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Home My WebLink AboutPR17-11253K101010 BA1i yz CITY OF DIAMOND BAR 'A DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, 91765 CA PRESS (909) 839-7020 Fax: (909) 861-311.7 Building Inspection Hotline (909) 839-7027 � y r" BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamonea.gov )FIRMLY JOB SITE ADDRESS1101 APN A LOT TRAC OWNER IAr ADDRESS , C AIC CITY I GPMh W ZIP 9M')�S TEL. APPLICANT SSG , TEL ��( � 77- Q q 4S7— CONTRACTOR G In CJi C) Y)L ADDRESS Of 111 V CITY C.1 ZI flZZLT ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION [ hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasons) Indlcated 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 1n 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 (Cfrapter 9) Commencing with Section 7900 of Division 3 of the Business and Professions Godej or that he or she is exempt from Ilcensure and the tests for the alleged exempflon, Any violation of Section 7D31,5 by any applicant for a permit subjects the appllcantto a civil penalty of not more than five hundred dollars ($EGO). (U I, as owner of the property, or my employees with wages as their sole compensation, will do i all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions i 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 Owrer-Bullder will have the burden of proving that it was not built or improved for the purpose of sale.). 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' Stats License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). LI I am exempt from licensure under the Contractor's State License law for the fallowing reason(s): Date: Sign: By my signature below I acknowledge that, excepttor my personal residence in which I must have resided for at least one year prior to cool of the Improvements covered by this permit,l cannot legally sell a structure that I have bunt 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 available upon request when this application Is suhmitted or at the following Web site; http/www.leglnfo.ca.gov/calaw.htmi. LICENSED CONTRACTOR'S DECLARATION I hereby afflrm 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 l€Ifl Ul farce and effect. LICENSE CLASS: LIC. NO.: 'S �U EXP, DATE: -17- m CONTRACTOR: _ ii WORKER'S COMPENS DN ECLARATION 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. I have and will maintain Worker's Compensation Insurance. as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARcod fi1ER POLICY NUMBER 1 (IBIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certifythat in the performance of the work forwhich thls permit Is Issued, I shall notempioy any person in any manner so as to become subject to the Worker's Compensatlon Laws of Calffornla. And agree that if I should become subject to the Workers Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply *n fhose 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 one hundred thousand dollars ($1 DQ000}, in addition to the cast of the compensation, damages as provlded for in sect€on 3708 of the labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the perfomanoe of the work for which this permit is issued (Sec. 3097, Civ. C.). - LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to building constructlon, and hereby authorize representaijves of this county to enter upon the ahove-mentioned property for Inspection purposes il llril PERMITTEE NAME (PRINT) Abb SIGNATURE OF PERMITTEE CAT APPLICATION DATE: 9U,31+ ISSUE DATE: PERMIT# TYPE CONST, P/O# f R 9-4 '11 11-63 : PR it ZS OCC GROUP: Scope of Work insuIa-hon_—�$/ # DWEL. UNITS # STORIES A .L_ # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFIR/ADD/REM Garage/Carport w Patle/Deck ILL ri Pool/Spa ZRe -Root 12 Commercial m Value*ern: Adj. Area: QUANTITY DESCRIPTION FEE a s r U Ll.f ui m m a U Z x cs CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: '. SMIP: - 5� ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: cil PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS P/C: PAID BY: VALIDATION: 1 RECEIPT# q PAID BY: VALIDATION: WHITE —Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy SE[ BACK/ LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG, ELECTRICAL UFFR GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEAl11ING SHEAR WALLS EX FHIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL .__.. __..._...,......._.-- ROUGH ELECTRICAL W( } C ( ) ROUGH PLl1ME3lNG INSULATION WAI ! INSULATION I FILING DRYWALL. LATH (PlIF.) LATH FXTFHI0R LATH INTERIOR GAS LL:S I SCRAIG}I COAT ELF.G; Hl( METER RELEASE GAS Mi- -IL.R RELEASE SPECIAL. INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: `ITY OF DIAMOND BAR INSPECTION TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR _ INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/GESSPOOL HERS REPORT DECEIVED DEMOLITION ROOF 013AINS ROUGH CONDUIT POOLISPA ROUGH PLUMBING _.... _....___. __.._-_____ - ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE .... _ POOL PRE DECK BONDING — ..... _. _.. __. __-- P fHAP FENCE I GATE/ ALARM FINAL POOI WALLS: WAII FOOTING/STEEL W& L STFF.L.1sT( ) 2N°( ) I IFT WALL. BOND BEAM WALL.. DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT f FINAL PLANNING _.--- - FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL. WASTE