performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as required by Section 3700 afthe 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 (THIS SECTION NEED NOT BE COMPLETED IFTRE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I csfffVthat In the performance of the workiorwhich this permit is issued, I shall notamploy 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 WOO of the panne Code: I shall forthwith comply with Tose provisions DATE:_ APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shalt subject an employer to criminal penalties and civil flnes up to one hundred thousand dollars ($100,000), 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, Div, C.). LENDER'S NAME LENDER'S ADDRESS: I certify that I have read this application and slate 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-irentloned property for inspection purposes. PERMITTEE G,44E (P INT) —jZ SICNATURE d'F PERMITTEE DATE APPLICATION DATE: _7 -Zi z 1 `51 ISSUE DATE: 7-Z 0 ?—/1 h_PEFl I: TYPE CONST. OCC GROUP: Scope of Work zrn :Z DWEL. UNITS #STORIES #BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATiON SFR/ADD/REM Garage/Carport Patio/Deck LL Pool/Spa Z Re -Roof 0 j Commercial Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a L; W C.D e0lifilluous WOM Deeal !his permit _,%A C.D L -W4 1wi then the days !1 CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RILTILNTION FLE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: "4 3 3A Poor k d or* p, --r OA TOTAL FEES COMMENTS: Z S tzk r 0 ui- P/C: PAID BY: VALIDATION: REOEIPT# PAIDBY: VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy SETBACK/ LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL (fflOU UG. PLUMBING T—BAR UG. ELECTRICAL........ _ INTERCEPTER — UFER GROUND HOT MOPISHOWERPAN SEWER LATERAL SEPTIC/CFSSPOOL MAIN WATER LINE BIERS REPORT RECEIVETI SEWER CLEANCUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIORPOOUSPA ............ SHEAR WALLS INTERIOR ROUGH PLUMBING FRANIINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL... ROUGH ELECTRICAL W( ) C () GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING _m..__..,_...._.... __. INSULATION CEILING P—TRAP DRYWALL FENCE/ GATE/ALARM (- _ --- LA"IEI PfiL ""� FINAL POOL �� I A I EI [ X LC WALLS: I.ATI I INTFRI(( WALL F007NG/STEEL 1. GA5 TLS' I WALL STEEL 1sr( Zmo( )F_ T _ LIFT _ SCRAICII GOAT w. WALL BOND BEAM LLL( IML MQLliRELE:AS w � �,e �`� WALL DRAIN/ SEAL GAS MF I LH It FWALL FINAL d... SE'E.LIAI.1NSPk L i10N R0. FRAMING PLANNING APPROVAL FINAL BUll s� a .' .,, ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT _..._. _... ........ ._ -- FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT of-.0-CM-PANCY. FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE, COMMENTS ................. .