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Home My WebLink AboutPR17-0516CITY 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@diamondbarca.gov p 99 F$ APPLICATION DAT : lhyd r, �6 �� w e/! /C# El� _051(0 Cl JOB SITE ADDR S !!ff APNAVd--W-7 P-7 LOT_ TRACT L� n OWNER �3 CITY '? iF/ rpaTEL �a F;. P`+v APPLICA t�i��P 1 "T TEL��—b" s g CONTRACTOR m ADDRESS 0 Tar CITY ZIP TEL. o ARCH/ENG/ z DESIGNER ADDR,ESS&,Z1L?CZ0., ado- m CITY � L- ZIP OWNER -BUILDER DECLARATION tr CD f hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law far the reason{s) oindicated below by the checkmark(s), I have placed next to the applicable Items) [Section 7031.5, Business and z 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 pursuantto the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section cn 7000 of Division 3 of the Business and Processions Code] or that he or she Is exempt from €icansure and the basis for `n the allagedexemption,AnyviolationofSection7031.5byanyappllcantforapermitsubjectstheapplicanttoacivilpenalty � of not more than five hundred dollars (5500). q (_)1, as owner of the property, or my employees with wages as their sale compensation, will do (j all of or [j portions z of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The LLI 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 pimprovement Is sold within one year of completion, the Owner -Builder will have the burden of prming that it was not built 0-' or improved for the purpose of sale.). zL) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section rn 7044, Business and Professions Gode: The Contractors' State License Law does not apply to an owner of property who y bulldsorimprovesthereon,andwhoccntraclsfortheprejectswitha€icensedContractorpursuanttotheContractors'State cc License Law.). 0 U I am exempt from licensure under the Contractor's State License law for the following reasoli L� z Date, Sign: C) By my signature below I acknowledge that, except for my personal residence In which I must have resided for at 1eas1 one 4 � year prior to compietlon of the improvements covered by this permlt,l cannot legally sell a structure that I have but€t as an E: owner-huilder If It has not been constructed in its entirety by llcensed contractors. I understand that a copy of the rX applicable law, Section 7044 of the Business and Professions Cade is available upon request when this application Is c3 suhmided or at the following Web sli httptwwwleginfo.cagovlcaiawhtml. v LICENSED CONTRACTOR'S DECLARATION mI hereby affirm under penalty of perjury that I am llcensed under provisions of Chapter 9 (oommencing with Section 7000) of Div{sion 3 of.,I lin s a; Prof Codefand my I ns inn ll force and effect. On 553✓ �✓ CJC/�`n o LICENSE C A - LIC. NO.: M EXP. DATE:' CONTRACTOR: a o WORKER'S COMPENSATION DECLARATION LU I HEREBY AFFIRM CINDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: o_ I have and will maintain a Ca"I cafe of Consent to Self -Insure for Worker's Compensation, as provided by J Section 3700 of the Labor Cade, for the performance of the work for which this permit Is issued. I have and wi[I 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 o PalicyNumherarrC Z LU CARRIER z o^ POLICY NUMBER c- (THIS SECTION NEED NOT BE COMPLE71ED IFTHE PERMIT IS FOR ONE HUNDRED DOLLA S $100 OR LESS), p I certifythat in the performance of the work far which this permit Is Issued, l shall not employ any person in any manner so as to n become subject to the Worker's Compensation Laws of California. And agree that it I should become subject to the Worker's JCompensation provisions of Section 3700 of the Labor Code,1 shall forthwith comply with those provisions, L� DATE: APPLICANT'S WARNING: Failure to secure Worker's Compensation coverage Is unlawful, and shall subject Rn employer to criminal w penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, o damages as provided for in section 3708 of the labor code, interest, and attorney's fees. Cr CONSTRUCTION LENDING AGENCY Lu 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.). LENDER'S NAME. LENDER'S ADDRESS: LJ �- I certify that 1 have read this application and state that the above information Is correct. I agree to comply with all city and z county afinances and tate 1 relating to building construction, and hereby authorize representatives of this county to Q enter up the above- enti a probes fe ins ectlon purpo ,r ("C13 PERM E NAM Fill T) d �l E SIGNATUpKfF PERI / DATE e -- ISSUE TYPE CONST Scope of Work P"})' T#: OCC GROUP: # DWEL. UNITS # STORIES # BEDROOMS W LJ LL 0 Z d J_ n to DESCRIPTION SO, FT. FACTOR PSF ADJ, AREA/VALUATION SFR/ADD/REM Garage/Carport Patie/Deck POCVSpa Re-ROOf Commercial Val ion: " `i - Adj. Area: CONSTRUCTION: PLAN REVIEW: QUANTITY DESCRIPTION FEE ELECTRIC: U U J w MECHANICAL: z SMTP: a ENERGY P/C: cs ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: z a PLOT PLAN: CONSTRUCTION: PLAN REVIEW: 343.71 ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: tO 7 - ZONING CLEARANCI=:Aq TOTAL FEES COMMENTS: a °? -� PIC: 6 I PAID BY: l } VALIDATION: J"L RECEIPT# PAID BY: 112® y® �P — VALIDATION: Q WHITE — Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy CITY OF DIA ONS BAR INSPECTION SETI3ACK/ LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL LIFER GROUND SEWF Ii LATERAI MAIN WATER LINE SEUVEfi CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR MALLS EkTERIOR SHEAR WALLS INTERIOR FRAMINGIVENTING ROUGH MECHANICAL ROUGH ELECTRICAL W{ ) C { ) ROUGH PLUMBING INSULATION WALL. INSULATION CEILING DRYWAI I. LATH (PHI-) I ATH EXFI' RIOR LATH INTERIOR — GAS TES I SCRATCH COAT ELECTRIC METER RELEASE (:IAS METE:II RELEAtiF SPECIAL INSPECTION FINAL BUILDING y � FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY ICE�T. ®� CCElPANCY COMMENTS TRACT AND LLDGER SWITCII GEAR _. .— COMMERCIAL 1100D T -BAIT INTEIWEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RFGEIVED OEMOI IT1ON _ ROOF D{TAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GIINITE _ POOL PRE DECK BONDING P -TRAP FENCE 1 GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL _ WALL STEEL 1 2Na( ).LIFT WALL BOND BEAM WALL DRAIN/ SEAL. WALL FINAL 110. FRAMING PLANNING APPHOVAL ROUGH FIRE APPROVAL FINAL FIDE DEPARTMENT FINAL PLANNING� W _ FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. NAL INDUSTRIAL WASTE_