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Home My WebLink AboutPR17-12785CITY OF DIAMOND BAR DEPAR'T'MENT 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 wwwv.cityafdiamondbar.com building@diamandbarca.gov JOB SITE ADDRESS " F74 L APN LOT TRACT OWNER ADDRESS CITY 1, TEL. 2. Tyr APPLICANT` vP TEL. CONTRACTOR Jill C_ I ADDRESS c� o - q%�' ell CITY .rt- 4 40-1211" 641EL, 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 far the reasan(s) indicated below by the checkmark(s), I have placed next to the applicable Items) [Sectlon 71 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 prov[sions 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 applicant to 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 O all of or (_) portions of the work, and the structure is rot intended or offered for sale (Section 7044, Business and Professions Cade: 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 cr offered for sale. If however, the building or Improvement Is said within one year of completion, the Owner -Builder will have the burden of proving that it was not built or Improved forthe 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' Slate 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 € 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,€ cannot legally sell a structure that I have built as an owner -builder if it has not been constructad 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 appllcatlon is submitted or atthe following Web site: httplwww.leginfo.ca.gcvfcaiaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions Df Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pratessiors Code, and my license is in full force and effect. LICENSE CLASS: �° LIC. NO.: �2 EXP, DATE: CONTRACTOR. --A: -0, l qx> 4F I WORKER'S COMPENSATION DECLARATION I HEREBYAFFIRM UNDER PENALTYOf PERJURY ONE DFTHE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by tion 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 3700 of the Labor Code, for the performance of the work for which this permit is is�1/ y Worker's Compensation Insurance Carrier and PolCAicyNumheC'l �- � ! [� �i17 f� CARRIER )'�,i✓3,[..k-#�'fi � I POLICY NUMBER 9HIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED COLLARS $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 nsto become subject to the Worker's Compensation Laws of CafifDrnia. And agree that if € should become subject to the Worker's Compensation provisions of Secilon 3700 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 penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3798 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certifythat I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to ent7uptheabove-mentioned property for inspection purpos --, . PERMITTEE NAME(P , T) SIGNATU IERWTlil DATE APPLICATION DATI > l i PIC# ISSUE DATE: �41 �- � 1':$r PERMIT# : FK4- \—I TYPE CONST. OCC GROUP: Scope of Work Pil¢" # DWEL. UNITS # STORIES )S ) ."A. # BEDROOMS DESCRIPTION SQ. FT, FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport u1 Patio/Deck 1 �. Pool/spa ZRe -Roof Q Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE J a v U W w cv z m a U Z U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: of cyc") BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: 05�,� . 9a PIC: PAID BY: RECEIPT# SLO l PAID BY: VALIDATION. VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy 4 SETBACK/ LETTER FOOTINGS FORMS .......... . SLAB ........ UG. PLUMBING UES. ELECTRICAL UFFR GROUNO SEWEFI LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) — — I ATH EXTERIOR LATH INTERIOR GAS 1I ST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CELT, of OCCUPANCY COMMENTS: CITY OF DIAMOND INSPECTION RECORD I> A IRAQI AND LFWlR SWIT CLI (iKi COMMF[ IA1_ I IOOD F -RAR INT E11(l.P I E HOT MOP/SHOWFRPAN ................. SEPTIC/CESSPOOI HERS REPORT RFCFIVFT) DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL ....... --_.__........_._.,_._,_..,.._....._.......... _...,....... GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL ls'( )2N0( ) I, I T WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ Pill FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, FINAL INDUST RIAL WASTE