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Home My WebLink AboutPR17-9977DIAMOND BAR' r� 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 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov Jae SITE ADDRESSli �I n APN LOT TRACT OWNER ADDRESS CITY ZIP TEL. APPLICANT h TEL.✓; `'e° CONTRACTOR+'3�w y e„ ADDRESS ` lg' CITY fw't. i t; ZIP _.$ =_ TEL. ARCH/ENG/ DESIGNER ADDRESS l I '-lZA `a K, CITY ?''� vt.. ,•Va:� 'Ea6 ZIP C: Ott^ y rr yc6'�, OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasen(s) Indicated below by the checkmark(s), I have placed next to the applicable Item(s) [Section 701 Business and Professions Code: Any city or county that requires a permit to construct, star, 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 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 not more than five hundred dollars ($500). . U I, as owner ofthe property, or my employees with wages as their sole compensation, will do (_) sit of or O portions of the work, and the structure is not 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 empleyaes` er personal effort, holds 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 for the purpose of sale.). (-) I, as owner of the property, am exclusively contmcRng 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 pursuant to the Contractors' State License Law.). (-) I am exempt from licensure under the Contractor's State License Taw for the fallowing reason(s): Date: Sign: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion ofthe improvements covered by this permlt,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed 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 application is submitted or at the following Web site, httplwww.leglnfooa,gov/calaw.html. LICENSED CONTRACTOR'S DECLARATION f 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. [CENSE CLASS: LIC. NO.: t -'n XP. DATE'. r. _ 'CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Seif-Insure for Worker's Compensatlon, as provided by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensatlon Insurance, as required by Section 3700 of the Labor Code, for the performance ofthe work for which this permit is issued. My Worker's Compensation Insurance Carrier and Polley Number are: CARRIER POLICY NUMBER -(THIS SECTION NEED NOT BErCOMPLETED IF E PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). . I cerfify that in the performance a#ths wcrkfor which this permit is issued, l shall not employ any person in any manner sa m to become subject to the Worker's Compensation Laws of Caldornia And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Later Cade, I shall forthwith comply with those provisions. i DATE: APPLICANT: i WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal i penalties and civil fires up to one hundred thousand dollars {$100,000}, in addition to the cost of the compensation, i damages as provided for in section 3708 afthe labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY i 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, Clv, C.), LENDER'S NAME: LENDER'S ADDRESS: 7 - I certify that 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 retailing to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for Inspection purposes, PERMITTEE AME inn T} INWORE 01TEWITTEE DATE APPLICATION DATE: 4/zya ISSUE DATE: X I ` PERMIT# : TYPE CONST. P/C# Pf1j T"9 I �'N—I — 'R S- OCC GROUP: IF, > Scope of Work T E¢ 1`. F I C7r, lvl-V a cc-,U�arf & # DWEL. UNITS # STORIES .i. p r rr j d g xc m `a-Qif f? T # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSE ADJ. AREA/VALUATION SFR/AD E C� Garage/Carport Patio/Deck LL Pool/Spa 2 Re -Roof R Commercial C3 Valuation: C, Adj. Area: QUANTITY DESCRIPTION FEE U t w z m • f.. c� z x U CONSTRUCTION: PLAN REVIEW: ln+rrs ELECTRIC: 4. c S PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: Z,� ca SMIP: d T y ENERGY P/C: 8 q • 3-" ENERGY PERMIT: RETENTION FEE: PRE ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: q3..3q TOTAL FEES �f �•�� COMMENTS: P/C: ,3 Ej PAID BY: Y Llr3ol VALIDATION: RECEIPT# PAID BY: 4 VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DIA00ND INSPECTION SETBACK/ LETTER FOOTINGS FORMS SLAB UG. PLUMBING- UG, ELECTRICAL 1 HAC ['AND LEDGER SWI I(;11 GEAR COMMFRCIAL HOOD ... T-IiAli INIERCLPTER HOT MOL'ISHOWERPAN SFPTI(;/CFSSPOOL HERS REPORT RECEIVED LIFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING F1 OOH SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTEMOR DEMOLITION ROOF DRAINS ROUGH CONDUIT POGLISPA ROUGH PLUMBING FRAMING/VENTING_ ® / DOUGH MECHANICAL ROUGH ELECLHICAL W( ) C (} ROUGH PLUMBING a INSUI AT[ON WAII INSULATION (,FII.IN(, DRYWALL. LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASL ROUGH ELEC fRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ AI -ARM FINAL POOL MALLS: WALL FOOTING/STEHI WALL STEEL IsT( ) �No( j LIFT WALL BOND BEAM WALL DRAIN/ SEAL GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING a „ WALL. FINAL 110. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL