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Home My WebLink AboutPR17-3591'T CITY OF DIAMOND BAR I i 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 X4 9- BUILDING PERIMIT APPLICATION vr%iv.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS 915 S'dyer�ap Dr. APN LOT TRACT OWNER A rylt -� A prelCrdG0 ADDRESS V .c g A 1 .6 V e- - CITY ZIP TEL. APPLICANT P.o v,4 6 TEL. 0 09 7 85 -J 7 J CONTRACTOR t C i c ADDRESS 109 M 01P1,I _S -r✓ :jilG 4 Y_ CITY YZIP_J1_J8& TEL. (7.71)YJ2--��tl ARCH/ENO/ 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 next to the applicable items) [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 pursuantte the provisions of the Contractor's State License Law (Chaptel Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a chit penalty of not more than five hundred dollars ($500). L) I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' nr personal effort, builds or Improves the property, provided that the Improvements are not Intended or offered for sale. If however, the building or Improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not hunt or improved for the purpose of sale.). (,1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property wino builds or i mproves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law,), - U I am exempli licensure under the Contractor's State License law for the foTlowing reason(s): Date: Sign: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of thn improvements covered by this porni cannot legally sell a structure that I have butt as an owner-huiider if it has not been constructed In Its entirety by licensed contractors. i understand that a copy of the applicable law, Section 7044 of the Business and Professions Code Is available upon request when this application 18 submitted or at the following Writ site: http/www.leginio.ce.gov/calaw.html LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am Ilcensetl under provisions of Chapter 9 (commencing with SBcfon 7000) of Division 3 of the Business and Professions Code, andmylicense is in full force and effect. C �u$l�9 LICENSE CLASS: LIC. NO.: 0 0 0S' 7 EXP. DATE: I d CONTRACTOR: V,J le, ir—'" C_ WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS' 1 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 ofthe work far which this permit Is Issued. V I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, for the performance at the work for which th€s permit is issued My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER S' k_ $ - 61` d POLICY NUMBER el I % I I (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS), I cortlfy that inthe performance ofthe workfor which this permit Is Issued, I shall not employ any person in any mannerso as to become subject to the Worker's Compensation Laws of California. And agree that If I should become subject fo the Worker's Compensation provisions of Section 3700 of the Labor Code, I strait forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage Is unlawful, and shall subject an employer to crim€nal penaltles and civil fines up to one hundred thousand dollars ($100,000), In addltion 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 afflrr 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 Ni 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 construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. ol PERMITTEE N7J g SIGNATURE PERMITTEE DATE f APPLICATION DATE; ISSUE DATE: TYPE CONST. rp PERMIT# : �917 S� d� OCC GROUP: Scope of Work i®a► So=6ie !d 161 rt-5Id 4 # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport L Patlo/Deck LL PooVSpa ZRe -Roof Commercial m Valuation: �I Adj. Area: QUANTITY DESCRIPTION FEE U s r U ll.f W z 0 m J a J Q �d x U CONSTRUCTION: PLAN REVIEW: 70 _ 40,70 ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 79,Z SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: ® PAIDBY'.f47 s� VALIDATION: RECEIPT # PAID BY: /r� — VALIDATION: WHITE —Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD SETBACK/ LETTER FOOTINGS FORMS SLAB UG, PLUMBING UG. ELECTRICAL. lJFFR GROUND - ................ .......... SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( j (: ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXIFRIOR LATH INMI'VOR GAS TE SI SCRATCII COAT ELE.L F RIC METER RELEASE _.... ..- GAS METER RELEASE - SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL - FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ----� — - ROOF DRAINS ROUGH CONDUIT POOLIS 'A ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING ......... _.... P -THAT' T - _ - ..... ..... _,...... FENCE 1 GATE/ ALARM FINAL. POOL WALLS: WAI.I. f OOrING/STFF.L. WALL STFFI I"'( } 1""( } LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL. FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW. FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE DL IONID B CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.j;ov JOB SITE ADDRESS T5 APN LOT TRACT OWNERJ� ADDRESS I a= Ga F A 6 0ye — CITY��yy y ZIP TEL, APPLICANTt- 9±61i » TEL. I t9-5 –5717 CONTRACTOI V3 t f e -c- 6 ._ ADDRESS f AI1i P- J ✓" 4 - CITY ZIP CA TEL q ARCH/E NG/ DESIGNE=R ADDRESS CITY ZIP TEL. DWNER-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 checkmark(s), i have placed next to the applicable items) [Section 7031.5, Business and Professions Code: Any city ur county that requires a permit to construct, alter, Improve, demolish, or repair, any structure, prior to Its issuance, also requires the applicant far the 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] orthat he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicantto a civil penalty 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 do a ail of or L1 po tions 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 sale. If however, the build€ng or improvement is sold within one year of completion, the Owner-Bullder 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 Cmntractors 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 licensers under the Contractor's State license law for the following reasonts): 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 permlt,I cannot legally sell a structure that I have built as an owner -builder it it has not been constructed in its entirety by licensed contractors. I undersland chat 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: httplwwvv.leginfo.ca.gov/calaw.html LICENSED CONTRACTOR'S DECLARATION I hersby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 ofthe Business and Professions Code, and my license is in full force and effect ICENSECLASS: -t� LIC. NO.:�J5 r1 XP DATE: f!3 tr CONTRACTOR: V3 T,1 e-4 2 - WORKER'S 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 prmvided 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 ofthe Labor Code, for the performance ofthe work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number F, f✓�_ POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS), I cerlify that in the performance of the work for 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 Code, I shall forthwith compiy with those 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 ($100,000), in addition to the cost of the compensation, damages as provided for in section 37UB ofthe 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 application and state thatthe 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 enter upon ve-menfianed property for ion purposes. �eFF T) IGN�S ATURE OF PERMITTEE DAT APPLICATION DATE: ISSUE DATE: � E T_PERMiT# TYPE CONST, OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARFANALUATION SFR/ADD/REM Garage/Carport w Patio/Deck w LL Pool/Spa ZRe -Hoof LJ Commercial 0] VatfuatFon: Adj. Area: QUANTITY—F DESCRIPTION FEE it A - �a . 4h G r 6✓a S.- .Y A U w m rl U_ x w CONSTRUCTION: PLAN REVIEW: ELECTRIC: ; L5 PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: ;, 12- SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL. FEES l COMMENTS: P/C:y# pt PAID BY: 2 VALIDATION: RECEIPT#_ a#��'"l6, PAID BY: q3 VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK --- Assessor Copy SLAB UG. PLUMBING UG. ELECTRICAL UFFR GROUND SEWER LATERAL MAIN WATL.R LINE SEWER Cl EANOUT ROOF SHCATHING FLOOR SIIEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTEMOR FRAMING/VENTING COMMERCIAL HOOD I -BALI INTERCEPTER 1-10T MOP/SHOWERPAN SEPTIC/CESSPCOL - HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL- ROUGH ELECTRICAL W( ) C () ROUGH PLUMB[NG INSUI ATION WALL, INSM ATION CEILING DRYWALL [Al 11 (PRE) I A'fH EXTERIOR �% I. ATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METE13 IIELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING . P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STFFI.. WALL STEEL 1 ST( ) 2N°( ) LIFT WALL BOND BEAM. WALL DRAIN/ SEAL WALL FINAL _ _._ .. ..... _ RD. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING - ..... PRINIALPLUMBING OCCUPANCY FINAL ENGINEERING/ PVA FINAL COMMUNITY SERVICES FINAL HEALTH REPT. FINAL INDUSTRIAL WASTE