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Home My WebLink AboutPR17-13554DIi1�1011TD BAIR �..:.IH O.AJ CITY OF DIAMOND BAR'" DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES xrA �PRESS 21810 Copley Drive, Diamond Bar, CA 91765 FIRMLY (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea gov F- JOS SITE ADDRESS Asa r / 7#+itsil z LOT TRACT APN OWNER lGf 111111 11 14Gil`► r w CITY WfJ�li ZIPVIi�TEL. °rUei ' fibJry ' S CD APPLICANT r CONTRACTORim cJ R* ADDRESS 1 �Uq �iir-irl rr CITY ZIP P7 EL, y • -7 0 a ARCH/ENG/ z DESIGNER C) ADDRESS m CITY ZIP TEL. OWNER -BUILDER DECLARATION ci hereby affirm under penalty of perjury that I am exempt from the Contractor`s State License Law for the reason s LU C) 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, atter, improve, demolish, or repair, any applicant for the permitto Nle a signed statement that he or she structure, prior to its issuance, also requires the 00 is licensed pursuant to the provisions of the Gonlracter's State License Law (Chapter 9) Commencing with section c=n 7000 of Division 3 of the Business and Professions Cade] or that he or she is exemptfrom licensure and the basis for `n the alleged exemption Any violation Of Ssctlon 7031.5 by any applicant for a permit subjects the appllcartto a civil benalty cc of not more than five hundred dollars ($500). p portions ® {� I, as owner of the property, or my employees with wages as their sole compensation, wih do (� all of or U r� for sale (Sec of the work, and the structure is not Intended or offered tion 7044, Business and Professions Code: The w Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, Builds or improves the property, provided thatthe improvements are not intended or offered for sale. It however, the building or improvement is sold wlthln one year of completion, the Owner-Bullciv will have the burden of proving that It was not built 0 c' or improved for the purpose of sale 1. as owner of the property, am exclusively contracting with licensed Contractors toconstruct tr p opeproject S8Gt1Oo 7044, Business and Professions Cade: The Contractors' State License Law does not apply e owner builds or improves thereon, and who contracts for We projects with a licensed Contractor pursuant to the Contractors' State License Law,), (a I am exempt from licensure under the Contractor's State Llcense law for the following reasurl Sign: Date: rsonal residence In which I must have resided for at least one By my signature below I acknowledge that, except for my pe �d year prior to completion of the Improvements covered by this parmlt,l cannot legally sell R 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 avallable upon request when this appllcation is CDsubmitted or atthe following Web site: http/wvvw.loginio.on.goV/08law.htmi- LICENSED CONTRACTOR'S DECLARATION ILL1 hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) ca DIVISIOn 3 of the Business and Professions Code, arid my Iieenss is in full force and effect, =,O� LICENSE CLASS f LIC. NO.: (0 C/ EXP. DATE: 3 P CQNTRACTOR' WORKEll CONP%SATION DECLARATION Ql HEREBY AFFIRM llNi)FR PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: p I have and will maintain a Certificate of Consent to SBIf-insure for Worker's Compensation, as provided by .Section 3700 of the labor Code, far this performance of the work for which this permit Is issued. 7 �,�/ have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for 0 zd the performance of the work for which this permit 18 issued. My Worker's Compensation Insurance Carver an Policy Number are: f� Al— CARRIER POLICY NUMBER N %AJ C in F- (THIS SECTION NEED NOT BE COMPLETED IF TWE PERMIT IS FOR ONE HUNDRED DO IS $100 OR . I certfy that in the performance of the workfor which Ynls permit is Issued, I shall not employ any ner person In any manso as to 0 Q become subject to the Worker's Compensation Laws of California. And agree that If I should become subject to the Worker's U1 Compensation provisions of Sudden 3700 of the Labor Cade, 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 finds up to one hundred thousand dollars (SIOOOG0), in addition to the cost of the compensation, Odamages as provided for in section 3708 of the labor code, Interest, and attorney's fees. 2 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.). e- LENDER'S NAME: LENDER'S ADORES&'. d certify that have read this appllcation and state that the atove Information is correct, I agree to comply with all city an c" county ordinances and slate laws relating to Building construction, and hereby authorize representatives of this county tc Qenter upon the above red property for spectfon purposes. J m PirA ERM[TT NAME (PRINT) Cn B cn _ PATE � &IGNATURE CF PERMITTEE APPLICATION DATE: 7'I -171FIC#// ISSUE DATE: 4- PERMIT# : ! TYPE CONST OCC GROUP: Scope of Work 0 s 1r1kr� I v '1111 ng t! rr C,f e 3v e t ez- V1 SSD ODMS � S .UNITS # STOR4 L./ ll()q DESCRIPTION SQ. FT. FAC PSF AD�AREA/V�ALUATION SFRIADI IREM Garage/Carport W Patlo/Deck ti Pcoli zRe -Roof Q Commercial m valuation Lr v Adj. Area: QUANTITY DESCRIPTION FEE m a U a x CONSTRUCTION: PLAN REVIEW: _ CLECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: q3 - ISSUANCE! —r_'2 SMIP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: G BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PAID BY: VALIDATION: PIC: _ RECEIPT# PAID BY: VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy CITY OF DIAMOND RECORD . INSPECTION SLTBACIU LEI TER � - - - FOOTINGS FORMS TRACI AND LEDGER — — — — —_ - - — — — SLAB�.— SWITCH GF.AR —_ - - — — UG. PLUMBING — — — — COMMERCIAL HOOL7 —. —. UG. ELECTRICAL — — — — —T-BAR— UFFR GROUND — — IN I ERCEP"f ER —. — - - SEWER LATERAL_ HOT MOP/SHOWERPAN — — — — — — — — — — .— — — MAIN WATER LINE — SEI'T1C/CFSSPOOL— — — — — — — — — — — — — — SEWER CLEANOUT- — HERS REPORT RECEIVED — — - _ _ ROOF SI.IEATHIN(a — — .� — — — — — — — — — — DEMOLITION — — — — — — — — — — FLOi1R SHEATHING — — —ROOF DRAINS — — — — — — R `.--_.._.— .—.— —.— — ShIEAR WALLS EXTERIOR — — — — — � — � —ROUGH CONDUIT — — —. SHEAR WALLS INTERIOR PDOUSPA — — ` — — FRAMINGNENTlNG ROUGH PLUMBING _—. —..—_ �..—_ —_� —_ —.. ROUGH MECHANICAL ROUGH ELECTRICAL ROUGH ELECTRIGAL W — — — — ---_. ROUGH MECHANICAL �� ----�— ROUGH PLUMBING—_ —. GAS TEST — — INSUTATION WALL_ —" PRE GUNITE — — INSULATIfiN CEILING— — — EILING — — — — POOL. PRE DECK BONDING — — —. _— --.�. DRYWALL — —.— -- P -TRAP —...——..--..—_ 1 LATH (PRI.) FENCE / GATF/ ALARM — — — — — — — — —.. �..— — — —.—. TH LXTE:RiUR_ FINAL POOLLA —.— —.— TH INTERfOR — — — — — — — — — — — — — — diLLS: — — — — - — - — — — — — S TEST —.—--.--- — — — — — — — — — — — — — —. WALT . FO{)TING/S FEEL — —— COAL— — — — —.-- WALt. ST1:EL IST( ) Zvo( )LIFTfiATl;H — ST - - — —.--.—`----.— ELL CTfIIC METI.:RRELEASE BEAM GA5 M{:TER RELEASE WALL. DRAIN/ SEAL — — — — -- -- -- — — -- - — SPECIAI JWIPE( TION WALL. FINAL FINAL BUILDING — � — — - —...IR LAPPROVAL— FINAMSCIIANICAL �.—. RC FRAMING PLANNING APPROVAL — — — - —. E —.— — _ FINAL ELECTRICAL — —��. — — —. FINAL. FIRE DEPARTMENT w— —---—..-- FINAL PLUMBING FINAL PLANNING - — — — — — — — t�f OCCUPANCY — — — — — FINAL ENGINEERING/ PVA . lclt Oi {iiGCUPA0Y FINAL COMMUNITY SERVICES � — FINAL HEALTH KEPT.—.. -- FINAL INDUSTRIAL WASTE