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Home My WebLink AboutPR17-13190DIjonv Bim. CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & 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 building@diamondbarea.gov JOB SITE ADDRESS APNLOT TRACT OWNER rr "1 1 Al S CITY I/— ZIP 7 TED APPLICANT M. i✓� TEL. 3 1 CONTRACTOR p ADDRESS C t✓ � CITY 'Vq-n ZIP l q TEL. C,7 ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION € hereby affirm under penalty of perjury that I am exempt from the Contractor's Slate License Law for the reasons) indicated below by the checkmark(s), I have placed next to the applicable lteal [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 provisinns 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 exemptfrom hi and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicantfor a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500). U I, as owner of the property, or my employees with wages as their sole compensation, will de U all of or U portions of the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property, provided that the Improvements are not intended or offered for snip, If however, the building or Improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or Improved for the purpose of sale.). U 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the following reason(s): Date! Sign: By my signature below I acknowledge that, except for my personal residence In which I must have resided for at least one Year prior to completion of the improvements covered by this ti cannot legally sell a structure that I have built us an owner -bulkier tf ii has not been constructed in Its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at the following Web site M/www.leglrfo.ca.gov/cE]aw.htwl- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Seton 7000) of Division 3 of the Business and Professlons Code, andel my license isin full force and effect, LICENSE CLASS: ^' Fi C. NO.: (f„ 6 `+$ EXP, DATE: ' —C CONTRACTOR Gl _�� k"'eig 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 for Worker's Compensation, as provided by Section 3700 of the Labor Code, forthe performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 5700 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: CARRIER POLICY NUMBER (% [ i (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS), I certify that in the performance of the worktor 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 i Compensation provisions of Section 3700 of the Labor Code, € 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 i penalties and civil fines up to one hundred thousand dollars {$100,000}, In addition to the cost of the compensation, i damages as provided for in section 3708 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY i 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 3 county ordinances and state laws rotating to bullding constructi , and hereby authorize representatives of this county to enter upon the above)-ment€oned property for Inspection purpose . 1: --cam! ®`�/—f e- c /-Yt PERMI NAME (PRINT) s �� SIXATt1FlLS6rPFRMI7EE DATE APPLICATION DATE: R 1-7 P/ C# F9 1 ,366 ISSUE DATE: 4 ��, PER MTill TYPE CONST. OCC GROUP: �a Scope of Work # DWEL- UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT- FACTOR PSF Al AREA/VALUATION SFR/ADD/REM Garage/Carport W Patio/Dock LU UL Pool/Spa ZRe -Root Commercial m valuation: p Adj. Area: QUANTITY DESCRIPTION FEE ca ZE w w [o z m J rl a ca z a x CONSTRUCTION: �® PLAN REVIEW: $� ELLCTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMP: a all ENERGY P/C: ENERGY PERMIT: RETENTION FEE: A -A• ®'a PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES '� b COMMENTS: P/C: • 7-1PAID BY:®0` �'� VALIDATION: RECEIPT # � �� PAID SY: V ®g ® �r � VALIDATION: gnR WHITE — Department Copy, YELLOW --- Finance Copy, PINK — Assessor Copy SETBACKILETTER FOOTINGS FORMS SLAB UG. PLUMBING UG, ELECTRICAL UFER GROUND SFWER LATERAL MAIN WATER LINE S[W4 R CLEANOUT ROOF SHEATHING] FI..00R SHEATHING ............ SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR - _ ............_.. FRAMINGNENTING ROUGH MECHANICAL ROUGH EI...ECTRICAL W( ) C ( ) U ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYVVALI . LATH (PRF) LATH EXTERIOR LATH INTERIOR GAS TEST CRATCH COAT ELECTRIC METER RILEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL ._ FINAL PLUMBING - ........... . T.C. of OCCUPANCY CERT. of OCCUPANCY COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOPISHOWERPAN SEPTICACF."POOL HERS REPORT DECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOLISPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITF POOL PRE DECK BONDING _ P TRAP FENCE / GATF/ ALARM FINAL POOL MALLS: WALL FOOTING/STEEL _W WALL STEEL Ier( ) 2-( ) LIFT WALL BOND BEAM — WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING RIVAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE