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Home My WebLink AboutPR17-8857 (9)z LU x H LU LU rl c� z O co m 4 on on H CITVY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 r (909; 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (949) 839-7027: 01 1,4LDINGPERMITAPPLICATION wvvv►.cityoldianttondloar.com building�d mondbarca.gov JOB SITE ADDRESS �" ��°►� { _- yL �� C� APN LCO'i� TRACT OWNER i t'i ADDRESS '-7j Ix?4ti✓ (�ec. CITY ZIP1�;Tl APPLICANT A i4a_, - ;b®rns►-r:.v TEL. CONTRACTOR I- •fie ADDRESS /-I q& I t� • ``� ��$ Lc'._._ CITY 1 ZIP '"qTEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated below by the checkmark(s), € have placed next to the applicable item(sj [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 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for the alleged exemption, Any Oil ofSection7D31.5byanyapplicantforapermitsubjectstheapplicantIDacivilpenalty of not more than five hundred doliars ($500} U I, as owner of the property, or my employees with wages as their sale compensation, will do L 1 all of or I 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 -Builder will have the burden of proving that it was rot built or improved for the purpose of sale.). U 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 not apply to an owner of property who builds or improves thereon, and who contractsforthe projects with a licensed Contractor pursuantto the ContradtorS` State License Law.). (_y 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 priorto completion of the improvements covered by this permit,I cannot legally sell a structure that I have built as an owner -builder If it has nut heen 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 available upon request when this application Is submitted or at the following Web site: http/www.leglniu.ca.gov/calaw,html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that i am I Icensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: 6/0 LIC. NO,, % Ll EXP. DATE: i'Z- P P 9' CONTRACTOR: e4L—r-7 WORKER'S COMPENSATION DECLARATION I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS, 1 have and will maintain a Certlflcate of Consent to Salf-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. have and will maintain Worker's Cornpensadon Insurance, as required by Section 3700 of the Labor Code, for the performance afthe work for which this permit Is Issued. My Worker's Compensation Insurance Carrier and Policy Number ars: CARRIER POLICY NUMBER CA.) elili , III .................-- (THIS SECTION NEED NOT BE COMPLETED 1F7HE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I cahifythat in the performance of the werkfor which this permit is issued, I shall not employ any person in any manner so said become subject to the Worker's Compensation Laws of Calromia. And agree that h I should become subject to the Worker's Compensation provisions ofSecfion 3700 ofthe Labor Code, I shall torthwiih complywiih those provisions. DATE APPLICANT: WARNING: Failure to secure Worker's Corrpensatlon coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3709 of the Tabor code, interest, and attorney's teas, 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 €s issued (Sec, 3097, Civ. Cp} LENDER'S NAME: 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-mentioned property for inspection purposes. _ -y&C PERMITTEE NAME (PRINT} SIGNATURE OF PERMITTEE DATE PRESS FIRMLY APPLICATION DATE: �6 P}° ��'� P//C# ISSUE DATE: PERMIT# TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION S0. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport w Patio/Deck ILL LL Pool/Spa ZRe -Roof O Commercial CD Valuate®n: Adj. Area: QUANTITY DESCRIPTION FEE c V c� u� w co z rq rL 4 c5 z x U CONSTRUCTION: PLAN REVIEW: %4R Scj ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 4 2-_ 7 -Ll SMIP: . �{ ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FESS • COMMENTS: q r. Plc: S's -1 r \ PAID BY: �{ P60 BC l VALIDATION: RECEIPT#_3583777 PAID6Y: 3n66 34hq VALIDATION: ®*-IN WHITE —Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy SETBACK/LEITER FOOTINGS FORMS SLAB UG, PLUMBING UG. ELECTRICAL UFER GROUND SEWER LJVl FRAL — MAINWAi[-RLINE _ SEWER CLEANOUT ROOF SHI ATHINGRai FLOOR SaIIEATHING SHEAR WALLS EX I ERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHAN{CAL ROUGH ELECTRICAL W( ) C (. ROUGH PLUMBING INSUI. ATION WAI I INSUI ATION CEILING DRYWALL LATH (PRE) LAM I EXTERIOR 1. ATI INTERIOF] _GAS TEST SCRATCH COAT ELECTMG METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING Q FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY DEMOLITION U ROOF DRAINS ROUGH CONDUIT POOL/SPA HOUGH PLUMBING ROUGH ELECTRICAL HOUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FFNCE / GATE/ ALARM FINAL POOL —..� WALLS: WALL FOOTING/STETI. WALL STEEL 1sT( ) 2N"( ) LIFT WALL BOND BEAM WA -L'.1- DRAIN/ SEAL WAII FINAL