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Home My WebLink AboutPR17-9775e I 1011v BAR ,_, r CITY OF DIAMOND BA DEPARTMENT OF COMNIUNIi Y & 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 builong@diamondbarea.gov JOB SITE ADDRESS -" f C -L✓ ry APN LOT TRACT OWNER ' ADDRESS ^ _ CITY ; 6.. P TEL. APPLICANT r_zW1 TEL CONTRACTOR fi i - ADDRESS a CITY Z 21P Li TEL. 6 L6 L�Kll ARIDWENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated below by the Oeckinark(sJ, I have planed next to the applicable item(s) [Section 7031.5, Business and Protesslons Code: Any airy or county that requires a permit to construct, alter, Improve, demolish, or repair, any, structure, prior to its issuance, also requires the applicant forthe 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 lcensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ( j I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through smployees' or personal effort, builds or improves the property, provided that the Improvements are not intended or offered for sats. It however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that It was not 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 Cods', The Contractors' State License Law does not apply to an owner of property who bullds or improves thenen, and who centractsforthe projects with a licensed Contractor pursuantto the ContractorsState License Law) U f am exemptfrom licensers under the Contractor's State License law for the fallowing reasons}; Date: Sign: By my signature below € acknowledge that, exceatfor my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permltJ cannot legally sell a structure that I have bull as an owner -builder if it has not been constructed In Its entirely 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 atthe following Web ell http/www.leglnfo.ca.gcv/calawhtml. 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 force and effect. LICENSE CLASS: LIC. NO.: 121A C, t EXP. DATE: CCNTRACTOR� - C, It, WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have a d will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Se 3700 of the labor Code, for the performance of the work for which this permit Is issued. 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: ARRIER %' POLICY NUMBER Cli / (PHIS SECTION NEED NOT BE COMPLETED IF RMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certify that In the performance of the workfor 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 should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. DATE'. APPLICANT: WARNING: Failure to secure Worker's Compensatlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (SIOU,000), in addition to the cost of the compensation, damages as provided for in section 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 performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LEN DER'S NAME: LEN DER'S ADDRESS: i I cerlity that I have read this application and state That the above €nformaiion is correct. I agree to comply with all city and county ordin ccs and state laws relating to building construction, and hereby authorize representatives of this county to enter upon above-meniioned property for inspection purposes. i PERMITTEE NAME (P SIGNATU PER EE OAT d APPLICATION DATE: ISSUE DATE: -7 JPERMIT# TYPE CONST. P/C# OCC GROUP: Scope of Work ) # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT, FACTOR PSF ADJ. AREA/VALUATION SFP/ADD/REM Garage/Carpori w Patio/Deck Lu LL Pool/spa ZRe-Rocf 0 Commercial Z) CO valuation: Adj. Area: QUANTITY DESCRIPTION FEL J V_ w w Z, z M J a U Z Q x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 1'3-F J MECHANICAL: INSPECTION FEE: ISSUANCE: 0 0— SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: �® BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: —76. 0 PIC: PAID BY: RECEIPT # Cl / fes° PAID BY' VALIDATION: / VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy CITY OF DIAMO�D INSPECTIOM Cei SETI3AGK1 LL1" I ER FOOTINGS FOHM5 SLAB UG. PLUMBING UG, LLFCTRICAL UFFR GROUND SFWFR LATERAL MAIN WATER LINE SLWER CLEANOUT ROOF SHEATHING FLOOR SHEATH€NG SHEAR MALLS EXTERIOR SHEAR WALLS INTERIOR ..................._.. FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING' INSULATION WALL INSULATION CEILINGS DRYWALL - LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COA7 ELECTRIC METUR RE(.EASE GAS METER RELEASE SPECIAL INSPFCT1ON FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERA' oC OCCUPANCY COMMENTS: TRACT AND LEDGER ........... SWI I C I I (SEAR COMMEIICIAL HOOD I RAR IN f E IGEPTER HOT MOP/SHOWERPAN SEPT1CICESSPOOL HERS REPORT RECEIVED DEMOLIT[ON ROOF DRAINS ROUGH CONEIUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE