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Home My WebLink AboutPR17-0121 (7),.— CITY OF DIAMOND BAR `:. ill I I I i 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@diamondbarca.gov FIRMLY JOB SITL ADDRE"Lli APN LOT TRACT OWNER G:. 0 l< ADDRESS CITY a°a ;:i f.wa ZIP APPLICANT — -- �2, � �..C�Yv� a1'� TEL 'i C� ��"`D 7 f� _�.g, CONTRACTOR V -,-_<t.... . ADDRE S(.r,� CITY _`:r i.' ZIP AHCH/ENG/ DESIGNER ADDRESS CITY ZIP —Ti OWNER -BUILDER DECLARATION I hefoby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable dorms) [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 or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter S) Commencing with Section 7000 of Division 3 of the Business and Professions Code] orthat he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any app€Icantfor a permit subjects the applicantto a civil penalty of not more than five hundred dollars ($500). 11. as owner of the property, or my employees with wages as their sole compensation, will do { j 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 not apply to an owner of property who, through empfeyees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. It however, the building or Improvement Is sold within one year of completion, fhe Owner-Ruilder w€!I have the hurden of proving that It was not bulft or improved for the purpose of sage.). L) I, 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 Pat apply to an owner of property who builds or improves thereon, and who cortractsforthe projects with a licensed Contractor pursuant to the Confractors' Stafe License Law ) O I am exempt from 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 In which I must have resided for at least one year prior to completion of the Improvements covered by this permit,I cannot legally sell a structure that I have built as an ownef-builder If It has rot 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 avallabia upon request when this application Is submitted or at the following Web site, http/www.leginfo.ca.gov/calaw.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 I'di farce and effect. LICENSE CLASS: C'LIC, N0.'. EXP. DATE: CONTRACTOR: LC r�C _ t `spa.... c WORKER'S COMPENSATION OECLARA71ON I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certrficate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 Df the tabor Code, for the performance of the work ter which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance ofthe work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Nunoberare: qq pp y CARRIER 'S � 6 POLICY NUMRFR Id. 1144Z FITS SECTION NEED NOT RE COMP FTED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 5100 OR LESS). 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 shoo€d become suhject to the Worker's Compensation 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 penalties and civil fines up to ore hundred thousand dollars ($100,000), in addition to the cost of the compensat€on, damages as provided for In section 3708 ofthe 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, ON C.). LENDER'S Ni LENDER'S ADDRESS: I certify that I have read this application and state 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-mentloned _property for Inspection purposes. _ PERMITTEE NAME {PRINT( SIGNATURE APPLICATION DATE: 0 9 Z1_+ P/C# ISSUE DATE: I PERMIT# : TYPE CONST. OCC GROUP: Scope of Work , �d �'(t a G L_�, t # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport W Patio/Deck Lu LL Pool/Spa ZRe -Roof QCommercial a 0] Valuattom Adj. Area: QUANTITY DESCRIPTION FEE V J v� z J a U Z x U CONSTRUCTION: . PLAN REVIEW: ._ ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: _ _ (S . SMTP: . ENERGY P/C: ENERGY PERM IT: RETENTION FEE: �y `�,00 PRE -ALT FEE: �? BASF: CSS PLOT PLAN: ZONING CLEARANCE: TOTAL FEES (0 COMMENTS: gC�gi g �g VALIDATION: �� `.1J fl+q7- RECEIPT # PAID BY: to 9 'T •i - VALIDATION: LC_ WHITE—Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy SETBACK/LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATFRAL MAIN WATLR LINE SEWER CLEANOUT ROU[ SHEATHING FLOOH SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR Ff3AMINGNENTING HOUGH MECHANICAL ROUGH ELECTRICAL_ W( ) C ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEII ING DRYWALL LATH (PFE) — LATH EXTERIOR LATH INTERIOR GAS TEcT SCIIAICII COAT ELL(,l I RIC METER RELEASE GA`; METER RELEASE tiPFCIAL INSPECTION FINAL BUILDING FINAL MECHANICAL. FINAL ELECTRICAL FINAL PLUMBING T,C. of OCCUPANCY CERT, of OCCUPANCY COMMENT S: CITY I i s DAR INSPECTION HECK D TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTICICESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS _ ROUGH CONDUiT �__....... _ POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL_ ROUGH MECHANICAL_ Y GAS TEST PRE GUNITE .. ............ POOL PRE DECK BONDING F - TRAP RAP FENCE / GATE/ ALAR _ — .... .... ............ _._ FINAL:. POOL WALLS: WAIL FOOTING/STC C L. ACI STC I L 1sr :rn 2ND( ) LIFT WALL BOND BEAM 04 C, WALL DRAIN/ SIAL WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FILIAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE m