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Home My WebLink AboutPR17-8024=r T* CITY OF DIAMOND BAR t 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 'yNp BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov Zi APPLICATION DATE:_ Pico P R VT � a JOB SITE ADDRESS 0 o ` ooT# : k)� & tZe j ISSUE DATE: ill I PERMIr CD n APN LOT TRACT U OWNER A, J, TYPE CONST. OCC GROUP: o s ADDRESS )AA Q Akio l CITY ZIP TEL. ] APPLICANT TEI. 0 CONTRACTOR Q ADDRESS r CITY ZIPP_jTEL. + ARCH/ENG/ DESIGNER ADDRESS n CITYZIP TEL. 2 OWNER -BUILDER DECLARATION r 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 Rol [Section 7031.5, Business and z Professions Code, Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any 'J structure, prior to its issuance, also requires the applicantfof the permltto file a signed statemerrithat he or she is licensed pursuant 10 the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section n 7000 of Division 3 of the Business and Professions Codej or that he or she is exempt from licensors and the basis for n the alleged exompton. Any VlolationcfSection7b31.5byany applicantforapermit subjects tire apppcanttoaCivil p=natty r of not more than five hundred dollars ($500). (� I, as owner of the property, or my employees with wages as their sale 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 w Contractors' State Llcense 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 cD 0 improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built U or improved for the purpose of safe.). (, I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section Uy 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who ad builds or improves thereon, and who contracts for the projects All a licensed Contractor pursuanttohire Contractors' State m License Law.). 0 L� U I am exempt from licensure under the Contractor's State License law for the following reason(s): z Oate: Sign CD By my signature below 1 acknowledge that, axceptfor 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-hullder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the X applicable law, Section 7044 of the Business and Professions Code Is available upon request when this application Is LLI cD submitted or atthe following Web site http/www.leglnfe.ca gov/calaw html. F v LICENSED CONTRACTOR'S DECLARATION LU I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 Do of Division 3 of the Business and Professions Code, and any license Is In full force and effect. oLICENSE CLASS: LIC. NO.: _„ ��-➢ < M EXP. DATE: CONTRACTOR: is C 6 WORKER'S COMPENSATION DECLARATION 6 I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS, o I have nd will malntain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by J ion 3700 of the Labor Code, for the performance of the workfor which this permit is issued, pe a I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work far which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are.. ZCARRIER S A L^ POLICY NUMBER cn � (PHIS SECTION NEED NOT BE COMPLETED IFTNE PERMIT IS FOR ONE HUNDREi] DOLLARS $100 DR LESS[, � 0 I certify that in the performance of the work for which this permh is issued, I shall not employ any parson in any mannerso f to M become subject to the Worker's Compensation Laws of California. And agree that If E should became subject to the Worker's JCompensation provisions of Section 3700 of the Labor�CJode, shall forMVui�t eomplywNh th/us�,provisians, LDATE: WARNING: Failure to secure Worker's Compo tion coverage is unlawful, an shall subject an employer fo criminal LJ penal, and civil fines up to ane hundred thousand dollars ($100,OCDl, in addition to the cast of the compensatlan, CD damages as provided for In section 3708 of the labor code, interest, and attorney's fees CONSTRUCTION LENDING AGENCY w I hereby affirm under penalty of perjury that there Is a Construction Lending Agency for the performance of the work for which this permh is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: C I certify that I have read this application and state that the above information is correct I agree to cool with all city and z county ordinances and state laws relating to building construction, and hereby authorize representatives ofthis county to onenter upon the above-mentioned party for inspection purposes. m PERMITT NAME (PRINT) cn 2 SIGNATURE OF DATE Scope of Work AA As S # DWEL. UNITS # STORIES#BEDROOMS rn Lu Lu LL 0 Z 17 J S m DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFWADD/PEM Garage/Carport Patio/Deck Pool/Spa =-Roof Commercial Valued®n: �� Adj. Area: CONSTRUCTION: PLAN REVIEW: QUANTITY DFSCRI PTI O N FEE J U MECHANICAL: w ,: - f l SMTP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FFE: _ t a PLOT PLAN: U U °-i CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: ,: - f l SMTP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FFE: _ t BASF:' PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: °-i PIC: 2, PAID BY: ® p VALIDATION: RECEIPT # 3C5 � � PAID BY: '✓ 2'q VALIDATION: C WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy COMMFNTS: CK/ LETTER CITE OF DIAMOND INSPECTION .. __. BAR EC TRACT AND LEDGER 7FOOTINGSFORMS UG. PLUMBING _.. UG ELECTRICAL UFER GROUND SEWERIATERAL MAIN WA1 FR LINE SEWER CLEANOUT ROOF SHI-ATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SWITCII GEAR _. COMMFRCIAL HOOD T -BAR INTERCEPTER HOT MOPISHOWFRPAN SEPTIC/{iFSSP00l HERS REPORT RECEIVED DEMOLITION ROOF DRAfNS HOUGH CONDUIT ) POUL6SPA ROUGH PLUMBING SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL HOUGH ELLCT81GAL VV( } C ( } ROUGH PLUMBING` INSULATION WALL INSULATION CEILING DRYWALL LA. 1.11(PRE) LATI I EXTERIOR LAPP INTERIOR GA5 TEST _ SCRATCH COAL ROUGH ELECTRICAL I10UGH MECHANICAL GAS TEST 3.. FRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM FINAL POOL.. WALLS: WAIL FOOTING/STEFI. 4 WALL STEEL Is'O11 ()LIFT WALL. BOND 13LAM WALL DRAIN/ SEAL ELE{; ERIC ME1 Hi RELEASE GAS METER RELEASE SPECIAL INSPEC KION FINAL BUILDING (�It ..... _ FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL. FIRE DEPARTMENT FINAL PLANNING FINAL, ENGINEERING/ PW FINAL COMML1N11Y SERVICES FINAL HEALTH DEPT, _.. CEn of OCCUPANCY FINAL INDUSTRIAL WASTE COMMFNTS: