The URL can be used to link to this page

Home My WebLink AboutPR17-25416LU CL DIAMOND B r r CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DE' 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building In. ..ae (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS 9-3 a e APN LOT TRACT OWNER ADDRESS _ CITY d r :.' ZIP C E 6 EL. APPLICANT TEL. ` tea- Z CONTRACTORS ADDRESS -Z-_i � b " ve— CITY ��€ • -rte[ J-_ ZIP 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 reasons) indlcated below by the checkmarKs), i have placed next to the applicable ltem(sj [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 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 the alleged Exemption. Any violation of Section 7031,5 by any applicant for a permit subjects the applicant to a civil penalty of nct more than five hundred dollars ($500), (J 1, as owner of the property, or my employees wlth 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' or personal effort, builds or improves the property, provided that the Impravaments 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 for the purpose of sale.). U 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 tD an owner of property who builds or Improves thereon, and who contracts forthe 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 helow 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 perni cannot legally sell a structure that I have built as an owner -builder if it has not been constructed In its entirety by Ilcensed 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 Is submitted or at the following Web site', httplwww.loglnfo•ca•govlcaiaw.htmL LICENSED CONTRACTOR'S DECLARATION I herahy 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 iisppin` full force and effect. LICENSE CLASS, re� LIC. Ni CZ 2>1_1t! [� EXP.DATE:s CONTRACTOR'S L WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE CP THE FOLLOWING DECLARATIONS: I hi and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by option 3700 of the Labor Gode, for the performance of the work for which this permit Is Issued• have and will maintain Worker's Compensation lnsurance, as required by Section 3700 ofthe Labor Code, toy the performance of the work for which this permit is issued My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (7H1S SECTION NEED NOT RE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $1 DO OR LESS). I certify that In the performance ofthe workfor which this permit is issued, I shall not employ any pown in any manner so as to become subject to the Worker's Compensation laws of California. And agree that If l should became subject to the Worker's Compensation provisions of Section 3700 of the Later Code, I shall forthwith comply with those provisions, DATE; APPLICANT: i WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal I penalties and civil fines up to one hundred thousand dollars (5100,000}, in addition to the cost of the compensation, damages as provided for in section 3708 ofthe labor code, interest, and atlomey'a fees. CONSTRUCTION LENDING AGENCY i I hereby affirm under penalty Df perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Clv. C.). LENDER'S NAME: LENDER'S ADDRESS', i I certify that 1 have read this application and state thatthe above information Is correct. I agree to comply with all city and I county ordinances and state laws relating to building construction, antl hereby authorize representatives of this county to $ enter upon the above-mentioned property for Inspection purposes. r -- i f PERMITTEF NAME (PRINT),..r SIGNATURE OF PE APPLICATION DATE: ISSUE DATE: TYPE CONST, Pic# PERMIT#: OCC GROUP: gg yy� Scope of Work b" r- Z_f 6 i `Fr 'LF ig # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. IFT. FACTOR PSF ADJ. AREA/VALLIATION SFR/ADD/REM Garage/Carport W Patio/Deck LU LL Pool/Spa ZRe -Roof JJ Commercial Valuation: Adj. Area: QUANTITY DESCRIPTION FEE Q OO05(lti v w co a cTa J a a U Z 4 x U 21 i CONSTRUCTION: PLAN REVIEW: 1 ELECTRIC: L PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: _ i.31 ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: of BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P PAID IS VALIDATION: REGEI PAID B ' VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy !S1.713ACK/ LETTER .MOND JN RECORD TRACTAND LEDGEH.._... OOTINGS FORMSSWITCH GEAR LAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG ELI CTRICALINTERCEPTER __....... _- UFFR GROUND SEWER I AlF.HAL MAIN WA IF R I MF SEWER CLLANO(1T ROOF SHEAII IING FLOOR SHEATHING SHEAR WALLS EXTkRIOR SHEAR WALLS INTERIOR HOT MOPISHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT Pbf3LlSPA ROUGH PLUMBING ` ROUGH ELECTRICAL FRAMINGNENTINC; _ ROUGH MECHANICALROUGH y_ MECHANICAL LEAS I'FST PRE CAUNIT1 POOL PRE DECK BONDING P -TRAP FENGF / GATE/ ALARM _.._.._. ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING W - INSULATION WALL [NSULATION CEILING DRYWALL LATH (PRE) FINAL POOL MALLS: - . .......... I ATH EXTERIOR I ATFI INTERIOR WALL FOOTING/STEEL GAS TEST SO HATCH COAT ELF(; I III; METER RELEASE GAS METER RI L EASE SPECIAL INSPEG [ION FINAL BUILDINGva FINAL MECHANICAL WALL STE F I v;l( )2 NU( } LIFT WALL BOND Bl AM WALL DRAIN! SEAL _ ..._. WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLUMBING FINAL PLANNING FINAL ENGINEERING/ PW T.G. of OCCUPANCY FINAL COMMUNITY SERVICES FINAL HEALTH DEPT.. FINAL INDUSTRIAL WASTE CERT, of OCCUPANCY COMMENTS: