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Home My WebLink AboutPR17-18770O W H ¢ 0 Y. 0 d 0 z CD U3 CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810Copley Drive, Diamond Bar, CA 91765 PR�� (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-702 FIRMLY � L� BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@d€amondbarea.gov 02-m 14JOB SITE ADDRESS APN —LOTe� � TRACT OWNER _ e r L h� ADDRESS CITY Z€P TEL. 01 APPLICANT tin EL. CONTRACTOR Al C7Y IP TEL. ARC H/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Corrtractor's State License Law for the reasen(s) Indicated below by the checkmark(s), I have placed next to the applicable Itam(s) [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 fire 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 Dlvislan 3 of the Business and Professions Cade] or that he or she Is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicartfor a permit subjects the applicantio a civil penalty of not more than five hundred dollars (5500}. {_) I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 applyte an owner of property who, through employees' or personal effort, builds cr improves the property, provided that the improvements are not intended or offerad for sale. If however, the bulldln® or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built er improved fortha purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7944, Business and Professions Code; The Contractors' State License Law does not apply to an owner of property who huilds or Improves thereon, and who contractsforthe projects with a licensed Contractor pursuantte the Contractors' State License Law}, U I am exemptfrom licensure under the Contractor's Stale 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 poll cannot legally sell a structure that I have built 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 Web site; httplwwwleginfo ca gov/caiaw.html, LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provlslons of Chapter 9 (commencing with Section 7600) of Division 3 of the Business and Professions Code, and my license is in full force and effect LICENSE CLASS: LIC. NO.: EXP. DATE: CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS, I have and will maintain a Certificate of Consent to Self -Insure lot 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 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 Number are: pe CARRIER d VrJC 7 •r POLICY NUMBER �d (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $10C OR LESS). i certify that in the performance of the work forwhlch this permit is Issued, I shall not employ any person in any mannerso alto become subject to the Worker's Compensation Laws of California And agree that if i should become subjectto the Worker's Compensation provisions of Section 3740 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 peva€ties 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 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.). LENDER'S NAME' LENDER'S ADDRESS: I certify that I have read this ap 'cation and state that the above Information is correct. I agree to comply with all city and county ordinances and st s relating to building construction, and hereby authorize representatives of this county to enter upon the above tinned property for Inspection purposes. PERM AME (PRINT) ATURE OF PERMITTEE DATE APPLICATION DATE: 71/11 PP//C# ISSUE DATE: PERMIT# : �F�\\ O 70 TYPE CgNST. OCC GROUP: C=Per Scope of Work # DWEL. UNITS # STORIES 441-1 # BEDROOMS DESCRIPTION SQ, FT. FACTOR PSF ADJ. AREANALUATION SFR/ADDlREM Garage/Carport Lid Patio/Deck LL Pool/Spa ZRe -Roof Commercial m Valuation: Adi Area: QUANTITY DESCRIPTION FEE J U V W � w [c z m J a J ¢ U Z 4 x V g CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: �7 Plc: PAID BY: v� RECEIPT# PAID BY: 6� VAL€DATION: VALIDATION: V V WHITE— Department Copy, YELLOW Finance Copy, PINK Assessor Copy CITY OF DIAMOND INSPECTION CC SETBAGK/ LEI TER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBINGT-BAR ---- ...__.. UG. ELECTRICAL ........_ INTERCEPTER UFER GROUND -- RIOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE MFRS REPORT RECEVED . SEWER CLEANOUT [ FIVIOI.ITION ROOF SHEATHING ROOF /DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOL/SPA _..._. _ _ ........ .... .. SHEAR WALLS INTERIOR . -_ ROUGH PLUMBING ERAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROACH MECHANICAL ROUGH ELECTRICAL W( ) C { ? ,. _ GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL F'RF DECK BONDING INSULATION CEILING P TRAP DRYWALL - ----- FEN CF / GATE/ ALARM ............ _ LATH (PRF)F{NAL .. .....__.__-_ POOL _.._ ._ .... _.... _.. .__.... I AI II FXTFRIOR WALLS: I...ATH INTERIOR WALT.. (OOTiNG/STEEL GAS I ES I WALL. S-1 f /7.I. 1 V( ) 2NC( ) LIFT SCIiAICH COAL WALL BOND BLAM ELLCIFIIC MLILR 4LEASF WALL DRAIN/ SEAL GAS; ME IEll IiFLHASE: WALL FINAL, SPECIAL INSPLCI ION . — RO. FRAMING PLANNING APPROVAL ...... _ FINAL BUILDING ..... BOUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL 4 FINAL PLANNING FINAL PLUMBING _ ._r. ! FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEALTH DEPT. _...._.-. FINAL INDUSTRIAL WASTE COMMENTS: