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Home My WebLink AboutPR17-14095. ..... BAR _NT COMMUNITY & D r E"VELOPMENT SERVICES V' 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 it FIRMLY BLILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS ;/--60o E_ APN LOT TRACT OWNER ,L s ADDRESS 7 I'l CI T GL XF� s y�ZI P TE; APPLICANT° ar s� z's �F' TEL. ?.l CONTRACTORr = ADDRE S , s CITY J%�m" ZIP Am ARCH/ENG/ 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 reasons) Indicated below by the checkmark(s), I have placed nett to the applicable itom(s) [Section 7431.5, 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 fife a signed statement that he or she is licensed pursuant be 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 exemptfrem licensure and the basis for the alleged exemption. Any violation of Sectlon 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). L) I, as owner ofthe property, or my employees with wages as their sole compensation, will do (j 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' Slate License Law does not apply to an owner of properly who, through employees' 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 cempletion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). (_) 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projectswith a licensed Contractor pursuant to the Contractors' State License Law.). V I am exempt from licensure under the Contractor's State License law for the fallowing reasan(s): 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,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 submitted or at the following Weh site: http/www.logir[fo.ca.gov/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 CLABS: b LIC. NO.: DATE: e. CONTRACTURE WORKER'S CO EN fOkV CLARAON I HEREBY AR RM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DY RAHONS: 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, forte performance oftho workfor which this permit is issued. A have and will maintain Worker's Compensation Insurance, as required by Sectlon 3700 of the labor Code, for the performance of the workfer which this permit is issued. My Worker's Compensation Insurance Carrier and Panty Number CARRIER -'_��e�..,•' - --... _...._ POLICY NUMBER ��' ."'"`��'t �)-% �'• (THIS SEC HUN NEED NOT BE COMPLETED IF TRE PERI IS FOR ONE HUNDRED DOLLARS ($100) 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 asto become subject to the Worker's Comp en efien ws T;g[rf ruts. And ag that'rf I should become subject to the Worker's ii Compensation prov [ons of Section 370 of the La . r Cade bdil_forth comply with those provisions. DATE: PPLICANT:-e--"' i WARNIN Failure to secure Worker's Compensation doderage €s dnlamti, and shall subject an empieyer to criminal penalties and civil fines up to one hundred thousand dollars ($1(0,00` ° In addition #o the cost of the comp creation, damages as provided for in section 3708 of the labor code, interest; an 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.). LENDER'S NAME; LENDER'S ADDRESS: i 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 ante ppaleihe shove-nior nyd property)for in ion purposes. 'i v Tz PERMI E NAME ( y SIGNAITO) PER DATEy APPLICATION DATE: ' + PERM ISSUE DATE: 24 f T# : TYPE CONST. PIC# —4�T 5 i" I + '� 1 LJ G1 Ll 5 OCC GROUP: 5 Scope of Work § ,. F X'�. i mwk a> 14 Lakin R' It DWEL. UNITS # STORIES {lg �pY �! 6a�"1 # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM GaragelCarport rn LO Patio7Deck W ri Pool/Spa ZRe-Raof i Commercial 5 03 Valuation:_ Adj. Area: QUANTITY DESCRIPTION FEE J s U LJ w c� z m J d a v z c� CONSTRUCTION: PLAN REVIEW:, ELECTRIC: h 5 1 re too. RO PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: , 2. 2 BASF: f� PLOT PLAN: ZONING CLEARANCE: 1-5: C. TOTAL FEES COMMENTS: PIC: PAID BY: VALIDATION: RECEIPT 7— PAIDI3Y: i H VALIDATION: WH7E— Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy CITYOF I .ivim%L, INSPECTION EC SETBACKI LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCHGEAR COMMERCIAL HOOD SLAB UG. PLUMBING T -BAR __.. UG. ELECTRICAL INTERCEPTER HOT MOP/SHOWLRPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED LIFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH COHDUIT SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR POOUSPA ROUGH PLUMBING FRAMING/VENTING —�- �^ ROUGH ELECTRICAL -� ROUGH MECHANICAL_ ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) GAS TEST ROUGH PLUMB)NG _ _........_ - PRE GUNITE POOL PRE DECK BONDING - INSULATION WALL. INSULATION(CUING _................. _._ . _ ....... DRYWALL LATH (PRF) LATH EKTEERIOIi LAI H INTERIOR GAS TEST SCRATCH COAT EL.EGTRIC ML TFR RT.I.TAST GAS ME IEE"R RELEASE SI' C14. INS PFCTI ON _._._..__..._ . _ __...._ P -TRAP FENCE / GATE/ ALARM FINAL POOL ..... ......... WALLS: ---- .............. WALL FOOTING/STEEL WALL STEEL I ( ) 2`°( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL FINAL BUILDING FINAL MECHANICAL FINAL ELECTI LGAL FINAL PLUMBING T -C. of OCCUPANCY ....__. CERT of QCGUIPANCY ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT zn FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES --__. _ _ -_- FINAL HEALTH DEPT. ----- COMMENTS- FINAL INI7i1S7RIAL UVASTE