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Home My WebLink AboutPR17-7163 (14)CITY OF DIAMOND BAR DEPARTMENT OF CONIM-UNITY & 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 bnilding@diamondbarca.gov JOB SITE ADDRESS ✓— ` b'v's-_ Al LOT TRACT OWNER SdK � I'rT,crib ADDRESS 7-0 f,00 e..,e.af ... CITY ZIP TEL`i 0"i-`�"L�et- Z3! APPLICANT 6-e-4-0 e -.z�tr—k- , TEL sg' CONTRACTOR ADDRESS `i®4! int<�c �4 mss' L-A CITY Nc§1hl:�tws leir�ZIP`l Ti 4'1a Sil- 4:4`$ ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors State License Law for the reason(s) Indicated below by to cIrKkmark(s), I have placed next to the applicable Hari [Section 7031.5, Business and Professions Coder 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 7000 of Division 3 of the Business and Professions Cade] or that he or she Is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the appiicanf to a civil penalty of riot more than five hundred dollars ($506). 0I, as owner of the property, or my employeeswith wages as their sole compensation, will do U all of or (-.) 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 -Bulkier will have the burden of proving that It was not built or improved for the purpose of sale.). 11, I, as owner of the property, am exclusively contracting with licensed Contractors to construct theproject (Section 7G44, Business and Professions Code: The Contractors' State License Law does net apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuantto the Contractors' State License Law.). (-) I am exempt from Ilcensure 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 priorto completion of the improvements covered by this permiLl 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 Buslness and Professions Code Is available upon request when this application is submitted or at the following Web site: httplwww,leginfo,ca.govlcalaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my, license is in full lorce and effect. LICENSE CLASS; f2;�' LAC. NO.: 10 � t 2 EXP. DATE, CONTRACTOR: 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 Self -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. )rave and will malnta€n Worker's Compensation Insurance, as required by Section 3706 of the Labor Coda, for the performance ofthe work for which this permit is issued. My Worker's Compensation insurance Carrier and Policy Number are: ! GABBIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IFTHE P DRED DOLLARS $100 OR LESS}- ; I cerEfy that in the performance of the work for which this per s i Is line ploy any person in any manner so as to become subject to the Worker's Compensation a of Go' d re that if I hould become subject to the Worker's Compensation provisions of Section 3700 of-taor I III rth ith omplyw those provisions. CATE1 i WARNING, Failure to secure Worker' 0ompensa n cov ge is shall subject an employer to criminal i penalties and civil tines up to one hundred thousand della 60,006 , In addition to the cost of the compensation, i damages as provided far in section 3708 ofthe tabor code, interest, and attorney's fees, CONSTRUCTION LENDING AGENCY j I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which chis permit is issued (Sec. 3097, ON. C.). LENDER'S NAME: LENDER'S ADDRESS: r - I certify that €have read this application and state that the above information is correct. I agree to comply with all city and county orefnances and state laws relating to building construction, and hereby authorize representatives of this county AD i enter upon the above-mentioned property for Inspection purposes. i r PERMITT WNATILAE�jlf PERMITTEE DATE APPLICATION DATI L, " a P/C# ISSUE DATE: -PERI P F1 TYPE CONST. OCC/ GROUP: Scope of Work 'mac°`$ 5't'+"s*P f FSC �'�-C 4-a � # I UNITS # STORIES � - ;✓'!ci'-:.?J y F g Fog ia'%T_9i_� # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Patio/Deck � POOVSpa Re -Roof _j Commercial Valuation: Adj. Area: QUANTITY DESCRIPTION FEE c� w w c7 z m a a U 4 x v CONSTRUCTION: PLAN REVIEW: 1-15 ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 3 1 SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: 9 BASF: ` PLOT PLAN: ZONING CLEARANCE: 14 TOTAL FEES COMMENTS: PIC: PAID BY: VALIDATION: pp RECEIPT!! t _ PAID BY: ``' VALIDATION: WHITE —Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy CITY OF DIAMOND INSPECTION Retrofitting windows on the sides and front and rear of the property. Prior work done by contractor was not legalized. Owner is trying to legalize windows by retrofitting windows to meet egress. mss: SIRGIE RY FMOMI lLWAUn ��i RAE ji E ®ih51m un, GA 917a G.Mmu JMHM RESIDENCE GEM commutm Co. �T 2M CROM CREU Y 1 �°°MA a ` yg "mss UMM @AR, M 51765 11 AWFUM M% M 9=4 m V5 WMIM � � l k 353ssu59tt6 VO %Mtl filew a QRLIS V3! ffw I�SEfdilil€1$�y ' s eA IQ li I RUN 11370 9mw . a I -------- --- aagg - 1 �ze�n �� z - � $.9R2Qag 2 6p0 Z 2 0 a I ----------- aagg - -43 �ze�n �� -