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Home My WebLink AboutPR17-13985CITY 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) 83%-7027°-- �s�g> FIRMLY BUILDING PERMIT APPLICATION www.citynfdiamoudbat:com builldin0Wiamondbarca.vnv JOB SITE ADDRESS)( C'"1-1 CA r-)- ,_Ah APN LOT TRACT OWNER s a U ADDRESS Q01.6 XiAn CITY ` E -6i',2. e/ � v0 APPLICANT TEL. CONTRACTOR'n, a.:'" l7F AA t'e e`4% ) eG ADDRESS '�i g�. CITY s.zEpaw (�a E" ZIP TEL. ARCHlENG/ 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 checkmark(s), I have placed next to the applicable ifEei [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 Seca" 7000 of Division 3 of the Business and Professions Cade] or that he or she is exempt from licensure and the hasis for the alleged exemption. Any violation of SectlDe 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500) L) I, as owner of the property, or my employees with wages as their sole compensation, will do () all of or U portions of the work, and She 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 amployees' or personal effort, bunds 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,), O 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 property who builds or improvesihereon, and who contracts for the projects with a licensed Contractor pursuantto the Contractors' State License Law.). (-) I am exemptfrem licensure under the Contractor's State License law for the following reason(s): Date: Sign: By any signature below I acknowledge that, exceptfor my personal residence In which € must have resided for at roasters year prior to completion ofthe improvements covered by this permit,i cannot legally sell a structure that I have built as an owner -builder If it has not been constructed in its entirely by licensed contractors I understand that a copy of the applicable law, Seotlon 7044 of the Business and Professions Code Is available upon request when this application Is submitted ar at the following Web site: httplwww.leginfo.ca,gev/calaw.html, LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectlon 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect ICENSE CLASS;.?, LIC. NO.: P. DATE g J CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, for the performance of the workfor which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are; CARRIER POLICY NUMBER PIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $1GO OR LESS). I certify that in the performance of the workfor which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Cade, 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 (5100,060), in addition to the cost of the compensation, damages as provided for In section 3708 of the labor code, interest, and attorney's lees 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, Cru C.}. LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and stale that the above information is correct, I agree to comply with all city and wunty, ordinances and state laws retailing to huirding construction, and hereby authorize representatives of this county to enter upon a bove•mentloned p, perty for �speptim purposes. �!. , ERM17EE NAME T) . , SIGNATU EE _�?` DATE APPLICATION DATE; '81 ;14, `� P/C# ISSUE DATE: `14-i 1 PERMIT# : _ 'P1I i-1 - 1 2:,, 111 <— TYPE CONST. OCC GROUP: Scope of Work,. / ( # DWEL. UNITS # STOFPIES # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADDi Garage/Carport EB PatID/Deck Lu LLL PocVSpa ' ZRe -Roof O Commerciat CX1 Valuation Adj. Area: QUANTITY DESCRIPTION FEE a U 2 c� w w co a m d J a V Z x U LLi CONSTRUCTION: (® PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: 1 ENERGY PIC: ENERGY PERM€T: RETENTION FEE: 1 j PRE -ALT FEE: BASF: s� PLOT PLAN: ZONING CLEARANCE: TOTAL FEES "� 1 COMMENTS: P/C: ryPgAID BY: VALIDATION; RECEIPT# �?(=rr� tt�1 PAID BY; VALIDATION: - WHITE — Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy CITY OF DIAMOND INSPECTION L`d SETBACK/ LETTER I IIACT AND LEDGER FOOTINGS FORMS SNATCH (,EAR SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR - - UG. ELECTRICAL INTERCEPTER LIFER GROUND HOT MOPISHOWFRPAN —_ . SEWER I_ATEfRAL SEPTIC/CESSPOOL MAIN WATER LINE HERS itf.PORT RECEIVED — .._. SEWER CLEANOUT DEMOI (TION fiCOF 5HEA1'IiING ROOF DRAINS —�.. FLOOR SHEATHING �.- ROUGH CONDUIT _ —... �. SHEAR WALLS EXTERIOR .— .. PAUL/SPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGIiIENTING ROUGH ELECTRICAL ROUGH MECHANICALROUGH MECHANICAL ROUGH ELECTRICAL M } C () GAS EST _. �...— ROUGH PLUMBING PRE GUNITE INSULATION WAL.I POOL PRE DECK BONDING ASIILATION CEII INC —.. P TRAP - DRYWALL . _� .. — FEN / GATE/ ALARM .. LAl"li (PRf) FINAL POOL. LAIN EXTERIOR WALLS: LATH INTI=RIOR WALL FOOTING/STrEL . — . ... _ —. GAS TE51 WALL STELL isr( )2 NO( } LIFT SCRATCH COAT .. _ �.. WALL BOND BEAM ELECTRIC METER RELLASE WALL DRAIN/ SEAL GAS METER RLl_EASE WALL FINAL _—..--- FINALAII. INS NOTION J - --- --ROUGH CRO. FRAMING PLANNING APPROVAL FIRE APPROVAL _ -- FINAL MECHANICAL FINAL FIRE DEPARTMENT _-- FINAL ELECTRICAL FINAL PLANNING _.. FINAL PLUMBING _. FINAL ENGINEERING/ PW - T.C, 0f OGC11pANGY FINAL COMMUNITY SERVICES CERT of DCCUPA14CY FINAL HEALTHDEPT _ FINAL INDUSTRIAL WASTE � _,_-- COMMENTS: