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Home My WebLink AboutPR17-13045CITY OF DIAMOND BAR I i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES - 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection hotline (909) BUILDING PERMIT APPLICATION www.cityofdiamondbar.com JOB SITE ADDRESS -p AP N - l HJT TRACT OWNERT- ADDSys CITY ] UE APPLICANT TEL. CONTRACTORe' �w B, ADDR� =� CITY ~' ' � ZIP u.. 1 TE { ARCLVLNG/ 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 item(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 permitto file a signed statementthat he or she Is licensed pursuantto the provisions ofthe ConIxactor'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 licensure and the basis for iheallegedexemptlon Any violation of Section 7031. Eby any applicant for a permit subjectstire applicant toacivil penalty of not more than five hundred dollars ($500) (_)1, as owner of the property, or my employees with wages as their sole compensation, will do U all ofor(-) 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 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 built or Improved far the purpose of sale,), {_) I, 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 pursuantto the Contractors' State License Lai L) I an exempt from licensure under the Contractor's State License law for the following reason(s1: Date:_ _, Sign:_ By my signature below I acknowledge that, except for my personal residence in which k must have resided for at least one year prior to completion of the improvements covered by this permlt,l cannot legally sel€ a structure that I have built as an owner -builder if it has not teen constructed In its entirety by licensed contractors, I understand that a copy of the appl€cable law, Section 7044 of the Business and Professions Code Is available upon request when this application Is submitted or at the following Web site: htip/wwvr.leginfo.ca.gov/calaw.html, 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. I LICENSE CLASS:LIC. NDr,� EXP. DATE: ' " _ ONTRACTCR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: i I have and will maintain a Certificate of Consent to Self -insure for Worker's Compensation, as provided by I Section 3704 of the Labor Code, for the performance ofthe work for which this permit is issued. a € have and will maintain Worker's Compensation Insurance, as Toddled by Section 3700 ofthe Labor Code, for the performance ofthe workfor which this permit Is Issued. My Worker's Compensation Insurance Carrier and Policy Numbrar are: F' CARRIER - f t _, .1 - f .D A, 'I p % POLICY NUMBER rJn i (THIS SECTION NEED NOT BE COMPLETED IF TIE PERMIT IS FOR ONE HUNDRED DOLLARS $SOC CR 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 c become subject to the Worker's Compensation Laws of California, And agree thgt if -,S ou 1 •subject to the Worker's j Compen ion pr visions of fico ion 3700 oflhe Labor Code, I sha€I1ortstrC'ompl s avisions,',-. DATE' PLICANT: f WARNING: Failure to secure Worker's Compensation coverage is unlawful, a" shall_..s.�act"an employer fi criminal 3 penalties and civil fines up to one hundred thousand dollars {$100,000), in add+;ioffto the cast of the compensation, j damages as provided far In section 3708 ofthe labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction > orrding 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 5 anter upon the above-mentionad property for Ispectjp r purposes. o...._ - z PERMITTEE NAME (PRINT) 0 2 SIGNATURE OF PERM17EF ATE ,• PRESS a.gov FIRMLY APPLICATION DATE: C� f J G� PIC#g��a ¢� ISSUE DATE: PERMIT# : i J F TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Patio/Deck Lu LL Pool/spa ZRe -Rauf Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U v w w m 2 m r v z z CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING:✓ MECHANICAL: INSPECTION FEE: ISSUANCE: I SMIP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: ' BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID BY: RECEIPT# PAIDBY: . ;q VALIDATION: VALIDATION: .-. WHITE— Department Copy, YELLOW — Finance Copy, PINK Assessor Copy CITY OF DIAMOND INSPECTION RAMIN{aIVEN I lNG ROUGH ELLOFFI CAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH LLE{ IRICAL W( ) C { ) GAS TEST ROUGH 111 UMBING PRE GUN€TE INSULATION WALL POOL PRE BECK BONDING INSULATION CFIL.ING P -TRAP DRYWALL FENCE / GATE/ ALARM LATH (PRE)FINAL POOL LATH EXTERIOR... WALLS: ..._ -- LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL S1( ) 2�`D( ) LIFT SCRAI CH COAT WALL BOND REAM ELECTRIC METER RELEASE: WALL DRAIN/ SEAL GAS VL 1ER RELEASE WALL FINAL. SPECIAL. INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMPING � � m. _ r � _ FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEAllH DEPT. FINAL INDUSTRIAL WASTE SETBACK/ LETTER TRAGI AND LEDGER SWI IG i GEAR FOOTINGS FORMS SLAB COMMERCIAL HOOD T -RAR IN1 L RCL PTER HOT MOWSHOWERPAN SEPTIC/L,L'SSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT LIG. PLUMBING UG. ELECTRICAL LIFER GROUND ;iFWF.R LATERAL MAIN WATER LINE SEW€ R CLEANOUT R001" SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR PGOUSPA ROUGH PLUMBING F RAMIN{aIVEN I lNG ROUGH ELLOFFI CAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH LLE{ IRICAL W( ) C { ) GAS TEST ROUGH 111 UMBING PRE GUN€TE INSULATION WALL POOL PRE BECK BONDING INSULATION CFIL.ING P -TRAP DRYWALL FENCE / GATE/ ALARM LATH (PRE)FINAL POOL LATH EXTERIOR... WALLS: ..._ -- LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL S1( ) 2�`D( ) LIFT SCRAI CH COAT WALL BOND REAM ELECTRIC METER RELEASE: WALL DRAIN/ SEAL GAS VL 1ER RELEASE WALL FINAL. SPECIAL. INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMPING � � m. _ r � _ FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEAllH DEPT. FINAL INDUSTRIAL WASTE