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Home My WebLink AboutPR17-4560x CL 0 LU Q Cd 0 z 0 LU c� Cn 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 �g4 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS APN LOT T T OWNER COW ADD sz.. CITY r _ ZIP _TFL. ., b APPLICANT CONTRACTOR ADDRESS CITY ZIPS TEL.��`: 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 for the reason(s) indicated below by the checkmork(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 file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Slate 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 the alleged exemption. Any violation of Section 7031.5 by any appllcardfor a permit subjects the app€icarri a civil penalty of not more than five hundred dollars ($50C). L) t, as owner ofthe property, or my employees with wages as their sole compensation, will do (_) all of or (-) 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 torthe purpose of sale.). (j 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 properly who builds or improves thereon, and who contracts forthe projects with a licensed Contractor pursuantto the Contractors' State License Law.). U I am exempt from IICenSnre under the Contractor's State License law forthe following reason{s); By my signature below I acknowledge that, except for my personal residence in which I must have resided forat least one year priorm compleh'on 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 constructed In its entirety by licensed coniractars. 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: httplwwvv.leglrfo.ca.govlealaw.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 farce and effect. LICENSE Cl !.a LIC. NO.: DATE: CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I ha nd will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by coon 3700 of the Labor Code, for the performance ofthe work for which this permit is Issued. I have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit k issued, My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (17115 SECTION NEED NOT BF COMPLETED IFTHF PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that into performance ofthe work for which this permits; issued, I shall not employ any person In any manner so asio became subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Workers Compensa[ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawfui, and shall subject art employer to criminal penalties and civil fines up to one hundred thousand dollars (5100,000), in atldDian 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 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 (Sea 3087, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that 1 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 holding construction, and hereby authorize representatives of this county to ented.upon the ahove-mentioned property for inspection purposes. P 7TEE NAME PRINT) { A MI DATE APPLICATION DATE:_ �`'7 1-:21 1 \—{- P/C# biC. ISSUE DATE: CP �- ��.,,\-� PERMIT# : \-1 r TYPE CONST. OCC GROUP: j Scope of Work/ - A # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFFVADD/REM Garage/Carpert toati LL eck 4 9 ur Pool/Spa zRe -Root Commercial m valuation: Adj. Area: QUANTITY DESCRIPTION FEE J s U J W co z in d J 4 v z x U CONSTHUCTION: PLAN REVIEW: 5 3 , ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: "i d SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: $ • oc=. BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PIC: ryPAID BY: VALIDATION: RECEIPT # �,`�J PAID BY: Er� �✓� VALIDATION: 1 WHITE Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy SETBACK/LETTER FOOTINGS FORDS _3/�" SLAB UG. PLUMBING UG. ELECTRICAL UFER {;BOUND SEWFII LATERAL MAIN WATER LINF SEWER CLEANOUT ROOF SHEATHING FL()OR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING _ ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ROUGH PLUMBING INSULATION WALL INSULATION (:FILING OIIYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH � COAT ELECTRIC METER RELEASE GAS MEI I:li RELEASE SPECIAL. INSPECTION FINAL BUILDING 3 FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY GERT. of OCCUPANCY MOND A, N RECORD LA d TRACT ANN) LE 1) SWITCH GEAR COMMERCIAL HOOD T -BAR _— - INTERCEPTER. HOT MOPISHOWERPAN SEPTIC/CESSPOOL HERS REPOlin RECEIVED DEMOLHION 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 15T( ) 2ND( ) LIFT WAIL BOND BEAM WALL DRAIN/ WAIL 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