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Home My WebLink AboutPR17-19281M 0 cc d X W4 0 H U W m U) 0 z a CITY OF DIAMOND PAR r DEPARTMENT OF COMMII & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 " — y FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS APN LOT TRACT OWNER G i= ii ADORE S ✓4 CIN P TEL. APPLICANT TEL CONTRACTOR lefolC ADDRESS CITY 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) indicated below by the checkmark(si I have placed next to the applicable Item(s) [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 10 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 applicantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). La 1, as owner of the property, or my employees with 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' cr 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 €mproved for the purpose of sale.), U 1, 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant 10 the Contractors' State License Law.). (a I am exempt from licensure under the Contractor's State License law for the following reason(s): Date: Sign, By my signature below I acknowledge that, except for my personal residence in which I most have resided for at least one year prior to completion of the Improvements covered by this permit,l cannot legally sell a structure that I have built as an owner-buhdor 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 fallowing Web slier httplwwwleginfo,ca govlca]aw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of parjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Dlvlslen 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: LIC. NO.: ERP. DATE: CONTRACTOR: WORKER'S COMPENSATION DELLA TION I HERE 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 ofthe Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofthe 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 POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certify that in the performance office work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the Worker's Compansation Laws of California. And agree that if I should become subject to the Worker's Comp ensa' n p visions of Section 3700 of t abor de all fodhwi mpw�those provisions DATE: APPLICANT: WARNING: I re 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 ($100,000), in addition to the cost of the compensation, damages as provided far in section 3708 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Landing Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. Cu. LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all chy and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon tin hove -mentioned prop y for inspection purposes, PERMI EE N (P T7 SIGNATUR OF P RMITTEE AT a. P/C#k APPLICATION DATE: Al ISSUE DATE/P/, PERMIT# : %� _/ -I TYPE CONST- OCC GROUP: 27 1 Scope of Work /� 33r e,,,d 7T�00 _09 # DWEL. UNITS e# STORIES A—P®014— #f BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport rn W PatiolDeck W LL Pool/Spa Re -Roof Commercial Z) m Vafuatfo+s: Adj. Area: QUANTITY DESCRIPTION FEE U w c� z m rL z a V CONSTRUCTION: PLAN REVIEW: ELECTRIC: �. PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: �• P SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: k es BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: m P/C: PAID BY: RECEIPT # PAID BY: VALIDATICN: VALIDATION: WRITE— Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy SETBAW LETTER ®, TRACT AND LEDGER I - FOOTINGS FORMS" SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL INTEPICEPTER LIFER GROUND HOT MOP/SHOWERPAN SEPTI(;/CF SPOOL. HER$ RFPOI T RFG IVFI) I MWITION DRAINS ROUGII CONDUIT POOL/SPA HOUGH PLUMBING ROUGH ELECTRICAL SEWER LATERAL MAIN WATER LINE ... _. _. SEWER CLEANOUT ROOF SHEATHINGROOF' -- FLOOR SHEATHING SHEAR WALLS EXTERIOR —.... SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHAMCAL . _......_.__.._.... ..... ......... ROUGH MECHANICAL ROUGH I_LE:CTH CAL W( ) C ( ) ---,_. _ ROUGH PLUMBING INSIJI A f I0N WAI I INSIII ATION CHI €NG DlYWAI I.FENCE _. I ATH (Pm) I.A6I1 LXTERIOR GAS TEST _...... _. - - -.. PRE GUNITE POOL PRE DECK BONDING P -TRAP - - - / GATE/ ALARM __ FINAL POOL -. ... .......... ....... .. - WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 ST( ) 2`( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.G. of OCCUPANCY FINAL COMMUNITY SERVICES GF TA of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL, WASTE lit