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Home My WebLink AboutPR17-19255w z 0 0 LU Cr a c Le. a cc c c L L F ' - ° CITY OF DIAMOND BAR r i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond liar, CA 91765 PRESS 4q (909) 839-7020 Fax: (909) 861-3117 Bdilding Inspection Hotline (909) 839-702t` FIRMLY ry�9 BUILDING PERMIT APPLICATION www.cityafdiamondbar com building@diamondbarca.gov JOBSITEADDRESS27Tk&r,v APN L T TRACT OWNER —V 04 ADDRESS I � r,�III CITY ZIP TE Ait ` '. APPLICANT L•F GONTRACTOR ADDRESS �� CIN fir' ZIP EL 4 ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law far the reason(s) Indicated below by the ctreckmark(s), I have placed next to the applicable items) [Section 7031.5, Business and Professions Cade: 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 pursuant to the provisions of the Conlrantor's Slate License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exemptfrom licensure and the basis for the alleged exemption. Any violation of Section 7031,5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). Q €, as owner of the properly, or my employees with wages as theirsole compensation, will do (J all of or U portions of the work, and the structure Is not intanded 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, bubds or improves the property, provided that the improvements are not intended or offered for sale If however, the buhding or improvement Is sold within one year of completion. the Owner -Builder wlll have the burden of proving that it was not built or improved for the purpose of sale,(, (_) €, 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 properly 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: Slgm By my signature below I acknowledge that, exceptfor my personal residence In which I must have resided for at least one year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner -builder If It has not been constructed in its entirety by llcansed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is available upon request when this Rpplication Is submitted or at the following Web site: httplwww.loginfo.ca.gov/caIRW.html LICENSED CONTRACTOR'S DECLARATION r I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7006) of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CiA55:> _ LIC. NO.: I DATE4, `-"2 `°`1 CONTRACTOR: y WORKER'S COMPED SATI'ON,j�ECLARATf� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING D RATIONS: have and will maintain a Cerdflcate of Consent W Self-InsGre for Worker's Compensation, as provided by ISection 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Lahor Cade, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carder and Policy Number e; CARRIER POLICY NUMBER JHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT 1S FOR ONE HUNDRED DOLLARS $100 OR LESS}. j 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 Cempensatlon 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 ] panaltes and civil fines up to one hundred thousand dollars (61 00,000), in addition 10 the cast of the compensation, j damages as pfovlded for in section 3708 of labor code. Interest, and attorney's fees. E CONSTRUCTION LENDING AGENCY u 1 hereby affirm under penalty of perjury that there Is a Construction Lending Agency for the performance at the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME' LENDER'S ADDRESS: U L € certify that I have read this application and state that the above information is correct. I agree to comply with all city and a county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to J enter upon to above-mentioned properyfor repecciion purposes, T PERMITTEE NAME (PRINT) n E I SIGNATURE OF PERINI "� ': i �'' DATE APPLICATION DATE: fZ / d � __ PIG# ISSUE DATE: �2 PERMIT# : PP1-4- _ i C17_ss TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF Al AREA/VALUATION SFi/ADD/REM Garage/Carport W Patio/Deck W LL Pool/Spa ZRe -Roof O Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE V U u+ ca Z -7 M J a a 2 . U_ �d U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 3Z4,36 MECHANICAL: INSPECTION FEE: ISSUANCE: Si ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: - TOTAL FEES 383, 9 2— COMMENTS: COMMENTS: P/C: PAID BY: VALIDATION: RECEIPT # PAID BY: VALIDATION: WHITE— Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy CITY OF DIAMOND INSPECTION d MEMO= ACK/ LETTER 7FOO1INGSFORIVIS TRACT AND LEDGER SNITCH GEAR COMMEIICIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL_ INTERCFf' I ER - UFFR GROUND ROT MOP/SHOWERPAN SEWED I AIFRAL - _ SEPTICIGFSSPDOL MAIN WAT R LINE REPORT RECEIVED SEWER CI CANOUT _HERS DEMOLITION ROOF SI IFATLIING ROOF DRAINS FLOOR SI f LATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR PODUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELEG f HICAL W( } C ( ) GAS TEST —'ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION GFIL.ING P -TRAP DRYWALL FENCE/GATE/ALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1''( J 2"D( } LIFT SCRATCH COAT WALL BOND SLAM ElECTRIG VIETHi fIELE:ASE WALL DRAIN/ SEAL GAS METER RELLASE WALL FINAL SPECIAL fNSPEC fION R0. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLUMBING FINAL PLANNING FINAL ENGINEERING/ PW T,C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT, of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENT& __ _