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Home My WebLink AboutPR17-9230LU co DJOND BAR s -^. ,IJ 1 a' CITY OF DIAMOND BAR r— Gt Vr: tn, DEPARTMENT OF COMM -UNIT ~'LOPMENT SERVICES 21510 Copley Drive, Diamond Bar, CA 9176 ESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITEADDRESS APN LOT TRACT OWNER Y ADDRESS CITY !AlAl-ij0 4ZI EL. 67 �:Y APPLICANT �1 15 TEL. CONTRACTOR ADDRESS CITY ZIP TEL. ARCH/ENG/ DESIGNER s . m Cr" a.d T 'A "`r `"f r ADDRESS - �f7T;9'_. CITY g`£:i A,�,.-t l ZIP ��L OWNER-111JIFLIDER DE15LARATION hereby affirm under penalty of perjury that I am exempt from the Contractor's Stale License Law for the reasons) Indicated below by the checkmark(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 State License Law (Chapter 9) Commencing with Section 7000 of Division 3 ofthe Business and Professions Cade] or that he or she is exempt from licensure and the basis for the alleged exemption Any violation of Section 7031.5 by ary applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). (_) I, as ownerof the property, or my employees with wages as Meir sale minpensalion, will do U all of or U portions of the work, and the structure is not Intended or offered for sale (Seciion 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employeeser 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 for the purpose of sale,}. (-) 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 for the projects with a llcensed Contracfor pursuantfo the Contractors' State License Law.). (_) I am exempt from licensure under the Contractor's State License law for the following reason(s): Date;__ __Slgn: By my signature below I acknowledge that, exceptfor my personal residence In which I must have resided for at least one year priorto completion of the improvements covered by this permit,l cannot legally sell a structure that t 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 PTOfessions Code is available upon request when this application is submitted or atthe foilowing Web site: http/www.IEginfo.ca.govlcalaw,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 Divlslen 3 of the Business and Professions Code, and my license is in full force and effect. a LICENSE CLASS IC. NO r.: _ ry .� _ EXP. DATE: 7-a NO EXP. t`? i°f0.:' ? 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 Sclf-Insure for Worker's Compensation, 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 Compensation lnsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER e4-`,,.a.�>w'`1, POLICY NUMBER - (THIS SECTION NEED NOT BE COMPLETED 1F THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS}, I certlfy that In the performance of the work for which this permit Is Issued, I shall not employ any person in any manner so as to become subject to the Worider's Compensation Laws of California. And agree that If I should become subject to the Worker's Compensation provisions of Section 3700 of the LahorCode. I shall forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Componsatlor coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, Interest, and attorney's toes 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, Civ. C.}. LENDER'S Ni LENDER'S AODRFSS: I cerlify 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 relating to building construction, and hereby authorize representatives of this county to anter upon the above-mentioned property for Inspection purposes. PERMITTEE NAME(P NAME(PANT) SIGNATURE OF P7QITTEE CA- l APPLICATION DATE: �/�� I l"� PIC# �! R-1 T ISSUE DATE: PERMIT# : PRI IT "` TYPE CONST. OCC GROUP: Scope of Work ( `+ cAAE Ai g JGCT < ct i- # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARFANALUATiON SFR/ADD/REM Garage/Carport LJ Patio/Deck L1 L Pool/Spa ZRe -Roof Commercial CO Valuation. L� tx 0 Adj. Area: QUANTITY DESCRIPTION FEF - -.� -_�- L. � �� 3 5? ��.- i;�;•,.j�� .'�rL- per'. w Ur i�O z rz U CON87RUCTJON: PLAN REVIEW: ELECTRIC: PLUMBING: V MECHANICAL: INSPECTION FEE: ISSUANCE. igg qF SMIP: 1g. (DCS ENERGY P/C: te)i ENERGY PERMIT: 10 4�„54 RETENTION FEE: GO PRE -ALT FEE: BASF:- PLOT PLAN: ZONING CLEARANCE: _ TOTALFEES COMMENTS: P/C: `gJ� P 1 PAID BY: r VALIDATION: } RECEIPT # PAID BY: tf j5 - VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy SETBACK/ LETTER FOOTINGS FORMS SLAB UG, PLUMBING UG. ELECTRICAL UFFR GROUND SEWER LATERAL MAIN WATER LINE SL.WER CLEANOUT ROOF SHEATHING LL.00R SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELEC I-RICAL W( ) C ( ) ROUGH PLUMBING INSULATION WAI_I_ INSULATION LFILING DRYWALL LATH (PRI"j LATH EXTERIOR LATH INTERIOR GAS TLS I SCgNiGH COAT ILECTRIC METER RHLIASE GAS METER RELEASk SPECIAL INSPEC-1ION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.G. of OCCUPANCY CERT. of OCCUPANCY CITY OF MAIW01-NDBAR., INSPECTION C 1 RACT AND LEDGER SWITCH GEAR COMMERCIAL HODD I - BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT REGOVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL;SPA ROUGH PLUMBING ROUGH ELECTRICAL. ROUGH MECHANICAL GAS TEST PRE GI.INITE POOL PRE UEC K BONDING P -TRAP ..... ............... .._ FENCE GATE/ ALARM FINAL POOL WALLS WAI I. FOOTINGISTFEL WALL. STEEL 13T( ) 2N°( ) LIFT WALL BOND BEAM WALL DRAIN/ SLAL WALL FINAL R0. FRAMING PLANNING APPROVAL -- ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PIN FINAL COMMUNITY SERVICES - _ ......... ........ ................ .... FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE